TIME health

New Crisis Line Aims to Help Transgender People at Risk of Suicide

On 2014's annual day of remembrance for transgender victims of violence, a new hotline is ready to field calls

On Nov. 20, people are gathering at events around the nation to read names of transgender people who have died in the past year in violent crimes. The descriptions on the website for the occasion, the annual Transgender Day of Remembrance, are chilling: “massive trauma, found dead in an alley,” “murdered and burned,” “gunshot to the back.” Transgender people, particularly transgender women, are subject to high rates of violence and harassment. A 2013 report found that 72% of homicide victims in LGBT-related hate crimes were transgender women of color.

On this somber day, an organization based in the Bay Area is trying to get the word out that there’s a new resource available to fight what may be an even deadlier problem among transgender people: suicide.

According to the most definitive report on transgender issues in recent years, 41% of transgender people attempt to commit suicide, a statistic that doesn’t necessarily factor in successful attempts. That’s a number that the people behind Trans Lifeline (877-565-8860), a crisis hotline staffed entirely by transgender people, want to see decreased.

“There are a ton of suicide hotlines. There’s no shortage of them,” says Greta Martela, a software engineer and president of the organization that went live this month. “But it’s really difficult to get a person who isn’t trans to understand what it’s like to be trans.”

Empathy is a powerful emotion for people attempting to come to terms with being transgender. Many transgender people say they only had the courage to come out once they met someone else who was living a happy life as an openly transgender person, people Orange Is the New Black actress Laverne Cox calls “possibility models.”

Martela came out last year, as a 44-year-old parent. Before she did, she was plagued by anxiety and debilitating panic attacks. In the process of coming out, she called a suicide hotline. A man answered the phone, she says, and when she explained the trouble she was having, he just went quiet and told her to go to the hospital. “They had no idea how to deal with a trans woman,” she says. And when she got to the hospital seeking help, she had to explain what being transgender was to the hospital staff.

Her aim is to get people in crisis—whether that person is a suicidal, closeted teenager or the confused parent of a six-year-old—access to volunteers who can understand what they’re going through right away and direct them to more help wherever they are. “Those are the people I want to call the most,” Martela says of parents who are trying to understand what a child is going through. “Getting them good resources could spare their child a lifetime of pain.”

Right now, the corporation—which has applied for status as a non-profit—is a shoestring operation, fueled by open source software that allows Trans Lifeline to funnel calls to on-duty volunteers wherever they are. They’re raising funds for advertising to get their number out there, to people like Martela who couldn’t find anything like the hotline when she needed it. “There’s a body count associated with people not accepting trans people,” Martela told TIME in a previous interview for a cover story on transgender issues. “It’s costing lives.”

TIME Health Care

Obama Administration Boosted Obamacare Numbers With Dental Plans

Obamacare Expedited Bid Process Limited Who Could Build Website
Andrew Harrer—Bloomberg/Getty Images

Says it was a "mistake," having earlier counted dental plans separately

The Obama administration discreetly included dental plan sign-ups in its most recent report on the Affordable Care Act’s enrollment numbers.

The White House claimed in September that 7.3 million people had enrolled in insurance plans under Obamacare, surpassing President Obama’s 7 million sign-up goal. But investigators from the House Oversight and Government Committee analyzed these enrollments and found that as many as 400,000 of the plans were simply for dental coverage, Bloomberg reports. In earlier reports, the administration had counted dental plans separately.

Excluding dental plans, Obamacare enrollment would be around 6.7 million — missing the administration’s stated goal. The Department of Health and Human Services issued a statement Thursday calling the numbers a “mistake”:

A mistake was made in calculating the number of individuals with effectuated Marketplace enrollments. We have determined that individuals who had both Marketplace medical and dental coverage were erroneously counted in our recent announcements. The correct number of individuals with effectuated Marketplace medical coverage as of October 15 is approximately 6.7 million. Our target for 2015 open enrollment remains 9.1 million individuals. Moving forward only individuals with medical coverage will be included in our effectuated enrollment numbers.

U.S. Health and Human Service Secretary Sylvia Mathews Burwell called the error “unacceptable”

Burwell had perviously asserted that the success of Affordable Care Act should be measured by the U.S. uninsured rate, not the Obamacare enrollment numbers, which may fluctuate. The uninsured rate is down about four percentage points to 13.4% over the past year.

 

[Bloomberg]

TIME Infectious Disease

Africa Nears Polio Eradication, CDC Says

German Minister Mueller Travels Nigeria
German Development Minister Gerd Mueller vaccinates a child against polio in a hospital on June 11, 2014 in Abeokuta, Nigeria. Thomas Imo—Getty Images

Health officials credit successful vaccination efforts in Nigeria

Correction appended, November 21, 2014

Wild poliovirus has nearly been eradicated in Africa thanks to successful vaccination efforts in Nigeria, the Centers for Disease Control and Prevention revealed in a new report Thursday.

No case of polio has been recorded on the continent since August, the report finds. There have been 22 cases of polio in Africa overall since the beginning of 2014, six of which were in Nigeria, one of the last three endemic nations alongside Pakistan and Afghanistan. The latest tally marked a drastic reduction from 49 cases in Nigeria the previous year.

That drop has been credited to vaccination campaigns in the country’s restive northern states, where a decade of periodic outbreaks had reintroduced the virus to 26 polio-free countries. “Interrupting all poliovirus circulation in Nigeria is achievable,” the report finds, but only with expanded vaccination coverage to some of the region’s most remote and hard-to-reach communities.

Correction: The original version of this article misstated the total number of polio cases across Africa and how many countries were affected. There were 22 cases in Africa since the beginning of 2014 and the virus was reintroduced to 26 polio-free countries since 2003.

TIME Obesity

Obesity Now Costs the World $2 Trillion a Year

Half the world's population could be obese by 2030, warns a McKinsey Global Institute report

The global cost of obesity has risen to $2 trillion annually, according to a new report, more than the combined costs of armed violence, war and terrorism.

The McKinsey Global Institute report says currently almost 30% of the world’s population is obese, and that if present trends continue, that almost half the population will be clinically overweight or obese by 2030.

The report cautioned that no single solution would reverse the problem, instead calling for a “systemic, sustained portfolio of initiatives” to tackle the crisis, such as better nutritional label, healthier food at schools, advertising restrictions on fatty foods and beverages, and public health campaigns.

TIME Parenting

The 5 Trends Driving the Surge in ADHD

Jupiterimages;Getty Images

Researcher says it's less to do with brain chemistry and more to do with money

Until recently, 90% of all Ritalin takers lived in the U.S. Now, America is home to only 75% of Ritalin users. But that’s not because Americans are using less of the drug, says a Brandeis professor. That’s because ADHD diagnoses, and treatment via pharmaceuticals are growing in other parts of the world.

In a recent paper in the journal Social Science and Medicine, sociologists Peter Conrad and Meredith Bergey looked at the growth of ADHD in the United Kingdom, Germany, France, Italy and Brazil and found that prescriptions for Ritalin-like drugs have risen sharply, particularly in the U.K. and Germany.

Attention Deficit Hyperactivity Disorder, or ADHD, is a controversial subject among many parents, educators and medical professionals. Some doctors insist it’s a genuine neurological condition, if occasionally over-diagnosed and not treated properly. Others believe parents are giving their children drugs unnecessarily. (For a look at what it’s like to be, or parent, an ADHD child, read TIME’s special report, Growing Up with ADHD).

Conrad and Bergey, while not doctors, fall into the second camp. They list five possible reasons for the jump in ADHD diagnoses that have little do with medicine.

1) Pharmaceutical companies are well-resourced and determined lobbyists, and have coaxed some countries to allow stimulants, such as Ritalin and Adderall to be marketed more directly.

2) Treating patients with counseling and non medical therapies is becoming less popular than treating them with medicine. (Many insurers, including Medicaid, will pay for drugs but not for psychotherapy, for example.)

3) The Diagnostic and Statistical Manual (DSM), the bible of mental disorders, is gaining more traction in Europe and South America. The DSM has slightly broader standards for diagnosing ADHD than the system used by many other countries, the International Statistical Classification of Diseases and Related Health Problems (ICD), hence more folks are falling within the standard.

4) ADHD advocacy groups are raising awareness of the condition.

5) Because everybody is occasionally fidgety and distracted and nearly everybody despairs of not getting enough done, people turn to the internet for answers and find checklists put up by drug companies, with overly general questions like: “Are you disorganized at work and home?” and “Do you start projects and then abandon them?” and encourage people to ask their doctors about medication.


According to the study, fewer than 1% of kids in the U.K. had been diagnosed with ADHD in the 1990s, but about 5% are today. In Germany, prescriptions for ADHD drugs rose 500% over 10 years, from 10 million daily doses in 1998 to 53 million in 2008. Conrad, author of The Medicalization of Society, worries that we may be addressing a sociological problem with a chemical solution.

“There is no pharmacological magic bullet,” says Conrad, who suggests that the one-size-fits-all compulsory education system might be more to blame for kids who can’t sit still rather than a flaw in brain chemistry.

“I think we may look back on this time in 50 years,” writes Conrad, “and ask, what did we do to these kids?”

TIME Birth Control

Going Off the Pill Could Affect Who You’re Attracted to, Study Finds

New research shows that going off the pill could affect how attracted you are to your mate

Your birth control pill could affect your relationship, and not just because it halts baby-making. A new study published in the Proceedings of the National Academy of Science followed 118 couples who met while the woman was on hormonal birth control and found that going off the pill could impact how attracted she was to her partner.

Whether a woman’s attraction to her mate shifted post-Pill seemed to be determined by how objectively good-looking he was by evolutionary standards, which means his attractiveness is an indicator of genetic fitness. Some women with partners who were not conventionally attractive reported being less attracted to him after stopping oral contraceptives, whereas a decrease was not seen in women whose partners were conventionally handsome.

“Women who choose a partner when they’re on hormonal contraceptives and then stop taking them will prioritize their husband’s attractiveness more than they would if they were still on it,” says Michelle Russell, the Florida State graduate student who is the lead author on the study. “The effect that it would have on her marital satisfaction would carry more weight.” That means that if your husband is not conventionally attractive and you go off the Pill, his attractiveness might bother you more than before. Conversely, if you’re bored of your foxy husband, going off the Pill might make you more excited about him. Maybe.

Russell says the change may be attributed fluctuating estrogen levels, but says there could be many hormonal reasons for this effect. She also doesn’t suggest that this finding should dissuade women from using oral contraceptives. “This is just one finding,” she says.

Other studies have looked at how the Pill affects female attraction. A 2008 paper published in The Proceedings of the Royal Society B found that while women are usually attracted to the scent of men who are genetically different from them, women on the Pill are attracted to the scent of men who are more genetically similar. This may be because the Pill fools your body into thinking it’s pregnant, and pregnancy can affect attraction. In discussing the 2008 study, Scientific American hypothesized that while non-pregnant women would be more attracted to genetically dissimilar men (to avoid the possibility of incest and maximize immunity of their offspring,) women on the Pill may be more drawn to genetically similar men because pregnant women seek out family members.

Another study of 365 couples published this year in Psychological Science found that women who went on or off the Pill during a relationship were less sexually satisfied than women who were consistently on the Pill or who had never been on it.

While the exact mechanisms for how oral contraceptives affect female attraction aren’t totally clear, there is mounting evidence that hormonal birth control can affect more than just fertility. But scientists are not necessarily advocating that the risks outweigh the benefits. “Any drug that you take, people want to be informed consumers,” Russell says. “This is just one factor women might want to consider when deciding whether or not to use them.”

TIME Diet/Nutrition

Should I Eat Dark Chocolate?

Fact checking this superfood's health promises

Welcome to Should I Eat This?—our weekly poll of five experts who answer nutrition questions that gnaw at you.

Illustration by Lon Tweeten for TIME

5/5 experts say yes.

Oh, chocolate! Are you even debatable? The experts have spoken, and it appears not.

“You can, of course, overeat the stuff—but in moderate doses it is perhaps the quintessential example of a food to love that will love you back,” says David Katz, MD, director of the Yale University Prevention Research Center. “A considerable body of research, including several studies in my own lab, show decisive cardiovascular benefits with intake of dark chocolate,” he says, provided that it’s kept between one to two ounces.

Cocoa is rich in flavonols, bitter antioxidant compounds that have been shown to be good for the heart. Dark chocolate has been linked to lowering blood pressure and increasing anti-inflammatory activity, which helps protect against heart disease, says Augusto Di Castelnuovo, PhD, in the department of epidemiology and prevention at the IRCCS Istituto Neurologico Mediterraneo Neuromed in Italy. But his own study found that the positive effects vanish when you’re out of the moderate range, so keep dark chocolate to about 1.7 ounces per week and really savor it, he suggests.

If you fantasize about squashing stress with sweets, dark chocolate’s for you. A September 2014 study showed that people who ate dark chocolate were significantly less stressed when doing a stressful task two hours later than the group stuck with placebo chocolate. “Dark chocolate buffers endocrine stress responses to acute psychosocial stress induction apparently at the level of the adrenal gland,” says study author Petra H. Wirtz, PhD, professor in the department of psychology at the University of Konstanz in Germany. It appears dark chocolate is as downright destressing as a bubble bath.

Kristin Kirkpatrick, registered dietitian and manager of wellness nutrition services at Cleveland Clinic’s Wellness Institute, is also jazzed about its stress-busting effects. “A 2009 study found that having a small amount of dark chocolate actually helped to ease subjective stress in study participants,” she says. “This is significant because only a small amount was needed to gain results and it was a food that we know is high in healthy flavonols, as opposed to the normal stress foods like mac and cheese, candy and alcohol.”

OK, but what about those pesky percentages? They’re meant to indicate how much of the bitter cocoa bean is in your bar, along with the healthy flavonols that go along with them. Katz advises sticking to at least 60% cacao, and Kirkpatrick recommends at least 70%. A rule of thumb is that the higher, the darker, the healthier.

But Tod Cooperman, president of the independent tester of health products ConsumerLab.com, led a recent investigation that tested popular brands of dark chocolate and found that you can’t judge a chocolate by its wrapper. While many of them had high levels of flavanols, many did not, and you couldn’t always tell which kind you were getting from the percentage printed on the labels. That’s because the percentage is a sum of cocoa liquor, cocoa powder and cocoa butter—and cocoa butter does not contain flavanols, the report says.

“Some have as much as three times the concentration of flavanols as others,” he says. One of the 85% bars actually had fewer flavanols than a 72% bar. But some brands, like Ghirardelli and Endangered Species, were true to their percentages.

And in an interesting twist, they also found that dark chocolate bars might be safer for your health, in some ways, than pure cacao powder. “[ConsumerLab] found heavy metal contamination in many cocoa powders, so chocolate may be a safer choice for heavy users,” Cooperman says.

Sadly, the world is running out of chocolate just as we here at TIME are finally convinced to embrace it. Reader, can you spare a square?

TIME Obesity

You Exercise Less When You Think Life Isn’t Fair

The 'why try' effect gets in the way of weight loss

People who have been the target of weight discrimination—and who believe the practice is widespread—are more likely to give up on exercise than to try to lose weight, according to a new study published in Health Psychology.

The online study of more than 800 Americans specifically looked at whether participants believed in “a just world,” or in this case, the belief that their positive actions will lead to good results. People who experienced weight bias in the past and didn’t believe in a just world were more likely to say they didn’t plan to exercise than those who did believe the world is just. In a separate part of the study, participants primed with anecdotes designed to suggest that the world is unjust were more likely to say they didn’t plan to exercise.

Experiencing discrimination leads some people to adopt a pessimistic view of the world, and they accept negative stereotypes about themselves, including the belief that they’re lazy, said study author Rebecca Pearl. “When someone feels bad about themselves and is applying negative stereotypes to themselves, they give up on their goals,” said Pearl, a researcher at Yale University, referring to a phenomenon known as the “why try” effect.

It’s an area of conflicting research. Some previous studies found that weight discrimination leads to weight loss, while others concluded that weight discrimination discourages exercise. Belief in a just world may be the factor that distinguishes between the two, Pearl said. People who think their exercise will pay off are more likely to try.

Because believing in a just world is key to losing weight, Pearl said that legislation and other public policy efforts could act as a “buffer against loss of sense of fairness.”

“It’s important for doctors to be aware of what people are experiencing, to know that these experiences might have real effects on people’s confidence,” Pearl said.

TIME World

A CDC Epidemiologist Talks About Life on the Front Lines of the War Against Ebola

Redd, right, with local medical student Francis Abu Bayor.
Redd, right, with local medical student Francis Abu Bayor. Christina Socias—CDC

The CDC's Dr. John Redd spent weeks in Sierra Leone, combatting Ebola. He talks with TIME about the experience

Dr. John Redd, a captain in the U.S. Public Health Service, was sent in September by the Centers for Disease Control and Prevention (CDC) to Sierra Leone, one of the three West African countries most devastated by the Ebola epidemic. The 52-year-old was assigned to Makeni, the capital of the northern district of Bombali (pop. 434,000). After six weeks battling the deadly disease, Redd returned to his home in Santa Fe, N.M., where he described his experience to Time Inc. senior editorial adviser Richard B. Stolley.

 

THE ROLE OF CDC DOCTORS DEPLOYED TO FIGHT EBOLA IS NOT PATIENT CARE. WHY?

I am a medical epidemiologist, and epidemiologists control disease at a population level. I volunteered to go to Sierra Leone with CDC to help control the outbreak and support local efforts to slow it down.

 

WASN’T IT DIFFICULT FOR YOU NOT TO TREAT PATIENTS?

I was treating patients, but not one at a time. That’s public health. I was supporting the system of outbreak control so that there will ultimately be fewer patients to treat.

 

WHAT WAS YOUR GOAL?

To slow down the spread and reduce transmission, because that’s what really controls an outbreak like Ebola. It’s the public health measures that will end the outbreak, not treatment, as important as treatment is.

 

HOW DID YOU PROCEED?

First is case identification or case finding. That means helping local authorities find people in the community as early as possible who have the disease or may have it, moving them into holding centers so they are removed from their community while their labs are pending, and then sending patients who are positive to an ETU, Ebola Treatment Unit. That’s where personnel from Doctors Without Borders, the International Red Cross and other aid organizations work – the part of the Ebola system most people are familiar with.

 

WHAT WAS THE LOCAL MEDICAL INFRASTRUCTURE LIKE?

Though extremely under-resourced by American standards, there is an existing public health surveillance system, just as in the U.S., where we have systems to count cases of diseases like influenza. In Sierra Leone, it had been used for diseases other than Ebola, like malaria and typhoid fever. The country also has an existing clinical medical system, which starts with very small health stations in many villages. In my district there were more than 100 of those, leading all the way to the government hospital in Makeni.

 

WHAT WAS THE EBOLA SITUATION WHILE YOU WERE THERE?

We investigated more than 800 patients with suspected Ebola, and more than half were confirmed with the disease. There were over 100 deaths, but that is probably an underestimate. There’s a delay in reporting deaths from ETUs, and some deaths in rural areas are not reported. By the time I left, the numbers in our district had begun to decrease. But in -areas around Freetown—the capital of Sierra Leone—cases are still on the rise.

 

WHAT WAS YOUR FIRST CONTACT WITH A PERSON WITH EBOLA?

I saw my first patient the day after I arrived, through a window in a holding center in Makeni. We could not go inside. We had three holding centers with a total of 140 beds, with a physical gradation according to patient risk. In the middle of each center were confirmed patients waiting transit to an ETU in another district. They were vomiting, had diarrhea and were very weak. Anyone who treated those patients, mainly nurses from Sierra Leone, needed to be in full protective gear in spite of the heat – near 100ºF – and high humidity. Those nurses were incredibly heroic. There was another section for patients waiting for blood test results, and a third for patients being observed for 21 days after their tests turned out negative. This separation of patients, and the nursing procedures, were all designed to minimize the risk that someone who was negative could get the disease there.

 

WHEN DID YOU WITNESS YOUR FIRST EBOLA DEATH?

It was the same morning. As many as eight people were dying some days.

 

HOW DID THE SURVEILLANCE PROCESS WORK?

We had about 100 college and public health students from Sierra Leone, mostly men, some women, whose classes had been cancelled because of Ebola. For now, school isn’t happening in Sierra Leone. They were the team’s disease detectives. Every morning they would ride their motor bikes out to respond to alerts that a household member was ill or had died. They would call an ambulance to remove the body or take the patient to a holding center. We had only four ambulances, so sometimes we would have to ask patients to walk to the holding center. We had to be very practical about it. Then the surveillance officer would talk to the family about who might have come in contact with the patient. These contacts would be followed for 21 days.

 

WHERE WERE THESE FAMILIES LOCATED?

Mostly in the south of the district, around Makeni. But some were in villages in the rural north. Many did not have electricity, and most did not have running water or flush plumbing. Unfortunately these conditions are conducive to the transmission of Ebola.

 

THESE INVESTIGATORS WERE GOING HOUSE TO HOUSE AND LITERALLY KNOCKING ON DOORS?

That is correct.

 

YOU SEEM TO HAVE GOTTEN CLOSE TO THOSE YOUNG PEOPLE. HAVE YOU STAYED IN TOUCH?

Yes, especially with a med student named Francis Abu Bayor. We worked side by side over there, and we’ve been emailing since. He was the leader of the surveillance team and in charge of our database on all the patients. He was an absolute optimist. His phrase was “challenge.” He would say, “Dr. John, we have a challenge” and that could mean anything from a new Ebola outbreak in a previously unaffected neighborhood to the printer being out of paper. Everything was just a challenge to be overcome.

 

IS HE STILL THERE?

He’s waiting for medical school to reopen. On my last day there, we gave him a stethoscope, which is traditional in medicine. My parents gave me one when I graduated from med school. Getting hold of a stethoscope was pretty convoluted. I ordered it from Amazon.com and had it delivered to a doctor in Atlanta who was coming to Sierra Leone. When he arrived in Freetown, he gave it to another doctor who was staying in my hotel. Then the three of us who had worked with Francis — Brigette Gleason, Tiffany Walker and I — presented it to him. He told me he was so inspired by his connection with CDC that he was going to make his career in public health.

 

WHAT WERE OTHER OBSTACLES YOU HAD TO OVERCOME?

Fuel was a constant problem because the investigators had to travel so far. So I put in a request to the CDC Foundation for fuel money, and it was granted. One of my jobs most afternoons was to take those fuel vouchers to the gas station and fill up the vehicles that were transporting the blood samples. And sometimes I’d fill up the investigators’ motor bikes as well.

 

WAS A SICK PERSON EVER RELUCTANT TO GO TO THE HOLDING CENTER?

Sometimes, at first. I helped in a few cases. We would talk to the head of the household and to the chief of the village. And we talked to the sick person, of course. To make sure I myself was not exposed to Ebola, I never passed over the threshold of a house. I’d ask the person to come out and we would talk from a distance in the street, usually a dirt path or road. Nobody was taken against their will, and I never saw anyone refuse to go. People were quite aware of Ebola because the education they had received had been very effective.

 

HOW DID FAMILIES REACT WHEN THIS HAPPENED?

It could be tragic. In some cases, it was the last time they ever saw their loved one. They would say goodbye in the house, and because they were contacts, they would have to remain there and be monitored for Ebola. Getting information on that patient in the holding center could be very difficult, though the surveillance officers tried. If the person turned out to be positive, he or she would be taken away to a distant treatment unit, where sometimes they died. Those were some very touching situations.

 

ONCE IN THE HOLDING CENTER, WHAT HAPPENED?

Patients with possible Ebola would receive medications for malaria and typhoid fever, intravenous fluids and also oral rehydration solution, which contains water, sugar and salt. And the blood draw would go as quickly as possible. That had to be done in full protective equipment. It’s quite a heroic job for someone to be drawing blood on Ebola patients all day long. Their dedication is hard to imagine. I was there 42 days, which I found very challenging, physically, mentally and emotionally. But the local health workers have been working like that for months.

 

HOW WERE THE BLOOD SAMPLES TESTED?

They had to be driven four to five hours to a CDC run lab in a town called Bo, which would email or telephone me the results. We had more than 800 samples sent for testing while I was there, and our goal was to have no more than 48 hours between someone’s lab test and learning whether they were positive or negative. It’s below 48 hours now, which considering the logistics is a real victory.

 

THEN WHAT?

There were many days when I would go to the holding centers to deliver blood test results to the nurses and help with the disposition of patients. If positive, we would get that person to a treatment center as quickly as possible, but it was three to four hours away. We, the lab and the treatment center were all in different locations. One way to conceptualize this is to imagine someone is suspected of Ebola in Dallas, has to be taken to Fort Worth to draw blood, then the blood is driven to Wichita, Kans., and if positive, the patient is transported from Fort Worth to Little Rock, Ark., for treatment. That is based on the actual drive times in Bombali.

 

HOW WERE THE ROADS?

Mostly dirt. It was the end of the rainy season, which meant that they were often mud. The vehicle carrying the lab samples crashed twice in one week because of road conditions. One of the scariest moments for me was hearing about those two accidents. I worried that there were unsecured blood samples at the site, but they were packed in a strong puncture-resistant container, and the samples were fine and were tested normally.

 

WHAT WAS THE CDC PRESENCE IN YOUR DISTRICT?

About 60 CDC personnel were in Sierra Leone at any one time, and we had seven staying in Makeni and working in Bombali and the adjacent district, Tonkolili. Six were doctors or epidemiologists, and one was a communications specialist because a vast part of outbreak control is educating people. We all stayed in the same hotel, and often ate breakfast and dinner together. Lunch was a PowerBar at our desks. Most everybody worked until midnight or 1 a.m., but one evening we all got together to relax and watch a movie I had on my laptop —Die Hard—and some of the hotel employees watched too. It was a nice diversion. I felt extremely close to the CDC colleagues I was working with.

 

ANY CHANCE TO EXERCISE?

Four or five times a week, I got on the elliptical at the hotel for an hour at the end of the day. It didn’t plug into the wall, didn’t need electricity. So when the power went out, which happened frequently, I kept going in the dark. The other people in the gym would laugh, but exercise is very important to me, both at home and traveling. When the lights were on, I was on my BlackBerry most of the time on the elliptical. That was routine multi-tasking.

 

HOW DID YOU PROTECT YOURSELF FROM EBOLA?

The most important thing was no touching. No shaking hands, no hugging. It was a massive societal change. I’d never been to Sierra Leone before, but I’d heard that the people are affectionate and physical. It was really something to live in that reality where you never touch another person — except a couple of times when I inadvertently bumped into someone at a meeting. Also, before being posted, we were trained at CDC in Atlanta in the use of personal protective equipment which all of us carried in backpacks at all times. Fortunately I never needed to put mine on.

 

DID YOU EVER GET SICK OVER THERE?

I got mild food poisoning after a weekend trip to CDC headquarters in Freetown. At first, I didn’t know what it was, but I followed all our established procedures. I isolated myself in my hotel room for 24 hours. We had a supply of MREs [meals ready to eat] so I didn’t have to leave. I checked my temperature and reported it to my supervisor so a decision could be made as to how to handle it, depending upon the symptoms, and if needed, discussions with Atlanta. My symptoms went away quickly, and I never had a fever. It wasn’t Ebola.

 

WHAT WERE BURIALS LIKE?

Every person who died, no matter what the circumstances were, was supposed to be tested for Ebola with a cheek swab and then buried safely. The body was quickly placed in a body bag, which was sprayed with chlorine by a protected burial team. Then it was taken to a new and separate communal cemetery especially set aside for this purpose. To the burial teams’ great credit, they were extremely respectful. Families could not say goodbye at a funeral and could not be at the burial, but could wait nearby. And after the ground was also sprayed with disinfectant, loved ones could leave small memorials and markers there. Seeing that cemetery was one of the most moving experiences of my entire life.

 

THESE WERE HIGHLY EMOTIONAL MOMENTS. DID YOU EVER FIND YOURSELF IN TEARS?

I did cry a couple of times, but only in the evenings at the hotel, not in public. I think most of the CDC workers cried at one time or another. All of the CDC people supported one another a great deal, because everyone realized how stressful it was. So I never felt alone. I felt emotional very frequently, and tears were close, but the days were so busy and long that I was able for the most part to keep my attention on the matters at hand.

 

DID YOU FINALLY GET ACCUSTOMED TO THE DANGER?

I never felt personally threatened, but of course my risk was not zero. To keep it at zero, I would have had to stay home. We were all accepting some level of risk. But it was more the constant psychological cost of having to worry about it, of never touching people, maintaining distance, having to stay disconnected from potential patients. It was like a blanket over all our activities. On a human level, it was very difficult, many hours a day, seven days a week, and it was frequently very sad.

 

WHAT WAS THE FEELING ABOUT AMERICANS THERE?

I didn’t feel a negative vibe even once. People said thank you routinely. It was really touching. When I spoke to the young men and women we were working with, I would emphasize that we were brothers and sisters in the fight against Ebola. We were all on the same team. I think that’s the way everyone felt.

 

HOW DID YOUR OWN FAMILY FEEL ABOUT YOUR ASSIGNMENT?

They were very supportive. My wife, Bernie, actually encouraged me to go to Sierra Leone. She is a physician herself and understood both the gravity of the situation and the contribution I could make to it. Most deployments are for 29 days, and when the CDC asked me to stay longer, she said it sounded like a good idea. We kept in touch mostly by email, but I bought a local phone card and we talked a couple times each week. The connection wasn’t bad. I was able to see my daughters at college on Skype from time to time. It helped that they didn’t seem worried. When we talked or e-mailed, I tended to emphasize the positive aspects of what we were doing and minimized the sad things I’d seen.

 

NOW THAT YOU’RE BACK HOME, ARE YOU IN QUARANTINE?

Technically, I was not. I was in a category that’s called low risk, but not zero risk for 21 days. I had to report on my temperatures twice a day to both the state of New Mexico and CDC. I wasn’t supposed to go to work, but Sandia National Laboratories was very supportive and understanding. I am detailed there by CDC as an epidemiologist on their International Biological Threat Reduction team. I could leave home briefly to buy food or something like that, but my wife was happy to take care of those things. I was told to report any illness or symptoms immediately. It ended November 19, and I’m fine.

 

WHAT DID YOU LEARN IN SIERRA LEONE?

As a physician, I learned how quickly someone can get terribly sick from Ebola and die. As a medical epidemiologist, I saw that the public health efforts to which CDC is contributing are going to be what eventually ends this outbreak. As a human being, I learned how hard working, brave and heroic my Sierra Leonean colleagues were. At no time did I feel that what I was doing was futile. Ultimately, what I really learned about Ebola is that it is controllable.

 

WOULD YOU GO BACK?

Without question.

TIME Cancer

Scientists Develop New Way to Treat HPV-Related Cancer

hpv image
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A drug already off-patent may provide better treatment for cervical cancer

A drug called cidofovir that’s already used to target viruses could also be used as part of a novel way to treat cervical cancer.

In new research presented at an annual Symposium on Molecular Targets and Cancer Therapeutics in Barcelona, Spain, researchers tested cidofovir in tandem with chemotherapy and found that the drug caused shrinkage of cervical cancer tumors in all of the trial participants, and in 80% of the patients the tumors disappeared completely. The combination also showed no toxic side effects.

The clinical trial was small with only 15 women, who received doses of the drug weekly for two weeks, and then every two weeks after chemoradiation started.

One of the side effects of cidofovir can be kidney damage, but there was no damage observed in the participants, suggesting the dosage was safe. The researchers hope to move on to a phase II and phase III trial to look at how the drug impacts overall survival.

In the U.S. alone, about 12,000 women get cervical cancer each year. Human papillomavirus (HPV) is a very common STD, and it’s also the most common cause of cervical cancer. But cervical cancer is a common disease worldwide, and the researchers, lead by Eric Deutsch, a professor of radiation oncology at the Institut Gustave Roussy, Villejuif, France, say they see their drug treatment being very cost effective for low-income countries since it’s now available off patent.

That’s another reason it’s hard to get the support for the research. “This is also why it has taken us more than ten years to move from the first preclinical data to a phase I trial,” said Deutsch in a statement. “Due to lack of interest and support from the pharmaceutical industry, the trial had to be performed with 100% academic funding.”

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