Buttigieg’s order grounding private drone flights in flood zones crashes and burns: ‘Hiding something’

 Transportation Secretary Pete Buttigieg ordered private drone flights suspended in North Carolina’s Hurricane Helene flood zone, sparking fierce outcry from those frustrated by the government’s lackluster response to the deadly crisis.

“Drone pilots: Do not fly your drone near or around rescue and recovery efforts for Hurricane Helene,” the official DOT X account wrote Tuesday afternoon, nearly a week after the storm brought near-unprecedented flooding to the mountainous region.

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Transportation Secretary Pete Buttigieg ordered private drone pilots to keep their aircraft away from rescue zones, drawing sharp criticism from many who are unimpressed with the government’s efforts.x/USDOT/

“Interfering with emergency response operations impacts search and rescue operations on the ground,” the announcement continued.

North Carolina has suffered the brunt of the death toll from last week’s historic storm, the west of the state accounting for 94 of the more than 200 casualties confirmed by authorities so far, with hundreds more still unaccounted for.

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Despite these grim figures, many have expressed deep dissatisfaction or even anger with the tepid response from the Federal Emergency Management Agency (FEMA), which is on the verge of running out of funds after spending $640 million on the migrant crisis.

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FEMA teams have rescued more than 2,100 people in their post-storm response efforts so far, but many have criticized the agency for not acting faster.x/SecretaryPete

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Of the more than 200 deaths confirmed in the storm so far, at least 94 were from Western North Carolina.x/fema

Considering the maddeningly slow pace of the rescue effort, Buttigieg effectively ordered residents not to fend for themselves and instead put their trust in an agency many believe have already dropped the ball was adding insult to injury.

“You would think more eyes in the sky would be a good thing when there are people that need to be rescued but what do i know,” one X user replied.

“Your ‘help’ is worse than doing nothing,” seethed another.

Others pointed out how private drones have been used to deliver items like insulin and baby formula to those in need, particularly those living in more remote terrain who have been largely cut off from the rest of the world since the storm.

“Private citizen drones and helicopters have been saving lives for days, and still are. You should be ashamed,” said another user.

Some users felt the order was an effort to prevent citizen journalists from capturing the true extent of the damage on film.

“You’re hiding something,” a poster said accusingly.

Buttigieg also suffers a credibility problem in the eyes of many — his tenure as transportation secretary has been plagued by almost continuous problems, from Boeing’s free-fall to the collapse of the Francis Scott Key bridge to rampant supply chain disruptions on the US West Coast and elsewhere.

https://nypost.com/2024/10/03/us-news/buttigiegs-order-grounding-private-drones-in-hurricane-helene-flood-rescue-zones-crashes-and-burns/

U.S. School-Entry Vaccination Rates Fall as Exemptions Keep Rising

 U.S. kindergarten vaccination rates dipped last year and the proportion of children with exemptions rose to an all-time high, according to federal data

opens in a new tab or window posted Wednesday.

The share of kids exempted from vaccine requirements rose to 3.3%, up from 3% the year before. Meanwhile, 92.7% of kindergartners got their required shots, which is a little lower than the previous 2 yearsopens in a new tab or window. Before the COVID-19 pandemic the vaccination rate was 95%, the coverage level that makes it unlikely that a single infection will spark a disease cluster or outbreak.

The changes may seem slight but are significant, translating to about 80,000 kids not getting vaccinated, health officials say.

The rates help explain a worrisome creep in cases of whooping cough, measlesopens in a new tab or window, and otheropens in a new tab or window vaccine-preventable diseases, said Raynard Washington, PhD, MPH, chair of the Big Cities Health Coalition, which represents 35 large metropolitan public health departments.

"We all have been challenged with emerging outbreaks ... across the country," said Washington, the director of the health department serving Charlotte, North Carolina.

CDC data show that coverage with the measles, mumps, and rubella (MMR); diphtheria, tetanus, and acellular pertussis (DTaP); polio; and chickenpox vaccines decreased in more than 30 states among kindergartners for the 2023-2024 school year, Washington noted.

Public health officials focus on vaccination rates for kindergartners because schools can be cauldrons for germs and launching pads for community outbreaks.

For years, those rates were high, thanks largely to school attendance mandates that required key vaccinations. All U.S. states and territories require that children attending child care centers and schools be vaccinated against a number of diseasesopens in a new tab or window, including, measles, mumps, polio, tetanus, whooping cough, and chickenpox.

All states allow exemptions for children with medical conditions that prevent them from receiving certain vaccines. And most also permit exemptionsopens in a new tab or window for religious or other nonmedical reasons.

In the last decade, the percentage of kindergartners with medical exemptions has held steady, at about 0.2%. But the percentage with nonmedical exemptions has inched up, lifting the overall exemption rate from 1.6% in the 2011-2012 school year to more than twice that last year.

The rates can be influenced by state laws or policies that make it harder or easier to obtain exemptions, and by local attitudes among families and doctors about the need to get children vaccinated. For example, according to CDC data, 14.3% of kindergartners had an exemption to one or more vaccines in Idaho. But fewer than 1% did in Connecticut and Mississippi.

Within states, clustering of unvaccinated kids can be even more concentrated in particular communities or schools, said Noel Brewer, PhD, a University of North Carolina professor of health behavior.

"People who are skeptical [about vaccines] tend to live close to one another and create the conditions for a breakthrough of measles and other diseases," he said.

The slide in vaccination rates was not unexpected. Online misinformationopens in a new tab or window and the political schismopens in a new tab or window that emerged around COVID-19 vaccines have led more parents to question the routine childhood vaccinations that they used to automatically accept, experts say.

A decrease has already been reported in Louisville, Kentucky -- a city that has been celebratedopens in a new tab or window as a vaccination success story. And a CDC report last week noted a decline in vaccination rates for 2-year-olds.

Measles and whooping cough cases are at their highest levels since 2019, and there are still 3 months left in the year. And 200 flu-associated pediatric deaths were reportedopens in a new tab or window in the 2023-2024 season, the most since 2009.

Charlotte's Mecklenburg County this year saw North Carolina's first measles case since 2018. Mecklenburg also saw 19 whooping cough infections and three people with mumps earlier this year, said Washington, who noted the county usually sees none.

Increases in international travel and people moving to the Charlotte area from other countries raise the risk of introduction of vaccine-preventable diseases, "so it's concerning when you start to lose coverage of vaccines among your population," Washington said.

https://www.medpagetoday.com/pediatrics/vaccines/112245

Hospitals Still Feeling Impacts of Hurricane Helene

 A week after Hurricane Helene wreaked havoc across the Southeast, the storm's impact on healthcare continues.

Hospitals in states including Tennessee, North Carolina, Florida, and Georgia have all felt the effects to varying degrees.

For instance, in Erwin, Tennessee, dozens of people were rescued from Unicoi County Hospital after waiting for hours on the roof of the building and in lifeboats due to rising floodwaters, NBC News reportedopens in a new tab or window.

"We all eventually started kind of panicking because water just kept rising, and we didn't know when we would get rescue to us," Angel Mitchell, 46, whose 83-year-old mother had been admitted days earlier for pneumonia, told NBC News. "We all started kind of getting really scared that the whole building was going to be under [water] or it was going to collapse."

Ultimately, it took rescue boats and helicopter crews from the Tennessee Army National Guard and Virginia State Police to safely transfer people out of the facility, NBC News reported.

In western North Carolina, Asheville's Mission Hospital operated on a backup generator for several days before power was restored, North Carolina Health News reportedopens in a new tab or window. However, water still remains a challenge.

One nurse told NBC Newsopens in a new tab or window that the "entire water infrastructure to the area was obliterated," adding that the sewage system was so backed up it wasn't possible to flush toilets at the hospital.

"We were pooping in bags and buckets," the nurse said, adding that the lack of water also meant they couldn't help patients who were drenched in floodwater saturated with gasoline, chemicals, and other toxins to get cleaned up.

Mission Hospital still has "no pressurized water," Nancy Lindell, director of public and media relations for HCA Healthcare's North Carolina Division/Mission Health, told MedPage Today in an email.

HCA, which acquired Mission in 2019, said it has supplied more than 20 tanker trucks of water each day to keep clinical operations running. There are also plans for additional mobile units to be used as kitchens, bathrooms, handwashing stations, and laundry facilities on-site, according to reports.

The company has also bussed in healthcare workers from other states to provide relief to hospital staff who have been working long hours, and in some cases, unable to check on their own families and homes, North Carolina Health News reported.

"This is a difficult time and we are doing all we can to bring help and relief to those in need," Lindell told MedPage Today. "Our staff, all of whom have been personally affected by this storm, have been exceptional, and we are grateful for their dedication to our patients."

On Wednesday, HHS said that medical teams from the Administration for Strategic Preparedness and Response's National Disaster Medical System are providing care across western North Carolina to support local hospitals and shelters, and that, overall, approximately 300 personnel have been deployed in the region.

In Florida, hospitals along the Gulf Coast and panhandle were well-prepared for Helene, AP reportedopens in a new tab or window. Mary Mayhew, president and CEO of the Florida Hospital Association, attributed the preparedness to experience from previous storms and statewide coordination.

For Tampa General Hospital, preparedness meant a temporary flood wall, called the AquaFence, to stay dry, the Washington Post reportedopens in a new tab or window. Tampa General invested in the barrier -- which can withstand 15 feet of storm surge -- in 2019, as the hospital is the only Level 1 trauma center in the region, the Post noted.

In neighboring Georgia, hospitals were affected by strong winds, AP reportedopens in a new tab or window. For instance, patients had to be moved to another part of Irwin County Hospital in Ocilla because a nearby gas station caught fire.

It's not just hospitals that are feeling the effects of Helene. An AP analysis of federal Medicare data showed that at least 540,000 people in Florida, Georgia, South Carolina, Tennessee, and North Carolina use in-home medical equipment powered by electricity. (Power outages battered the Southeast during and after the storm.)

Healthcare executives across the Southeast said it will be a long road back to normalcy. North Carolina Health News noted that emergency crews "are still rescuing people; floodwaters stewing with storm debris, runoff, and removal of downed trees pose health risks for people as they move around more."

https://www.medpagetoday.com/special-reports/features/112244

As #Mouthtape for Sleep Apnea Takes Off, Research Raises Concern for One Group

 Mouth closure during sleep worsened airflow in some patients with obstructive sleep apnea (OSA), according to a study that cast doubt on a viral trend for "mouth taping" in an attempt to treat the condition.

When researchers manually closed the mouths of 54 study participants during a drug-induced sleep, overall inspiratory flow rose by 27.8 percentage points (1.0 L/min, 95% CI 0.4-1.9), a benefit limited to those with a moderate amount of mouth breathing, reported Daniel Vena, PhD, of Brigham & Women's Hospital and Harvard Medical School in Boston, and colleagues in JAMA Otolaryngology-Head & Neck Surgeryopens in a new tab or window.

However, manually keeping the mouth closed actually worsened airflow by some 40 percentage points for the 12 patients who relied the most on mouth breathing, dropping it by 1.86 L/min (95% CI -3.1 to -0.6) among those with more than 2.2 L/min oral airflow on a normal breath during sleep.

Given that disrupted airflow, "the study suggests caution in universally applying therapies to prevent mouth breathing in OSA patients," Vena told MedPage Today. "Further clinical studies are required. Meanwhile, clinicians should closely monitor the effect of therapies for preventing mouth breathing to ensure they are not worsening the condition."

According to a commentaryopens in a new tab or window accompanying the study, thousands of TikTok videos are touting the value of mouth closure on OSA symptoms. Videos on the social media platform that use the hashtag #mouthtape -- referring to taping the mouth shut with surgical tape to prevent mouth breathing -- have drawn 7 million views, the commentary says, although it doesn't cite a source for the data.

"There's limited objective data available on forced mouth closure during sleep, and worse, on the lack of protocols and regulations to ensure its appropriate implementation," wrote commentators Jeffrey Chadwick, DDS, MSc, PhD, of the University of Texas Health Science Center at Houston, and Andrew Huang, MD, of Baylor College of Medicine in Houston.

The nonrandomized clinical study didn't specifically examine mouth taping, but instead explores its presumed effect – obstruction of mouth breathing.

Staff members induced sleep via medication in order for routine clinical endoscopies to be performed, and staff members briefly closed the mouths of subjects in order to measure the impact on airflow. "The drug-induced sleep aspect is important because it allowed us to apply pressure to the chin, using our hands to close the mouth, without the patient waking up. We knew the mouth was closed when we felt the teeth touch," Vena said.

"We did mouth closure on alternating breaths," he added. "On breath 1, we closed the mouth. Once that breath was completed, we released and allowed the mouth to resume the relaxed position for breath 2. At the end of breath 2, we then closed the mouth again for breath 3 and relaxed for breath 4. We did this as many times as we could up to about 15 breaths or so."

This strategy allowed researchers to determine whether patients were aroused due to changes in airflow.

Mouth closure was harmful to mouth-breathers and patients with severe obstruction in the soft palate, part of the airway between the nasal cavity and the oral cavity, Vena said.

"Patients with severe soft palate obstruction tended to mouth breathe the most and had a negative response to mouth closure," he told MedPage Today. "Our explanation is that severe soft palate obstruction makes it harder to breathe along the nasal route, which passes through the soft palate. These patients compensate by breathing through the mouth to bypass the soft palate obstruction. When you close the mouth and force them to breathe nasally, the obstruction at the soft palate leads to reduced airflow."

On the other hand, the most benefit tended to be among patients with collapse at the oropharyngeal lateral walls in the throat behind the mouth, he said.

The commentary authors wrote that "these findings highlight the danger of recommending the universal application of mouth taping during sleep."

For the 2021-2022 study, researchers enlisted 54 patients who were a median 55 years old, with a BMI of 28.9, and apnea-hypopnea index 26.9 events/hour, and 72.2% of whom were male. Another 54 patients were excluded because they would wake up when their mouths were closed, and 12 because their airflow was already too limited.

Researchers reported that the mouth-closure maneuver successfully stopped almost all mouth breathing.

In 32 patients with moderate levels of mouth-breathing (pre-maneuver oral airflow 0.05-2.2 L/min), mouth closure was beneficial, increasing air flow by 53.1 percentage points (2.0 L/min). It had no impact on those who usually breathed through their nose during sleep.

The researchers noted study limitations including the fact that sleep was induced by a drug (propofol). Also, it was an acute outcome of mouth closure in single breaths, "which does not reflect the longer-term outcome of mouth closure," they added. In addition, "we did not measure the contribution of nasal obstruction to open-mouth breathing, which may be important."

Disclosures

Vena reported grants from the American Heart Association supporting the study and from the National Heart, Lung, and Blood Institute. He also reported personal fees from Inspire Medical.

Other study authors reported grants that supported the study from the Korean government, National Institutes of Health, American Academy of Sleep Medicine, and the National Heart, Lung, and Blood Institute. They also reported multiple and various relationships with industry.

Chadwick and Huang had no disclosures.

Primary Source

JAMA Otolaryngology-Head & Neck Surgery

Source Reference: opens in a new tab or windowVena D, et al "Mouth closure and airflow in patients with obstructive sleep apnea: a nonrandomized clinical trial" JAMA Otolaryngol Head Neck Surg 2024; DOI: 10.1001/jamaoto.2024.3319.

Secondary Source

JAMA Otolaryngology-Head & Neck Surgery

Source Reference: opens in a new tab or windowChadwick JW, Huang AT "Should mouth taping and obstructive sleep apnea therapies be regulated?" JAMA Otolaryngol Head Neck Surg 2024; DOI: 10.1001/jamaoto.2024.2564.

https://www.medpagetoday.com/pulmonology/sleepdisorders/112246

2nd Major Union Dumps Harris As Firefighters Votes No Endorsement

 Two weeks ago the Teamsters Union announced that they would not endorse a presidential candidate this year for the first time since 1996, after internal polling revealed that 58% of its members back Trump vs. 31% for Harris.

Today, the International Association of Firefighters (IAFF) - which was the first major union to endorse Joe Biden in the 2020 election - became the second major union to abstain from endorsing a candidate, after taking "unprecedented steps to hear our members' views on the candidates and the policy issues that matter most to them."

The IAFF represents over 300,000 career firefighters and emergency responders.

"The IAFF Executive Board determined that we are better able to advocate for our members and make progress on the issues that matter to them if we, as a union, are standing shoulder-to-shoulder," IAFF General President Edward Kelly said in a statement.

"This decision, which we took very seriously, is the best way to preserve and strengthen our unity."

As Politico notes, this is significant:

IAFF’s late non-endorsement — with votes already being cast in some states — carries particular weight given that the union was the first to endorse President Joe Biden at the outset of his campaign to defeat Donald Trump in 2019. That was partly due to Biden’s decades-long ties with IAFF and its then-leader, Harold Schaitberger, who stepped aside in 2021.

Under Schaitberger the IAFF had also preliminarily planned to endorse Hillary Clinton’s 2016 campaign but scuttled the idea after taking stock of its membership, The New York Times reported in 2015.

And to think, Harris's campaign mocked VP candidate JD Vance after a few people booed him at the firefighters union conference...

https://www.zerohedge.com/political/2nd-major-union-dumps-kamala-international-association-firefighters-votes-no-endorsement