Alphabet's Verily plans cost cuts amid pressure on Other Bets unit

 Alphabet's health science unit is planning additional expense cuts after losing more money than expected so far this year, the Wall Street Journal reported on Wednesday, citing an internal presentation.

Verily Life Sciences posted wider-than-expected operating losses through June, missing its projections by $17 million, the report said. Last year, operating losses totaled $568 million on revenue of $559 million.

Part of Google parent Alphabet's Other Bets unit, which was born out of the Google X research program in 2015, Verily already laid off employees and discontinued some products earlier this year, the report added.

Alphabet and Verily did not immediately respond to Reuters requests for comment.

The Other Bets businesses, which have racked up more than $30 billion in losses since Alphabet began separately reporting their financial performance, now feel pressure to rein in spending and turn their research into commercial profits, the report said, citing people familiar with their operations.

According to the report, Verily's chief financial officer, Utpal Koppikar, told employees last week that the company was performing below expectations, but Google would still provide additional funding if necessary.

In January, Verily laid off more than 200 employees, or about 15% of its workforce, marking the first time in at least six years when Alphabet or its affiliate announced job cuts.

https://au.news.yahoo.com/alphabets-verily-plans-cost-cuts-041532409.html

'Extreme heat may mean using a different sunscreen'

 Are you using the right sunscreen?

With world temperatures reaching record highs this summer - experts say you might need to think twice.

Sunscreens aren't all the same - and during extreme heat - those differences can matter.

There are two major types.

Mineral sunscreens create a physical barrier that reflects UV light before it penetrates the skin.

They're not absorbed, so older formulas often felt greasy - and left that iconic white cast.

Chemical sunscreens form a thin protective film that absorbs UV rays and changes their structure.

If your sunscreen comes in the form of a lighter cream or spray - it might be this.

But according to the American Academy of Dermatology -

you'll want to reach for mineral sunscreens during heatwaves...

when temperatures hit 90 degrees Fahrenheit or above - with high humidity.

That's because chemical sunscreens can lose their filtering abilities when exposed to extremely high temperatures.

And it's not just about choosing the right sunscreen - habits matter too.

Many people only apply about 20% to 50% of the sunscreen they need.

Adults need one ounce of sunscreen, about a shot glass full.

And dermatologists recommend a double layer for your face, or anywhere else that's more exposed.

Sunscreens should usually be reapplied every two hours, and after swimming or sweating.

But you'll be sweating more during a heatwave, so you need to reapply more often.

They also say, leaving your sunscreen out in the heat can decrease its efficacy, so try storing it in a cool dark place.

https://news.yahoo.com/extreme-heat-may-mean-using-202943020.html

Bidens staying at Lake Tahoe home of climate activist Tom Steyer

 President Joe Biden, his wife Jill, son Hunter and other family members have arrived at Lake Tahoe for a week of August vacation, and they are staying at a home rented from billionaire climate activist Tom Steyer.

The Bidens arrived late on Friday in the Glenbrook community on the eastern shore of the lake, on the Nevada side. Steyer and his wife, Kat Taylor, own the home but are not present.

Steyer ran for the Democratic presidential nomination in 2020 but failed to gain traction and dropped out after the first four state contests. Biden eventually won the nomination and went on to defeat incumbent Republican Donald Trump.

The White House said the Bidens are renting the home at fair market value.

Biden's son, Hunter Biden, flew separately on a commercial flight with his wife Melissa Cohen and their son Beau and were already at the residence when the other Bidens arrived, the White House said.

Hunter Biden is facing a special counsel investigation on tax evasion charges. President Biden, asked about the case at a Camp David news conference on Friday, declined comment.

Biden is to travel to Hawaii on Monday to get a firsthand look at the destruction wrought by wildfires that killed dozens of people in Maui.

https://news.yahoo.com/bidens-staying-lake-tahoe-home-153514290.html

The rise of anti-trans bills in the U.S.

 Lawmakers in 37 U.S. states have introduced at least 142 bills to restrict gender-affirming healthcare for trans and gender-expansive people this year, nearly three times as many as last year.

Four-fifths target gender-affirming care for trans children under 18, while the remainder target adults or anyone regardless of age. Reuters has reviewed the bills, taking stock of where they stand in the approval process, the treatments they seek to restrict and the penalties they would impose.

SB 14

Texas governor Greg Abbott on June 2 signed into law SB 14, which bars transgender children under 18 from receiving hormone therapies and puberty blockers. It goes into effect next month.

Gender-affirming care covers a range of steps to support a person's gender identity, from adopting a different name and pronouns to counseling. Around the start of adolescence, it can include medical treatment such as puberty blockers, hormones, and later, in some cases, surgery.

Donna Campbell, a Republican Texas state senator and one of the sponsors of SB14, said in April after the legislation passed that it aims to "protect Texas children from harmful, medically unnecessary gender modification treatments."

SB 14 bans certain procedures only if they are performed for the purpose of "affirm[ing] a person's perception of his or her sex if that perception is inconsistent with the person's sex." A third of the 142 bills introduced this year have such restrictions.

"If you, as the parent of a 16-year-old, want your child to have breast augmentation because she wants a larger bosom and she is a cisgender girl, she can do it," said Dr. Diana Finkel, associate professor of medicine at Rutgers University Medical School, noting that the law would ban a trans girl from having the same surgery.

In a series last year, Reuters found that the number of children seeking gender-affirming medical care in the form of puberty blockers and hormone treatments has risen sharply in recent years. U.S. clinicians who provide gender-affirming care for minors broadly support medical interventions for adolescents when appropriate. But they also say there is a need for more research on the long-term efficacy and safety of such treatments, Reuters reported.

The World Professional Association for Transgender Health (WPATH), a global body of doctors and other experts specialized in treating trans and gender-diverse people, emphasizes the need for comprehensive assessments of an adolescent's medical and mental health history to determine whether their gender-affirming care should include medical interventions.

In its most recent guidelines from last September, WPATH also noted that "despite the slowly growing body of evidence supporting the effectiveness of early medical invention, the number of studies is still low" and that there are few studies that follow children into adulthood.

In March, WPATH decried the "broad and sweeping legislation" in many U.S. states seeking to ban access to gender-affirming care and noted that such care covers a wide range of support, not just medical interventions. Such legislation was "in direct contradiction to decades of research and numerous studies touting the overwhelming mental and physical health benefits of gender-affirming care," WPATH said.

22 BILLS PASSED

Indiana is among the 20 states where legislatures with Republican majorities have banned or restricted gender-affirming care for transgender minors.

The bills are part of a wave of anti-trans legislation, which includes bans on trans girls participating in girls’ sports and measures requiring trans people to use the bathroom corresponding to their sex assigned at birth. Conservative lawmakers have placed gender identity at the heart of a divisive political debate over cultural values, which range from what can be taught in schools to tougher abortion laws.

Many Republican legislators say they want to protect the rights of parents in raising their children and to uphold their religious beliefs, while Democrats say conservatives are undermining public education and targeting vulnerable groups and women's rights.

Three experts told Reuters that state-level bills are often seen as legislative testing grounds. Language in bills adopted in one state may surface in bills introduced in others or in Congress.

Indiana's SB 480, signed into law on April 5, establishes a precedent for wide-ranging bans on gender-affirming care, including puberty blockers, hormone therapy and procedures such as:

"augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation, hair reconstruction, or associated aesthetic procedures" for minors assigned male at birth; and "subcutaneous mastectomy, voice surgery, liposuction, lipofilling, pectoral implants, or associated aesthetic procedures" for minors assigned female at birth.

The law was partially blocked by a federal judge on June 16 following a lawsuit by the American Civil Liberties Union on behalf of four trans minors, their parents and an Indiana physician who provides gender-affirming care. The only part now in effect is the ban on gender-transition surgeries for minors.

The defendants in the lawsuit, which includes members of the Medical Licensing Board of Indiana, appealed the temporary order.

9 BILLS PASSED AT LEAST ONE CHAMBER

Bills that pass one chamber of a state legislature are sent to the other for approval. If a bill passes both chambers, it is sent to the governor who may sign it into law or veto it.

93 BILLS INTRODUCED

Five experts told Reuters that even the introduction of bills seeking to ban gender-affirming care can cause uncertainty within the trans community and deter doctors from providing treatment.

"The mere introduction of these bills sends a message to transgender people in their state that they are not welcome or that there is this organized force that is trying to kick them out of their state," said Vivian Topping, director of advocacy and civic engagement at Equality Federation, an organization that monitors U.S. state legislation affecting LGBTQ+ communities.

Two sponsors of the bills declined to answer Reuters' questions on the legislation and its impact. Thirty of them did not respond.

18 BILLS VETOED OR FAILED

Some bills don't get enough votes to pass both chambers during a legislative session. Bills also fail if a governor vetoes or declines to sign it into law.

RESTRICTING CARE FOR MINORS AND ADULTS

117 of the bills restrict gender-affirming care for trans children under the age of 18. Around 180,000 trans children aged 13-17 live in the states where lawmakers have introduced these bills, according to the Williams Institute, a research center at UCLA's Law School focused on gender identity law and policy.

Supporters of these bills say they are protecting children who are too young to understand the health impacts of such care.

One side effect in children who take puberty blockers can be a decline in bone density, but this can often be treated with vitamin D or calcium supplements.

"The latest study we have showed that the bone density was back to average for the age after about two or three years of hormone treatment," said Dr. Ole Petter Hamnvik, an endocrinologist at Brigham and Women's Hospital. "It is still an area we are actively researching."

A 2015 review of the effects of hormone therapy on trans people's fertility found that it may reduce reproductive capability. Those impacts may be reversed if the person stops taking hormones, but the loss of fertility can be permanent in some cases. Trans men can get pregnant and give birth.

The Endocrine Society, a global medical organization devoted to hormone research, says in its guideline for treating gender dysphoria that most adolescents have "sufficient mental capacity to give informed consent" to hormone therapy by age 16.

28 of the bills - or one in five - restrict care for adults or for anyone regardless of age. Nearly 400,000 people above 18 live in states where these bills have been introduced.

WHO IS PROHIBITED FROM PROVIDING OR RECEIVING CARE?

108 of the bills prohibit healthcare providers: Of these bills, 16 ban mental health professionals from providing, assisting, or making referrals for gender-affirming care.

22 bills provide anyone from providing or assisting care: Using broader language, these bills prohibit any "person or entity" from providing or assisting gender-affirming care.

9 apply to parents: Some bills would take away custodial rights of parents who consent to gender-affirming care for their children.

3 bills directly ban trans people from undergoing gender-affirming care: One bill bans trans children under 18 from undergoing gender-affirming care. Two bills — one in Oklahoma and one in South Carolina — ban trans people under 21 from undergoing such care.

The Oklahoma bill says it is "unlawful" for people under 21 to undergo gender-affirming care and that doing so is a felony carrying a minimum three-year prison sentence and maximum of life.

These bills have not yet passed.

EXPOSING PEOPLE TO CIVIL LIABILITY AND CRIMINAL CHARGES

84 of the bills carry civil liability. These bills would make it legal for third parties to sue people who provide or assist gender-affirming care.

"What this is meant to do is essentially incentivize massive amounts of lawsuits that are impossible to stop and to make it impossible for any provider to actually provide this care," said Alejandra Caraballo, clinical instructor at Harvard Law School.

76 bills suspend or revoke medical licenses: These bills would suspend or revoke licenses of healthcare professionals who provide gender-affirming care.

27 result in a felony charge: These bills would criminalize providing, assisting, or undergoing gender-affirming care. Twenty of them carry sentences ranging from four years to life.

As of publication, Reuters could not find cases where individuals were prosecuted under these laws.

MULTIPLE RESTRICTIONS

Almost 60% of bills contain multiple measures restricting gender-affirming care, from cutting health insurance coverage to revoking medical licenses and criminal charges. Eleven of them have already passed.

Experts in gender-affirming care say the expansive nature of these bills could affect many of the support networks for people who are transitioning.

Florida's S 254

The bill signed into law by Florida's Governor Ron DeSantis on May 17 bans gender-affirming care for trans minors and prohibits nonphysicians, such as nurse practitioners, from providing gender-affirming care to trans adults. According to Planned Parenthood, 80% of such care is administered by nurses.

A federal judge issued a preliminary injunction on June 6 that partially blocked this law, allowing three trans children to continue receiving puberty blockers. The state has appealed the injunction.

Thia law would remove custody from parents whose children receive gender-affirming care.

S 254 makes it a felony for healthcare practitioners to provide gender-affirming care for people under 18.

BANNING HEALTH INSURANCE COVERAGE

27 bills across 15 states — 4 of which have passed — would ban Medicaid or publicly funded health plans from covering gender-affirming care. 18 bills across 12 states — only one of which has passed — would ban private health insurers from doing the same.

According to the think tank Movement Advancement Project, Medicaid policies in 26 states and D.C. explicitly cover transition healthcare.

North Carolina's S 639

This North Carolina bill, introduced in April, prohibits providers receiving state funds from performing gender-affirming care for minors.

It bars government health plans from covering gender-affirming care.

This bill prohibits social workers, therapists and other mental health professionals from providing or "aiding and abetting" gender-affirming care for minors.

EXCEPTIONS TO GENDER-AFFIRMING CARE BANS

Most bills have exceptions to these bans, such as an exceptionally early onset of puberty.

One crucial exception: surgeries for intersex children, who are born with reproductive anatomy, chromosomes, or hormone levels that don't fit into strict binary understandings of male and female sex.

112 out of the 142 bills explicitly allow pediatric surgeries on intersex children, which more than 30 countries have condemned as "medically unnecessary surgeries" that violate human rights.

Tennessee's SB 1, which went into effect on April 1, bans doctors from providing gender-affirming care to trans minors and has exceptions for intersex children. In April, the U.S. Justice Department filed a complaint challenging the law, saying it violated the Fourteenth Amendment, which promises equal protection.

https://news.yahoo.com/rise-anti-trans-bills-u-174841512.html

The doctors, dentists and anthropologists striving to identify Maui's victims

 Inside a temporary morgue near the Maui County coroner's office, a team of specialists – including forensic pathologists, X-ray technicians, fingerprint experts and forensic dentists – labor 12 hours a day to identify the charred remains of the victims of this month's cataclysmic wildfire.

They are members of the federal Disaster Mortuary Operational Response Team program, or DMORT, deployed when a mass fatality incident overwhelms local authorities.

The team's breadth of experience underscores the difficulty of the task it faces. The number of victims is unknown, hundreds remain on lists of those missing, and in some cases the inferno has consumed all but the barest remnants of the bodies.

The work is vitally important, with families desperate to know the fate of their relatives – and to have a chance to say goodbye. The death toll in the devastated town of Lahaina has surpassed 100, but only a handful have been officially identified, emphasizing the long road ahead.

"It's so important for families to get their loved ones back – that's our mission, and when we make that happen, it's a great day," said Frank Sebastian, 68, the commander of the Maui DMORT and a retired medical examiner from the Seattle area.

There are 10 regional DMORTs around the United States, comprised of more than 600 civilian members, that spring into action for disasters as varied as airplane crashes, hurricanes and mass attacks such as the Sept. 11, 2001, hijackings.

While the work can be emotionally taxing, DMORT members already confront death in their day jobs as funeral directors, medical examiners and coroners. They are better equipped than most to compartmentalize their feelings and concentrate on the mission at hand.

"I deal with things that most people don't understand or couldn't process on a daily basis," said Kathryn Pinneri, a long-time DMORT member and pathologist who runs the forensic services department in Montgomery County, Texas.

MAUI CHALLENGES

The U.S. Department of Health and Human Services, which oversees DMORTs, has deployed three dozen members to Maui, including logistics staff and mental health specialists.

The agency also transported one of three Disaster Portable Morgue Units – some 22.5 tons of supplies and equipment to set up a fully functioning mortuary, including examination tables, x-ray machines and fingerprinting equipment.

Work is divided into two buckets: "postmortem" – analyzing remains – and "antemortem" – gathering information from surviving relatives.

Each day, search-and-rescue teams combing Lahaina bring suspected remains to the temporary morgue. Remains are typically assigned a "tracker" to stay with them through the entire process, according to Pinneri.

The remains then move from station to station, depending on their form. A human body, for instance, would be fingerprinted and have features such as hair color, height, weight and tattoos recorded. An X-ray might pinpoint useful details such as a hip implant; a dental examination can be compared to dental records.

Skeletal remains would be examined by forensic pathologists and anthropologists for clues. DNA samples have become a crucial tool; Sebastian said the Maui team has partnered with a company that can process DNA in just hours.

A separate group, known as a "Victim Identification Center" team, is helping to collect details from surviving relatives for possible matches: DNA swabs, the names of victims' dentists and whether fingerprint records might exist.

Fires present particular challenges. For instance, intensely burned bone fragments may no longer have usable DNA strands, according to Paul Sledzik, a forensic anthropologist and former DMORT commander. Dental records may have been destroyed in the blaze.

The Maui wildfire is what experts call an "open" disaster, in which the number of victims, and their identities, is uncertain and potentially unknowable, he said. In a "closed" disaster, those factors are known, such as a plane crash in which the airline has a list of passengers and crew.

"That's going to be a challenge in Hawaii, resolving the list of missing people," Sledzik said.

'OVERWHELMING'

The federal DMORT program was established in 1992, after USAir Flight 405 crashed on New York's Long Island, killing 27.

For years, teams responded to major transportation accidents, cemetery floods and natural disasters. But the Sept. 11, 2001, attacks represented a pivot point, when DMORT teams helped city authorities sift through thousands of remains.

"I think it was September 11 when people really began to realize how important this function was," said Dawn O'Connell, assistant U.S. secretary for preparedness and response for HHS. "We had hundreds of team members deployed for months."

"We do this work for the families," said Sledzik, who commanded a team dispatched to the Sept. 11 crash site near Shanksville, Pennsylvania. "We never use the term closure, because I've worked with enough families to know that doesn't exist, but we hope to provide them with the knowledge that their loved ones are gone."

In the wake of the attacks, cities and states began implementing mass fatality management plans, with some creating their own versions of DMORTs, Sledzik said. But federal teams remain essential for disasters in remote locations or those with fewer resources.

The missions can vary widely, and every disaster brings its own obstacles, team members said. DMORTs were sent to Puerto Rico in 2017, when Hurricane Maria killed nearly 3,000 people on the island. In 2020, teams were dispatched to New York as the city's hospital morgues and funeral homes were inundated with the dead at the height of the COVID-19 pandemic.

David Hunt, a funeral director in Indiana who commands two regional DMORTs, had to negotiate with the Haitian military following the catastrophic 2010 earthquake, when his mission was to identify and repatriate American victims.

"When I look back on it, I'm just a small-town funeral director, and just to be involved in some of these historical events...sometimes it's overwhelming," said Hunt, recalling how it felt to stand on the grounds of the World Trade Center in 2001.

Wildfires represent a relatively new response area for DMORTs; teams responded to the 2018 Camp fire that killed 85 in California and the 2020 Oregon wildfires.

But climate change, which scientists say will exacerbate wildfires, hurricanes and other natural disasters, may increase the frequency of mass fatality incidents.

"As we're starting to see this era of 'polycrisis,' making sure we have enough DMORT team members that we can deploy is going to be really important," O'Connell, the senior HHS official, said.

https://www.yahoo.com/news/doctors-dentists-anthropologists-striving-identify-100412750.html

US Has No Clear, Achievable Goal in Ukraine, Nor Does Anyone Else

 What’s the US goal in Ukraine? Is it doable? What about Russia’s goal? Ukraine’s?

The lead image is from the BBC article ‘People call us the Ghosts of Bakhmut’

Minus the troops, the setup in Ukraine is starting to look like the US fiasco in Vietnam, in Afghanistan, and Iraq.

None of hose actions had a clearly defined mission that was remotely achievable. Ukraine doesn’t either.

What is the US Mission?

• Stop Russia?
• Win back all the territory Ukraine lost?
• Get Ukraine in NATO?

If the mission is for Ukraine to win back all lost territory, then progress is torturously slow and haphazardly thought out.

Supplying more weapons could help. But the expense could be a nuclear response by Putin.

Is the mission to stop Russia’s advance? If so, that is not compatible with Ukraine’s goal of winning back 100% of the territory it lost.

To what extent is the US willing to keep paying for Ukraine’s goal if the US goal is not the same?

Russia’s initial thrust was to put a puppet regime in Kyiv, but that failed. Does anyone know what Russia’s goal is at this point?

Perpetual War

After many months and at great cost Russia finally captured the Ukrainian city of Bakhmut. The city was totally destroyed in the process. Now Ukraine is struggling to win it back.

This reminds me of fighting over meaningless hills just like the US did in Vietnam.

Journalist Peter Arnett’s Vietnam dispatch for the Associated Press: “It became necessary to destroy the town to save it.”

On Feb. 10, an Oregon newspaper rendered it “We had to destroy the village in order to save it.” Two weeks later the St. Louis Post-Dispatch reported on a group of protesters carrying a banner that read, “It Was Necessary to Destroy the Village in Order to Save It.” In whatever form, the words had become a mantra of the anti-war movement, a quick and simple summary of what was wrong with the entire Vietnam adventure.

Arnett has always been adamant that he got the quote right, and I have no reason to doubt him. Still, I would be remiss if I failed to note that there are skeptics.

Peace for Territory?

Any time the US or EU brings up the notion of peace for territory, Ukraine’s president Volodymyr Zelenskyy goes off the rails, frequently accompanied by the battle cry, “We cannot reward Putin”.

At best, there are three conflicting goals, none of which is clearly defined other than Ukraine’s.

Complicating matters, Ukraine’s goal is not remotely achievable without massive US spending and risk of a nuclear confrontation with Putin.

Meanwhile, a stalemate can go on for quite a while, perhaps with a debate over the shape of the negotiating table.

That may sound ridiculous, but a lengthy debate over the shape of the table happened in the Vietnam War Peace Negotiations

Vietnam Peace Talks

One of the largest hurdles to effective negotiation was the fact that North Vietnam and the National Front for the Liberation of South Vietnam (NLF, or Viet Cong) in the South, refused to recognize the government of South Vietnam; with equal persistence, the government in Saigon refused to acknowledge the legitimacy of the NLF. Harriman resolved this dispute by developing a system by which North Vietnam and U.S. would be the named parties; NLF officials could join the North Vietnam team without being recognized by South Vietnam, while Saigon’s representatives joined their U.S. allies.

A similar debate concerned the shape of the table to be used at the conference. The North favored a circular table, in which all parties, including NLF representatives, would appear to be “equal”‘ in importance. The South Vietnamese argued that only a rectangular table was acceptable, for only a rectangle could show two distinct sides to the conflict. Eventually a compromise was reached, in which representatives of the northern and southern governments would sit at a circular table, with members representing all other parties sitting at individual square tables around them.

Can’t Leave Now

This takes me back to 7th grade memories when our teacher, Harry Don Wirth left mid-year for Vietnam. I recall him saying something to the effect “I don’t think we should be there, but we can’t leave now.”

The war was still going on when I graduated high school and two more years on top of that.

The US was in Vietnam for 8 years and Afghanistan for 20 years. What good became of either of them?

Eventually, the US left both countries, humiliated .

In this case, we don’t have troops in Ukraine, but we happily supply missiles. Importantly, it was US meddling in Ukraine in 2014, led by Senator John McCain and the CIA, that led to the mess we are involved in now.

That does not excuse Putin, but history is clear. US meddling in foreign affairs of other nations never leads to anything good.

Prolonged War is Inflationary

Ukraine in not in any position to be demanding anything from us. But without clearly defined goals, we keep cruising down the path of a prolonged if not perpetual war, with escalating costs.

It’s yet another inflationary aspect of US policy.

https://mishtalk.com/economics/the-us-has-no-clear-achievable-goal-in-ukraine-nor-does-anyone-else/

Maui fire survivors are confronting huge mental health hurdles, many while still living in shelters

 The evacuation center at the South Maui Community Park Gymnasium is now Anne Landon’s safe space. She has a cot and access to food, water, showers, books and even puzzles that bring people together to pass the evening hours.

But all it took was a strong wind gust for her to be immediately transported back to the terrifying moment a deadly fire overtook her senior apartment complex in Lahaina last week.

“It’s a trigger,” she said. “The wind was so horrible during that fire.”

Mental health experts are working in Maui to help people who survived the deadliest fire in the U.S. in more than a century make sense of what they endured. While many are still in a state of shock, others are starting to feel overcome with anxiety and post-traumatic stress that experts say could be long-lasting.

Landon, 70, has twice sought help in recent days to help her cope with anxiety. One psychologist she spoke with at an evacuation shelter taught her special breathing techniques to bring her heart rate down. On another occasion, a nurse providing 24/7 crisis support at her current shelter was there to comfort her while she cried.

“I personally could hardly talk to people,” she said. “Even when I got internet connection and people reached out, I had trouble calling them back.”

The person sleeping on the cot next to her, 65-year-old Candee Olafson, said a nurse helped her while she was having a nervous breakdown. Like Landon, Olafson fled for her life from Lahaina as the wind-whipped flames bore down on the historic town and smoke choked the streets. The trauma of the escape, on top of previous experience with depression, became too much to bear.

Anne Landon walks along a beach with her dog, LaVida in Kihei, Hawaii. (AP Photo/Rick Bowmer)

“Everything culminated — I finally just lost it,” she said.

Olafson said a nurse came over and told her, “Just look at me,” until she calmed down. Looking into the nurse’s eyes, she came back down to earth.

“These people pulled me out faster than I’ve ever been pulled out from the abyss,” she said.

What they witnessed as they fled will remain with them a long time — trauma that comes with no easy fix, something impossible to simply get over.

In this photo provided by Anne Landon, her dog LaVida rests on a cot in an evacuation shelter on the Hawaiian island of Maui. (Anne Landon via AP)

“I know some of the people died in the water when I was in the water,” said John Vea, who fled into the ocean to avoid the flames. “I have never seen anything like this before. I’m never gonna forget it.”

Dana Lucio, a licensed mental health counselor with the Oahu-based group Healthy Mothers, Healthy Babies Coalition of Hawaii, is among the experts working on Maui to help support survivors. She’s been going to different donation hubs around Lahaina on the western side of the island, and sometimes even door to door, to be present for people and give them a shoulder to cry on.

Lucio, who used to be in the Marine Corps and was deployed twice to Iraq and once to Afghanistan, said she’s able to understand some of their emotions because she has experienced post-traumatic stress herself.

“I can connect with them in a way that most people can’t,” she said of those affected by the fire. “The trauma therapy that I do, I’ve learned within myself.”

Global medical aid organization Direct Relief has been working with groups like Lucio’s to distribute medication to people who fled without their antidepressants and antipsychotic prescriptions, said its director of pharmacy and clinical affairs, Alycia Clark.

In a natural disaster, people often leave their medication behind during sudden evacuations. Downed cellphone towers and power outages can prevent them from contacting their doctors, and damage to health care clinics and a lack of transportation can all combine to complicate medical access, she said.

It can take weeks to find the right dose for a mental health patient and stopping medication suddenly can cause withdrawal symptoms, Clark said. For this reason, she added, Direct Relief includes mental health medication in most of its emergency and disaster response kits for those who are missing their prescriptions.

Lucio, the mental health counselor, said she hopes people think about treatment as something that’s long term, as the initial shock wears off and the awful reality sets in.

“This is not something their brains were prepared to understand,” she said. “There is going to be a need for ongoing therapy.”

https://apnews.com/article/hawaii-wildfires-maui-lahaina-mental-health-a7ed87701c314224bd4b20f8575b4608