As bird flu spreads beyond dairy herds within the Central Valley to farms in Southern California, Gov. Gavin Newsom declared a state of emergency Wednesday to strengthen and streamline the state's response to the virus.

“This proclamation is a targeted measure to ensure government agencies have the resources and flexibility they need to respond quickly to this outbreak,” Newsom said in a Opinion.

The emergency declaration allows the governor to release state funds and other resources to assist state and native governments hire staff and award contracts to combat the contagion. If vital, it gives the governor broad authority to issue mandates intended to slow the spread of the virus and bypass certain state laws that would slow the response.

It could also help increase testing capability, which officials hope will help find cases that likely have gone undetected. There aren’t any reports of the virus arriving at dairies in rural areas of the Bay Area, although the state just isn’t releasing the names of affected farms.

According to the Centers for Disease Control and Prevention, the present public health risk is low. So far this 12 months, 61 human cases of bird flu have been confirmed within the United States. The virus just isn’t known to spread amongst humans and is never transmitted through contact with infected animals. When infections have occurred in humans, they are frequently mild and manageable.

But on Wednesday, the CDC confirmed the primary known serious avian flu infection in a patient from southwest Louisiana. The hospitalized patient is over 65 years old and has other health complications, in line with the Louisiana Department of Health.

The Louisiana patient's virus is genetically different from the virus spreading amongst dairy cows. The strain that sickened the Louisiana resident is often known as genotype D1.1 and is found amongst wild birds and poultry staff. The strain circulating in dairy cows and infecting California farm staff is often known as the B3.13 genotype.

Recently D1.1 infected a teen in Vancouver, British Columbia, who had a severe case that required intensive care. The sequencing data suggests that the teenager's virus contained two possible mutations that would improve the virus's ability to contaminate human cells and one other mutation that would allow it to copy more easily in human cells only within the cells of its usual avian host. in line with the journal Nature. None of the infected teenager's three dozen close contacts became in poor health.

Bird flu doesn’t spread through food, except raw milk. A current Stanford study found that the virus stays infectious in refrigerated raw milk for as much as five days. It is killed by pasteurization.

After emerging in 2020, the virus caused large outbreaks in birds in Europe, Africa and Asia. It arrived within the U.S. in January 2022 and stormed through the nation's largest clusters of poultry farms within the East and Midwest, driving up egg prices.

Despite a rapid response – biosecurity measures at farm entrances, immediate killing of doubtless infected animals, quarantine of affected farms – the disease has continued to spread and infect dairy cattle.

The continued spread of the virus, now widespread amongst wild birds and affecting nearly half of California's dairy farms, is a worrisome development. The more it spreads, the greater the possibility it has of mutating.

California's local health officials welcomed the statement, saying the state must rebuild core workforce and public health infrastructure capability to quickly detect, reply to and contain public health threats.

“We appreciate Governor Newsom’s actions that provide flexibility and enable California to request more federal funding to support health officials’ ongoing efforts to prevent the spread of H5N1, also known as avian influenza, in livestock and people,” said Elsa Mendoza Jimenez, President Member of the County Health Executives Association of California and Director of Health Services for the County of Monterey Health Department.

In an additional step to escalate the response The US Department of Agriculture announced this on Tuesday that a second round of states has been added to its recent National Milk Testing Strategy, bringing the number to 13. These states represent eight of the 15 largest milk producing states and account for half of the country's total production. Farmers and milk processors in these states could also be required to supply raw milk samples upon government request.

The The USDA confirmed five additional outbreaks in dairy herds on Tuesday4 from California and one from Texas. The outbreak affected 865 dairy herds in 16 states this 12 months. The overwhelming majority of those diagnoses are in California, while Nevada and Texas have each tested positive.

The USDA also reported additional poultry outbreaks in three states. Bird flu has also been confirmed in nearly 124 million poultry in 49 states.

Some counties, like Sonoma, had previously declared a state of emergency to mitigate the impact of the disaster, including providing support to businesses. In November 2023, bird flu raged through Sonoma County's historic poultry region, leading to the slaughter of greater than one million birds and causing heartache and economic disaster to small family farmers within the once famous “Egg Capital of the World.”

“While the risk to the public remains low,” Newsom said, “we will continue to take all necessary steps to prevent the spread of this virus.”

Originally published: December 18, 2024 at 5:09 pm PST

Local News

During one Emergency negotiation On Tuesday, Boston City Council members heard testimony accusing U.S. Postal Service leaders of mismanagement that led to significant delays in deliveries. Adding to the frustration, the USPS declined to send a representative to testify before city councilors.

Councilors Sharon Durkan, Henry Santana and Ben Weber submitted a motion Hearing Order last month to analyze a “lack of adequate postal service” in Boston’s Mission Hill neighborhood. Both businesses and residents have been affected, and complaints have been received from across town, Durkan said Tuesday.

“Let me be clear about what we are experiencing in our communities. Residents are missing important communications, including legal documents and financial reports. Neighbors at risk are experiencing delays in receiving vital medications. Small businesses are struggling with unreliable postal services,” Durkan said. “Most critically, with election season approaching, an unreliable postal service threatens to undermine our democratic process.”

USPS spokespeople didn’t reply to a request for comment Wednesday morning.

According to Durkan, internal emails were by accident forwarded to council members before the hearing by which a USPS official accused the council of pursuing a political agenda and never caring about customers. Several city councilors expressed outrage on the accusation.

“It is outrageous that someone from the postal service accused us of having a political agenda. Our goal is to ensure Boston residents receive their mail. That they get their checks, that they get their medications, that they get their ballots,” Weber said. “This isn’t political, it’s just about making sure Boston residents have a basic public service.”

At the hearing, executives from three different unions representing USPS employees within the Boston area testified. According to Scott Hoffman, a national business representative who represents USPS employees within the New England region of the American Postal Workers Union, “bizarre” hours at post offices are one in all the core problems. Early and constant closures are attributable to USPS leadership's unwillingness to supply them with sufficient staff, although employees are sometimes available for work.

“The additional time lost due to improper closures only results in fewer staff being available, which in turn impacts service. It’s a built-in system designed for a downward spiral,” Hoffman said.

The flow of mail through the USPS system could be blocked in a wide range of ways, he said. Due to staffing shortages, employees are being assigned to customer support windows on the expense of behind-the-scenes work facilitating mail distribution. USPS leaders will force trucks not to go away their offices for mail delivery until they’re at full capability. Hoffman compares this to a bus company that postpones a night bus until the following morning because not all seats are occupied.

This is consistent with a consistent theme of complaints about management: that decisions are made for business reasons with little or no consideration of the service disruptions they cause. Additionally, poor worker retention ends in the remaining employees being swamped with enormous workloads.

Several residents reported on their experiences. They described instances of important health care not being delivered within the mail, delays in necessary paychecks and problems with insurance coverage as a consequence of USPS service problems. Mitch Hilton, who worked as a letter carrier for greater than 35 years before retiring in 2006, said he has seen a big change in service since then. Hilton has recorded 44 instances of its mail not being delivered on time to this point this yr, with September being the worst month for on-time delivery.

Postal service within the Boston region is “up to date and meeting performance standards,” a spokesman for the USPS Northeast Region said in September. Nearly all first-class mail in Massachusetts arrived “within one day of the service standard” in the ultimate quarter of the fiscal yr. On average, mail is delivered within the state in 2.5 days.”

Last month, the USPS recorded an 89% on-time rate for first-class mail in a county consisting of Massachusetts and Rhode Island, in keeping with the agency's online service dashboard. Just over 96% of first-class mail was delivered with an additional day, in keeping with the dashboard, and mail took a mean of two.6 days to be delivered.

Durkan expressed skepticism concerning the accuracy of metrics published by the USPS.

“If I had believed that their weekly performance standards were accurate based on what I was hearing from constituents, I would not have requested this hearing,” she said. “We’re being gaslighted in Boston. We’re being gaslighted.”

Attorney General Rob Bonta announced Wednesday that he has filed a lawsuit against AHMC Healthcare, the operator of Seton Medical Center, over the temporary closure of its Coastside emergency room in Moss Beach.

AHMC, a key health care provider for northern and coastal San Mateo County, has struggled with operational difficulties since taking on the beleaguered hospital in 2020. In March, employees on the Daly City site protested changes to their health care advantages, and county officials criticized the prolonged closure of the Moss Beach emergency room for repairs attributable to last yr's storms.

Hospital officials expect the work to be accomplished by December 2024, which some residents say is taking far too long because it is the one emergency room within the coastal area.

As a stopgap measure, San Mateo County awarded the Dignity Health Medical Foundation $480,000 last June to expand its emergency take care of coastal residents.

AHMC acquired Seton from Verity Health Systems following bankruptcy proceedings. The hospitals function a security net for the region's low-income residents.

Then-Attorney General Xavier Becerra approved the sale on the condition that Seton's Daly City and Coastside centers remain open for not less than five and a half years and supply care to people earning lower than 250% of the federal poverty level while partially subsidizing the care other economically disadvantaged patients.

“The conditions established with AHMC should protect patients and ensure continued access to essential health services,” Bonta said. “Unfortunately, AHMC has failed to meet these obligations, endangering patient care and public health. This is unacceptable and we will hold them accountable.”

Bonta is asking the court to implement the agreement, impose fines and issue an order reopening Coastside facilities and restoring services at Seton Medical Center.

Under state law, the sale or change of control of a nonprofit health care facility requires approval from the attorney general. When AHMC purchased Seton, the corporate agreed to take care of services including emergency rooms, stroke certification, heart attack care and expert nursing facilities. According to Bonta's office, AHMC allowed key certifications to lapse and closed facilities, including Coastside's emergency room, without notifying the attorney general.

In response to the lawsuit, Seton spokesman and chief operating officer Tim Schulze said the emergency room closure was essential since the constructing remains to be “unsafe for human occupancy.”

“The attorney general is under the false impression that Seton Coastside could open its doors once the roof replacement is completed in early fall,” Schulze said. “Not like that. Even after the roof was replaced, the building was still unsafe for human occupancy, and there was no safe way to occupy the building while the other emergency repairs were still needed.”

He also said the lawsuit's claim that the upgrades were purely cosmetic and that the shutdown was to deal with deferred maintenance issues slightly than storm damage was “false and misleading.”

“We have diligently addressed these matters and made the necessary repairs to reopen the Seton Coastside emergency room and skilled nursing facilities and otherwise comply with the AG’s terms,” Schulze said. “We have also cooperated with the AG’s office’s investigation of these issues as they relate to the AG’s conditional approval of the sale of this distressed hospital in 2020, which faced closure had AHMC not purchased it.”

San Mateo County Supervisor Ray Mueller, who represents the coastal areas, insists Coastside's closure is “more than a breach of contract.”

“It was a violation of the trust that our community placed in them,” Mueller said. “The attorney general’s lawsuit lays the foundation for a lawsuit by the county that AHMC violated the terms of a multimillion-dollar loan provided to San Mateo County.”

Rep. Anna Eshoo, who represents parts of San Mateo and Santa Clara counties, wrote to Bonta back in July, calling the shutdown “devastating” for her constituents. She noted that the county has spent $500,000 on emergency care for the reason that shutdown.

“I am very pleased that the California Attorney General has responded forcefully to my call to hold AHMC accountable for its blatant violations of the law and violations of the purchase agreement,” Eshoo said. “Today’s action underscores an important message: irresponsible actors must not jeopardize patients’ well-being.”

Originally published: October 2, 2024 at 12:46 p.m

By Aaron Bolton, MTPR and KFF Health News

Missoula is certainly one of Montana's largest cities, but is surrounded by rural mountain communities where ranching is predominant. Despite its latitude and altitude, this region has experienced severe summer heat waves lately.

Residents are struggling to adapt to the warming climate and recent seasonal changes. Many don’t have air-con and are unprepared for the brand new pattern of daytime temperatures within the 30s for days and even weeks. Dehydration, heat exhaustion, heat stroke, and heart rate and blood pressure abnormalities are only a number of the many health complications that may end up from excessive exposure to high temperatures.

It can occur anywhere to anyone, said Missoula firefighter Andrew Drobeck. He recalls a recent emergency call. The temperature had risen to over 90 degrees that day and an worker at an area dollar store had fainted. “She's sensitive to heat. Her air conditioning wasn't working very well,” Drobeck said. “I guess they're only getting a 15-minute break.”

Drobeck said lots of the heat emergency calls his department receives come from seniors who’re having trouble keeping cool of their old homes. Montana's population is among the many oldest within the country. About 1 in 4 residents are over 60. Those over 65 are particularly in danger to heat-related illnesses, in line with the Centers for Disease Control and Prevention. As we age, our bodies don’t adapt to the warmth in addition to they did once we were younger and produce less sweat, amongst other things.

In July, a heat dome that settled over much of the Western U.S. burned hot within the region, breaking two forms of temperature records: day by day highs and the variety of consecutive days with temperatures above 90 degrees. Although the Northwest, including western Montana, is often cooler, the region experienced record-breaking heat this summer.

Emergency responders like Drobeck have noticed. Drobeck says the variety of emergency calls during heat waves has increased in recent summers. But Missoula County officials desired to know more: They wanted higher data on the residents calling and the communities most affected by the warmth. So the county teamed up with researchers on the University of Montana to sift through the info and create a map of emergency calls during heat waves.

The team combined call data from 2020 with census data to seek out out who lived within the areas where high numbers of emergency calls were made during hot weather. The evaluation found that for each 1 degree Celsius increase in average day by day temperature, the variety of emergency calls increased by 1%, the researcher said. Christina BarskyCo-author of the study.

While which will sound like a small increase, Barsky explained that a 5-degree increase in average day by day temperature can lead to a whole lot of additional emergency calls over the course of a month. These call volumes can place an enormous burden on emergency responders and native hospitals.

The Missoula study also found that a number of the highest emergency call rates during extreme heat events got here from rural areas outside of the Missoula urban core. That shows that rural communities are scuffling with the warmth, even in the event that they get less media attention, Barsky said. “What about those people, right? What about the places that are experiencing heat on a scale that we were never prepared for?” she said.

Barsky's work showed that communities with more residents over 65 are inclined to make more emergency calls during heat waves. That could also be one reason so many emergency calls come from rural residents in Missoula County: Barsky said people living in Montana's rural areas and small towns are inclined to be older and more vulnerable to severe heat-related illness.

And the aging population in rural communities can create additional problems during heat waves. Even if it cools down at night, an elderly person living without air-con cannot endure the high temperatures of their home for hours throughout the day. It is just not unusual for rural residents to need to drive an hour or more to succeed in a library with air-con, a community center with a cooling room or medical care. Such isolation and scattered resources should not unique to Montana. “I grew up in the Upper Peninsula of Michigan,” Barsky said. “There are no air-conditioned rooms within at least 50 miles. The hospital is 100 miles away.”

Heat research equivalent to the Missoula study focused mainly on Big citieswhich are sometimes hotter than the distant areas, as a consequence of the “Heat island” effect. This phenomenon explains why cities are inclined to get hotter throughout the day and funky less at night: This is because pavements, buildings and other structures absorb and store heat. City dwellers may experience higher temperatures throughout the day and fewer relief at night.

In contrast, researchers are only just starting to review and understand the impacts of warmth waves in rural areas. The impacts of utmost heat on rural communities have been largely ignored, said Elizabeth DoranProfessor of Environmental Engineering on the University of Vermont. Doran leads a ongoing study in Vermont shows that even towns with just 5,000 residents might be hotter at night than surrounding rural areas as heat radiates off the new asphalt. “If we as a society only focus on large urban centers, we're missing a large portion of the population and our strategies will be limited in their effectiveness,” Doran said.

Brock Slabach, with the National Rural Health Associationagrees that rural residents urgently need assistance adapting to extreme heat. They need support installing air-con or attending to air-conditioned places to chill down throughout the day. Many rural residents have limited mobility as a consequence of age or disability or don’t drive much. And since they often need to travel longer distances to access medical services, additional delays in care during a heat-related emergency could lead on to more serious health consequences. “It is not at all unreasonable to assume that people will be harmed if they do not have access to such services,” he said.

Helping rural populations adapt can be a challenge. People in rural areas need assistance where they live, of their homes, said Adrian BeckDirector of the Missoula County Emergency Management Office. Opening a cooling center in a small community might help people in town, nevertheless it's unrealistic to expect people to drive an hour or more to chill off. Beck said the Missoula County Emergency Management Office plans to make use of data from the 911 study to higher understand why persons are calling in the primary place.

In the approaching years, the department plans to talk directly with people in rural communities about what they should adapt to rising temperatures. “It could be as simple as knocking on their door and asking, 'Would you benefit from air conditioning? How can we connect you with the resources to make that possible?'” Beck said.

But that won't be possible for each rural household because there simply isn't enough money on the county and state level to pay for that many air conditioners, Missoula County officials said. That's why the county wants to arrange for warmth waves prematurely and have special protocols for reaching out to and assisting at-risk rural residents.

“Ideally, we would be in a situation where we might have community paramedics that we can send out to these areas when we know these types of events are going to happen so they can check in and prevent hospitalizations,” Beck explained. She added that stopping heat-related hospitalizations amongst rural residents can ultimately save lives.

MTPRNPR

---

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

Originally published: September 17, 2024 at 11:44 am

San Jose has entered into an agreement with Santa Clara County to supply a further emergency support team for town, fulfilling its commitment to supply alternative responses to mental health emergencies apart from police.

The city will provide $450,000 to create a brand new Trusted Response Urgent Support Team (TRUST), which can include a primary responder, crisis intervention and peer support specialists, and a dedicated hotline for city employees to succeed in dispatchers and help people in need more quickly. This is the primary time San Jose has allocated funding for these additional services.

“We all agree that it is important to invest in alternative response methods and make sure that when an emergency occurs, we send the right person or the right resource,” said San Jose Mayor Matt Mahan.

Although there’s currently friction between town and Santa Clara County authorities over a proposed jail diversion program to be situated in a short lived housing development in South San Jose, Mahan said he has had discussions with county officials about providing more mental health services and believes cooperation between government agencies is crucial to bring about meaningful change.

San Jose has faced questions on the way it responds to incidents involving mental illness after an investigation by the Bay Area News Group, KQED and the California Reporting Project found that over a decade, nearly three-quarters of all use-of-force incidents involving San Jose police involved individuals with mental health issues — including 80% of killings.

Responding to mental health emergencies can also be a burden for the police, who’re currently fighting a shortage of staff.

“This program is a critical milestone for our city that was long overdue and will help create a safer and more compassionate San Jose,” said fifth District Councilmember Peter Ortiz.

A city-commissioned evaluation of 911 calls last 12 months found that 58.5% of reports were flagged as mental health-related, without requiring a police report. The same study also found that just about 1 / 4 of homeless-related calls resulted in a citation or arrest.

“They're taking a lot of calls where people aren't committing a crime, they're having an emergency,” Mahan said. “It takes up a lot of resources and our police have indicated they'd like to see an alternative.”

TRUST teams provide a direct short-term solution and have proven results. A 2023 report shows that in 72% of cases they were in a position to stabilize people without the necessity for further assistance.

“We want family, friends and community members to be matched with the right responders for their needs,” wrote Brian Powers, executive director of Neighborhood Hands, in an email to the City Council supporting the initiative. “Crisis response without police is public safety. We look forward to continuing to expand crisis response without police in cases where another type of responder would be more effective, such as welfare checks and homeless incidents.”

While San Jose has reallocated money from City Hall beautification and modernization funds to fund TRUST, Mahan said the project must be operational by April. He also urged town to gather more data on residents' connections to services and report on results on the bottom to extend accountability.

“I've seen this happen walking around and seeing police citing and arresting the same people over and over again,” Mahan said. “I want to see a real intervention that breaks this cycle.”

The US-Mexico border once more dominates a US presidential election.

With voters Immigration is highly regarded On their list of concerns, each Democratic presidential candidate Kamala Harris and Republican candidate Donald Trump have promised Strengthening border security and to stem the influx of asylum seekers across the country's southern border.

As Academic Researcher and because the daughter of immigrants, I wanted to know the consequences of restrictive immigration policies prior to now. Newspaper archive, Government reports and accounts of Non-governmental organizations From the early Nineteen Nineties to the current, I even have found that laws and policies designed to slow migration on the U.S.-Mexico border, while failing to cut back migration generally, have consistently resulted in additional migrants dying on the journey.

I even have also found that mobile phone-based innovations designed to make the asylum process safer and easier may not help as much as intended.

Further migration

Since 1993, many years of economic and political instability, increasing violence and the consequences of climate change throughout Latin America rising migration rates to the USA when people flee life-threatening situations. In 2023, U.S. Customs and Border Protection reported about 2.5 million arrests and deportations of migrants on the US-Mexico border. That's a rise of 750% since 1992.

This boom within the early Nineteen Nineties coincided roughly with Operation Blockadean attempt by the Federal Government to enhance security on the thenrelatively porous Border checkpoint in El Paso, Texas. By stationing about 450 border guards at a 20-mile-long border section check that every one individuals entering the United States have a visa or other authorizationThe US goal was to forestall illegal border crossings in El Paso.

To evade document checks, a growing stream of migrants began taking longer and more dangerous routes through the desert to achieve the United States.

Many of them were asylum seekers who fled persecution and other dangers of their home country and whose goal was to come back to the United States and apply for asylum. This known as “filing a “defensive” asylum applicationin contrast to a “positive” application submitted before entering the USA

It is a once common process that has only turn out to be harder in recent times. During the COVID-19 pandemic, the Trump administration began using Title 42 to require migrants to remain in Mexico and from there apply for asylum within the USAAfter expiry of this rule in May 2023The The Biden administration created A recent federal rule Border officials can deny asylum at an official port of entry along the U.S.-Mexico border to almost any migrant who has not previously sought asylum en path to the United States.

This recent rule requires asylum seekers to use for asylum before arriving on the border using the U.S. Customs and Border Protection's recent mobile app. CBP One.

This cell phone innovation should simplify the asylum process. The app is notoriously flawedand the agency not enough additional time slots added in its calendar to take account of the flood of latest appointments within the context of the positive asylum application, which might otherwise have been ‘defensive’.

Because asylum seekers cannot legally enter the United States until their claim is submitted, they are actually trapped on the Mexican side of the border for a median of seven months waiting for his or her appointment at Customs and Border Protection.

Migrants housed in shelters in Mexican border towns say they live in fear that the persecutors they fled from will find them there. They are also vulnerable to the Violence and kidnappings against asylum seekers along the border.

Death now or later?

As the United States has tightened security measures at official border crossings through the years, akin to in El Paso, migrants have begun crossing the border in essentially the most distant areas of the Sonoran Desert in Arizona.

The treacherous route has made an already dangerous migration much more deadly. The US Government Accountability Office found that the death rate at border crossings greater than doubled from 1995 to 2005, although there was no increase within the variety of registered immigrants to the United States during this era.

In 2023, almost half of the 686 migrants died People attempting to cross the US-Mexico border died within the deserts of Sonora and Chihuahua, mainly from extreme heat and cold. Before Operation Blockade, lower than a 3rd as many individuals died attempting to enter the US – 205 in 1993.

“The punishment imposed by the difficult terrain” is its own migration policy, to cite the scientist Jason De Léon in his 2015 book “The land of open graves.”

In order to cut back the variety of deaths amongst migrants in Arizona’s deserts, the humanitarian organization Humane Borders launched Negotiations with the US Department of Homeland Security the installation of communication facilities for public safety on the Observation towers This yr, recent devices were installed along the border. This equipment enabled migrants to call 911 – but nobody else – to request emergency services.

However, by calling 911, migrants expose themselves to the chance of deportation. Report 2023 by the humanitarian organization No further deaths found that almost all 911 calls for assistance from suspected migrants in Pima County, Arizona, were routed to Customs and Border Protection as an alternative of receiving immediate search and rescue assistance. Border agents can then determine the caller's location using the Tower monitoring equipmentincluding radar, image sensors and edge computing hardware.

Like local emergency response centers, border officials must assess needs and supply emergency medical assistance, but they may detain and deport illegal migrants.

“As soon as you try to call someone to pick you up,” says one migrant Researchers said in a 2017 studyBorder patrol agents “know where you are and they will look for you.”

Those battling dehydration or injuries face a grim decision. If they don’t call 911, they may die within the desert. If they call, they may die latereither in US immigration detention centers – where Dozens of individuals die from preventable diseases or mental illnesses yearly – or back home after they are sent back to the risks they fled from.

Studies suggest that some migrants Feel safer with a phoneknowing that they or their smugglers can call for assist in an emergency, other are too afraid of being discovered to hold or use their mobile device.

The ability to call for emergency assistance has prevented several deaths within the American border areas. The Tucson Emergency Services Center reported on the receipt In 2021 alone, there have been about 40 calls per day from the border region. But restrictive border policies are hampering the life-saving potential of mobile phones.

The Need and desire to emigrate to the USA has only increased in recent many years, however the US's willingness to simply accept immigration has declined – with deadly consequences.

What is mpox?

Why are cases increasing?

Where are the cases?

What does the WHO statement mean?

What are the authorities doing?

China

India

Japan

South Korea

WASHINGTON – Kyleigh Thurman was bleeding and in pain, but she didn't know her unlucky pregnancy could kill her.

Emergency room doctors at Ascension Seton Williamson Hospital in Texas gave her a pamphlet about miscarriages and advised her to “let nature take its course” before discharging her without treating her ectopic pregnancy.

When the 25-year-old returned three days later, still bleeding, doctors finally agreed to present her an injection to terminate the pregnancy. But it was too late. The fertilized egg growing in Thurman's fallopian tube would rupture it and destroy a part of her reproductive system.

According to a Complaint Thurman and the Center for Reproductive Rights last week, asking the federal government to analyze whether the hospital violated a federal law when staff initially refused to treat her in February 2023.

“I was just left helpless,” Thurman said. “I was just misled.”

Despite the Biden administration's public warning to hospitals to treat pregnant patients only in emergency situations, the facilities proceed to violate federal law. The issue got here under the administration's highlight after reports of improper treatment of ladies in emergency rooms emerged following the Supreme Court's ruling greater than two years ago striking down the constitutional right to abortion.

More than 100 pregnant women in medical distress looking for care in emergency rooms have been turned away or treated negligently since 2022, an Associated Press evaluation of investigations at federal hospitals found.

Two women – one in Florida and one in Texas – suffered miscarriages in public restrooms. In Arkansas, a girl went into septic shock and her fetus died after being sent home within the emergency room. At least 4 other women with ectopic pregnancies had trouble getting treatment, including a California woman who needed a blood transfusion after sitting in an emergency room waiting room for nine hours.

The White House says that despite state bans, hospitals must provide abortions when it’s essential to avoid wasting a girl's health. Texas challenged that policy, and earlier this summer the Supreme Court rejected to repair the issue.

Abortion bans make it difficult to take care of high-risk pregnancies

In Texas, doctors resist 99 years in prison if convicted of performing an illegal abortion. Medical and legal experts say the law makes it harder to make decisions about emergency pregnancy care.

Although terminating an ectopic pregnancy will not be considered an abortion under state law, the draconian penalties deter Texas doctors from treating these patients, argues the Center for Reproductive Rights.

“As much as hospitals and doctors are afraid of violating these state abortion bans, they also have to worry about violating federal law,” said Marc Hearron, a federal government attorney. Hospitals face federal investigation, heavy fines and the specter of having their Medicare funding cut off in the event that they violate federal law.

The organization filed two complaints with the Centers for Medicare and Medicaid Service last week alleging that various Texas emergency rooms didn’t treat two patients with ectopic pregnancies, including Thurman.

Another Complaint says Kelsie Norris-De La Cruz, 25, lost a fallopian tube and most of an ovary after an Arlington, Texas, hospital sent her home without treatment for her ectopic pregnancy, despite the fact that a physician said discharge was “not in her best interest.”

“Doctors knew I needed an abortion, but these bans make it nearly impossible to get basic emergency care,” she said in a press release. “I am filing this complaint because women like me deserve justice and accountability from those who have hurt us.”

Definitely diagnosing an ectopic pregnancy might be difficult. Doctors can't at all times determine the situation of the pregnancy through an ultrasound, explained three different doctors consulted for this text. Hormone levels, bleeding, a positive pregnancy test and an ultrasound of an empty uterus all indicate an ectopic pregnancy.

“You can't be 100 percent sure — that's the hard part,” said Kate Arnold, a Washington gynecologist. “They're literally time bombs. It's a pregnancy growing inside this thing that can only grow to a certain extent.”

John Seago, director of Texas Right to Life, said state law clearly protects doctors from prosecution in the event that they terminate an ectopic pregnancy, even when the doctor “makes an error” in diagnosis.

“Sending a woman home is totally unnecessary and totally dangerous,” Seago said.

But the state law has made doctors “absolutely” afraid to treat pregnant patients, says Hannah Gordon, an emergency physician who worked at a Dallas hospital until last yr.

“It will force doctors to create questionable scenarios for their patients, even if it is very dangerous,” Gordon said. She left Texas in hopes of becoming pregnant and was nervous concerning the care she would receive there.

Gordon recalled a pregnant patient in her emergency room in Dallas who had signs of an ectopic pregnancy. Because the gynecologists said they couldn't clearly diagnose the issue, they waited to terminate the pregnancy until the patient returned the subsequent day.

“It left a bad taste in my mouth,” Gordon said.

“Oh my God, I'm dying.”

When Thurman returned to Ascension Seton Williamson for a 3rd time, her gynecologist told her she would wish surgery to remove the ruptured fallopian tube. Thurman, who was still bleeding heavily, was reluctant to undergo the procedure. Losing the fallopian tube would put her fertility in danger.

However, her doctor told her that if she waited any longer, she would die.

“She came in and said, either you need a blood transfusion, or you need surgery, or you're going to bleed to death,” Thurman said through tears. “I just thought, 'Oh my God, I'm dying.'”

Ascension Seton Williamson declined to comment on Thurman's case, but said in a press release that the hospital is “committed to providing quality care to all who use our services.”

In Florida, a 15-week pregnant woman lost amniotic fluid for an hour within the emergency room at Broward Health Coral Springs, federal documents show. An ultrasound revealed that the patient's fetus was not surrounded by amniotic fluid, a dangerous situation that may result in serious infections.

The woman suffered a miscarriage in a public toilet that very same day after the emergency room doctor declared her condition “improved” and discharged her without consulting the hospital’s gynecologist.

Emergency personnel took her to a different hospital, where she was placed on a ventilator and discharged after six days.

Abortions after 15 weeks were illegal in Florida on the time. The medical director of obstetrics at Broward Health Coral Springs told an investigator that induction of labor in women with premature rupture of the membranes “has been the standard of care for some time, regardless of the heartbeat, because of the risk to the mother.”

The hospital declined to comment or share its policies with AP.

In one other case in Florida, a physician admitted that state law made emergency pregnancy care harder.

“Because of the new laws … staff can only intervene when the patient's health is in danger,” a physician at Memorial Regional Hospital in Hollywood, Florida, told an investigator looking into the hospital's refusal to supply an abortion to a pregnant woman whose water ruptured at 15 weeks, long before the fetus could survive.

Problems transcend states with abortion bans

In each states with and without abortion bans, serious violations occurred that endangered the health of the mother or her fetus, in line with the AP investigation.

In interviews with investigators, two hospitals in Idaho and Washington which are experiencing staff shortages admitted that they often sent pregnant patients to other hospitals.

A pregnant patient in an emergency room in Bakersfield, California, was examined quickly, but staff failed to acknowledge that she was affected by a uterine rupture. The delay, an investigator concluded, can have contributed to the infant's death.

According to the documents, doctors in emergency rooms in California, Nebraska, Arkansas and South Carolina failed to examine for a fetal heartbeat or discharged patients in mid-labor and left them to present birth at home or in an ambulance.

The shortage of nurses and doctors that hospitals have suffered because the Covid-19 outbreak, the issues in staffing ultrasound stations across the clock and latest abortion laws are making the emergency room a dangerous place for pregnant women, warned Dara Kass, an emergency physician and former official with the U.S. Department of Health and Human Services.

“It is increasingly unsafe to be pregnant and seek medical help in an emergency room,” she said.

Originally published: August 12, 2024 at 9:45 am