The Sentinel: Medical News

Tips for cooler weather and avoiding seasonal colds and the flu

Photo:Vitaly Gariev/Unsplash

Family Features - Although cold weather isn't directly to blame when you get sick, it creates an environment that makes it easier for germs and illnesses to thrive. In fact, understanding how cooler temperatures affect your chances of getting sick may be your best approach for preventive care.

Despite the old adage that "you'll catch your death of cold," the cold itself doesn't cause illness. More accurately, the cold is more hospitable to viruses, making it easier for them to spread. While you can't control Mother Nature, you can take steps to protect your health when temperatures drop.

Protect Your Immune System

A weakened immune system makes it harder for your body to ward off intrusive germs. If you're otherwise healthy, protecting your immune system can be as simple as stepping up typical healthy habits, like eating plenty of nutrient-rich produce, getting enough sleep and exercising. Managing stress and limiting alcohol consumption are also helpful in managing your body's immune response.

If your immune system is compromised by an underlying condition, it's a good idea to talk with your doctor about what you can do to add an extra layer of protection during the cooler months, including any vaccines that may help boost immunity.

Combat Congestion

Cool, dry conditions can wreak havoc on your nasal passages, drying them out and reducing the protective layer of mucus that helps fight infection. Sinus pressure and congestion are often some of the first warning signs you're coming down with something.

To treat your congestion symptoms, you can use a non-medicated option like Mucinex Sinus Saline Nasal Spray. This is the first-ever saline product with a nozzle that lets you switch between two spray pressures. The "gentle mist" helps clear everyday congestion and soothes the nose while the "power jet" helps clear tough nasal congestion often associated with colds. An added benefit is that the product can be used for children 2 years of age and older on the gentle mist setting and children 6 years of age and older on the power jet mode.

Spend Time Outdoors

People naturally spend more time indoors when temperatures drop, but there are some benefits to getting outdoors. One is the natural exposure to vitamin D. Sunlight is a natural source of this important vitamin, which plays a pivotal role in immunity. Sunlight also triggers the body to produce serotonin, which boosts your mood, and multiple studies show a strong correlation between mental and physical health.

Fresh air and exercise are also good for your overall health, and exposure to daylight can help keep your circadian rhythms regulated, which in turn promotes better sleep. What's more, acute exposure to cold can trigger your body to produce infection-fighting cells, so you're less prone to illness.

Practice Good Hygiene

It may seem overly simple, but the everyday act of washing your hands can play a big role in preventing illness, especially after you spend time in public places. While out and about, you likely come in contact with many surfaces others may have touched, including door handles, shopping carts, touch screens and menus.

Washing your hands frequently can help prevent you from transferring germs to your body when you touch your eyes, mouth or nose. Also make a habit of wiping down surfaces you touch frequently, such as your keyboard and phone, with disinfectant wipes.

Stay Hydrated

Keeping your body well-hydrated throughout the day can help ensure all your body's systems are functioning as they should. If you're dehydrated, your body can't use the nutrients you consume properly, which affects your immunity. In addition, drinking plenty of water helps flush toxins out of the body before they can cause an infection.

Find more practical tips and products to help manage your health during the colder months at Mucinex.com.

How to Relieve Nasal Congestion

Normally your sinuses are empty except for a thin layer of mucus. When you're exposed to irritating triggers, like bacteria, a cold or flu virus, allergies or environmental triggers like tobacco smoke and dry air, your body responds by mounting an immune response.

The delicate tissues lining your sinuses start to swell, and this, in turn, puts pressure on the underlying tissues in your face, causing painful sinus pressure.

You can relieve sinus pressure symptoms in several different ways, including:

Using a humidifier or vaporizer.
Taking a long, hot shower; it may have the same effect as using a humidifier if one is not available.
Drinking plenty of fluids.
Using a warm compress on your face; resting a warm towel over your sinuses may provide relief.
Irrigating your sinuses. Using a neti pot; saline nasal spray, such as Mucinex Sinus Saline Nasal Spray; or syringe with salt water may help flush debris from your sinuses to relieve sinus congestion.
Sleeping with your head elevated.

If these steps don't work, the next approach is typically over-the-counter medicine. When trying to relieve sinus pressure and nasal congestion, look for a decongestant. A decongestant can help shrink mucus membranes that have swollen in your sinuses, allowing the trapped mucus to drain.

Myth busting hygene, common health misconceptions you should ignore

You should modify your diet when sick to avoid trigger foods, like spicy or greasy foods, suggests Dr. Awad Alyami, a pediatrician at OSF HealthCare.

Photo: Nhung Tran/Pixabay

by Tim Ditman
OSF Healthcare

DANVILLE - From health care providers to websites to advice passed down through generations, there are a lot of ways to get health care information, especially tips for minor ailments you can treat at home.

Awad Alyami, MD, a pediatrician at OSF HealthCare, breaks down some common myths.

Myth: There’s a one-size-fits-all pill for common illnesses.

Fact: It depends on whether it’s a viral infection (like influenza, the common cold or coronavirus) or a bacterial infection (like pneumonia, strep throat or food-borne illnesses like salmonella).

“For the most part, with bacterial infections you need to see a health care provider. You’re probably going to need an antibiotic,” Dr. Alyami says. “Most viral infections just run their course, and you focus on the symptoms. If you have a fever, you take fever medication. If you have pain, you take pain medication. If kids are six years or older and have a cough, they can use over-the-counter cough medication.”

Dr. Alyami points out that you can take those medications to help with bacterial infection symptoms, too. But you need an antibiotic, too, to get better.

Myth: Feed a cold and starve a fever.

Dr. Awad Alyami

Fact: You should modify your diet when sick to avoid trigger foods, like spicy or greasy foods. But reducing the amount you eat and drink won’t make you better sooner. In fact, Dr. Alyami says hydration is critical.

“When kids have infections and a fever, one of the most common reasons they end up in the hospital is dehydration,” Dr. Alyami says. “When kids are sick, they lose fluids from their body and need hydration.”

So, drink plenty of water and eat nutritious foods as your body can tolerate.

Myth: I can go back to work or school as soon as I start to feel better.

Fact: Dr. Alyami says you should be fever-free (body temperature less than 100.4 degrees) for 24 hours with improving symptoms.

When you go back out, practice good habits like thorough handwashing and avoiding coughing or sneezing into the open air.

Myth: If I don’t look or feel dirty, I don’t need to shower or bathe.

Fact: Dr. Alyami says there’s no “catch all” advice for how often to wash off. Some people will shower or bathe daily. Others will do so every other day or less frequently. Dr. Alyami advises you to shower or bathe when you feel you need to or after you’ve been in a dirty or sweaty environment, like after playing sports or a hike in the woods. People with skin conditions should also clean themselves with care.

“For people with eczema or atopic dermatitis, I recommend daily showers,” Dr. Alyami says. “But they need to be quick because the more exposure to water we have, the more we dehydrate the skin. So, showers should not exceed 15 minutes, and you should apply moisturizer right away afterward.”

Myth: When I shower, bathe or wash my hands, really hot water is best to kill germs.

Fact: Really hot showers can feel good, but they may burn your skin. Dr. Alyami recommends setting your home’s water heater at 120 degrees or less. Then, when you use the shower or sink, warm, but not hot water is best.

Dr. Alyami adds that a cold shower after a sweaty summer activity is OK because it can reduce the chance of heat rash. But frequent cold showers can irritate your skin.

Myth: Q-tips are meant for cleaning your ear.

Fact: “The ear is a self-cleaning oven. Most everything inside the ear will come out on its own,” Dr. Alyami says. “When we put anything inside the ear, we are pushing everything from the outside to the inside, especially earwax. It makes it harder for the ear to clean itself.”

Using Q-tips and similar devices can lead to injuries to the ear canal or eardrum, Dr. Alyami adds. Instead, during your shower or bath, gently clean and dry the outside of your ears. If your ears look or feel off (pain or itchiness, for example), see a provider.

“We can clean you safely in the office,” Dr. Alyami says.

Myth: For cuts and scrapes, apply antibiotic ointment like Neosporin until it heals.

Fact: You can apply the ointment once after cleaning the wound and then again after the wound is healed. But doing so often can lead to contact dermatitis, a bad skin reaction.

Myth: The “five second rule” is OK for eating food that’s fallen on the floor.

Fact: Dr. Alyami puts this one to rest once and for all: Don’t do it. Always eat off a sanitary surface.

He even says that research has shown that bacteria from the floor can attach to food in as little as less than one second. Eating dirty food can lead to vomiting and stomach illnesses.

Regenerative reconstruction offers hope and fuller lives to amputees

Photo: Daniel Odame/Unsplash

by Matt Sheehan
OSF Healthcare

PEORIA - There’s a new hope for people facing amputations, and it’s in a mix of fascinating, perhaps unexpected methods.

Roughly 465,000 amputations take place in the United States each year, with 83% of them being lower limb amputations like toes and legs, according to the Amputee Coalition.

Eric Martin, DO, the chief of Vascular Surgery at OSF HealthCare Saint Francis Medical Center in Peoria, Illinois, has crafted a predictable and consistent method that provides reliable outcomes for heroic limb salvage. He does it through procedures referred to as regenerative reconstruction, a treatment currently reserved for the most serious of cases like severe bacterial infection, traumatic crushed limbs, and lower limb ulcers that have become infected and spread throughout the body. These procedures normally accompany a lower limb revascularization with either a bypass procedure or angioplasty and stenting.

“We're here to treat people who have a lot of disadvantaged anatomy and protoplasm (living part of cells) with many medical comorbidities, who otherwise would not be able to heal. Through regenerative reconstruction, we're able to accelerate wound healing and accelerate healing of other diseases processes much quicker,” Dr. Martin says. “In the past, amputation or death was the end point. Now we're able to save lives, have a much more robust limb salvage program here at OSF HealthCare which also makes a difference in terms of affecting mortality in certain patients."

OSF Saint Francis is the only location in Illinois performing advanced regenerative reconstruction procedures at this high of a level.

"We like to pride ourselves on being at the tip of the spear at regenerative reconstruction in the state of Illinois," Dr. Martin says. “We've built that up by having good relationships with companies and getting our hands on the latest and greatest products on the market. We’re always trying to optimize our arsenal of regenerative medicine to provide the best results for our patients. Not only to help with the regenerative reconstruction phase, but also to help address chronic biofilm (bacteria) in the inflammatory phase of wound healing.”

Fish skin, pig intestine, pig bladder and more!

Dr. Martin’s algorithm is built by a group of surprising products made up of animal tissue (xenografts) and human tissue (allografts). This includes fish skin, pig intestine, pig bladder, cow tendon and tissue from human umbilical cords that come from planned procedures with women who have planned, elective C-sections.

Photo provided

Dr. Eric Martin

"The healing capabilities of the fish skin have been quite remarkable," Dr. Martin says. “One of the big reasons is that it's very homologous (same make up) to human skin. The characteristics and composition of the fish skin are nearly identical to what you'd see with human skin. If you'd take a slice of human skin and a slice of fish skin and put it under an electron microscope and look at it, it'd almost look identical.”

The fish skin manufactured by Kerecis, a company in Iceland, spurs on new blood vessel growth and collagen deposition, and eventually helps encourage growth of the outer layer of skin. The fish are caught from the northern Atlantic Ocean near Iceland, and are then skinned and manufactured in plants located in Ísafjörður, Iceland. Dr. Martin started using the fish skin products in August 2023.

Smith calls regenerative reconstruction “medical miracles

Joe Smith, executive vice president of Research and Development and Product Life Cycle at Kerecis, traveled with other researchers to Peoria to learn more about Dr. Martin’s case studies. He says through these techniques, the world is going to see patients healed in ways we never have before.

“We harvest the fish skin right out of the ocean, take the scales off, and put it through a very gentle process,” Smith says. “What comes out is a medical device, homologous to human tissue, and totally absorbs in the body in seven days.”

Smith calls regenerative reconstruction “medical miracles,” and says with the combination of talented surgeons and top tier products these life-saving procedures can be done more and more.

"We also use pig bladder and pig intestine. One company (Organogenesis) has been able to take pig intestine and cross link it to increase its structural integrity and combine it with type 1 collagen. They then add PHMB (Polyhexamethylene biguanide) which is a very powerful antimicrobial agent. When this tissue is put into the human body, it's very good at killing recalcitrant bacteria that are resistant to antibiotics taken by mouth or through the veins," Dr. Martin says.

When Dr. Martin’s patients arrive at the hospital, their wound’s cross-sectional area can cover an entire lower leg or foot, depending on where the infection is. But the wounds don’t start that way. Even a quarter size ulcer on the bottom of someone’s foot, if left untreated, can grow substantially.

Pyoderma gangrenosum cure

A recent case is the first of its kind in the world of medicine. Dr. Martin and his team were able to cure a patient with a rare autoimmune disease called pyoderma gangrenosum. Traditionally, this disease did not have a cure and was treated with corticosteroids and immunosuppressive agents only. These medications had many unwanted side effects for patients.

“This is the first surgical cure in the history of medicine, where we were able to eradicate the ulcers that formed in his leg and were present for over a decade through the use of surgery and regenerative medicine," Dr. Martin says. "It was really the regenerative medicine that helped provide immunomodulation and benefit to him to help suppress his body's own immune system and allow him to heal and recover so nicely.”

Many people get amputations because after undergoing treatment time and time again, their wounds just won’t heal

Who could benefit from this treatment?

Dr. Martin says in the past, medication was offered to patients, but oftentimes the medicine would have side effects with it.

“So now by avoiding long-term use of medicine with many deleterious side effects, the surgery was curative for this patient, and he's done very, very well,” Dr. Martin says.

Most of his patients have diabetes and a history of compromised circulation or have peripheral artery disease. Most are people who smoke and have high levels of cholesterol and blood pressure as well. These people often go on to develop non-healing ulcers in their lower limbs that are arterial, venous or neuropathic in origin.

“Others are patients who have venous stasis disease where vein valves are not working properly, and they go on to develop a venous ulcer,” Dr. Martin adds. “You must first treat the reflux disease and ablate the incompetent vein, before going on to treat the ulcer. The treatment for this is either radio frequency ablation (RFA) or using glue, in the form of VenaSeal.

Many people get amputations because after undergoing treatment time and time again, their wounds just won’t heal. Dr. Martin calls these “chronic wounds.” He says they’re much more difficult to treat than acute wounds because the biofilm (bacteria) doesn’t respond to treatment like antibiotics.

The biofilm fixes in on one place, and something called quorum sensing takes place. Dr. Martin calls this a “bacterial forcefield,” which causes the medical team to be much more aggressive in treatment. Biofilm develops an extracellular polymeric substance (EPS) consisting of lipopolysaccharide (LPS). This substance made by biofilm, makes it much more resistant to degradation with standard antimicrobial therapy.

This calls for debridement to clear away the damaged tissue, normally from a saline jet system called VERSAJET, which aims to reduce the bacterial bioburden in wound beds. Then through a bottled wound lavage solution called Irrisept (chlorhexidine gluconate), Dr. Martin’s team can irrigate the area. In addition to sharp debridement with a scalpel, Dr. Martin’s team has other adjunctive means to address the biofilm.

Now it’s time to aggressively treat the area with human allograft tissue, fish skin and mammalian-based skin products.

Story straight from the operating room

While operating on a patient at OSF Saint Francis, Dr. Martin discussed his process. The patient’s Achilles’ heel was eroded because of the infection from her chronic wound that had grown for over a year. After debridement, Dr. Martin found a healthy part of the Achilles’ tendon sheet and was ready to treat the area.

“We’re going to be able to regenerate the tendon sheet by using an umbilical cord graft and a piece of fish skin called SurgiBind designed to help reconstruct tendon and cover bone,” Dr. Martin says. “This fish skin tends to be very homologous to human tissue, including similarities in the extracellular matrix (ECM) like laminin, fibronectin, glycosaminoglycan, hyaluronic acid, proteoglycans, collagen and elastin.” Dr. Martin remarks these characteristics are all important for the health of human tissue.

It’s easy to amputate, that would be the simple solution to this problem. This is the harder course and the road less traveled

Jessica Collins, a medical device representative and surgical specialist with Kerecis has seen the success stories from regenerative reconstruction.

“The massive amount of technology and products that Dr. Martin has figured out how they all work together synergistically and uses on these patients to help them save body parts, is remarkable,” Collins says.

This patient was suffering from a rare, serious disease called calciphylaxis in both of her legs. She had gone on to develop end stage renal disease (ESRD) with stage 5 chronic kidney disease and was in dire need of a kidney transplant. However, the calciphylaxis in her legs kept her from being eligible for a kidney transplant. In addition, the patient presented in septic shock to the emergency room because the area of skin ulcerations in her lower legs had become secondarily infected with an aggressive fungal infection and polymicrobial bacterial organizations. Because of this, Dr. Martin was consulted to help treat the patient, and the course of action became regenerative reconstruction. Her other option was bilateral above knee amputations (AKAs).

“It’s easy to amputate, that would be the simple solution to this problem. This is the harder course and the road less traveled,” Dr. Martin said during the regenerative reconstruction procedure.

Dr. Martin calls the start of his procedure a “triple stack” of different tissue products.

“We’ve put down the amniotic membrane grafts, we’ve selectively placed umbilical cord grafts and then I’ve wrapped the leg with Kerecis fish skin,” Dr. Martin says. “Why I’m doing this is because the amniotic membrane grafts will incorporate (attach) within three to five days. They contain an abundance of growth factors that are involved in cell signaling and cellular recruitment. The umbilical cord grafts tend to incorporate within 10-14 days, and they contain the progenitor stem cells that help to signal other stem cells to migrate to the wound bed. The fish skin takes more like 14 to 18 days to incorporate, and it contains many components of the extracellular matrix and collagen. It’s a sequential absorption of these grafts into the tissue which helps to build up the granulation tissue from the bottom up and to make this wound more superficial.”

After wrapping the leg, Dr. Martin injects a porcine (pig-derived) bladder xenograft around the wound. He says it addresses the “zone of injury” and will recruit cells to improve cell signaling, pulling healthy cells from the area around the wound bed into it. This pig bladder contains four types of collagens that help with cellular recruitment. He says this maneuver will help skin regenerate within a month in that area, starting to close the wound from the outside in.

“I’ve been doing this for about 10 years in over 350 patients. I’ve never had an adverse reaction, complications, or side effects from doing this,” Dr. Martin says. “Every time, I get a fairly consistent result of helping wounds shrink in size.”

The next step is to cover the wound with a layer of collagen-based product stemming from bovine tendon made by Integra Lifesciences.

“The tendon has two layers. An outer silicon layer that serves as a protection from the environment, similar to what the epidermis would do,” Dr. Martin says. “On the inside, it contains type 1 collagen and chondroitin sulfate from shark cartilage. This helps to generate cell migration into the wound bed.” This process benefits the healing process for patients, Dr. Martin continues, adding that it also protects the grafts underneath.

While the regenerative reconstruction is a very in-depth procedure, it actually decreases the amount of time someone is being treated and lessens long-term morbidity.

The bovine layer will then be stapled to the outer skin surrounding the wound bed. Before finalizing the wrapping of the bovine tendon, Dr. Martin places additional powdered fish skin in between the fenestrations of the fish skin product already sewn in place. This helps to promote granulation tissue, which develops during the process of healing. The bovine layer will be left in place for about 22-25 days.

Goals of regenerative reconstruction

The hope of the regenerative reconstruction is to heal wounds from the outside in. In other words, “shrink the wound.” Some of Dr. Martin’s patients had wounds for over a decade before they came in, and by that time their wounds are exponentially worse off.

“I definitely think if patients are able to get to us at a much earlier stage, and not so late because now they're facing sepsis as a result from their wounds becoming infected, now they have a blood stream infection, their blood pressure is low, their heart rate is elevated, and certain organ systems are beginning to fail (kidneys, lungs, liver, heart). A lot more goes into having to resuscitate them and keeping them alive in addition to treating their wounds,” Dr. Martin says. “So definitely before they get to the end stage of full-blown septic shock, it would be nice if patients could get to us at an earlier stage of their clinical presentation so we could treat them more aggressively and get them healed much quicker.”

While the regenerative reconstruction is a very in-depth procedure, it actually decreases the amount of time someone is being treated and lessens long-term morbidity. Someone’s life expectancy after a major amputation is normally around five years, Smith says.

While the cost of surgery can be a lot up front, Dr. Martin says by healing the wound quicker, it will decrease the cost in the long run for both patients and the hospital system. He adds the products used at OSF are all covered by the major health insurances as well.

Dr. Martin was invited to Iceland this June by Kerecis and was the 2024 grand prize winner for the most outstanding regenerative reconstruction in the United States and Europe for one of his cases. He’s slowly becoming one of the country’s foremost leading authorities in regenerative reconstruction, speaking to many research scientists around the country about his work.

Now his goal is to train other doctors around the world, using his techniques in regenerative reconstruction and offer patients new hope and a promise for a better tomorrow.

The new Covid vaccine has been approved, why you might not want to rush out to get it yet

by Arthur Allen and Eliza Fawcett, Healthbeat
Rebecca Grapevine, Healthbeat

Because viruses evolve as they infect people, the CDC has recommended updated covid vaccines each year.

The FDA has approved an updated covid shot for everyone 6 months old and up, which renews a now-annual quandary for Americans: Get the shot now, with the latest covid outbreak sweeping the country, or hold it in reserve for the winter wave?

The new vaccine should provide some protection to everyone. But many healthy people who have already been vaccinated or have immunity because they’ve been exposed to covid enough times may want to wait a few months.

Covid has become commonplace. For some, it’s a minor illness with few symptoms. Others are laid up with fever, cough, and fatigue for days or weeks. A much smaller group — mostly older or chronically ill people — suffer hospitalization or death.

It’s important for those in high-risk groups to get vaccinated, but vaccine protection wanes after a few months. Those who run to get the new vaccine may be more likely to fall ill this winter when the next wave hits, said William Schaffner, an infectious disease professor at Vanderbilt University School of Medicine and a spokesperson for the National Foundation for Infectious Diseases.

On the other hand, by late fall the major variants may have changed, rendering the vaccine less effective, said Peter Marks, the FDA’s top vaccine official, at a briefing Aug. 23. He urged everyone eligible to get immunized, noting that the risk of long covid is greater in the un- and undervaccinated.

Of course, if last year’s covid vaccine rollout is any guide, few Americans will heed his advice, even though this summer’s surge has been unusually intense, with levels of the covid virus in wastewater suggesting infections are as widespread as they were in the winter.

The Centers for Disease Control and Prevention now looks to wastewater as fewer people are reporting test results to health authorities. The wastewater data shows the epidemic is worst in Western and Southern states. In New York, for example, levels are considered “high” — compared with “very high” in Georgia.

Hospitalizations and deaths due to covid have trended up, too. But unlike infections, these rates are nowhere near those seen in winter surges, or in summers past. More than 2,000 people died of covid in July — a high number but a small fraction of the at least 25,700 covid deaths in July 2020.

Partial immunity built up through vaccines and prior infections deserves credit for this relief. A new study suggests that current variants may be less virulent — in the study, one of the recent variants did not kill mice exposed to it, unlike most earlier covid variants.

Covid rapid tests will no longer be free

Alexandra Koch/Pixabay

Public health officials note that even with more cases this summer, people seem to be managing their sickness at home. “We did see a little rise in the number of cases, but it didn’t have a significant impact in terms of hospitalizations and emergency room visits,” said Manisha Juthani, public health commissioner of Connecticut, at a news briefing Aug. 21.

Unlike influenza or traditional cold viruses, covid seems to thrive outside the cold months, when germy schoolkids, dry air, and indoor activities are thought to enable the spread of air- and saliva-borne viruses. No one is exactly sure why.

“Covid is still very transmissible, very new, and people congregate inside in air-conditioned rooms during the summer,” said John Moore, a virologist and professor at Cornell University’s Weill Cornell Medicine College.

Or “maybe covid is more tolerant of humidity or other environmental conditions in the summer,” said Caitlin Rivers, an epidemiologist at Johns Hopkins University.

Because viruses evolve as they infect people, the CDC has recommended updated covid vaccines each year. Last fall’s booster was designed to target the omicron variant circulating in 2023. This year, mRNA vaccines made by Moderna and Pfizer and the protein-based vaccine from Novavax — which has yet to be approved by the FDA — target a more recent omicron variant, JN.1.

The FDA determined that the mRNA vaccines strongly protected people from severe disease and death — and would do so even though earlier variants of JN.1 are now being overtaken by others.

Public interest in covid vaccines has waned, with only 1 in 5 adults getting vaccinated since last September, compared with about 80% who got the first dose. New Yorkers have been slightly above the national vaccination rate, while in Georgia only about 17% got the latest shot.

Vaccine uptake is lower in states where the majority voted for Donald Trump in 2020 and among those who have less money and education, less health care access, or less time off from work. These groups are also more likely to be hospitalized or die of the disease, according to a 2023 study in The Lancet.

While the newly formulated vaccines are better targeted at the circulating covid variants, uninsured and underinsured Americans may have to rush if they hope to get one for free. A CDC program that provided boosters to 1.5 million people over the last year ran out of money and is ending Aug. 31.

The agency drummed up $62 million in unspent funds to pay state and local health departments to provide the new shots to those not covered by insurance. But “that may not go very far” if the vaccine costs the agency around $86 a dose, as it did last year, said Kelly Moore, CEO of Immunize.org, which advocates for vaccination.

People who pay out-of-pocket at pharmacies face higher prices: CVS plans to sell the updated vaccine for $201.99, said Amy Thibault, a spokesperson for the company.

“Price can be a barrier, access can be a barrier” to vaccination, said David Scales, an assistant professor of medicine at Weill Cornell Medical College.

Without an access program that provides vaccines to uninsured adults, “we’ll see disparities in health outcomes and disproportionate outbreaks in the working poor, who can ill afford to take off work,” Kelly Moore said.

New York state has about $1 million to fill the gaps when the CDC’s program ends, said Danielle De Souza, a spokesperson for the New York State Department of Health. That will buy around 12,500 doses for uninsured and underinsured adults, she said. There are roughly one million uninsured people in the state.

CDC and FDA experts last year decided to promote annual fall vaccination against covid and influenza along with a one-time respiratory syncytial virus shot for some groups.

It would be impractical for the vaccine-makers to change the covid vaccine’s recipe twice every year, and offering the three vaccines during one or two health care visits appears to be the best way to increase uptake of all of them, said Schaffner, who consults for the CDC’s policy-setting Advisory Committee on Immunization Practices.

At its next meeting, in October, the committee is likely to urge vulnerable people to get a second dose of the same covid vaccine in the spring, for protection against the next summer wave, he said.

If you’re in a vulnerable population and waiting to get vaccinated until closer to the holiday season, Schaffner said, it makes sense to wear a mask and avoid big crowds, and to get a test if you think you have covid. If positive, people in these groups should seek medical attention since the antiviral pill Paxlovid might ameliorate their symptoms and keep them out of the hospital.

As for conscientious others who feel they may be sick and don’t want to spread the covid virus, the best advice is to get a single test and, if positive, try to isolate for a few days and then wear a mask for several days while avoiding crowded rooms. Repeat testing after a positive result is pointless, since viral particles in the nose may remain for days without signifying a risk of infecting others, Schaffner said.

The Health and Human Services Department is making four free covid tests available to anyone who requests them starting in late September through covidtest.gov, said Dawn O’Connell, assistant secretary for preparedness and response, at the Aug. 23 briefing.

The government is focusing its fall vaccine advocacy campaign, which it’s calling “Risk less, live more,” on older people and nursing home residents, said HHS spokesperson Jeff Nesbit.

Not everyone may really need a fall covid booster, but “it’s not wrong to give people options,” John Moore said. “The 20-year-old athlete is less at risk than the 70-year-old overweight dude. It’s as simple as that.”

KFF Health News correspondent Amy Maxmen contributed to this report.

Healthbeat is a nonprofit newsroom covering public health published by Civic News Company and KFF Health News. Sign up for their newsletters here.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Subscribe to KFF Health News' free Morning Briefing.

Diet program showed remarkable weight loss success

SNS - University of Illinois researchers found that flexible, personalized diet plans were crucial for weight loss in a regimen high in protein and fiber. Participants in a 25-month study within a self-directed dietary education program achieved the most success when they devised their own plans.

An ideal addition to your diet if you are trying to lose weight is raw pears because they are high in fiber. An average, medium-sized piece usually contains about 5.5 grams of dietary fiber.

Photo: David Trinks/Unsplash

At the one-year mark, successful dieters — 41% of participants — had shed 12.9% of their body weight, compared with the remainder of the study sample, which lost slightly more than 2% of their starting weight, according to a paper published in Obesity Science and Practice.

The dieters were enrolled in the Individualized Diet Improvement Program (iDip), which employs data visualization tools and intensive dietary education sessions to enhance participants' understanding of essential nutrients. This approach allows them to create personalized, safe, and effective weight-loss plans, said Manabu T. Nakamura, a professor in Nutrition Science at the University of Illinois Urbana-Champaign and the study's leader.

The main goal of the iDip program is centered around boosting protein and fiber intake while consuming 1,500 calories or less daily.

The iDip team created a one-of-a-kind, two-dimensional quantitative data visualization tool that plots foods’ protein and fiber densities per calorie and provides a target range for each meal. Starting with foods they usually ate, the dieters created an individualized plan, increasing their protein intake to as much as 80 grams and their fiber intake to close to 20 grams daily.

A total of 22 people finished the program, including nine men and 13 women. Most of them were between 30 and 64 years old. They said they had tried to lose weight at least twice before. Many of the participants had other health problems—54% had high cholesterol, 50% had bone or joint issues, and 36% had high blood pressure or sleep problems. Some of them also had suffered from diabetes, liver disease, cancer, or depression.

Throughout the program, participants experienced significant body transformations. They reduced their fat mass from an average of 42.6 kilograms to 35.7 kilograms after 15 months. Additionally, their waistlines shrank by about 7 centimeters after six months and a total of 9 centimeters after 15 months.

Tracking participants' protein and fiber intake, the team identified a strong link between higher consumption of these nutrients and weight loss at three and 12 months.

"Flexibility and personalization are key in creating programs that optimize dieters’ success at losing weight and keeping it off," Nakamura said. "Sustainable dietary change, which varies from person to person, must be achieved to maintain a healthy weight. The iDip approach allows participants to experiment with various dietary iterations, and the knowledge and skills they develop while losing weight serve as the foundation for sustainable maintenance."

What student-athletes need to know about Hypertrophic Cardiomyopathy

Illustration: Sanjay K J/Pixabay

Family Features - You may find it difficult to wrap your mind around the idea of an energetic student-athlete with a cardiac diagnosis. Heart conditions may be more often associated with older individuals, but you might be surprised to learn hypertrophic cardiomyopathy is the most common condition responsible for sudden cardiac death in young athletes. In fact, it's the cause of 40% of sudden cardiac death cases.

It's estimated 1 in every 500 adults living in the United States has hypertrophic cardiomyopathy, according to the American Heart Association, but a significant percentage are undiagnosed. More than 80% of individuals who experience this condition show no signs or symptoms before sudden cardiac death. While sudden cardiac death is rare, it can occur during exercise or in its aftermath. That's why it's important for student-athletes and their loved ones to learn more about this condition and talk to a doctor about their risk.

With proper knowledge and the support of a skilled care team, it's possible to manage hypertrophic cardiomyopathy with heart-healthy actions to prevent complications or worsening cardiovascular conditions like atrial fibrillation (a quivering or irregular heartbeat), stroke or heart failure. Hypertrophic cardiomyopathy awareness and education for athletes by the American Heart Association is made possible in part by a grant from the Bristol Myers Squibb Foundation.

What is hypertrophic cardiomyopathy?

Hypertrophic cardiomyopathy is the most common form of inherited heart disease and can affect people of any age. It's defined by thickening and stiffening of the walls of the heart. The heart's chambers cannot fill up or pump blood out adequately, so the heart is unable to function normally.

There are different types of this condition. Most people have a form of the disease in which the wall that separates the two bottom chambers of the heart (the septum) becomes enlarged and restricts blood flow out of the heart (obstructive hypertrophic cardiomyopathy).

However, sometimes hypertrophic cardiomyopathy occurs without significant blocking of blood flow (nonobstructive hypertrophic cardiomyopathy). The heart's main pumping chamber is still thickened and may become increasingly stiff, reducing the amount of blood taken in then pumped out to the body with each heartbeat.

What are possible symptoms?

Symptoms can include:

shortness of breath
chest pain
heart palpitations
fatigue

The severity of symptoms can vary, but if you experience them or if you have a family history of hypertrophic cardiomyopathy or sudden cardiac death, it may be a good idea to speak to your doctor about whether you have this condition.

For some people, symptoms can get worse and new symptoms can appear over time, resulting in people dealing with harsher effects and a diminished ability to do the activities they love. This decrease in functions can be one of the most challenging aspects of the disease. Keeping your health care team aware of any new or changing symptoms allows them to work with you to develop a plan to manage these symptoms and reduce their impact.

How is hypertrophic cardiomyopathy diagnosed?

Medical history, family history, a physical exam and diagnostic test results all factor into a diagnosis. A common diagnostic test is an echocardiogram that assesses the thickness of the heart muscle and observes blood flow from the heart.

If anyone in your family has been diagnosed with hypertrophic cardiomyopathy, other heart diseases or has been told they had thick heart walls, you should share that information with your doctor and discuss the need for genetic testing. Because this condition is hereditary, first-degree relatives, which include siblings and parents, should be checked.

Learn more at heart.org/HCMStudentAthlete.

Chemical contaminates found in Illinois rivers threaten food chain

SNS - Scientists tested nine fish species from four northern Illinois rivers for contamination with per- or polyfluoroalkyl substances, synthetic chemicals found in numerous industrial and commercial products and known to be harmful to human health. They found fish contaminated with PFAS in every one of their 15 test sites. Elevated levels of PFOS, one type of PFAS compound, were found in nearly all fish tested.

Study found that there were high levels of PFASs contamination levels in channel catfish found in Illinois waterways.

G.C./Pixabay

The qualities that make PFAS desirable for industrial uses — their durability and stability under stresses such as high heat or exposure to water, for example — also make these chemicals particularly problematic in the environment and hazardous to human and animal health, said Joseph Irudayaraj, a professor of bioengineering at the University of Illinois Urbana-Champaign who led the new study.

The findings are reported in the journal Science of the Total Environment.

Short-chain PFASs (per- and polyfluoroalkyl substances) are widely used as alternatives to long-chain PFASs. Long-chain PFASs become gradually regulated under REACH (EC No. 1907/2006) and other international regulations, due to having persistent, bioaccumulative and toxic properties and/or being toxic for reproduction. The increasingly used short-chain PFASs are assumed to have a lower bioaccumulation potential.

“PFAS contain multiple carbon-fluorine bonds, one of the strongest bonds in organic chemistry,” Irudayaraj said, who is also a professor in the Beckman Institute for Advanced Science and Technology and an affiliate of the Carl R. Woese Institute for Genomic Biology and the Carle Illinois College of Medicine at the U. of I. “Because of this, they are also very hard to break down. They persist for a long time because they are very, very stable.”

Considering such permanent exposure, it is very difficult to estimate long-term adverse effects in organisms. Enriched in edible parts of plants, the accumulation in food chains is unknown.

There are nearly 15,000 PFAS chemicals, according to the U.S. Environmental Protection Agency. These are classified either as short-chain PFAS, which have less than six carbon-fluorine bonds, and long-chain PFAS, with six or more of these bonds, Irudayaraj said.

Long-chain PFAS were widely used before awareness grew about the hazards of these chemicals. More recently, many industries switched to using short-chain PFAS.

“It was thought that the short-chain PFAS were less toxic, and that they could more easily degrade,” he said. “But surprisingly, that was not the case.”

Now, both types of PFAS are found in groundwater, soil and human tissues.

Short-chain PFASs have a high mobility in soil and water, and final degradation products are extremely persistent. This results in a fast distribution to water resources, and consequently, also to a contamination of drinking water resources. Once emitted, short-chain PFASs remain in the environment. A lack of appropriate water treatment technologies results in everlasting background concentrations in the environment, and thus, organisms are permanently and poorly reversibly exposed. Considering such permanent exposure, it is very difficult to estimate long-term adverse effects in organisms. Enriched in edible parts of plants, the accumulation in food chains is unknown.

“About 99% of people living in the U.S. have PFAS in their system,” Irudayaraj said.

Studies on animals have shown that short-chain PFAS (per- and polyfluoroalkyl substances) are almost completely absorbed when ingested or inhaled but not much through the skin. Both short- and long-chain PFAS don't break down easily in the body due to their strong chemical bonds. Even if these chemicals start off in different forms, they eventually turn into acids through several steps, which can be more toxic than the original chemicals. One such toxic substance, perfluorohexyl ethanoic acid (FHEA), has been found in various tissues from deceased people, according to research published by The Danish Environmental Protection Agency in 2015.

The time it takes for these acids to leave the blood varies depending on the specific chemical, the species, and even the sex of the animal. In general, sulfonates (a type of PFAS) take longer to be eliminated than carboxylates (another type), and longer chains take longer to leave the body than shorter ones. In animals, the time is often shorter for females due to differences in how their bodies process these chemicals. The time these substances stay in the blood can range from a few hours to days in rodents, a bit longer in monkeys, and much longer in humans, sometimes lasting years. However, shorter-chain PFAS tend to leave the body faster, except for PFHxS (a six-carbon chain PFAS), which has a longer half-life in humans than some other PFAS like PFOA and PFOS.

Despite a voluntary phasing out of some PFAS in industry in the U.S. and efforts to reduce PFAS pollution, these chemicals are still found in drinking water, household products, food packaging and agricultural products, he said.

Fish from the Rock River had the highest concentrations of PFAS in their tissues.

The manufacturers of chemical products using PFAS argue that the newer short-chain PFAS is safer than the widely known long-chain contaminants. Despite this assertion, the Auburn study's significant findings challenge these statements. The research indicates that short-chain chemicals are frequently present in drinking water systems and could potentially endanger human and environmental well-being. Additionally, current removal methods are relatively less efficient when it comes to eliminating short-chain PFAS in comparison to long-chain PFAS.

The Auburn study analyzed over 200 individual studies on PFAS finding that the short-chain contaminants may be just as harmful as the long-chain versions, if not more. The short-chain PFAS have been linked to hormonal and reproductive system harm.

The researchers in the U of I study focused on fish in northern Illinois rivers because they are close to urban and industrial areas. Industrial emissions and urban rainwater runoff may further contaminate local waterways with PFAS. Sport fishing is also popular across the state, including in areas inside and near Chicago. More than 666,000 fishing licenses were issued across the state of Illinois in 2020.

The researchers narrowed their research down to the fish in the Pecatonica River, Rock River, Sugar River and Yellow Creek from 2021-22. The team collected dozens of samples from nine species of fish, including bluegill, channel catfish, common carp, northern pike, smallmouth bass and walleye. The fish represented different levels of the food chain, from those that feed only on plants, like bluegill, to those eating other fish, such as channel catfish and northern pike.

Back in the lab, the scientists analyzed fish tissues for 17 PFAS chemicals. They found PFAS-contaminated fish in every river they tested and in every one of their 15 sampling sites. Fish from the Rock River had the highest concentrations of PFAS in their tissues. Contamination levels were highest in channel catfish, at the top of the food chain, and lowest in the plant eaters.

How to ensure your cosmetic surgery is safe and successful

Plastic surgery should always be performed by board certified plastic and reconstructive surgeons. You should also check to see that the surgical facility is accredited, too.

Photo: Pixabay

StatePoint Media - In the pursuit of beauty and self-enhancement, an increasing number of individuals are turning to plastic surgery.

However, beneath the promise of transformation lies a darker reality: the alarming rise of botched plastic surgeries due to an influx of undertrained, completely untrained, or reckless surgeries, most commonly undertaken by non-plastic surgeons.

“The consequences of choosing the wrong provider can be catastrophic,” says Dr. Alan Durkin, double board-certified plastic and reconstructive surgeon, Ocean Drive Plastic Surgery. “The risks associated with botched plastic surgeries are not just physical; they extend to emotional and financial repercussions.”

According to Dr. Durkin, patients who undergo procedures under the care of inexperienced practitioners face the following risks:

Physical Harm: Complications such as infections, scarring, nerve damage, and anesthesia-related issues can result from poorly executed surgeries.
Emotional Toll: Dealing with unexpected outcomes can lead to depression, anxiety, and a loss of self-esteem, reversing the procedure’s intended benefits.
Financial Burden: Correcting botched surgeries often requires additional procedures and expenses that may not be covered by insurance, leading to significant financial strain.

Choosing a Safe Practitioner

Amidst the risks, there are crucial steps you can take to mitigate them and ensure a safe cosmetic surgery experience. Dr. Durkin provides these factors to consider when selecting a practitioner:

1. Credentials and Accreditation

Plastic surgery should be undertaken by board certified plastic and reconstructive surgeons. Verify that your surgeon is board-certified by accredited organizations such as the American Board of Plastic Surgery or the American Society of Plastic Surgeons. Certification ensures that the surgeon has undergone at least six years of rigorous training and meets high standards of competency and ethics. Dual board certification offers an even greater degree of safety, but those practitioners are not in every market.

2. Experience and Expertise

Research the surgeon's experience performing the procedure you're considering. Experienced surgeons possess technical skill and a track record of successful outcomes and patient satisfaction. Ask about their specialization within plastic surgery and inquire about their frequency of performing the procedure. Further, ensure that your physician has hospital privileges for backup resources and that they carry malpractice insurance. It’s a big red flag to provide aesthetic procedures without malpractice insurance.

3. Facility Accreditation

Ensure your surgical facility is accredited by recognized organizations like the AAAASF, State Certification, Accreditation Association for Ambulatory Health Care or the Joint Commission. Accredited facilities adhere to strict safety standards and protocols, reducing complication risk during and after surgery. Most higher-end facilities, similar to hospitals, offer dual facility certification.

4. Patient Reviews and Testimonials

Read reviews. Websites like Google, US News and World Report and Healthgrades provide valuable insights into patient feedback, outcomes, and overall satisfaction with the surgeon and their practice.

5. Consultation and Communication

Schedule a consultation to discuss your goals, expectations and concerns. A reputable surgeon will take the time to thoroughly assess your candidacy for surgery, explain the procedure in detail, and address all your questions regarding risks, recovery and expected outcomes. Also interview the staff. Make sure you are comfortable with the process and personnel at your facility of choice.

6. Transparency and Red Flags

Red flags include discounted prices that seem too good to be true, pressure to undergo multiple procedures simultaneously, and promises of unrealistic results. A trustworthy surgeon prioritizes safety and provides transparent information about potential risks and limitations. Beware of clinics that do not provide adequate information about your procedure.

Legislative and Regulatory Measures

In response to the rise in botched plastic surgeries, legislative efforts are underway to enhance patient protections and regulate the industry more effectively. Initiatives like Senate Bill 1188 aim to strengthen oversight and ensure that only qualified professionals perform cosmetic procedures, protecting patients from harm and exploitation.

“Choosing to undergo plastic surgery is a personal decision that should be approached with careful consideration and thorough research. By educating yourself about the risks, selecting a qualified practitioner, and advocating for stronger regulations, you can achieve safer, more satisfying outcomes,” says Dr. Durkin.

Spillin' the tea; drinking it regularly will help you live longer and healthier

Photo: Andrea Piacquadio/PEXELS

Drinking three or more cups of green tea a day has been proven to maintain and improve cardiovascular health.

by Matt Sheehan
OSF Healthcare

PEORIA - So, what’s the tea?

You may have heard that tea is good for you, but when walking through the grocery aisle and being confronted by a barrage of options, it can be hard to choose.

Ashley Simper, the manager of dietetic services with OSF HealthCare, has done the research and has some helpful guidance.

Photo provided

Ashley Simper, Manager
Dietetic Services

To start, it’s best to understand the different kinds of teas and where they come from. Simper says black, white, oolong and green tea all come from the Camellia sinensis plant. Herbal teas come from root, stems and flowers of various plants, and they all have different benefits.

What’s the overall healthiest tea?

Overall, Simper says green tea shines above the rest. But diving into the specific benefits of each tea can help people choose what’s right for them.

“Consuming three or more cups of green tea a day leads to the most health benefits when it comes to cardiovascular disease, cancer and the overall risk of mortality,” Simper says. “The research is a little stronger when it comes to promoting heart health. The consumption of three to five cups of green tea a day has also been shown to lower blood pressure, stroke risk, and LDL (bad cholesterol),” Simper says.

Consuming three to five cups of green tea or black tea has also been shown to lower the risk of developing diabetes.

In 2022, a large study in the Annals of Internal Medicine showed that drinking black tea resulted in a modest reduction of overall death. A research team from the National Institutes of Health’s (NIH) National Cancer Institute (NCI) investigated roughly half a million adults, ages 40-60, in the United Kingdom (UK), who enrolled in the UK Biobank study between 2006-2010. The researchers followed participants until 2020 and found a 9-13% lower risk of death among people who drank at least two cups of tea per day than non-tea drinkers.

What makes tea so healthy?

“The compound in tea that leads to these health benefits is polyphenols. Polyphenols are a type of antioxidant, and antioxidants are linked to decreased inflammation and reduced risk of chronic disease,” Simper says. “The highest antioxidant compounds are in the green tea, followed by the oolong, black and then white teas.”

She adds that green tea and white tea contain an amino acid called L-theanine. Amino acids are the “building blocks” of protein, Simper adds.

“L-theanine has been linked to decreased anxiety, improved sleep and boosting mental clarity,” Simper says.

Green tea, high in antioxidants, offers the most health benefits. In beverage or dietary supplement form, it has been linked to improved mental alertness, relieving digestive issues and headaches, and assist with weight loss.

Photo: NipananLifestyle.com/PEXELS

Cancer: Mixed reviews, additional safety tips

“When it comes to cancer, the research is conflicting. People who drank higher amounts of green tea had a decreased risk of liver, ovarian, lung and breast cancers. But it is important to keep in mind, that if you’re drinking really hot tea, you have a higher risk of esophageal and gastric cancers,” Simper says.

To avoid the tea being scalding hot, Simper recommends allowing the just-boiled water to cool down for an appropriate amount of time before taking a sip.

Tea’s impact on the flu

“In lab and animal studies, they have found an antiviral effect with the consumption of green tea. In Japan, they did a study with kids that showed anywhere from one to five cups of green tea a day lowered the risk of flu,” Simper says. “There was also a study where they gargled green tea in a bottle, green tea extract or black tea extract, and there was a 30% decreased risk of flu.”

How to prepare your tea

As Simper mentioned, scalding hot tea can come with its own risks, more than just burning your mouth. But there are other ways, she says, to make sure you’re receiving the most benefit from drinking tea.

“They recommend boiling your own water and steeping it yourself instead of putting the water in the microwave to heat it up. They found you lose some health benefits if you microwave the water in your tea. Fresh is best, steep your own, and boil your own water. But let it cool down to a comfortable temperature before you consume it. “Freshly brewed tea with minimal additives, especially things like sugar and milk, is the way to go when it comes to adding tea to your daily intake,” Simper adds.

Benefits of herbal teas

Depending on which symptoms you’re dealing with, or health benefit you’re looking for, different herbal teas have different purposes.

Peppermint teas – Helps with upset stomach

Ginger tea – Helps with nausea

Chamomile teas – Can help decrease cardiovascular disease and some cancers. It can also help with premenstrual syndrome and help boost immunity, Simper says.

But what about all the caffeine?

“The caffeine in tea is about half the amount of coffee. You would have to drink eight or more cups of tea a day to get to that highest level we would recommend for caffeine. So, it’s not that much of a risk for people,” Simper points out. “However, if you’re going to start drinking three to five cups of tea a day, and you’re not normally a caffeine consumer, you might notice the effects of the caffeine.”

Connection to weight loss

If you’re looking to tea for weight loss, you might be waiting for some time, Simper says. She says the research is conflicting, and weight loss is minimal due to drinking tea. However, switching out caffeinated tea for sodas and coffees filled with sugar would be the healthier choice.

Backtracking the Biden-Trump debate, here's what they got wrong, and right

by Amy Maxmen
KFF Health News and PolitiFact

Trump campaigned on a promise to repeal and replace the Affordable Care Act, or ACA. In the White House, Trump supported a failed effort to do just that. He repeatedly said he would dismantle the health care law in campaign stops and social media posts throughout 2023.

President Joe Biden and former President Donald Trump, the presumptive Democratic and Republican presidential nominees, shared a debate stage June 27 for the first time since 2020, in a confrontation that — because of strict debate rules — managed to avoid the near-constant interruptions that marred their previous encounters.

Biden, who spoke in a raspy voice and often struggled to articulate his arguments, said at one point that his administration “finally beat Medicare.” Trump, meanwhile, repeated numerous falsehoods, including that Democrats want doctors to be able to abort babies after birth.

Illustration: Richard Duijnstee/Pixabay

Trump took credit for the Supreme Court’s 2022 decision that upended Roe v. Wade and returned abortion policy to states. “This is what everybody wanted,” he said, adding “it’s been a great thing.” Biden’s response: “It’s been a terrible thing.”

In one notable moment, Trump said he would not repeal FDA approval for medication abortion, used last year in nearly two-thirds of U.S. abortions. Some conservatives have targeted the FDA’s more than 20-year-old approval of the drug mifepristone to further restrict access to abortion nationwide.

“The Supreme Court just approved the abortion pill. And I agree with their decision to have done that, and I will not block it,” Trump said. The Supreme Court ruled this month that an alliance of anti-abortion medical groups and doctors lacked standing to challenge the FDA’s approval of the drug. The court’s ruling, however, did not amount to an approval of the drug.

CNN hosted the debate, which had no audience, at its Atlanta headquarters. CNN anchors Jake Tapper and Dana Bash moderated. The debate format allowed CNN to mute candidates’ microphones when it wasn’t their turn to speak.

Our PolitiFact partners fact-checked the debate in real time as Biden and Trump clashed on the economy, immigration, and abortion, and revisited discussion of their ages. Biden, 81, has become the oldest sitting U.S. president; if Trump defeats him, he would end his second term at age 82. You can read the full coverage here and excerpts detailing specific health-related claims follow:

Biden: “We brought down the price [of] prescription drug[s], which is a major issue for many people, to $15 for an insulin shot, as opposed to $400.”

Half True. Biden touted his efforts to reduce prescription drug costs by referring to the $35 monthly insulin price cap his administration put in place as part of the 2022 Inflation Reduction Act. But he initially flubbed the number during the debate, saying it was lowered to $15. In his closing statement, Biden corrected the amount to $35.

The price of insulin for Medicare enrollees, starting in 2023, dropped to $35 a month, not $15. Drug pricing experts told PolitiFact when it rated a similar claim that most Medicare enrollees were likely not paying a monthly average of $400 before the changes, although because costs vary depending on coverage phases and dosages, some might have paid that much in a given month.

Trump: “I’m the one that got the insulin down for the seniors.”

Mostly False. When he was president, Trump instituted the Part D Senior Savings Model, a program that capped insulin costs at $35 a month for some older Americans in participating drug plans.

But because it was voluntary, only 38% of all Medicare drug plans, including Medicare Advantage plans, participated in 2022, according to KFF. Trump’s plan also covered only one form of each dosage and insulin type.

Biden points to the Inflation Reduction Act’s mandatory $35 monthly insulin cap as a major achievement. This cap applies to all Medicare prescription plans and expanded to all covered insulin types and dosages. Although Trump’s model was a start, it did not have the sweeping reach that Biden’s mandatory cap achieved.

Biden: Trump “wants to get rid of the ACA again.”

Half True. In 2016, Trump campaigned on a promise to repeal and replace the Affordable Care Act, or ACA. In the White House, Trump supported a failed effort to do just that. He repeatedly said he would dismantle the health care law in campaign stops and social media posts throughout 2023. In March, however, Trump walked back this stance, writing on his Truth Social platform that he “isn’t running to terminate” the ACA but to make it “better” and “less expensive.” Trump hasn’t said how he would do this. He has often promised Obamacare replacement plans without ever producing one.

Trump: “The problem [Democrats] have is they’re radical, because they will take the life of a child in the eighth month, the ninth month, and even after birth.”

False. Willfully terminating a newborn’s life is infanticide and illegal in every U.S. state.

Most elected Democrats who have spoken publicly about this have said they support abortion under Roe v. Wade’s standard, which allowed access up to fetal viability — typically around 24 weeks of pregnancy, when the fetus can survive outside the womb. Many Democrats have also said they support abortions past this point if the treating physician deems it necessary.

Medical experts say situations resulting in fetal death in the third trimester are rare — fewer than 1% of abortions in the U.S. occur after 21 weeks — and typically involve fatal fetal anomalies or life-threatening emergencies affecting the pregnant person. For fetuses with very short life expectancies, doctors may induce labor and offer palliative care. Some families choose this option when facing diagnoses that limit their babies’ survival to minutes or days after delivery.

Some Republicans who have made claims similar to Trump’s point to Democratic support of the Women’s Health Protection Act of 2022, which would have prohibited many state government restrictions on access to abortion, citing the bill’s provisions that say providers and patients have the right to perform and receive abortion services without certain limitations or requirements that would impede access. Anti-abortion advocates say the bill, which failed in the Senate by a 49-51 vote, would have created a loophole that eliminated any limits on abortions later in pregnancy.

Alina Salganicoff, director of KFF’s Women’s Health Policy program, said the legislation would have allowed health providers to perform abortions without obstacles such as waiting periods, medically unnecessary tests and in-person visits, or other restrictions. The bill would have allowed an abortion after viability when, according to the bill, “in the good-faith medical judgment of the treating health care provider, continuation of the pregnancy would pose a risk to the pregnant patient’s life or health.”

Trump: “Social Security, he’s destroying it, because millions of people are pouring into our country, and they’re putting them onto Social Security. They’re putting them onto Medicare, Medicaid.”

False. It’s wrong to say that immigration will destroy Social Security. Social Security’s fiscal challenges stem from a shortage of workers compared with beneficiaries.

Immigration is far from a fiscal fix-all for Social Security’s challenges. But having more immigrants in the United States would likely increase the worker-to-beneficiary ratio, potentially for decades, thus extending the program’s solvency.

Most immigrants in the U.S. without legal permission are also ineligible for Social Security. However, people who entered the U.S. without authorization and were granted humanitarian parole — temporary permission to stay in the country — for more than one year are eligible for benefits from the program.

Immigrants lacking legal residency in the U.S. are generally ineligible to enroll in federally funded health care coverage such as Medicare and Medicaid. (Some states provide Medicaid coverage under state-funded programs regardless of immigration status. Immigrants are eligible for emergency Medicaid regardless of their legal status.)