For decades now, gay men have been barred from giving blood. In 2015, what had been a lifetime ban was loosened, such that gay men could be donors if they’d abstained from sex for at least a year. This was later shortened to three months. Last week, the FDA put out a new and more inclusive plan: Sexually active gay and bisexual people would be permitted to donate so long as they have not recently engaged in anal sex with new or multiple partners. Assistant Secretary for Health Rachel Levine, the first Senate-confirmed transgender official in the U.S., issued a statement commending the proposal for “advancing equity.” It “treats everyone the same,” she said, “regardless of gender and sexual orientation.” As a member of the small but honorable league of gay pathologists, I’m affected by these proposed policy changes more than most Americans. I’m subject to restrictions on giving blood, and I’ve also been responsible for monitoring the complications that can arise from transfusions of infected blood. I am quite concerned about HIV, given that men who have sex with men are at much greater risk of contracting the virus than members of other groups. But it’s not the blood-borne illness that I, as a doctor, fear most. Common bacteria lead to far more transfusion-transmitted infections in the U.S. than any virus does, and most of those produce severe or fatal illness. The risk from viruses is extraordinarily low—there hasn’t been a single reported case of transfusion-associated HIV in the U.S. since 2008—because laboratories now use highly accurate tests to screen all donors and ensure the safety of our blood supply. This testing is so accurate that preventing anyone from donating based on their sexual behavior is no longer logical. Meanwhile, new dictates about anal sex, like older ones explicitly targeting men who have sex with men, still discriminate against the queer community—the FDA is simply struggling to find the most socially acceptable way to pursue a policy that it should have abandoned long ago. Strict precautions made more sense 30 years ago, when screening didn’t work nearly as well as it does today. Patients with hemophilia, many of whom rely on blood products to live, were prominent, early victims of our inability to keep HIV out of the blood supply. One patient who’d acquired the virus through a transfusion lamented to The New York Times in 1993 that he had already watched an uncle and a cousin die of AIDS. Those days of “shock and denial,” as the Times described it, are thankfully behind us. But for older patients, memories of the crisis in the ’80s and early ’90s linger, and cause significant anxiety. Even people unaware of this historical context may consider the receipt of someone else’s blood disturbing, threatening, or sinful. As a doctor, I’ve found that patients tend to be more hesitant about getting a blood transfusion than they are about taking a pill. I’ve had them ask for a detailed medical history of the donor, or say they’re willing to take blood only from a close relative. (Typically, neither of these requests can be fulfilled for reasons of privacy and practicality.) Yet the same patients may accept—without question—drugs that carry a risk of serious complication that is thousands of times higher than the risk of receiving infected blood. Even when it comes to blood-borne infections, patients seem to worry less about the greatest danger—bacterial contamination—than they do about the transfer of viruses such as HIV and hepatitis C. I can’t fault anyone for being sick and scared, but the risk of contracting HIV from a blood transfusion is not just low—it’s essentially nonexistent. [Read: Blood plasma, sweat, and tears] Donors' feelings matter, too, and the FDA’s policies toward gay and bisexual men who wish to give blood have been unfair for many years. While officials speak in the supposedly objective language of risk and safety, their selective deployment of concern suggests a deeper homophobia. As one scholar put it in The American Journal of Bioethics more than a decade ago, “Discrimination resides not in the risk itself but in the FDA response to the risk.” Many demographic groups are at elevated risk of contracting HIV, yet the agency isn’t continually refining its exclusion criteria for young people or urban dwellers or Black and Hispanic people. Federal policy did prohibit Haitians from donating blood from 1983 to 1991, but activists successfully lobbied for the reversal of this ban with the powerful slogan “The H in HIV stands for human, not Haitian.” Nearly everyone today would find the idea of rejecting blood from one racial group to be morally repugnant. Under its new proposal, which purports to target anal sex instead of homosexuality itself, the FDA effectively persists in rejecting blood from sexual minorities. The planned update would certainly be an improvement. It comes out of years of advocacy by LGBTQ-rights organizations, and its details are apparently supported by newly conducted government research. Peter Marks, the director of the Center for Biologics Evaluation and Research at the FDA, cited an unpublished study showing that “a significant fraction” of men who have sex with men would now be able to donate. But the plan is still likely to exclude a large portion of them—even those who wear condoms or regularly test for sexually transmitted infections. An FDA spokesperson told me via email that “additional data are needed to determine what proportion of [men who have sex with men] would be able to donate under the proposed change.” Research done in France, Canada, and the U.K., where similar policies have since been adopted over the past two years, demonstrates the risk. A French blood-donation study, for instance, estimated that 70 percent of men who have sex with men had more than one recent partner; and when Canadian researchers surveyed queer communities in Montreal, Toronto, and Vancouver, they found that up to 63 percent would not be eligible to donate because they’d recently had anal sex with new or multiple partners. Just 1 percent of previously eligible donors would have been rejected by similar criteria. The U.K. assumed in its calculations that 35 to 50 percent of men who have sex with men would be ineligible under a policy much like the FDA’s, while only 1.4 percent of previous donors would be newly deferred. If the new rule’s net effect is that gay and bisexual men are turned away from blood centers at many times the rate of heterosexual individuals, what else can you call it but discrimination? The U.S. guidance is supposed to ban a lifestyle choice rather than an identity, but the implication is that too many queer men have chosen wrong. The FDA spokesperson told me, “Anal sex with more than one sexual partner has a significantly greater risk of HIV infection when compared to other sexual exposures, including oral sex or penile-vaginal sex.” If the FDA wants to pry into my sex life, it should have a good reason for doing so. The increasing granularity and intimacy of these policies—specifying numbers of partners, kinds of sex—give the impression that the stakes are very high: If we don’t keep out the most dangerous donors, the blood supply could be ruined. But donor-screening questions are a crude tool for picking needles from a haystack. The only HIV infections that are likely to get missed by modern testing are those contracted within the previous week or two. This suggests that, at most, a couple thousand individuals—gay and straight—across the entire country are at risk of slipping past our testing defenses at any given time. Of course, very few of them will happen to donate blood right then. No voluntary questionnaire can ever totally exclude this possibility, but patients and doctors already accept other life-threatening transfusion risks that occur at much greater rates than HIV transmission ever could. When I would be on call for monitoring transfusion reactions at a single hospital, the phone would ring a few times every night. Yet blood has been given out tens of millions of times across the country since the last known instance of a transfusion resulting in a case of HIV. [Read: How blood-plasma companies target the poorest Americans] Early data suggest that the overall risk-benefit calculus of receiving blood isn’t likely to change. When eligibility criteria were first relaxed in the U.S. a few years ago, the already tiny rate of HIV-positive donations remained minuscule. Real-world results from other countries that have recently adopted sexual-orientation-neutral policies will become available in the coming years. But modeling studies already support removing any screening question that explicitly or implicitly targets queer men. A 2022 Canadian analysis suggested that removing all questions about men who have sex with men would not result in a significantly higher risk to patients. “Extra behavioral risk questions may not be necessary,” the researchers concluded. If there must be a restriction in place, then one narrowly tailored to the slim risk window of seven to 10 days before donation should be good enough. (The FDA says that its proposed policy “would be expected to reduce the likelihood of donations by individuals with new or recent HIV infection who may be in the window period.”) As a gay man, I realize that, brief periods of crisis during the coronavirus pandemic aside, no one needs my blood. Only 6.8 percent of men in the U.S. identify as gay or bisexual, so our potential benefit to the overall supply is inherently modest. If we went back to being banned completely, patients would not be harmed. But reversing that ban, both in letter and in spirit, would send a vital message: Our government and health-care system view sexual minorities as more than a disease vector. A policy that uses anal sex as a stand-in for men who have sex with men only further stigmatizes this population by impugning one of its main sources of sexual pleasure. There is no question that nonmonogamous queer men have a greater chance of contracting HIV. But a policy that truly treats everyone the same would accept a tiny amount of risk as the price of working with human beings. Read More

Feb.2, 2023 – Add this to the list of social media’s potential health risks: unintended pregnancy. That’s for women who take birth control advice from influencers, particularly on YouTube, where many talk about stopping hormonal contraception and may give incomplete or inaccurate sexual health information. Read More

Glioblastoma is one of the most deadly and recalcitrant cancers to impact the brain. The cancer forms masses of tumors on the surface of the brain while concurrently migrating and rooting itself in the neural pathways. Patients with glioblastoma—children and adults alike—are plagued with headaches, nausea, seizures and more. Worse still, the few immune therapies that exist are ineffective, harshly impact the brain, and create spillover effects on cognition, mood, behavior and bodily functions. The average survival rate has hovered, unchanged, at around eight months for many years. A study published in the journal Science Translational Medicine begins to build on an alternative which may invigorate the field. Read More

Tennessee decided to scrap $8.3 million in federal grants to combat HIV after Matt Walsh and Ben Shapiro took aim at gender dysphoria treatment for minors. Read More

Hannah Frye is the Assistant Beauty Editor at mindbodygreen. She has a B.S. in journalism and a minor in women’s, gender, and queer studies from California Polytechnic State University, San Luis Obispo. Hannah has written across lifestyle sections including health, wellness, sustainability, personal development, and more. She previously interned for Almost 30, a top-rated health and wellness podcast. In her current role, Hannah reports on the latest beauty trends, holistic skincare approaches, must-have makeup products, and inclusivity in the beauty industry. She currently lives in New York City. Read More

During the winter, one of my favorite activities is to spend a day at the spa. Whether you book a massage or simply try out various pools and relaxation rooms, it’s the perfect way to stay warm and practice some always-needed self-care. On a recent visit, I was struck by the variety of sauna and steam rooms available to explore. Though these environments were great for relaxation, I realized I had no idea what exactly sitting in these types of heat was doing to my body ― or even the optimal way to use them. Read More

Thanks for reading Can We Talk?, a sex and relationships column that aims to tackle the burning questions about sex, dating, relationships, and breakups that you’re too afraid to ask your partner — or maybe even your besties. Last time, we heard from Refinery29 readers about whether they believed in being friends with their ex-lovers. Today, relationship therapist Moraya Seeger DeGeare, LMFT, helps someone who recently combined finances with their partner, bringing up an unexpected issue. Do you have a question for DeGeare about feeling ignored by a partner or potential lover that you’d you’d like to see answered as part of a future Can We Talk? Submit it here or send us an email at CanWeTalk@Refinery29.com. My partner and I recently combined finances, and it’s brought up an unexpected issue. I don’t drink much, but they will have one to two drinks with dinner if we go out. This is something I knew prior to our fiscal merger, but I didn’t expect it to cause me this much frustration. Before I had the receipts, I did think it was a waste of money to pay for craft beer versus drinking at home — but I didn’t realize how many big feelings I had tied to this opinion. A past partner of mine went from being a social drinker to abusing substances while we were together, and I’m still holding on to some of the fears associated with that time (which I recognize has nothing to do with my current boo as they’ve shown no signs of alcohol use disorder — I’m currently working through this history in therapy). Additionally, I grew up in an extremely conservative, Christian home where drinking was not allowed, and we were very frugal. As an adult, I still work not to judge others for their drinking.  It’s only been a few weeks of blended bank accounts and, after tracking our spending, I find myself growing resentful. I make about $105K annually and my partner makes $170K. We both are working together to save for retirement as well as a future home together. At first, I was insecure about him making more but he assured me it was “our” money. This makes me feel even more ashamed of my animosity toward his drinking habit. I would love to hear any advice for managing both shared expenses and any resentment that can accompany such a merger. What if we just don’t have shared values when it comes to money? How can we avoid any pitfalls associated with this?  Sincerely, Joint-Bank Jitters. Dear JBJ,  Your dilemma is a great example of the many challenges that come up when we blend our worlds with anyone, even our friends. Let’s be honest, JBJ, building a life with someone can be an uncomfortable process. Our views are often jostled around like ice in a cocktail shaker, and sometimes this means we must shift our perspectives, causing tension. But, hopefully, if we’re mixing it up in a loving way with someone we care about, the final product is delicious and well worth any pain points. The good news is, we are not alone in this merger – the other person is on the same ride, adjusting to us, even if we are total opposites in many ways. We can take comfort in that and even laugh about our little differences once we truly understand each other.  But, when it comes to money in particular, all the big emotions that can come with fusing our lives can be heightened. Even those who come from very similar cultures can have divergent values when it comes to cash. Your family’s socio-economic status likely impacted your views and access to wealth. Moreover, how the role models in your life growing up talked about money also likely had an impact on your relationship with your finances. For instance, if you are a first-generation American and your parents immigrated here with little money, the need to feel secure for survival’s sake might be intertwined with your identity.  All told, we typically enter into our intimate relationships later in life with set values around money, shaped in part by our childhoods. And, sometimes those values and habits don’t have the healthiest roots. Unpacking those financial histories — first processing them on our own (perhaps through journaling, therapy, or an app like Thinkladder, which has been helpful to me in becoming more self-aware) and then sharing them with our partners when we’re ready — can really help with the communication around any big spending clashes when we first blend up our bank accounts.  But it sounds like you have already been doing a good job at identifying some childhood and past experiences. I challenge you to shift your perspective when thinking about your previous relationship with someone who struggled with addiction: What if you considered this a moment of resilience for you? You recognized toxic behavior that didn’t serve you and you ended that situationship — I’m sure that was not easy. Anxiety can often carry over into our future partnerships, but good communication and this different way of looking at things can help you feel safer and reassure you. But beyond this history of your own, it sounds like there’s something about your current situation that’s still triggering some resentment and fear. Deciding if this fear is a real red flag — or simply what you’ve been conditioned to be scared of — is going to guide this conversation about values for you and your partner. To puzzle that together, let’s first check in on the threat relating to addiction. I hear you saying that you’re not actively concerned about alcohol abuse with this particular partner, but please do seek professional help if you think you need it (Al-Anon is a wonderful resource, and also supports loved ones of those navigating addiction). Additionally, I will note, even if you’re partner isn’t technically overdoing it with drinking, it’s important to ask: do you find yourself feeling that they are choosing a mood-altering substance over you? Do you feel like they respect your emotions and boundaries, and listen to your needs? Does their behavior change when they drink? If so, how is it impacting you? Do you feel like they are less reachable? Try journaling about these questions if you’re not sure. If you find there’s an emotional block between you two relating to alcohol — and this is about more than the money — it’s worth more reflection having a deeper discussion. Again, I’m not suggesting in any way that I think your partner has a problem with alcohol, but it’s worth talking through how the drinking is impacting your relationship, and noticing how they respond to your needs. As you have this talk, try to be curious, even in moments of discomfort, and do your best to use “I” statements so your partner doesn’t feel blamed or shamed.  If upon all this reflection, you find the root of your issue really is just about differing financial values (not about how alcohol is affecting your relationship), I’ll say this: There are times in a relationship when no one has done anything wrong, and yet one person is feeling hurt, resentful, or lonely. Those feelings are completely valid, even though we are not going to blame our partners for them. One of the trickiest parts of our continued personal responsibility in any relationship is taking the time to be introspective while questioning what showing up fully means to us. In these sorts of dilemmas when no one has technically done anything wrong, it can help to navigate your differences by asking: How do I want us both to show up in this relationship? And how can we bring our values together to make something beautiful?  One more practical way you can do just that is called the “splitting the check” method. I tapped the brilliant brain behind Refinery29’s “Taking Stalk” column, Paco de Leon — the author and illustrator of Finance for the People — to explain this financial philosophy. “Splitting the check involves collectively splitting your paychecks into three broad categories of expenses,” she explains. “There’s your “bills and life” category, for all the essential spending, like the rent or mortgage, food at home, insurance, and debt payments. Then there’s the “future and goals” category, which encompasses saving and investing money for your future selves; from emergency funds to retirement and everything in between. And the last category is the “fun and B.S.” category, for all the non-essential things that make life feel like life.”  To implement this method, create one specific checking account for your “bills and life” money. Then, make two “fun” checking accounts — one for each person to control themselves. (Your “future and goals” money is likely going into a 401k and other various savings and investment accounts automatically.) “There is a bit of upfront calculating to understand how you’ll be splitting up your check,” de Leon says. “Of course, there are some general guidelines too, like the 50/30/20 rule, where 50% of income goes towards essentials (bills and life), 30% towards non-essentials (fun), and 20% towards saving for the future.” “After you have your new accounts set up and you know your calculations, every time you’re paid, you simply split the check into your various checking accounts,” de Loen adds. (You can do most of this through automated payments). This system isn’t for every couple and it isn’t foolproof, but it does give people a sense of autonomy in their personal spending and may help decrease your anxiety in this case if just seeing the receipts is an issue. Also, if part of the resentment you mentioned is coming from the fact that you feel he’s being frivolous with shared fun money — thus forcing you to be even more frugal in areas you’d like to spend on — this nips that in the bud.  And with that, we’re back to a major root within your question: Resentment.  Resentment often builds when we are not communicating — and any avoidance or “hoping things will get better on their own” pretty much always makes things worse. As you find ways to express what you’re feeling, I recommend the following cycle: introspection (especially on issues mentioned above such as family history with money), talking as a couple, and then coming back to reflect on your own again. As you do the latter check to see if you are feeling more deeply understood and your body can feel more secure. Repeat as needed.  In fact, it can help to schedule regular check-ins to talk with your partner about any values-difference you may have that are causing strife — in this case, it could be talking about budgets, both of your past-driven emotions about spending, and how you can dissipate your resentment. These conversations will likely involve setting boundaries. The thing about boundaries is, they are typically less focused on how others will behave and more sharing clearly on how we will. So a boundary here could be, if we continue to follow our “split the check” plan, I will commit to working on my anxiety as we adjust and keep talking to you about how I’m feeling about our finances and specifically your alcohol spending. It also could look like him starting a conversation with you before he enters a situation where he might naturally spend more on drinks, such as a wedding or vacation. Starting these conversations with your partner could sound like “I have been thinking more about my discomfort about our spending. Can we keep talking about it, as we are adjusting to this new life together?” or “I noticed some feelings of resentment are distracting me when we are on dates, and all I want is to be present with you. Is now a good time to share more about what I realized is coming up for me?” By initiating and having these talks continually, hopefully, you’ll get to a place where you’re feeling gradually less and less bothered by this values difference in your relationship because you are both being heard and understood. So, go forth, be honest, and mix it up!  If you or a loved one is struggling with substance abuse, please reach out to the SAMHSA National Helpline at 9-8-8- or 1-800-662-4357 for free and confidential information. DeGeare is a licensed marriage and family therapist, who specializes in intimacy, LGBTQIA+ relationships, mixed-culture couples, and racial identity development. The advice in this column is to point you in a direction that encourages healing and creates safety for you in this world. It is not to replace the relationship with a licensed mental health professional who knows your personal history.  Like what you see? How about some more R29 goodness, right here? How Ethical Non-Monogamy Changed My Life. 4 People On Managing Chronic Pain & Relationships. I Hate That My Partner Is Friends With His Exes. Read More

Day 1: The longest run. At the start of the week, he is usually at his most rested, ready for his long cardio session. Lately, that’s been 40 minutes of running. If running is not your thing, Mr. Howell said, your cardio can involve a walk, an elliptical trainer, a stationary bike or a rowing machine. Read More

Stephen B. Thomas, the director of the Center for Health Equity at the University of Maryland, considers himself an eternal optimist. When he reflects on the devastating pandemic that has been raging for the past three years, he chooses to focus less on what the world has lost and more on what it has gained: potent antiviral drugs, powerful vaccines, and, most important, unprecedented collaborations among clinicians, academics, and community leaders that helped get those lifesaving resources to many of the people who needed them most. But when Thomas, whose efforts during the pandemic helped transform more than 1,000 Black barbershops and salons into COVID-vaccine clinics, looks ahead to the next few months, he worries that momentum will start to fizzle out—or, even worse, that it will go into reverse. This week, the Biden administration announced that it would allow the public-health-emergency declaration over COVID-19 to expire in May—a transition that’s expected to put shots, treatments, tests, and other types of care more out of reach of millions of Americans, especially those who are uninsured. The move has been a long time coming, but for community leaders such as Thomas, whose vaccine-outreach project, Shots at the Shop, has depended on emergency funds and White House support, the transition could mean the imperilment of a local infrastructure that he and his colleagues have been building for years. It shouldn’t have been inevitable, he told me, that community vaccination efforts would end up on the chopping block. “A silver lining of the pandemic was the realization that hyperlocal strategies work,” he said. “Now we’re seeing the erosion of that.” I called Thomas this week to discuss how the emergency declaration allowed his team to mobilize resources for outreach efforts—and what may happen in the coming months as the nation attempts to pivot back to normalcy. Our conversation has been edited for clarity and length. Katherine J. Wu: Tell me about the genesis of Shots at the Shop. Stephen B. Thomas: We started our work with barbershops and beauty salons in 2014. It’s called HAIR: Health Advocates In-Reach and Research. Our focus was on colorectal-cancer screening. We brought medical professionals—gastroenterologists and others—into the shop, recognizing that Black people in particular were dying from colon cancer at rates that were just unacceptable but were potentially preventable with early diagnosis and appropriate screening. Now, if I can talk to you about colonoscopy, I could probably talk to you about anything. In 2019, we held a national health conference for barbers and stylists. They all came from around the country to talk about different areas of health and chronic disease: prostate cancer, breast cancer, others. We brought them all together to talk about how we can address health disparities and get more agency and visibility to this new frontline workforce. When the pandemic hit, all the plans that came out of the national conference were on hold. But we continued our efforts in the barbershops. We started a Zoom town hall. And we started seeing misinformation and disinformation about the pandemic being disseminated in our shops, and there were no countermeasures. We got picked up on the national media, and then we got the endorsement of the White House. And that’s when we launched Shots at the Shop. We had 1,000 shops signed up in I’d say less than 90 days. Wu: Why do you think Shots at the Shop was so successful? What was the network doing differently from other vaccine-outreach efforts that spoke directly to Black and brown communities? Thomas: If you came to any of our clinics, it didn’t feel like you were coming into a clinic or a hospital. It felt like you were coming to a family reunion. We had a DJ spinning music. We had catered food. We had a festive environment. Some people showed up hesitant, and some of them left hesitant but fascinated. We didn’t have to change their worldview. But we treated them with dignity and respect. We weren’t telling them they’re stupid and don’t understand science. And the model worked. It worked so well that even the health professionals were extremely pleased, because now all they had to do was show up with the vaccine, and the arms were ready for needles. [Read: The flu-ification of COVID policy is almost complete] The barbers and stylists saw themselves as doing health-related things anyway. They had always seen themselves as doing more than just cutting hair. No self-respecting Black barber is going to say, “We’ll get you in and out in 10 minutes.” It doesn’t matter how much hair you have: You’re gonna be in there for half a day. Wu: How big of a difference do you think your network’s outreach efforts made in narrowing the racial gaps in COVID vaccination? Thomas: Attribution is always difficult, and success has many mothers. So I will say this to you: I have no doubt that we made a huge difference. With a disease like COVID, you can’t afford to have any pocket unprotected, and we were vaccinating people who would otherwise have never been vaccinated. We were dealing with people at the “hell no” wall. We were also vaccinating people who were homeless. They were treated with dignity and respect. At some of our shops, we did a coat drive and a shoe drive. And we had dentists providing us with oral-health supplies: toothbrush, floss, paste, and other things. It made a huge difference. When you meet people where they are, you’ve got to meet all their needs. Wu: How big of a difference did the emergency declaration, and the freeing-up of resources, tools, and funds, make for your team’s outreach efforts? Thomas: Even with all the work I’ve been doing in the barber shop since 2014, the pandemic got us our first grant from the state. Money flowed. We had resources to go beyond the typical mechanisms. I was able to secure thousands of KN95 masks and distribute them to shops. Same thing with rapid tests. We even sent them Corsi-Rosenthal boxes, a DIY filtration system to clean up indoor air. Without the emergency declaration, we would still be in the desert screaming for help. The emergency declaration made it possible to get resources through nontraditional channels, and we were doing things that the other systems—the hospital system, the local health department—couldn’t do. We extended their reach to populations that have historically been underserved and distrustful. Wu: The public-health-emergency declaration hasn’t yet expired. What signs of trouble are you seeing right now? Thomas: The bridge between the barbershops and the clinical side has been shut down in almost all places, including here in Maryland. I go to the shop and they say to me, “Dr. T, when are we going to have the boosters here?” Then I call my clinical partners, who deliver the shots. Some won’t even answer my phone calls. And when they do, they say, “Oh, we don’t do pop-ups anymore. We don’t do community-outreach clinics anymore, because the grant money’s gone. The staff we hired during the pandemic, they use the pandemic funding—they’re gone.” But people are here; they want the booster. And my clinical partners say, “Send them down to a pharmacy.” Nobody wants to go to a pharmacy. [Read: The COVID strategy America hasn’t really tried] You can’t see me, so you can’t see the smoke still coming out of my ears. But it hurts. We got them to trust. If you abandon the community now, it will simply reinforce the idea that they don’t matter. Wu: What is the response to this from the communities you’re talking to? Thomas: It’s “I told you so, they didn’t care about us. I told you, they would leave us with all these other underlying conditions.” You know, it shouldn’t take a pandemic to build trust. But if we lose it now, it will be very, very difficult to build back. We built a bridge. It worked. Why would you dismantle it? Because that’s exactly what's happening right now. The very infrastructure we created to close the racial gaps in vaccine acceptance is being dismantled. It’s totally unacceptable. Wu: The emergency declaration was always going to end at some point. Did it have to play out like this? Thomas: I don’t think so. If you talk to the hospital administrators, they’ll tell you the emergency declaration and the money allowed them to add outreach. And when the money went away, they went back to business as usual. Even though the outreach proved you could actually do a better job. And the misinformation and the disinformation campaign hasn’t stopped. Why would you go back to what doesn’t work? Wu: What is your team planning for the short and long term, with limited resources? Thomas: As long as Shots at the Shop can connect clinical partners to access vaccines, we will definitely keep that going. Nobody wants to go back to normal. So many of our barbers and stylists feel like they’re on their own. I’m doing my best to supply them with KN95 masks and rapid tests. We have kept the conversation going on our every-other-week Zoom town hall. We just launched a podcast. We put out some of our stories in the form of a graphic novel, The Barbershop Storybook. And we’re trying to launch a national association for barbers and stylists, called Barbers and Stylists United for Health. The pandemic resulted in a mobilization of innovation, a recognition of the intelligence at the community level, the recognition that you need to culturally tailor your strategy. We need to keep those relationships intact. Because this is not the last time we’re going to see a pandemic even in our lifetime. I’m doing my best to knock on doors to continue to put our proposals out there. Hopefully, people will realize that reaching Black and Hispanic communities is worth sustaining. Read More

Feb. 2, 2023 – It’s easy these days to take an at-home COVID test when you have symptoms like a fever and sore throat. But when the test is negative, the next step toward diagnosis usually means leaving the comforts of home. But that could soon change. The FDA says it is confident that at-home rapid tests like those for COVID-19 are forthcoming for the flu and respiratory syncytial virus, or RSV. Read More

Multiple reports describe waves of advancing Russians falling like zombies, while videos shows them staggering about, unable to defend themselves under bombardment. While there are suspicions drugs could be behind this behavior, there may be a simpler explanation. Read More

WASHINGTON — A new bipartisan duo is diving in to defend gas stoves. Senate Energy Committee Chairman Joe Manchin, D-W.V., and Sen. Ted Cruz, R-Texas, the new ranking member of the Commerce Committee, are teaming up on legislation Thursday that would bar the Consumer Product Safety Commission from using federal funding to ban new or existing gas stoves, according to a copy of the bill first shared with NBC News. Read More

I also wasn't necessarily looking for dramatic changes to my hair when I started this supplement, but much to my delight, my hair has grown significantly in the past few months—and I bet I can thank collagen for that extra nudge since collagen supplements provide many of the amino acids and nutrients needed for hair growth.* mindbodygreen's formula also includes biotin, the famous B vitamin that aids in the keratin-making process and promotes healthy, strong strands.* And let's not forget about the gut: I love that this collagen powder focuses just as much on gut health as it does on beauty benefits, like nail and hair growth.* Quick anecdote: Before I began supplementing with collagen, I implemented a strict ritual of one yogurt a day to help keep my gut health in check (as yogurt is naturally rich in probiotics). If I didn't eat my daily yogurt, I noticed a difference in my digestion, likely because of the influence on my gut microbiome. Read More

A new class of weight loss drugs on the market have been making waves since they were authorized as a treatment for obesity in 2021. Semaglutide injections, which you may know as Wegovy or Ozempic, have become wildly popular over the past several months, thanks to the buzz they’ve received from TikTok influencers (and rumors of use among some celebrities). The prescription injections were introduced as a diabetes treatment in 2017, but people soon realized that the medications — which help people with diabetes to manage their blood sugar levels — also led to significant weight loss in people with obesity who’d struggled to lose weight with other treatments. Read More

What’s the deal with sleep? [Doing my best Jerry Seinfeld here.] The kids don’t think they need it, the teens get too much of it, and the adults, well, we can’t seem to get enough of it. We’re living in a world where the only thing rivaling our burning desire to be constantly plugged in is the desperate need to unplug. It’s a tricky paradox because, as science-backed studies have indicated, a primary culprit of poor sleep is too much technology. More specifically, an over-abundance of electric and magnetic fields; also known as EMFs. This brings us to the solutions our sleep-obsessed society has concocted to combat the EMF background noise that can potentially impede a good night’s rest; ranging from the $0 act of maintaining a technology-free bedroom to a $500 semi-precious stone claiming to harmonize the energy inside your space. If you think the latter sounds like highfalutin’ snake oil, then I was right there with you. The suss device is called the Somavedic Harmony, and I, along with my deeply sleep-troubled partner, have been using it in our bedroom for the past three months to discern what effects (if any) it would have on our nighttime wellbeing. As a skeptic of shoppable sleep solutions living with an insomniac who will try anything to help him catch forty winks, this journey has been charged with intrigue, an appropriate amount of skepticism, and a LOT of obscure information for achieving a great sleep. But, before we get into all of the magic-stone-harmonizing stuff, let’s quickly run through EMFs and how they tie into sleep. What are EMFs? Short for electric and magnetic fields, EMFs are invisible energy waves (aka radiation) thought to be most commonly emitted through the use of electrical power sources. It sounds ominous but, in reality, is less so because not all EMFs are created equal. According to the National Institute of Environmental Health Sciences, there are two types of electric and magnetic fields: ionizing (high-level, potentially harmful radiation found in X-rays or UV-light) and non-ionizing (low-level, non-harmful radiation found in common household devices). Think of it like this: the heavy apron the dentist sacks you with before an X-ray protects against harmful ionizing EMFs; the blue-light baths you take from your TVs, tablets, and phones are non-ionizing EMFs that, while harmless to your immediate health, are thought to negatively impact sleep. If you haven’t dozed off yet, then now we get into the good stuff: whether or not the $500 Somavedic stone positively impacted my (and my restless partner’s) sleep. What is Somavedic? After spending considerable time attempting to discern what the heck the Somavedic product actually does, I landed on the brand’s “Science” page. From the word salad citing “independent lab testing,” I was able to pull out the following results: the “stone” carried positive effects on everything from cardiovascular to nervous-system health, heart rate variability, circulation, and internal balance — all of which, I presumed, correlate to sounder sleep. But what is the actual technology that achieves this? That question was somehow even trickier to answer. On the product page’s description, there’s a “How Somavedic works” section that states: “Somavedic is designed on the principle of controlled release of energy from precious and semi-precious stones, creating a coherent field covering more than 2,800+ square feet. Somavedic creates a coherent, life-supporting field, with the radius of 100 feet in all directions, penetrating floors and walls.” Wha? After spending extra time digging through the site’s “FAQ” and “About” pages, along with Googling the brand to see what the rest of the internet had to say, I’ve settled on a layman’s definition: it’s a device that’s been engineered by sciencey-techy people to emit some special type of energy waves that “neutralize” or “harmonize” the “negative” EMFs inside a space. This most bemusing part of this “technology” is that it’s harnessed inside a little UFO-looking stone (said to be precious AND semi-precious) that’s then safely encapsulated in 100% handblown glass (oooh-aaah). There are three “Essential” models (the Harmony, SKY, and Vedic) and two “Premium” models (the Amber, and Somavedic Gold), which range in EMF-fighting capabilities and effective radius coverage — meaning the more EMFs you want to block and the bigger the space you want to cover, the pricier the stones get (we’re talking up to $5,600). I went with the Harmony: the most affordable of the magic stone models priced at mouth-drying $498. Somavedic Harmony, $498 The Somavedic Harmony is described as the “smaller variant of the powerful Somavedic Sky model.” Although it was specifically designed for portability and smaller spaces (like cars or offices), I decided to put the more palatably-priced stone to EMF-blocking use inside my normal-sized bedroom. It arrived in a minimalist but formidable white box (much like the ones new Apple products come in) accompanied by only a charger, several adapters, and two instruction pamphlets — which essentially told me to just plug the thing in and let it do its thing. Does Somavedic work? The answer to this question, as with most questions in life, is complicated. Let me begin with a bit of sleep background on me and my partner. I would describe myself as a sensitive sleeper; avoiding caffeine or food too close to bedtime and requiring at least eight hours in an environment that is cool, dark, and quiet. My partner, on the other hand, is a textbook troubled insomniac — he’s regularly restless, overheats easily, and suffers from night terrors plus bouts of sleepwalking. To combat these bedtime woes, he’s tried every sleep aid from CBD gummies to melatonin-magnesium pills and the harder doctor-prescribed stuff while also partaking in more science-backed practices such as stretching, breathing exercises, and eating at least three hours before turning in. In terms of EMF-emitting devices inside our bedroom: we have a TV and both sleep with our phones plugged in directly next to our heads on the nightstands. My partner is strict about phone use and blue light in bed, while I am known to doom-scroll myself to sleep. To make this test all the more interesting, I did not tell my partner about the Harmony and plugged it in underneath my nightstand where he wouldn’t see it. It made no noise once it booted up, so the only way I could tell it was on and “working” was by its glow (pictured above), which I had to conceal — for both secretive purposes and my personal sleeping preferences — beneath a shoebox. After suffering a particularly restless night prior to installing the device, our first sleep with the Somavedic Harmony was suspiciously restful. My partner and I conked out in a way we both described as “deep” the following morning. As I sipped my coffee the next day, I wondered to myself — with my partner none the wiser — was it our exhaustion that made the slumber so intense or the magic EMF-fighting stone hidden beneath my nightstand? After a week of keeping the stone parked next to my bed — and one or two restless evenings that I chalked up to too much caffeine — there was a strange almost heavy effect of sleepiness that weighed over me when I laid down each night. With every passing week, I noticed an overall downward trend in my partner needing to get up and switch bedrooms in the middle of the night (a tactic he employs to combat particularly bad bouts of restless legs). Perhaps this was because I felt more at rest and nagged him less when he started to toss and turn. Or, it could be because he was tossing and turning less. Was the stone magic working or was this a placebo effect? Now, three months in, I often forget the Somavedic is there. Despite slacking off after the first month and not carefully tracking the soundness of my sleep, upon sitting down to write this review I realized that it doesn’t actually matter. So much of my sleep ability is rooted in my mindset. If I can’t shut off my mind, I can’t reach deep sleep. Whether or not Somavedic’s EMF-fighting technology is actually working to harmonize my sleep space or not, perhaps it “worked” by allowing my mind to loosen up enough that relaxation — and slumber — followed suit. However, is the promise of peace of mind worth close to $500? Given thefoggy facts behind this device’s functionality and my own unscientific approach to testing it out, I’m not sure I would recommend it. But, after revealing its existence, my sleep-desperate partner would argue otherwise. He spent the better part of an evening Googling EMFs and Somavedic, which prompted a bedtime request to please remove the hidden Harmony stone from its shoebox and re-home it on his nightstand. The question, therefore, seems less about whether or not the Somavedic worked — because I haven’t the faintest clue how anyone could definitively discern that — but instead is a matter of how much you’re willing to pay for some gosh darn shuteye. If a $500 EMF-blocking stone gives you peace of mind and a restful night’s sleep, then more power (and forty winks) to you. At Refinery29, we’re here to help you navigate this overwhelming world of stuff. All of our market picks are independently selected and curated by the editorial team. If you buy something we link to on our site, Refinery29 may earn commission. Like what you see? How about some more R29 goodness, right here? I Tried Quince's Affordable Linen Duvet Cover Set. I'm In Love With Bearaby's New Body Pillow. 12 Products That Took A Bad Sleeper To Snooze City. Read More

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When it comes to treating disease with food, the quackery stretches back far. Through the centuries, raw garlic has been touted as a home treatment for everything from chlamydia to the common cold; Renaissance remedies for the plague included figs soaked in hyssop oil. During the 1918 flu pandemic, Americans wolfed down onions or chugged “fluid beef” gravy to keep the deadly virus at bay. Even in modern times, the internet abounds with dubious culinary cure-alls: apple-cider vinegar for gonorrhea; orange juice for malaria; mint, milk, and pineapple for tuberculosis. It all has a way of making real science sound like garbage. Research on nutrition and immunity “has been ruined a bit by all the writing out there on Eat this to cure cancer,” Lydia Lynch, an immunologist and a cancer biologist at Harvard, told me. In recent years, though, plenty of legit studies have confirmed that our diets really can affect our ability to fight off invaders—down to the fine-scale functioning of individual immune cells. Those studies belong to a new subfield of immunology sometimes referred to as immunometabolism. Researchers are still a long way off from being able to confidently recommend specific foods or dietary supplements for colds, flus, STIs, and other infectious illnesses. But someday, knowledge of how nutrients fuel the fight against disease could influence the way that infections are treated in hospitals, in clinics, and maybe at home—not just with antimicrobials and steroids but with dietary supplements, metabolic drugs, or whole foods. Although major breakthroughs in immunometabolism are just now arriving, the concepts that underlie them have been around for at least as long as the quackery. People have known for millennia that in the hours after we fall ill, our appetite dwindles; our body feels heavy and sluggish; we lose our thirst drive. In the 1980s, the veterinarian Benjamin Hart argued that those changes were a package deal—just some of many sickness behaviors, as he called them, that are evolutionarily hardwired into all sorts of creatures. The goal, Hart told me recently, is to “help the animal stay in one place and conserve energy”—especially as the body devotes a large proportion of its limited resources to igniting microbe-fighting fevers. The notion of illness-induced anorexia (not to be confused with the eating disorder anorexia nervosa) might seem, at first, like “a bit of a paradox,” says Zuri Sullivan, an immunologist at Harvard. Fighting pathogenic microbes is energetically costly—which makes eating less a very counterintuitive choice. But researchers have long posited that cutting down on calories could serve a strategic purpose: to deprive certain pathogens of essential nutrients. (Because viruses do not eat to acquire energy, this notion is limited to cell-based organisms such as bacteria, fungi, and parasites.) A team led by Miguel Soares, an immunologist at the Instituto Gulbenkian de Ciência, in Portugal, recently showed that this exact scenario might be playing out with malaria. As the parasites burst out of the red blood cells where they replicate, the resulting spray of heme (an oxygen-transporting molecule) prompts the liver to stop making glucose. The halt seems to deprive the parasites of nutrition, weakening them and tempering the infection’s worst effects. [Read: Why science can be so indecisive about nutrition] Cutting down on sugar can be a dangerous race to the bottom: Animals that forgo food while they’re sick are trying to starve out an invader before they themselves run out of energy. Let the glucose boycott stretch on too long, and the dieter might develop dangerously low blood sugar —a common complication of severe malaria—which can turn deadly if untreated. At the same time, though, a paucity of glucose might have beneficial effects on individual tissues and cells during certain immune fights. For example, low-carbohydrate, high-fat ketogenic diets seem to enhance the protective powers of certain types of immune cells in mice, making it tougher for particular pathogens to infiltrate airway tissue. Those findings are still far from potential human applications. But Andrew Wang, an immunologist and a rheumatologist at Yale, hopes that this sort of research could someday yield better clinical treatments for sepsis, an often fatal condition in which an infection spreads throughout the body, infiltrating the blood. “It’s still not understood exactly what you’re supposed to feed folks with sepsis,” Wang told me. He and his former mentor at Yale, Ruslan Medzhitov, are now running a clinical trial to see whether shifting the balance of carbohydrates and lipids in their diet speeds recovery for people ill with sepsis. If the team is able to suss out clear patterns, doctors might eventually be able to flip the body’s metabolic switches with carefully timed doses of drugs, giving immune cells a bigger edge against their enemies. But the rules of these food-illness interactions, to the extent that anyone understands them, are devilishly complex. Sepsis can be caused by a whole slew of different pathogens. And context really, really matters. In 2016, Wang, Medzhitov, and their colleagues discovered that feeding mice glucose during infections created starkly different effects depending on the nature of the pathogen driving disease. When the mice were pumped full of glucose while infected with the bacterium Listeria, all of them died—whereas about half of the rodents that were allowed to give in to their infection-induced anorexia lived. Meanwhile, the same sugary menu increased survival rates for mice with the flu. In this case, the difference doesn’t seem to boil down to what the microbe was eating. Instead, the mice’s diet changed the nature of the immune response they were able to marshal—and how much collateral damage that response was able to inflict on the body, as James Hamblin wrote for The Atlantic at the time. The type of inflammation that mice ignited against Listeria, the team found, could imperil fragile brain cells when the rodents were well fed. But when the mice went off sugar, their starved livers started producing an alternate fuel source called ketone bodies—the same compounds people make when on a ketogenic diet—that helped steel their neurons. Even as the mice fought off their bacterial infections, their brain stayed resilient to the inflammatory burn. The opposite played out when the researchers subbed in influenza, a virus that sparks a different type of inflammation: Glucose pushed brain cells into better shielding themselves against the immune system’s fiery response. [Read: Feed a cold, don’t starve it] There’s not yet one unifying principle to explain these differences. But they are a reminder of an underappreciated aspect of immunity. Surviving disease, after all, isn’t just about purging a pathogen from the body; our tissues also have to guard themselves from shrapnel as immune cells and microbes wage all-out war. It’s now becoming clear, Soares told me, that “metabolic reprogramming is a big component of that protection.” The tactics that thwart a bacterium like Listeria might not also shield us from a virus, a parasite, or a fungus; they may not be ideal during peacetime. Which means our bodies must constantly toggle between metabolic states. In the same way that the types of infections likely matter, so do the specific types of nutrients: animal fats, plant fats, starches, simple sugars, proteins. Like glucose, fats can be boons in some contexts but detrimental in others, as Lynch has found. In people with obesity or other metabolic conditions, immune cells appear to reconfigure themselves to rely more heavily on fats as they perform their day-to-day functions. They can also be more sluggish when they attack. That’s the case for a class of cells called natural killers: “They still recognize cancer or a virally infected cell and go to it as something that needs to be killed,” Lynch told me. “But they lack the energy to actually kill it.” Timing, too, almost certainly has an effect. The immune defenses that help someone expunge a virus in the first few days of an infection might not be the ones that are ideal later on in the course of disease. Even starving out bacterial enemies isn’t a surefire strategy. A few years ago, Janelle Ayres, an immunologist at the Salk Institute for Biological Studies, and her colleagues found that when they infected mice with Salmonella and didn’t allow the rodents to eat, the hungry microbes in their guts began to spread outside of the intestines, likely in search of food. The migration ended up killing tons of their tiny mammal hosts. Mice that ate normally, meanwhile, fared far better—though the Salmonella inside of them also had an easier time transmitting to new hosts. The microbes, too, were responding to the metabolic milieu, and trying to adapt. “It would be great if it was as simple as ‘If you have a bacterial infection, reduce glucose,’” Ayres said. “But I think we just don’t know.” All of this leaves immunometabolism in a somewhat chaotic state. “We don’t have simple recommendations” on how to eat your way to better immunity, Medzhitov told me. And any that eventually emerge will likely have to be tempered by caveats: Factors such as age, sex, infection and vaccination history, underlying medical conditions, and more can all alter people’s immunometabolic needs. After Medzhitov’s 2016 study on glucose and viral infections was published, he recalls being dismayed by a piece from a foreign outlet circulating online claiming that “a scientist from the USA says that during flu, you should eat candy,” he told me with a sigh. “That was bad.” [Read: You can’t “starve” cancer, but you might help treat it with food] But considering how chaotic, individualistic, and messy nutrition is for humans, it shouldn’t be a surprise that the dietary principles governing our individual cells can get pretty complicated too. For now, Medzhitov said, we may be able to follow our instincts. Our bodies, after all, have been navigating this mess for millennia, and have probably picked up some sense of what they need along the way. It may not be a coincidence that during viral infections, “something sweet like honey and tea can really feel good,” Medzhitov said. There may even be some immunological value in downing the sick-day classic, chicken soup: It’s chock-full of fluid and salts, helpful things to ingest when the body’s electrolyte balance has been thrown out of whack by disease. The science around sickness cravings is far from settled. Still, Sullivan, who trained with Medzhitov, jokes that she now feels better about indulging in Talenti mango sorbet when she’s feeling under the weather with something viral, thanks to her colleagues’ 2016 finds. Maybe the sugar helps her body battle the virus without harming itself; then again, maybe not. For now, she figures it can’t hurt to dig in. Read More

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The pressure to have a “good workout” can be intense thanks to fitness trackers and influencers on social media. As a result, many people define a good workout as exercise with lots of sweat and a super-high heart rate ― not a more moderate fitness regimen like walking or yoga. But that’s wrong. Studies show that walking just 21 minutes a day can lower your risk of heart disease by 30%, while exercise like yoga can reduce chronic back pain and have huge benefits for your mental health. Read More

Cringe. You know, that powerful, full-body phenomenon that can make you thrash in bed like a goldfish after a flashback to something embarrassing you said eight years ago. Or spasm involuntarily in the shower, recalling that you once performed a Shania Twain song in front of your entire school in a sheer top, no bra. Or feel genuine anguish remembering the time you zoned out in the middle of a gym class and when you came to, you were facing the opposite way to 20 other people. Cringe is a cruel and altogether unpreventable certainty of life. We just can’t stop awkward things from happening. But in 2023, it’s time to reclaim the hold it has over our lives. Let me introduce you to your spokesperson: the cringe-free cow. For those of you who aren’t acquainted, I’m referring to an image (origin unknown) of a cow standing in the waves on a beach and staring off into the distance, accompanied by the words: “I am cringe but I am free.” Haters will say it’s just a silly meme but dig a little deeper and you’ll find it’s really a way of life. A movement. A sense of ease and lightness that can only come with finally throwing off the shackles of “I care so much about what others think” and embracing that weird, awkward part of yourself that you’ve been taught to shun socially. This is how I’m trying to be in 2023. We should all be more cow. And it seems like the internet is following suit.  “You have to desensitize yourself to being cringey,” says TikToker @dahmin454 in one video, which has 844k views. “Every extraordinary or successful or remotely memorable person in the world has only gotten to where they are because they didn’t give a fuck about being cringey.” @dahmin454 IM FEELING A LITTLE AGGRESSIVE TONIGHT. ♬ original sound – dahmin Dahmin goes on to give examples such as Facebook founder Mark Zuckerberg who, if sat next to you in high school, “would raise major red flags because of how cringe and socially awkward [he] was”. Now, of course, he’s a billionaire. Dahmin continues: “Every pop star or singer… imagine Ariana Grande. If you went to high school with her, she was probably singing all the time, like extra af, and nobody likes that girl who’s always singing.” Also “SoundCloud rappers…everyone was making fun of them until they blew up” and “every actor in action films who everyone’s always simping over were probably once just theater school kids”. In the comments on the video, people are rapturous in agreement. “Thanks bestie I needed this,” one commenter adds. Another says: “This is 10000% true.” One comment that has 26.2k likes (!) reads: “The fear of embarrassment is stopping y’all from being great.” In another video, aptly titled “2023 is the year of being a cringey loser”, TikToker @tess.barclay makes her case that in letting the fear of cringe stop you from doing things, the only person you’re harming is yourself. She admits that she used to be afraid of going to the gym, worrying that she didn’t know how to use the machines. She even overthought creating TikToks, fretting that old schoolfriends would send them to each other and mock her. “People’s opinion of you [has] 100% to do with them, and not you,” she says. “We need to stop waiting for the moment that we feel so confident and so cool… [By doing so] you take the power away from people calling you cringe, because cringe is in the eye of the beholder.”  The hard truth is, when you try in life, you run the risk of coming across as a bit of a dork. All over social media, there is an increasing number of videos extolling 2023 as the year of embracing cringe. We’ve seen how clean girl, pristine living, and overly curated Instagram aesthetics have died a little death in favor of dystopian-core, “frazzled English woman,” being delusional, and the celebrity cringe-chaos agents that are Julia Fox, The 1975’s Matty Healy, and Chicken Shop Date’s Amelia Dimoldenberg taking over our FYP. As the world burns and civilization as we know it crumbles, it seems we’re over pretending that we’re chill, or laid-back, or that there aren’t things that we long for with every fiber of our being. If anything, the celebrity world is a prime example of how fortune favors the cringe.  be cringe in 2023. your life will legit get better on every front this is not a joke.— Isabel⚡️ (@isabelunraveled) January 1, 2023 An epiphany I recently had as I was genuinely having the time of my life, two-stepping like a dad with a bad hip in London’s O2 Arena as I watched Matty Healy doing push-ups, chewing on a raw ribeye steak and smoking fake herbal cigarettes in the name of ‘art’: I had become immune to cringe. I couldn’t even summon an involuntary shudder. I mean, the guy seemed like he was having fun and deriving some genuine personal joy from being so authentically himself. The same thing happens whenever I see Austin Butler giving interviews, his accent now permanently trapped in the lilting Memphis chrysalis of ‘Elvis voice‘ (despite him being a Disney star from California and having never sounded like that until literally three years ago). Last year, I would squirm. This year? The guy won a Golden Globe. If he wants to keep doing his funny little accent, he’s earned the bloody right. After extensive research, I’ve decided that the hard truth is, when you try in life, you run the risk of coming across as a bit of a dork. I’ve realized that I rate that over someone who disengages in the name of being aloof and “cool” any day. @tess.barclay Normalize feeling cringe in 2023 ✨👏🏼💅🏻 #2023 #2023goals #2023resolutions #motivation #inspo #newyear #newyears #newyearsresolution #newyearsresolutions ♬ original sound – Tess Barclay 💕⚡️ Rachel Coffey, a London-based professional life, business, and career coach, believes that the timing of this renaissance is no coincidence. “During the pandemic, we all learned to inhabit our own space a little more,” she says. “Maybe even being able to explore interests that might not be seen as exactly on trend. Now we are back out in the real world, people are bringing their quirks and idiosyncrasies with them for all the world to see. And ‘being cringe’ is about celebrating that and not hiding our true selves away — whether it fits with what’s expected by society or not.” Last year, in Taylor Swift’s commencement speech for the graduates of New York University, she urged students to “learn to live alongside cringe… I promise you, you’re probably doing or wearing something right now that you will look back at later and find revolting and hilarious.” Cringe, Swift seems to say, is as inevitable as death and taxes so you might as well get to know it well — it’s not going anywhere. It is all obviously easier said than done. There’s a greater payoff for celebrities, whose fame hinges on the notion that all press is good press. Wouldn’t we all like to be more carefree versions of ourselves? The trouble has always been that modern living does everything to extract said freedom from our psyches. Thanks to the prevalence of social media, not only do a lot of us have a crippling fear of being perceived but we are also so chronically online. Every single thing that we do can be shared for the viewing pleasure of millions of strangers, to be laughed at, mocked, or canceled. We have never been so aware of our faces, our bodies, and the way we talk and come across. We’re at peak cringe-sentience so, according to Coffey, it’s going to take rewiring what we’ve been taught. Hard but not impossible. “If you find yourself changing your choices because of what others might think, press pause and ask what’s the worst that could happen?” she says. “Think of something that’s more or less acceptable to do but you think you’d find mortally embarrassing (doing a stand-up comedy set, for example), take a deep breath and do it. You’ll find getting out the other side alive totally exhilarating.” You might even find that in doing so, you connect more with your identity and desires, or even find your people. “Challenge yourself – find something that would normally be totally cringe within the social circle you inhabit but in another time or place wouldn’t have even been questioned,” says Coffey. Yes, eventually it’s about taking a big leap of cringe but it starts with small acts of resistance, of caring less. Start to think of obeying the cringe as another way of yielding to negative self-talk and minimizing or making ourselves smaller. Remind yourself that anything that has the potential to bring joy in life also runs the risk of being cringe: kissing, dancing, dating, starting a new hobby, traveling to a new country where you don’t speak the language, making new friends, the first day of a new job. In a now-viral-thread from the first day of this year, Twitter user @isabelunraveled hit the nail on the head: “If you constantly chase your edge of cringe you are probably getting closer to truth and authenticity because that is precisely what cringes people out.” She adds: “Conquering the fear of being cringe is fully a rite of passage to living life on your own terms.” It’s true. So, in the name of living life on your own terms in 2023, do what makes you cringe. Do the aqua aerobics, run for the bus, be rejected by babies (I mean that torturous moment when you’re trying really hard to make a baby laugh and they start crying instead). Write long, mushy Instagram captions. Make comedy TikToks with your boyfriend because it’s a bit of silliness in what can be a shitty world. Try really hard at the things you love and never again turn down your screen brightness on your phone on public transport to hide whatever godawful music you’re listening to (it’s The 1975). Repeat after me: To be cringe is to be free. Like what you see? How about some more R29 goodness, right here? Being Horny Is Fundamentally Embarrassing. Why Black TikTokers Are Unsubscribing From Reality. My New Favourite Thing Is Lying To Strangers. Read More

If you’ve ever been to London, you know that navigating its wobbly grid, riddled with curves and dead-end streets, requires impressive spatial memory. Driving around London is so demanding, in fact, that in 2006 researchers found that it was linked with changes in the brains of the city’s cab drivers: Compared with Londoners who drove fixed routes, cabbies had a larger volume of gray matter in the hippocampus, a brain region crucial to forming spatial memory. The longer the cab driver’s tenure, the greater the effect. The study is a particularly evocative demonstration of neuroplasticity: the human brain’s innate ability to change in response to environmental input (in this case, the spatially demanding task of driving a cab all over London). That hard-won neuroplasticity required years of mental and physical practice. Wouldn’t it be nice to get the same effects without so much work? To hear some people tell it, you can: Psychedelic drugs such as psilocybin, LSD, ayahuasca, and Ecstasy, along with anesthetics such as ketamine, can enhance a user’s neuroplasticity within hours of administration. In fact, some users take psychedelics for the express purpose of making their brain a little more malleable. Just drop some acid, the thinking goes, and your brain will rewire itself—you’ll be smarter, fitter, more creative, and self-aware. You might even get a transcendent experience. Popular media abound with anecdotes suggesting that microdosing LSD or psilocybin can expand divergent thinking, a more free and associative type of thinking that some psychologists link with creativity. [Read: Here’s what happens when a few dozen people take small doses of psychedelics] Research suggests that psychedelic-induced neuroplasticity can indeed enhance specific types of learning, particularly in terms of overcoming fear and anxiety associated with past trauma. But claims about the transformative, brain-enhancing effects of psychedelics are, for the most part, overstated. We don’t really know yet how much microdosing, or a full-blown trip, will change the average person’s mental circuitry. And there’s reason to suspect that, for some people, such changes may be actively harmful.   There is nothing new about the notion that the human and animal brain are pliant in response to everyday experience and injury. The philosopher and psychologist William James is said to have first used the term plasticity back in 1890 to describe changes in neural pathways that are linked to the formation of habits. Now we understand that these changes take place not only between neurons but also within them: Individual cells are capable of sprouting new connections and reorganizing in response to all kinds of experiences. Essentially, this is a neural response to learning, which psychedelics can rev up. We also understand how potent psychedelic drugs can be in inducing changes to the brain. Injecting psilocybin into a mouse can stimulate neurons in the frontal cortex to grow by about 10 percent and sprout new spines, projections that foster connections to other neurons. It also alleviated their stress-related behaviors—effects that persisted for more than a month, indicating enduring structural change linked with learning. Presumably, a similar effect takes place in humans. (Comparable studies on humans would be impossible to conduct, because investigating changes in a single neuron would require, well, sacrificing the subject.) The thing is, all those changes aren’t necessarily all good. Neuroplasticity just means that your brain—and your mind—is put into a state where it is more easily influenced. The effect is a bit like putting a glass vase back into the kiln, which makes it pliable and easy to reshape. Of course you can make the vase more functional and beautiful, but you might also turn it into a mess. Above all else, psychedelics make us exquisitely impressionable, thanks to their speed of action and magnitude of effect, though their ultimate effect is still heavily dependent on context and influence. [Read: A new chapter in the science of psychedelic microdosing] We have all experienced heightened neuroplasticity during the so-called sensitive periods of brain development, which typically unfold between the ages of 1 and 4 when the brain is uniquely responsive to environmental input. This helps explain why kids effortlessly learn all kinds of things, like how to ski or speak a new language. But even in childhood, you don’t acquire your knowledge and skills by magic; you have to do something in a stimulating enough environment to leverage this neuroplastic state. If you have the misfortune of being neglected or abused during your brain’s sensitive periods, the effects are likely to be adverse and enduring—probably more so than if the same events happened later in life. Being in a neuroplastic state enhances our ability to learn, but it might also burn in negative or traumatic experiences—or memories—if you happen to have them while taking a psychedelic. Last year, a patient of mine, a woman in her early 50s, decided to try psilocybin with a friend. The experience was quite pleasurable until she started to recall memories of her emotionally abusive father, who had an alcohol addiction. In the weeks following her psilocybin exposure, she had vivid and painful recollections of her childhood, which precipitated an acute depression. Her experience might have been very different—perhaps even positive—if she’d had a guide or therapist with her while she was tripping to help her reappraise these memories and make them less toxic. But without a mediating positive influence, she was left to the mercy of her imagination. This must have been just the sort of situation legislators in Oregon had in mind last month when they legalized recreational psilocybin use, but only in conjunction with a licensed guide. It’s the right idea. [Read: What it’s like to trip on the most potent magic mushroom] In truth, researchers and clinicians haven’t a clue whether people who microdose frequently with psychedelics—and are thus walking around in a state of enhanced neuroplasticity—are more vulnerable to the encoding of traumatic events. In order to find out, you would have to compare a group of people who microdose against a group of people who don’t over a period of time and see, for example, if they differ in rates of PTSD. Crucially, you’d have to randomly assign people to either microdose or abstain—not simply let them pick whether they want to try tripping. In the absence of such a study, we are all currently involved in a large, uncontrolled social experiment. The results will inevitably be messy and inconclusive. Even if opening your brain to change were all to the good, the promise of neuroplasticity without limit—that you can rejuvenate and remodel the brain at any age—far exceeds scientific evidence. Despite claims to the contrary, each of us has an upper limit to how malleable we can make our brain. The sensitive periods, when we hit our maximum plasticity, is a finite window of opportunity that slams shut as the brain matures. We progressively lose neuroplasticity as we age. Of course we can continue to learn—it just takes more effort than when we were young. Part of this change is structural: At 75, your hippocampus contains neurons that are a lot less connected to one another than they were at 25. That’s one of the major reasons older people find that their memory is not as sharp as it used to be. You may enhance those connections slightly with a dose of psilocybin, but you simply can’t make your brain behave as if it’s five decades younger. [Read: What it’s like to get worse at something] This reality has never stopped a highly profitable industry from catering to people’s anxieties and hopes—especially seniors’. You don’t have to search long online before you find all kinds of supplements claiming to keep your brain young and sharp. Brain-training programs go even further, purporting to rewire your brain and boost your cognition (sound familiar?), when in reality the benefits are very modest, and limited to whatever cognitive task you’ve practiced. Memorizing a string of numbers will make you better at memorizing numbers; it won’t transfer to another skill and make you better at, say, chess. We lose neuroplasticity as we age for good reason. To retain our experience, we don’t want our brain to rewire itself too much. Yes, we lose cognitive fluidity along the way, but we gain knowledge too. That’s not a bad trade-off. After all, it’s probably more valuable to an adult to be able to use all of their accumulated knowledge than to be able to solve a novel mathematical problem or learn a new skill. More important, our very identity is encoded in our neural architecture—something we wouldn’t want to tinker with lightly. At their best, psychedelics and other neuroplasticity-enhancing drugs can do some wonderful things, such as speed up the treatment of depression, quell anxiety in terminally ill patients, and alleviate the worst symptoms of PTSD. That’s enough reason to research their uses and let patients know psychedelics are an option for psychiatric treatment when the evidence supports it. But limitless drug-induced self-enhancement is simply an illusion. Read More

The Biden administration announced Monday that it will be ending the twin emergency declarations of COVID-19, marking the switch from COVID-19 “pandemic” to “endemic” status. Here's what to know. Read More

What is Verona Integron‐mediated Metallo‐β‐lactamase (VIM)‐ and Guiana‐Extended Spectrum‐β‐Lactamase (GES)‐ producing carbapenem‐resistant Pseudomonas aeruginosa (VIM‐GES‐CRPA)? Read More

The White House has announced an expiration date for the Covid-related national and public health emergencies. After that, consumers may face new costs. Read More

“[focus+] is a very smart, science-backed formula that includes some very important compounds—coffee bean and coffee cherry extract for instant and sustained energy, but also blended with things like guarana, vitamin B12, ginseng, L-theanine,”* Cole explains. “When you get all these compounds together…you get sustained mental acuity and sustained mental alertness throughout the day,” plus enhanced flow state, stress resilience, support with neurotransmitter synthesis, and bolstered cognitive task performance—all without the dreaded afternoon crash that seasoned coffee drinkers know all too well.* Read More

You’ve probably heard of white noise before, whether you’ve slept with it or used it to concentrate ― but did you know there are different color noises? “Green noise” is sweeping social media lately; TikTok users are swearing it’s the key to a restful night’s sleep. One user claimed it’s a “game changer.” Another said: “I haven’t slept so good in a while” after listening to green noise. Read More

If you crave routine and structure in order to function properly, I have found the best planner for you. Now, before you hit check out on the hundredth planner to add to your collection that will — let’s face it —inevitably stay blank as soon as the novelty of the new year wears off, let me explain why BestSelf’s Self Journal is different. She’s not like other girls! She’s put together, un-dated, and packed to the max with useful pages that will optimize your productivity. We’re talking a new year’s bucket list; a habit and 13-week goal tracker; monthly, weekly, and daily views with schedules, and after-weekly reflections. No, you’re not dreaming: This book is everything you’ve been longing for in a planner and journal combined. What else could one ask for to take on a stellar 2023? With nearly 6,000 happy reviews rating it 4.9-out-of-5 stars, this goal planner isn’t just loved and praised by its users, it also works. Developed with scientific study and success psychology, it’s designed to optimize our day and tackle specific goals in order to live a more fulfilling life. But the question is… how did it change my own day when I tried it? Was I feeling more productive and focused? Well, the answer is a lot more complicated than a simple yes or no. Self Journal, $32 The truth is that a lot of what the journal asks for are actually things I’ve been tackling in therapy for the past three years: task prioritization, figuring out how much time a task takes, comparing it to the actual time it took, scheduling my day to the hour, tracking habits, and more. Of course, when someone struggles with ADHD-like symptoms like executive dysfunction, filling up these pages can feel extremely overwhelming — which in and of itself is a task initiation problem. If any of these struggles sound like you, then I’ve got tough news: There isn’t a journal or planner that will cure everything you’re struggling with. But this journal is the closest thing I’ve found that provides all of the tools I need to help me solve my daily productivity issues. If you want to start fresh in the new year, with brand new goals and healthy habits, and then actually continue them, this is the planner you need. Plus, its un-dated nature means you don’t have to feel guilty if you miss a day or two! I have gone through this journal twice now! It’s the perfect life companion for keeping me on track with achievable goals, setting consistent habits, and reminding me to be grateful every day.BestSelf Reviewer I’ll break down my favorite sections for you. The weekly planning is divided into the top three weekly objectives, their estimated completion times, and a blank, everyday view. To me, it’s the perfect balance between freedom and structure — you can truly make it your own. You also have a weekly review where you can add up your “win the day” and “plan to reality” score from your daily pages, then reflect on your three biggest wins, the best thing to happen, and how to improve next week. The daily pages are structured with that similarly balanced approach with a schedule (with space to rate how much of your planned schedule was accomplished), important tasks, a gratitude question, a goal, and what would make today great. The page next to it is a dotted blank page for your notes with a mood tracker and “win the day” score on the bottom. If you’re anything like me (*cough* perfectionist *cough*), there’s a certain pressure to answer everything right and to leave blank anything that confuses you in fear of getting it wrong. I’ll give you the same advice my therapist told me: Think small. You won’t have grand goals every day, and you’re not here to impress anyone. This BestSelf journal is for your own eyes only, and you can fill it up however you want. My favorite sections are definitely the bucket list and goal tracker pages. The bucket list is exactly what you need to keep all your New Year resolutions in one place. Here’s the place to write all your hopes and dreams for 2023. Think big, think small, and write it all down. In our daily hustle, we often forget about the little things we want to accomplish during the year. Just think about how fun it will be this time next year to look back and see how many of these you’ve accomplished! The goal tracker is what I was especially excited about. I need my goals broken down like this because otherwise they seem too big and too overwhelming, and I’m anxious to even start. My main plan for these pages is to use them to consider the big features and articles I need to write for work: What are the deadlines? Whom do I need to contact or interview? When do I want all of my interviews to be completed? What’s my main motivation? If you struggle with task initiation, this breakdown is so helpful. In case it wasn’t yet clear, I highly recommend this journal. It may seem really overwhelming at first, with all its components (I didn’t even mention the online resources, PDFs, separate morning/night rituals, and goal-tracking calendar!), but it’s amazing once you take the pages one at a time. And what better time than when we’re all excited and prepping for the new year? Take full advantage of all that motivation to start your 2023 right. At Refinery29, we’re here to help you navigate this overwhelming world of stuff. All of our market picks are independently selected and curated by the editorial team. All product details reflect the price and availability at the time of publication. If you buy something we link to on our site, Refinery29 may earn commission. Like what you see? How about some more R29 goodness, right here? The 42 Best Planners For Starting Out 2023 Strong. The 15 Best Travel Journals For Your 2023 Trips. Genius Under-Bed Storage Solutions. Read More

These days, strolling through downtown New York City, where I live, is like picking your way through the aftermath of a party. In many ways, it is exactly that: The limp string lights, trash-strewn puddles, and splintering plywood are all relics of the raucous celebration known as outdoor dining. These wooden “streeteries” and the makeshift tables lining sidewalks first popped up during the depths of the coronavirus pandemic in 2020, when restaurants needed to get diners back in their seats. It was novel, creative, spontaneous—and fun during a time when there wasn’t much fun to be had. For a while, outdoor dining really seemed as though it could outlast the pandemic. Just last October, New York Magazine wrote that it would stick around, “probably permanently.” But now someone has switched on the lights and cut the music. Across the country, something about outdoor dining has changed in recent months. With fears about COVID subsiding, people are losing their appetite for eating among the elements. This winter, many streeteries are empty, save for the few COVID-cautious holdouts willing to put up with the cold. Hannah Cutting-Jones, the director of food studies at the University of Oregon, told me that, in Eugene, where she lives, outdoor dining is “absolutely not happening” right now. In recent weeks, cities such as New York and Philadelphia have started tearing down unused streeteries. Outdoor dining’s sheen of novelty has faded; what once evoked the grands boulevards of Paris has turned out to be a janky table next to a parked car. Even a pandemic, it turns out, couldn’t overcome the reasons Americans never liked eating outdoors in the first place. For a while, the allure of outdoor dining was clear. COVID safety aside, it kept struggling restaurants afloat, boosted some low-income communities, and cultivated joie de vivre in bleak times. At one point, more than 12,700 New York restaurants had taken to the streets, and the city—along with others, including Boston, Los Angeles, Chicago, and Philadelphia—proposed making dining sheds permanent. But so far, few cities have actually adopted any official rules. At this point, whether they ever will is unclear. Without official sanctions, mounting pressure from outdoor-dining opponents will likely lead to the destruction of existing sheds; already, people keep tweeting disapproving photos at sanitation departments. Part of the issue is that as most Americans’ COVID concerns retreat, the potential downsides have gotten harder to overlook: less parking, more trash, tacky aesthetics, and, oh God, the rats. Many top New York restaurants have voluntarily gotten rid of their sheds this winter. The economics of outdoor dining may no longer make sense for restaurants, either. Although it was lauded as a boon to struggling restaurants during the height of the pandemic, the practice may make less sense now that indoor dining is back. For one thing, dining sheds tend to take up parking spaces needed to attract customers, Cutting-Jones said. The fact that most restaurants are chains doesn’t help: “If whatever conglomerate owns Longhorn Steakhouse doesn’t want to invest in outdoor dining, it will not become the norm,” Rebecca Spang, a food historian at Indiana University Bloomington, told me. Besides, she added, many restaurants are already short-staffed, even without the extra seats. In a sense, outdoor dining was doomed to fail. It always ran counter to the physical makeup of most of the country, as anyone who ate outside during the pandemic inevitably noticed. The most obvious constraint is the weather, which is sometimes pleasant but is more often not. “Who wants to eat on the sidewalk in Phoenix in July?” Spang said. The other is the uncomfortable proximity to vehicles. Dining sheds spilled into the streets like patrons after too many drinks. The problem was that U.S. roads were built for cars, not people. This tends not to be true in places renowned for outdoor dining, such as Europe, the Middle East, and Southeast Asia, which urbanized before cars, Megan Elias, a historian and the director of the gastronomy program at Boston University, told me. At best, this means that outdoor meals in America are typically enjoyed with a side of traffic. At worst, they end in dangerous collisions. Cars and bad weather were easier to put up with when eating indoors seemed like a more serious health hazard than breathing in fumes and trembling with cold. It had a certain romance—camaraderie born of discomfort. You have to admit, there was a time when cozying up under a heat lamp with a hot drink was downright charming. But now outdoor dining has gone back to what it always was: something that most Americans would like to avoid in all but the most ideal of conditions. This sort of relapse could lead to fewer opportunities to eat outdoors even when the weather does cooperate. But outdoor dining is also affected by more existential issues that have surmounted nearly three years of COVID life. Eating at restaurants is expensive, and Americans like to get their money’s worth. When safety isn’t a concern, shelling out for a streetside meal may simply not seem worthwhile for most diners. “There’s got to be a point to being outdoors, either because the climate is so beautiful or there’s a view,” Paul Freedman, a Yale history professor specializing in cuisine, told me. For some diners, outdoor seating may feel too casual: Historically, Americans associated eating at restaurants with special occasions, like celebrating a milestone at Delmonico’s, the legendary fine-dining establishment that opened in the 1800s, Cutting-Jones said. Eating outdoors, in contrast, was linked to more casual experiences, like having a hot dog at Coney Island. “We have high expectations for what dining out should be like,” she said, noting that American diners are especially fussy about comfort. Even the most opulent COVID cabin may be unable to override these associations. “If the restaurant is going to be fancy and charge $200 a person,” said Freedman, most people can’t escape the feeling of having spent that much for “a picnic on the street.” Outdoor dining isn’t disappearing entirely. In the coming years there’s a good chance that more Americans will have the opportunity to eat outside in the nicer months than they did before the pandemic—even if it’s not the widespread practice many anticipated earlier in the pandemic. Where it continues, it will almost certainly be different: more buttoned-up, less lawless—probably less exciting. Santa Barbara, for example, made dining sheds permanent last year but specified that they must be painted an approved “iron color.” It may also be less popular among restaurant owners: If outdoor-dining regulations are too far-reaching or costly, cautioned Hayrettin Günç, an architect with Global Designing Cities Initiative, that will “create barriers for businesses.” For now, outdoor dining is yet another COVID-related convention that hasn’t quite stuck—like avoiding handshakes and universal remote work. As the pandemic subsides, the tendency is to default to the ways things used to be. Doing so is easier, certainly, than coming up with policies to accommodate new habits. In the case of outdoor dining, it’s most comfortable, too. If this continues to be the case, then outdoor dining in the U.S. may return to what it was before the pandemic: dining “al fresco” along the streetlamp-lined terraces of the Venetian Las Vegas, and beneath the verdant canopy of the Rainforest Cafe. Read More

By Dennis Thompson HealthDay Reporter WEDNESDAY, Feb. 1, 2023 (HealthDay News) -- Mila Clarke started taking Ozempic in 2020 to help manage her diabetes, but was pleasantly surprised to find herself soon shedding pounds. “I was like, this is really weird because I’m not having to try very hard to do this,” said Clarke, who has been diagnosed with both type 1 and type 2 diabetes and chronicles her diabetes journey on her Hangry Woman blog. “And as I kept going on, I kept noticing that the weight was falling off.” Read More

Washington’s runaway spending is highlighting the seemingly unstoppable growth of the big entitlement programs: Social Security, Medicare and Medicaid. Moreover, the trust funds for Social Security and Medicare are headed for insolvency. These looming disasters are prompting plenty of proposals on what to do: raise eligibility ages, raise taxes, cut benefits. Read More

The CDC warned that EzriCare Artificial Tears eyedrops may be linked to a drug-resistant bacterial infection that has caused permanent vision loss and one death. Read More

In this study1 from the Journal of Clinical and Aesthetic Dermatology, board-certified dermatologist Babar Rao, M.D., FAAD, a professor of dermatology and pathology at Robert Wood Johnson Medical School, and fellow researchers randomly assigned 60 participants with acne scars and deeper skin tones to two groups. They compared two different treatments, one being a chemical peel with 35% glycolic acid and the other a microneedling session—both administered every two weeks for 12 weeks. Read More

Images By Tang Ming Tung via Getty Images To no one’s delight, the hours after work regularly zoom by. Before you know it, you’re back at your desk and gearing up for another eight-hour workday. In other words, the time between work and bed is short and is often full of responsibilities and to-dos that aren’t very exciting. “It’s a sacred part of the day and for whatever reason it also feels like the most stressful part of the day,” said Joy Kiesch, clinical director and owner of Miami Vibes Counseling Center. This is why it’s important to make the most of this short time. Read More

Whether you rarely skip a workout or are feeling the urge to work up a sweat for the first time in a while, you'll want to be in your gym-going best. Luckily, Amazon — the reigning champ of speedy delivery — has a host of sporty goods for your high-impact needs.    In addition to power players like Nike and Under Armour, Amazon stocks tons of hidden fitness gems, such as its in-house brand Core 10, which makes size-inclusive tanks, leggings, and more. You'll find everything your workout style needs — with the convenience of lightning-fast home delivery. From leggings that don't fall to a sports bra that works for D-cups, see some of the best Amazon workout clothes, ahead. At Refinery29, we’re here to help you navigate this overwhelming world of stuff. All of our market picks are independently selected and curated by the editorial team. All product details reflect the price and availability at the time of publication. 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Airplane bathrooms are not most people’s idea of a good time. They’re barely big enough to turn around in. Their doors stick, like they’re trying to trap you in place. That’s to say nothing of the smell. But to the CDC, those same bathrooms might be a data gold mine. This month, the agency has been speaking with Concentric, the public-health and biosecurity arm of the biotech company Ginkgo Bioworks, about screening airplane wastewater for COVID-19 at airports around the country. Although plane-wastewater testing had been in the works already (a pilot program at John F. Kennedy International Airport, in New York City, concluded last summer), concerns about a new variant arising in China after the end of its “zero COVID” policies acted as a “catalyst” for the project, Matt McKnight, Ginkgo’s general manager for biosecurity, told me. According to Ginkgo, even airport administrators are getting excited. “There have been a couple of airports who have actually reached out to the CDC to ask to be part of the program,” Laura Bronner, Ginkgo’s vice president of commercial strategies, told me. Airplane-wastewater testing is poised to revolutionize how we track the coronavirus’s continued mutations around the world, along with other common viruses such as flu and RSV—and public-health threats that scientists don’t even know about yet. Unlike sewer-wide surveillance, which shows us how diseases are spreading among large communities, airplane surveillance is precisely targeted to catch new variants entering the country from abroad. And unlike with PCR testing, passengers don’t have to individually opt in. (The results remain anonymous either way.) McKnight compares the technique to radar: Instead of responding to an attack after it’s unfolded, America can get advance warning about new threats before they cause problems. As we enter an era in which most people don’t center their lives on avoiding COVID-19, our best contribution to public health might be using a toilet at 30,000 feet. Fundamentally, wastewater testing on airplanes is a smaller-scale version of the surveillance that has been taking place at municipal water networks since early 2020: Researchers perform genetic testing on sewage samples to determine how much coronavirus is present, and which variants are included. But adapting the methodology to planes will require researchers to get creative. For one thing, airplane wastewater has a higher solid-to-liquid ratio. Municipal sewage draws from bathing, cooking, washing clothes, and other activities, whereas airplane sewage is “mainly coming from the toilet,” says Kata Farkas, a microbiologist at Bangor University. For a recent study tracking COVID-19 at U.K. airports, Farkas and her colleagues had to adjust their analytical methods, tweaking the chemicals and lab techniques used to isolate the coronavirus from plane sewage. Researchers also need to select flights carefully to make sure the data they gather are worth the effort of collecting them. To put it bluntly, not everyone poops on the plane—and if the total number of sampled passengers is very small, the analysis isn’t likely to return much useful data. “The number of conversations we’ve had about how to inconspicuously know how many people on a flight have gone into a lavatory is hysterical,” says Casandra Philipson, who leads the Concentric bioinformatics program. (Concentric later clarified that they do not have plans to actually monitor passengers’ bathroom use.) Researchers ended up settling on an easier metric: Longer flights tend to have more bathroom use and should therefore be the focus of wastewater testing. (Philipson and her colleagues also work with the CDC to test flights from countries where the government is particularly interested in identifying new variants.) [Read: Are our immune systems stuck in 2020?] Beyond those technical challenges, scientists face the daunting task of collaborating with airports and airlines—large companies that aren’t used to participating in public-health surveillance. “It is a tricky environment to work in,” says Jordan Schmidt, the director of product applications at LuminUltra, a Canadian biotech company that tests wastewater at Toronto Pearson Airport. Strict security and complex bureaucracies in air travel can make collecting samples from individual planes difficult, he told me. Instead, LuminUltra samples from airport terminals and from trucks that pull sewage out of multiple planes, so the company doesn’t need to get buy-in from airlines. Airplane surveillance seeks to track new variants, not individual passengers: Researchers are not contact-tracing exactly which person brought a particular virus strain into the country. For that reason, companies such as Concentric aren’t planning to alert passengers that COVID-19 was found on their flight, much as some of us might appreciate that warning. Testing airplane sewage can identify variants from around the world, but it won’t necessarily tell us about new surges in the city where those planes land. Airplane-wastewater testing offers several advantages for epidemiologists. In general, testing sewage is “dramatically cheaper” and “dramatically less invasive” than nose-swab testing each individual person in a town or on a plane, says Rob Knight, a medical engineering professor at UC San Diego who leads the university’s wastewater-surveillance program. Earlier this month, a landmark report from the National Academies of Sciences, Engineering, and Medicine (which Knight co-authored) highlighted international airports as ideal places to seek out new coronavirus variants and other pathogens. “You’re going to capture people who are traveling from other parts of the world where they might be bringing new variants,” Knight told me. And catching those new variants early is key to updating our vaccines and treatments to ensure that they continue to work well against COVID-19. Collecting more data from people traveling within the country could be useful too, Knight said, since variants can evolve at home as easily as abroad. (XBB.1.5, the latest variant dominating COVID-19 spread in the U.S., is thought to have originated in the American Northeast.) To this end, he told me, the CDC should consider monitoring large train stations or seaports too. [Read: The COVID data that are actually useful now] When wastewater testing first took off during the pandemic, the focus was mostly on municipal facilities, because they could provide data for an entire city or county at once. But scientists have since realized that a more specific view of our waste can be helpful, especially in settings that are crucial for informing public-health actions. For example, at NYC Health + Hospitals, the city’s public health-care system, wastewater data help administrators “see 10 to 14 days in advance if there are any upticks” in coronavirus, flu, or mpox, Leopolda Silvera, Health + Hospitals’ global-health deputy, told me. Administrators use the data in decisions about safety measures and where to send resources, Silvera said: If one hospital’s sewage indicates an upcoming spike in COVID-19 cases, additional staff can be added to its emergency department. Schools are another obvious target for small-scale wastewater testing. In San Diego, Rebecca Fielding-Miller directed a two-year surveillance program for elementary schools. It specifically focused on underserved communities, including refugees and low-income workers who were hesitant to seek out PCR testing. Regular wastewater testing picked up asymptomatic cases with high accuracy, providing school staff and parents with “up to the minute” information about COVID-19 spread in their buildings, Fielding-Miller told me. This school year, however, funding for the program ran out. Even neighborhood-level surveillance, while not as granular as sampling at a plane, hospital, or school, can provide more useful data than city-wide testing. In Boston, “we really wanted hyperlocal surveillance” to inform placements of the city’s vaccine clinics, testing sites, and other public-health services, says Kathryn Hall, the deputy commissioner at the city’s public-health agency. She and her colleagues identified 11 manhole covers that provide “good coverage” of specific neighborhoods and could be tested without too much disruption to traffic. When a testing site lights up with high COVID-19 numbers, Hall’s colleagues reach out to community organizations such as health centers and senior-living facilities. “We make sure they have access to boosters, they have access to PPE, they understand what’s going on,” Hall told me. In the nearby city of Revere, a similar program run by the company CIC Health showed an uptick in RSV in neighborhood wastewater before the virus started making headlines. CIC shared the news with day-care centers and helped them respond to the surge with educational information and PPE. [Read: Whatever happened to toilet plumes?] According to wastewater experts, hyperlocal programs can’t usher in a future of disease omnipotence all by themselves. Colleen Naughton, an environmental-engineering professor at UC Merced who runs the COVIDPoops19 dashboard, told me she would like to see communities with no wastewater surveillance get resources to set it up before more funding goes into testing individual buildings or manhole covers. The recent National Academies report presents a future of wastewater surveillance that includes both broad monitoring across the country and testing targeted to places where new health threats might emerge or where certain communities need local information to stay safe. This future will require sustained federal funding beyond the current COVID-19 emergency, which is set to expire if the Biden administration does not renew it in April. The United States needs “better and more technology, with a funding model that supports its development,” in order for wastewater’s true potential to be realized, Knight said. Airplane toilets may very well be the best first step toward that comprehensive sewage-surveillance future. Read More

The use of vitamin D supplements may reduce the risk of suicide attempts and self-harm in U.S. veterans, a new study says. In particular, Black veterans and those with low blood levels of vitamin D had the most significant response to the supplements. Read More

InnovationRx is your weekly digest of healthcare news. To get it in your inbox, subscribe here. Therapists at mental health startup Resilience Lab voted to unionize on Wednesday, one of the first successful unionization efforts at a digital health company. The move comes two months after the New York-based company announced a $15 million Series A led by Viewside Capital Partners and Morningside. The current and former employees I spoke to said there were growing concerns among employees after the company fired 12 therapists, changed the way the rest were paid and introduced third-party software to track patient progress. Read More

Whether you diffuse or blow-dry your locks, take advantage of the cool setting. A shot of cool air helps seal down the cuticle, resulting in more hold and less frizz. Sharpton agrees: “Use the cool setting to lock in the lift,” he adds. In fact, you may even want to switch on the cool setting mid blow-dry. “When you have the hair sectioned and it’s rolled around the brush, press the cool air button to cool the hair and set the style. This creates a look that will last,” he adds. Then to keep your style looking fresh for as long as possible, you’ll want to protect the strands while you sleep. Tossing and turning all night long is a recipe for flat, lifeless (not to mention tangled) locks. “One of the easiest ways to keep curls intact for longer is placing your hair into a ponytail at the front forehead with a scrunchy on top when you sleep.” Sharpton adds. “This helps keep the curls from getting roughed up while you sleep. Also, silk pillowcases can help reduce frizz.” Read More

Bullying is generally associated with children, but the last few years have given us ample examples of adults showcasing classic bullying behavior. Workplace bullying returned to the spotlight last year, when President Joe Biden’s top science adviser, Eric Lander, resigned following an investigation that found he had violated the White House’s Safe and Respectful Workplace Policy. (He’s not an outlier boss; in a national survey, the Workplace Bullying Institute found that 19% of adults said they’d personally been bullied by a higher-up or colleague, while another 19% said they’d seen it happen to someone else.) Read More

Love is in the air, and there’s nothing we love more than treating ourselves, our partners, and our friends on Valentine’s Day. And just like with other gift-giving holidays, brands are catching our eye by dropping some of their very best Valentine’s Day sales. We’re talking up to 80% off sex toys and clothing, up to 70% off fashion, and up to 50% off V-Day gifts from all your favorite brands like Lovehoney, Dame, Lelo, Madewell, J.Crew, and more. Keep on reading to see only la crème de la crème of offerings for the cutest and most romantic holiday of the year. Valentine’s Day Sex Toys Sales Up To 50% Off At Lovehoney Just in time for the big day, get up to 50% off select best-selling vibrators and lingerie sets at Lovehoney. Plus, build your very own date-night kit, and save up to $50 when you choose any two sex toys, a lube, and a cleaner — no promo codes needed. Up To 30% Off Lelo For a limited time only, get up to 30% off all R29-reader-favorite vibrators at Lelo. Up To 30% Off Bundles At Dame Get up to 30% off Dame bundles that include some of its bestsellers: the Pom and Eva vibrators, the arousal serum, the Alu lube, and more. 20% Off At Zalo Using the promo code HOLIDAYS, get 20% off on all of Zalo’s super-cute, royalty-inspired sex toys with an order of over $100. Spin To Win Savings At Boutique Bellesa For a limited time only, enter your email and spin to win anything from a free sex toy to sitewide discounts at Boutique Bellesa. Up To 80% Off Select Sex Toys At Pinkcherry Using the code LOVE, save up to 80% off top-rated vibrators, handcuffs, lubes, butt plugs, and more toys at Pinkcherry. Up To 25% Off At Mystery Vibe From today through February 15, get up to 25% off Mystery Vibe’s top-rated vibrators: theCrescendo the Poco, and the Tenuto. Valentine’s Day Fashion Sales Up To 60% Off At Lisa Says Gah For a limited time, get up to 60% off all fashion-forward styles from Lisa Says Gah’s sale. Extra 60% Off Sale At J.Crew Get an extra 60% off already discounted sweaters, shoes, and more at J.Crew with the promo code SALETIME. Extra 50% Off Sale At Madewell With the promo code GOODMOOD, get an extra 50% off already on-sale styles at Madewell. Up To 60% Off At Outerknown Save up to 60% off sustainable styles (including top-rated cashmere sweaters) at Outerknown. Up To 70% Off At Mango For a limited time only, save up to 70% off bestselling stylish coats, sweaters, and more at Mango. Up To 40% Off At Lo & Sons Starting today through Monday, get up to 40% off select Lo & Sons bestselling bags — including up to 30% Off the Catalina weekender collection and 35% off the Waverly 2 crossbody bag. Up To 40% Off Underwear & Socks At Pair Of Thieves From today through February 4, get up to 40% off any underwear-sock combination from Pair of Thieves. Save 20% off on three to five packs, 30% off six to nine packs, and 40% off 10 to 15 packs. Valentine’s Day Gifts Sales 25% Off Sitewide At Ban.do Ending on January 23, get 25% off clothes, desk accessories, stationery, and everything else at Ban.do. Up To 50% Off At Kate Spade Shop hundreds of marked-down Kate Spade purses, accessories, wallets, and more for up to 50% off. Up To 50% Off 1-800 Flowers For a limited time only, save up to 50% off  Valentine’s Day flowers, gifts, chocolates, and more at 1-800 Flowers. Up To 25% Off Bed & Bath At Society6 No need for promo codes to get 25% off all bed and bath essentials at Society6. 20% Off Sitewide At Skylar For a limited time, get 20% off all fragrances, bundles, and more at Skylar with the promo code VDAY2023. At Refinery29, we’re here to help you navigate this overwhelming world of stuff. All of our market picks are independently selected and curated by the editorial team. All product details reflect the price and availability at the time of publication. If you buy or click on something we link to on our site, Refinery29 may earn commission. Like what you see? How about some more R29 goodness, right here? Valentine's Day Gifts For Your Non-Binary Partner. The Best Sites For Funny-Sexy-Cute Valentine's Day. PSA: It's Time To Place Your Flower Orders. Read More

Of the dozens of hormones found in the human body, oxytocin might just be the most overrated. Linked to the pleasures of romance, orgasms, philanthropy, and more, the chemical has been endlessly billed as the “hug hormone,” the “moral molecule,” even “the source of love and prosperity.” It has inspired popular books and TED Talks. Scientists and writers have insisted that spritzing it up human nostrils can instill compassion and generosity; online sellers have marketed snake-oil oxytocin concoctions as “Liquid Trust.” But as my colleague Ed Yong and others have repeatedly written, most of what’s said about the hormone is, at best, hyperbole. Sniffing the chemical doesn’t reliably make people more collaborative or trusting; trials testing it as a treatment for children with autism spectrum disorder have delivered lackluster results. And although decades of great research have shown that the versatile molecule can at times spark warm fuzzies in all sorts of species—cooperation in meerkats, monogamy in prairie voles, parental care in marmosets and sheep—under other circumstances, oxytocin can turn creatures from rodents to humans aggressive, fearful, even prejudiced. Now researchers are finding that oxytocin may be not only insufficient for forging strong bonds, but also unnecessary. A new genetic study hints that prairie voles—fluffy, fist-size rodents that have long been poster children for oxytocin’s snuggly effects—can permanently partner up without it. The revelation could shake the foundations of an entire neuroscience subfield, and prompt scientists to reconsider some of the oldest evidence that once seemed to show that oxytocin was the be-all and end-all for animal affection. Cuddles, it turns out, can probably happen without the classic cuddle hormone—even in the most classically cuddly creatures of all. [Read: The weak science behind the wrongly named moral molecule] Oxytocin isn’t necessarily obsolete. “This shouldn’t be taken as, ‘Oh, oxytocin doesn’t do anything,’” says Lindsay Sailer, a neuroscientist at Cornell University. But researchers have good reason to be a bit gobsmacked. For all the messy, inconsistent, even shady data that have been gathered from human studies of the hormone, the evidence from prairie voles has always been considered rock-solid. The little rodents, native to the midwestern United States, are famous for being one of the few mammal species that monogamously mate for life and co-parent their young. Over many decades and across geographies, researchers have documented how the rodents nuzzle each other in their nests and console each other when stressed, how they aggressively rebuff the advances of other voles that attempt to homewreck. And every time they checked, “there was oxytocin, sitting in the middle of the story, over and over again,” says Sue Carter, a behavioral neurobiologist who pioneered some of the first studies on prairie-vole bonds. The molecular pathways driving the behaviors seemed just as clear-cut: When triggered by a social behavior, such as snuggling or sex, a region of the brain called the hypothalamus pumped out oxytocin; the hormone then latched on to its receptor, sparking a slew of lovey-dovey effects. Years of follow-up studies continued to bear that thinking out. When scientists gave prairie voles drugs that kept oxytocin from linking up with its receptor, the rodents started snubbing their partners after any tryst. Meanwhile, simply stimulating the oxytocin receptor was enough to coax voles into settling down with strangers that they’d never mated with. The connection between oxytocin and pair bonding was so strong, so repeatable, so unquestionable that it became dogma. Zoe Donaldson, a neuroscientist at the University of Colorado at Boulder who studies the hormone, recalls once receiving dismissive feedback on a grant because, in the words of the reviewer, “We already know everything that there is to know about prairie voles and oxytocin.” So more than a decade ago, when Nirao Shah, a neurogeneticist and psychiatrist at Stanford, and his colleagues set out to cleave the oxytocin receptor from prairie voles using a genetic technique called CRISPR, they figured that their experiments would be a slam dunk. Part of the goal was, Shah told me, proof of principle: Researchers have yet to perfect genetic tools for voles the way they have in more common laboratory animals, such as mice. If the team’s manipulations worked, Shah reasoned, they’d beget a lineage of rodents that was immune to oxytocin’s influence, leaving them unfaithful to their mates and indifferent to their young—thereby proving that the CRISPR machinery had done its job. That’s not what happened. The rodents continued to snuggle up with their families, as if nothing had changed. The find was baffling. At first, the team wondered if the experiment had simply failed. “I distinctly remember sitting there and just being like, Wait a sec; how is there not a difference?” Kristen Berendzen, a neurobiologist and psychiatrist at UC San Francisco who led the study, told me. But when three separate teams of researchers repeated the manipulations, the same thing happened again. It was as if they had successfully removed a car’s gas tank and still witnessed the engine roaring to life after an infusion of fuel. Something might have gone wrong in the experiments. That seems unlikely, though, says Larry Young, a neuroscientist at Emory University who wasn’t involved in the new study: Young’s team, he told me, has produced nearly identical results in his lab. The explanations for how decades of oxytocin research could be upended are still being sussed out. Maybe oxytocin can attach to more than one hormone receptor—something that studies have hinted at over the years, Carter told me. But some researchers, Young among them, suspect a more radical possibility. Maybe, in the absence of its usual receptor, oxytocin no longer does anything at all—forcing the brain to blaze an alternative path toward affection. “I think other things pick up the slack,” Young told me. That idea isn’t a total repudiation of the old research. Other prairie-vole experiments that used drugs to futz with oxytocin receptors were performed in adult animals who grew up with the hormone, says Devanand Manoli, a psychiatrist and neuroscientist at UCSF who helped lead the new study. Wired to respond to oxytocin all through development, those rodent brains couldn’t compensate for its sudden loss late in life. But the Stanford-UCSF team bred animals that lacked the oxytocin receptor from birth, which could have prompted some other molecule, capable of binding to another receptor, to step in. Maybe the car never needed gas to run: Stripped of its tank from the get-go, it went all electric instead. It would be easy to view this study as yet another blow to the oxytocin propaganda machine. But the researchers I spoke with think the results are more revealing than that. “What this shows us is how important pair bonding is,” Carter told me—to prairie voles, but also potentially to us. For social mammals, partnering up isn’t just sentimental. It’s an essential piece of how we construct communities, survive past childhood, and ensure that future generations can do the same. “These are some of the most important relationships that any mammal can have,” says Bianca Jones Marlin, a neuroscientist at Columbia University. When oxytocin’s around, it’s probably providing the oomph behind that intimacy. And if it’s not? “Evolution is not going to have a single point of failure for something that’s absolutely critical,” Manoli told me. Knocking oxytocin off its pedestal may feel like a letdown. But it’s almost comforting to consider that the drive to bond is just that unbreakable. Read More

Nonstop inflammation and immune problems top the list of potential causes of long COVID, but doctors say it’s growing clear that more than one factor is to blame for the wide swath of often debilitating symptoms that could last months or even years. Read More

The move comes after the startup, which raised $15 million in November, fired 12 therapists, changed the way the rest were paid and introduced new software to track patient progress. Read More

Being overweight in midlife has been linked to greater risk of developing Alzheimer’s disease or dementia, and a new study shows that brain changes in obese people mirror some of those with Alzheimer’s. Read More

In addition to seeking out a kelp-forward diet, following a Meditteranean eating plan can also help reduce your personal carbon footprint. New research published in the journal Environmental Health found that those who had higher adherence to the Mediterranean diet (which is high in fruits, vegetables, whole grains, beans, legumes, nuts, seeds, omega-3 rich fish, poultry, eggs, cheese, yogurt, olive oil, herbs, and spices) had lower dietary CO2 emissions. Following this eating pattern was also associated with lower land use, water consumption, and energy consumption. And like so many sustainable actions, this one is great for your personal health, too. (Read the research here.) Read More

You probably know some people who can fall asleep as soon as their head hits the pillow. For others, falling asleep can be a tedious task. Whether that’s because you simply aren’t tired, have a lot on your mind, can’t get comfortable, or anything else, these common sleep issues can rob you of rest. “Sleep is universally important and each sleeper has their own unique preferences for promoting sleep,” said Dr. Peter Polos, a sleep medicine specialist in New Jersey. “There are many elements that contribute to sleep onset and what works for one person may not work for the next, but the key is to find those elements that work for you and make an effort to maintain them at bedtime.” Read More

For all the legwork that public-health experts have done over the past few years to quash comparisons between COVID-19 and the flu, there sure seems to be a lot of effort nowadays to equate the two. In an advisory meeting convened earlier today, the FDA signaled its intention to start doling out COVID vaccines just like flu shots: once a year in autumn, for just about everyone, ad infinitum. Whatever the brand, primary-series shots and boosters (which might no longer be called “boosters”) will guard against the same variants, making them interchangeable. Doses will no longer be counted numerically. “This will be a fundamental transition,” says Jason Schwartz, a vaccine policy expert at Yale—the biggest change to the COVID-vaccination regimen since it debuted. Hints of the annual approach have been dropping, not so subtly, for years. Even in the spring of 2021, Pfizer’s CEO was floating the idea of yearly shots; Peter Marks, the director of the FDA’s Center for Biologics Evaluation and Research, teased it throughout 2022. This past September, Joe Biden officially endorsed it as “a new phase in our COVID-19 response,” and Ashish Jha, the White House’s COVID czar, memorably highlighted the convenience of combining a flu shot and a COVID shot into a single appointment: “I really believe this is why God gave us two arms.” Still, in today’s meeting, FDA officials were pushier than ever in their advocacy for the flu-ification of COVID vaccines. “We think that simplification of the vaccination regimen would contribute to easier vaccine deployment, better communication, and improved vaccine coverage,” Jerry Weir, the FDA’s director of the division of viral products, said at the meeting. The timing is important: After renewing the U.S.’s pandemic-emergency declaration earlier this month, the Biden administration seems set to allow its expiration this coming April. That makes the present moment awfully convenient for repackaging a chaotic, crisis-caliber vaccination paradigm as a scheduled, seasonal, normal-seeming one. A once-a-year strategy, modeled on a routine recommendation, suggests that “we’re no longer in emergency mode,” says Maria Sundaram, a vaccine researcher at the Marshfield Clinic Research Institute. Or at least, that’s the message that the public is likely to hear. But federal regulators may be trying to fit a COVID-shaped peg into a flu-shaped hole. The experts I spoke with largely agreed: Eventually, someday, annual autumn shots for COVID “will probably be sufficient,” says Gregory Poland, a vaccinologist at Mayo Clinic. “Are we ready for that yet? I’m not sure that’s the case at all.” Even in the short term, COVID-vaccination tactics need a revamp. “It’s clear above all that the current approach isn’t working,” Schwartz told me. Despite abundant supply, demand for COVID boosters in the U.S. has been abysmal—and interest seems to be declining with each additional dose. Last fall’s bivalent shot has reached the arms of only 15 percent of Americans; even among adults over 65—a majority of whom sign up for flu shots each fall—the vaccination rate hasn’t yet reached 40 percent. For most of the time that COVID shots have been around, figuring out when to get them has been a hassle, with different guidelines and requirements that depend on age, sex, risk factors, vaccination history, and more. Pharmacies have had to stock an absurd number of vials and syringes to accommodate the various combinations of brands and dose sizes; record-keeping on flimsy paper cards has been a total joke. “I do this for a living, and I can barely keep track,” Schwartz said. Recommendations on the proper timing and number of doses have also changed so many times that many Americans have simply checked out. After the bivalent recipe debuted, polls found that an alarming proportion of people didn’t even know the shot was available to them. Streamlining COVID-vaccine recommendations will remove a lot of that headache, Sundaram told me. Most people would need to keep only one mantra in mind—one dose, each fall—and could top off their flu and COVID immunity at the same time. Burdens on pharmacies and clinics would be lower, and communication would be far easier—a change that could make an especially big difference for those with children, among whom COVID-vaccine uptake has been the lowest. “It’ll be more scheduled, more systematic,” says Charlotte Hobbs, a pediatric infectious-disease specialist at the University of Mississippi Medical Center. COVID shots could simply be offered at annual well-child visits, she told me. “It’s something we already know works well.” The advantages of a flu-ified COVID shot aren’t just about convenience. If we have to shoehorn COVID vaccines into an existing paradigm, Sundaram told me, influenza’s is the best candidate. SARS-CoV-2, like the flu, is excellent at altering itself to dodge our defenses; it spreads readily in winter; and our immunity to infection tends to fade rather quickly. All of that adds up to a need for regularly updated shots. Such a system has been in place for decades for the flu: At the end of each winter, a panel of experts convenes to select the strains that should be targeted by the next formulation; manufacturers spend the next several months whipping up big batches in time for an autumn-ish rollout. The pipeline depends on a global surveillance system for flu viruses, as well as regular surveys of antibody levels in the community to suss out which strains people are still protected against. The premise has been so well vetted by now that researchers can skip the chore of running large-scale clinical trials to determine the efficacy and safety of each new, updated recipe. But a seasonal strategy works best for a seasonal virus—and SARS-CoV-2 just isn’t there yet, says Hana El Sahly, an infectious-disease physician at Baylor College of Medicine. Though flu viruses tend to hop between the globe’s hemispheres, alternately troubling the north and the south during their respective cold months, this new coronavirus has yet to confine its spread to one part of the calendar. (Marks, of the FDA, tried to address this concern at today’s meeting, asserting that “we’re starting to see some seasonality” and that fall was indeed the very sensible for an annual rollout.) SARS-CoV-2 has also been spitting out concerning variants and subvariants at a faster rate than the flu (and flu shots already have a hard time keeping up with evolution). The FDA’s new proposal suggests picking SARS-CoV-2 variants in June to have a vaccine ready by September, a shorter timeline than is used for flu. That still might not be fast enough: “By the time we detect a variant, it will have ripped through the global population and, in a few more weeks, died down,” El Sahly told me. The world got a preview of this problem with last year’s bivalent shot, which overlapped with the dominance of its target subvariants for only a couple of months. A flu model for COVID would make more sense “if we had stable, predictable dynamics,” says Avnika Amin, a vaccine epidemiologist at Emory University. “I don’t think we’re at that point.” Murkiness around vaccine effectiveness makes this transition complicated too. Experts told me that it’s gotten much more difficult to tell how well our COVID vaccines are working, and for how long, fueling debates over how often they should be given and how often their composition should change. Many people have now been infected by the virus multiple times, which can muddy calculations of vaccine effectiveness; better treatments also alter risk profiles. And many researchers told me they’re concerned that the data shortcuts we use for flu—measures of antibodies as a proxy for immune protection—just won’t fly for COVID shots. “We need better clinical data,” El Sahly told me. In their absence, the hasty adoption of a flu framework could lead to our updating and distributing COVID shots too often, or not often enough. A flu-ish approach also wouldn’t fix all of the COVID vaccines’ problems. Today’s discussion suggested that, even if a new COVID-shot strategy change goes through, officials will still need to recommend several different dose sizes for several different age groups—a more complex regimen than flu’s—and may advise additional injections for those at highest risk. At the same time, COVID shots would continue to be more of a target for misinformation campaigns than many other vaccines and, at least in the case of mRNA-based injections, more likely to cause annoying side effects. These issues and others have driven down interest—and simply pivoting to the flu paradigm “is not going to solve the uptake problem,” says Angela Shen, a vaccine-policy expert at Children’s Hospital of Philadelphia. Perhaps the greatest risk of making COVID vaccines more like flu shots is that it could lead to more complacency. In making the influenza paradigm a model, we also threaten to make it a ceiling. Although flu shots are an essential, lifesaving public-health tool, they are by no means the best-performing vaccines in our roster. Their timeline is slow and inefficient; as a result, the formulations don’t always match circulating strains. Already, with COVID, the world has struggled to chase variants with vaccines that simply cannot keep up. If we move too quickly to the fine-but-flawed framework for flu, experts told me, it could disincentivize research into more durable, more variant-proof, less side-effect-causing COVID shots. Uptake of flu vaccines has never been stellar, either: Just half of Americans sign up for the shots each year—and despite years of valiant efforts, “we still haven’t figured out how to consistently improve that,” Amin told me. Whenever the COVID-emergency declaration expires, vaccination will almost certainly have to change. Access to shots may be imperiled for tens of millions of uninsured Americans; local public-health departments may end up with even fewer resources for vaccine outreach. A flu model might offer some improvements over the status quo. But if the downsides outweigh the pluses, Poland told me, that could add to the erosion of public trust. Either way, it might warp attitudes toward this coronavirus in ways that can’t be reversed. At multiple points during today’s meeting, FDA officials emphasized that COVID is not the flu. They're right: COVID is not the flu and never will be. But vaccines can sometimes become a lens through which we view the dangers they fight. By equating our frontline responses to these viruses, the U.S. risks sending the wrong message—that they carry equal threat. Read More