Considering a new workout routine? A new yoga practice? Determined to use your recumbent bike for something other than hanging your clothes? Whatever the case, it never hurts to reconsider whether your fitness program is best suited for you, given the many options all claiming to being your surest route to better health. To make things easier, we tapped eight personal trainers for their best bits of wisdom on how to level up your workout. Focus on mobility first One piece of fitness-related advice that has changed the life of Ackeem Emmons, coach at Tonal, an interactive home gym system, is the power of mobility. For years, the New York City-based personal trainer focused solely on strength and speed—his only metrics of success. “It was not until I matured, started training others, and kept getting injured that I learned to appreciate mobility,” he says. “When I started to incorporate mobility, stretching, and improving my flexibility, I saw major improvements in how I felt, coached, and looked.” These days, Emmons’ dynamic pre- and post-workout routine includes moves like the “World’s Greatest Stretch,” squat to stand, and scorpion stretch, which have boosted his well-being and fitness. “The obstacle to our strength goals,” he says, “[is] the lack of mobility and body awareness.” Restoring a city’s charm Branded Content Restoring a city’s charm By China Daily Ignore your fitness tracker This tip comes from Laura Thomas, a holistic movement coach in Cleveland. “Sometimes, we must not listen to our fitness trackers and do what feels good right now,” she says. “Even if your Fitbit barks at you to do more cardio, you know your body better than anyone else.” Read More: Why You Should Change Your Exercise Routine—and How to Do It Check in with yourself before a workout about your stress levels, how you slept, and what you ate that day. “Should you push through a challenging workout when you feel fatigued? Most likely not,” Thomas says. Instead, consider if mobility work or gentle yoga will fill your cup that day. Stay open-minded to new research and workout approaches Kaleigh Ray, an exercise physiologist and staff writer for Treadmill Review Guru in St. George, Utah, warns clients not to get trapped in fitness fads and to be open to new research. For instance, she was “really into” minimalist and barefoot shoes for a long time, but upon reading research on running-shoe construction, she came to believe her preconceptions were false. “I still think barefoot shoes and minimalist shoes are great, but I’m also open to the benefits of maximalist shoes,” she says. To that point, Ray strongly recommends that you incorporate multiple training techniques into your routine. “Believing one method is beneficial doesn’t mean you have to exclude all others forever. What serves you at one point in your fitness journey may not be what you need later,” she says. “Often, clinging to one fitness principle forces you to ignore an entire body of research.” Start with just five minutes “When the weather is awful, my schedule feels packed, or my motivation is low, my go-to advice is: commit to just five minutes of movement,” says Sarah Pelc Graca, owner and head coach at Strong with Sarah Weight Loss Coaching in Novi, Mich. “Whether it’s a quick warm-up stretching session, a walk around the house, or five minutes of lifting weights, the key is starting small. “ More often than not, she finds five minutes turn into 15 minutes, 20 minutes, or even a full workout. Read More: Does Face Yoga Really Work? Pelc Graca learned this lesson a few years ago as a new mom juggling her business and caring for her newborn, when the idea of squeezing in a workout felt impossible. “I quickly realized the hardest part was getting started,” she says. “Once I began moving, I wanted to keep going because it felt so good.” She still uses this mindset, whether it’s a quick few minutes of jumping rope or squeezing in body-weight squats while waiting for her coffee to brew. Remember: There is no finish line when it comes to your health and fitness This motto comes courtesy of personal trainer Tami Smith, owner of Fit Healthy Macros in St. Augustine, Fla. “Your journey is ongoing: there's no rush, no end date, just a continued commitment to show up in the best way you can daily,” Smith says. Too often, she adds, we get caught up in wanting to achieve a certain goal, like losing an amount of weight by a specific date. . Rather, though, embrace the idea that these efforts will continue for the rest of your life, even though there will be ebbs and flows. This, Smith says, “leads to better adherence, less stress, and improved results.” Befriend heavy weights This advice applies especially to women, who often shy away from greater weight loads at the gym or home, says Michelle Porter, a personal trainer and yoga instructor in Hoboken, N.J. “Lift heavy, and don’t stress about your heart rate or calorie burn while strength training,” she says. “Focus on form, challenge your muscles, and the results will come.” Read More: How to Stop Checking Your Phone Every 10 Seconds Porter first became acquainted with this “lift heavy” principle in 2011 at a CrossFit class. “As a personal trainer at the time, barbell strength training and Olympic-style lifting were entirely new to me,” she says. “Like many women, I worried that lifting heavy weights would make me ‘bulky.’ But it didn’t — it helped me lean out and define my muscles.” Stop comparing yourself Bill Camarda, a personal trainer and owner of Limitless Fitness in Epping, N.H., never forgets the humbling moment of being told that somewhere in the world, there's always going to be someone doing better than he is in the gym. “There's always someone lifting more weight. There's always going to be someone in better shape. There's always someone who can run faster, jump higher, do more push-ups,” he says. “When someone pointed this out to me, it helped me to realize that the only person I needed to compare myself to was myself.” Recognizing this not only helped Camarda check his ego at the gym door, but also do what was best for his body rather than trying to keep up with others. Pick the right music Or podcast, or audiobook. Emily Abbate, a personal trainer in New York City and host of the wellness podcast Hurdle, is all about finding “the right soundtrack for your sweat,” as she puts it. Research shows that upbeat music or other audio fare can help you work both harder and for longer. “So when your motivation may be lacking, seek out something sweet for your headphones that inspires you to get up and out,” she says. “You may be surprised at what happens next.
In the late afternoon of Feb. 26, members of the U.S. Food and Drug Administration (FDA)'s expert committee on vaccines received an unusual email. It informed them that their upcoming meeting on March 13 to determine which influenza strains to include in the next flu shot—a meeting that has occurred every year since the late 1960s, even during the pandemic—was canceled. One of the email recipients was Dr. Paul Offit, director of the vaccine education center at Children’s Hospital of Philadelphia, co-inventor of the rotavirus vaccine, and a member of the committee since 2017. “It said the meeting was canceled—not postponed—and there was no evidence that it would be rescheduled,” he says. In a statement, the FDA said: "The FDA will make public its recommendations to manufacturers in time for updated vaccines to be available for the 2025-2026 influenza season." “I assume that will be without the advice of the expert independent advisory committee,” Offit says. “I don’t know what this means, who made the decision, or why they made the decision. We were told nothing about it.” The cancellation came one day before new government-issued data was published showing the high effectiveness of the latest flu vaccine at keeping kids and adults out of the hospital. Enterprises eye China’s huge consumer market Branded Content Enterprises eye China’s huge consumer market By China Daily Here's what to know. What the vaccine committee does The Vaccines and Related Biological Products Advisory Committee (VRBPAC) is a group of vaccine experts who volunteer their time to review data on the yearly update to the flu vaccine. They do the same for any new vaccines against infectious disease, as well as biological products that companies hope to sell to the public. The committee's primary responsibility is to discuss the safety and effectiveness of these health therapies. To ensure the members are reviewing and analyzing the data objectively, the committee is independent; voting members are not active employees of the government, although government officials join the discussion. Read More: When Is the Best Time to Get a Flu Shot? After reviewing data provided by vaccine makers on studies the companies have conducted on their vaccines, the committee votes on whether it believes a vaccine should be approved or not. In the case of the annual flu shot, they vote on which strains to include in the vaccine, based on recommendations from the World Health Organization and data from flu cases in the southern hemisphere, which goes through its flu season before the northern part of the world. This process led to the emergency use authorizations and ultimately approvals of the COVID-19 vaccines. The VRBPAC members met to discuss data, as they became available, on each of the new COVID-19 vaccines; based on the recommendations from the committee, the FDA then made the final decision on whether vaccines were safe and effective enough for the public. What usually happens after the committee meets Once the FDA commissioner decides to approve a vaccine or update the strains in a vaccine, the work then shifts to the U.S. Centers for Disease Control and Prevention (CDC). The CDC has a vaccine committee of its own: the Advisory Committee on Immunization Practices, or ACIP, which meets several times a year to make recommendations for the childhood and adult vaccine schedule. Based on these insights, CDC then recommends certain vaccines to the public and outlines how frequently and how many doses should be provided. Doctors rely almost exclusively on the data from both the FDA and the CDC when discussing and administering vaccines to their patients. Signs of trouble for vaccines Soon after Robert F. Kennedy Jr., became head of the Department of Health and Human Services, which oversees both the FDA and the CDC, the CDC announced that its vaccine committee meeting scheduled for Feb. 26 to Feb. 28 was postponed. Kennedy has been a long-time skeptic of vaccines; he continues to question their safety and highlights what he describes as conflicts of interest in the vaccine review and approval process. Read More: What to Know About the Measles Vaccine Not having a discussion and incorporating advice from independent experts “is worrisome,” says Offit, who has also served on ACIP. “We are getting the sense that expertise isn’t really valued.” Without the work of both the FDA and CDC committees, the message is that “doctors and parents should figure it out for themselves,” he says. “But there are things discussed at these meetings that most physicians in private practice aren’t going to intuit on their own. That’s why they look to the advisory committees to help give them advice and provide that information.” Committee members don't always agree. But “it’s important to have dissenting votes and have a vigorous discussion to make sure the science behind public policy is well-tuned," Offit says. "This is an independent group. It is independent of the pharmaceutical industry, and independent of government.” Without its advice, it means the government would be making important decisions affecting the public’s health on its own. New research on the importance of flu vaccines The meeting cancellation came one day before the CDC issued its weekly MMWR report, a scientific update on the latest public-health news. In the Feb. 27 edition, CDC scientists published new data on the benefits of flu shots in protecting both children and adults from serious complications. The latest data on the most recent flu season from 2024 to 2025 show that children and teens who were vaccinated were up to 78% less likely to be hospitalized for flu than those who weren’t, and adults who got their flu shot were up to 55% less likely to get hospitalized. The report concludes by reiterating the agency’s recommendation that people who are eligible should get a flu shot every year.
It’s impossible to predict when you’re going to die. But if you’re aiming for a long and healthy life, it pays to worry less about your genes—which you can’t change anyway—and more about your lifestyle and surroundings. That’s the conclusion of a new study in Nature Medicine that takes a broad look at the longstanding environment-vs.-heredity debate, and comes down firmly in the environment camp. The work was based on data from more than 490,000 people, all of whom are registered with the UK Biobank, a massive collection of participants' detailed medical histories including gene sequencing; MRIs; blood, urine, and saliva samples; family health stories; and more. Researchers used this rich data to study the influence of genetics and more than 100 environmental factors on the risk of 22 diseases that make up most of the major causes of death. To do that, they focused especially closely on a subset of 45,000 people whose blood samples had been subjected to what is known as proteomic profiling: an analysis of thousands of proteins that help determine physical age compared to calendar age. “We can get an estimation of how quickly or slowly each participant is aging biologically compared to their chronological age,” says lead author Austin Argentieri, a research fellow at Massachusetts General Hospital. “This is referred to as the ‘proteomic age gap,’ since it’s the gap in years between protein-predicted age and chronological age. [It] is a very strong predictor of mortality…[and] it is also associated strongly with many important aging traits like frailty and cognitive function.” Enterprises eye China’s huge consumer market Branded Content Enterprises eye China’s huge consumer market By China Daily Just knowing that age gap, of course, is only part of the picture. Equally important is the cause of that gap. To help determine that, the researchers analyzed people's many environmental and behavioral exposures that contribute to disease and biological age. These factors include income, neighborhood, employment status, marital status, education, and diet, as well as whether people smoke or exercise regularly. To cover the genetic side, researchers analyzed people’s genomes, looking for genetic markers associated with the 22 key diseases. In addition, they noted which individuals had already developed any of those diseases. Read More: 12 Weird Symptoms Dermatologists Say You Should Never Ignore The results were striking. Environment and lifestyle accounted for 17% of people’s disease-related risk of dying, compared to just 2% for genetics. Of the various environmental exposures, smoking was the riskiest behavior, linked to 21 diseases; socioeconomic factors such as household income, neighborhood, and employment status were associated with 19 diseases; and a lack of physical activity was linked to 17 diseases. Environmental exposures had the greatest impact on lung, heart, and liver disease, while genetics played the greatest role in determining a person’s risk of breast, ovarian, and prostate cancers, plus dementia. Disturbingly, the study also revealed that the influence of environment begins early in life. High or low body weight as young as age 10 and maternal smoking around birth were found to affect health and mortality many decades later. The investigators looked not just at the factors that increase the risk of dying from one of the chronic diseases, but also those that decrease it. Of those, living with a partner, being employed, and being financially comfortable had the greatest effect on extending lifespan. “Our research demonstrates the profound health impact of exposures that can be changed either by individuals or through policies to improve socioeconomic conditions, reduce smoking, or promote physical activity,” said senior author Cornela van Duijn, professor of epidemiology at Oxford Population Health, in a statement that accompanied the release of the paper. The researchers do not see the current study, for all its sweep, to be the end of their work. In the future, they recommend looking more closely at multiple factors, including diet, exposure to novel pathogens such as COVID-19 and bird flu, and environmental factors such as plastics and pesticides. All of those are potentially powerful—but understudied—influences on lifespan.
Your skin is your largest organ—and unlike your heart or lungs or kidneys, you can actually see it. That makes it a useful window into what’s going on inside your body. “It’s an immediate indicator of potential internal health concerns,” says Dr. Amy Basile, a dermatologist at Dermatology Partners in Philadelphia, starting on day one of life: If a baby’s skin is jaundiced, for example, doctors know to look for high levels of bilirubin or an immature liver. Throughout the years that follow, the skin continues to provide clues about underlying health concerns, from cancer to autoimmune disease. It’s key, however, to know what to look for. Not every blemish is a marker of internal turmoil, but certain ones raise red flags for dermatologists, who then investigate further. We asked skin doctors to share the weird or surprising symptoms that make them take notice. A bleeding acne-like bump Dr. Rina Weimann constantly sees patients who come in complaining about a solitary, stubborn bump they’ve had on their nose or face for a few months. “It looks like a pimple, but it doesn't have a head,” says Weimann, a dermatologist at Schweiger Dermatology Group and assistant professor of dermatology at Drexel College of Medicine. “It’s like a shiny pink bump, and it bleeds without you touching it.” Having that kind of growth linger for so long isn't normal, she adds, and warrants a biopsy to ensure it's not skin cancer. Biopsies aren’t as scary as they might sound: Typically, dermatologists remove a small sliver of your skin and send it to a pathologist. It takes about one or two weeks to get results, Weimann says. And if you do have skin cancer, “it doesn't mean you have to have your nose cut off," she says. “Especially on the face, we do a specialized surgery called Mohs surgery to conserve tissues, so you're not taking a ton of skin out.” Grottoes bear the enduring touch of Tang Branded Content Grottoes bear the enduring touch of Tang By China Daily Sudden changes in body odor Dr. Angela Brimhall still remembers the stench she encountered during her dermatology residency, when she stepped off the elevator at the hospital. Down the hall, a patient was suffering from severe gangrene, “and the odor that it puts off is very unique and telling,” she says. While not always so noxious, Brimhall often sees patients with odor-related symptoms, which can indicate a range of hormonal issues or infections. Read More: What’s the Best Skin-Care Routine? While gangrene causes a foul, musty odor, for example, “Staph and strep have been described as having a mildly sweet smell—but like if something sweet is turning sour,” says Brimhall, a dermatologist at Sage Dermatology & Mohs Surgery in Draper, Utah. A metabolic disorder called trimethylaminuria, meanwhile, makes your sweat smell like rotten fish. Some people experience it episodically, like at the start of menstruation, and dietary tweaks can help relieve it; other times, antibiotics are necessary. “You don't have to suffer with it forever,” she says, but first you need a doctor’s help to figure out what’s going on. “Your skin is a dynamic organ, and it’s communicating with you, telling you what's going on inside.” Visible veins or blood vessels If your veins suddenly take on a starring role on the canvas that is your skin, call your doctor—especially if the newfound prominence is accompanied by swelling, pain, or redness. “If they were previously just minding their own business, and you couldn't see them, that could indicate deep vein thrombosis,” Brimhall says. “It can also happen with some autoimmune diseases.” Factors like vigorous exercise, hot weather, sun exposure, and tight clothing can also make your veins more noticeable, which is why it’s important to have your doctor take a look and determine the seriousness of the situation. Blue discoloration of the skin Any change in skin color, especially if it’s widespread or worsening, warrants a doctor’s appointment. Blue discoloration often ends up being related to a medication or supplement someone is taking, Basile says. Supplements with silver, for example, can cause a difficult-to-treat condition called argyria that turns the skin bluish-gray, while the antibiotic minocycline can cause the same discoloration on the arm, face, and shins. If you go out in the sun without protection while taking the arthritis drug Plaquenil, you could end up with blue-gray arms and feet, Basile adds. Usually, when that happens, “you stop the medication and find an alternative,” she says. “In some cases, it goes away, and other times, these pigmentations need to be removed with lasers,” which can be time-consuming and expensive. Read More: 12 Weird Symptoms Endocrinologists Say You Should Never Ignore A blue tinge to the skin might also signal someone is taking kratom, an herbal supplement that can have opioid- and stimulant-like effects. Sometimes, people taking kratom develop gray-blue hyperpigmentation in areas that are exposed to the sun. “You have to really pry and say, ‘Are you taking any new teas? Are you adding anything to your orange juice? Are you taking any new vitamins?’” Basile says. “These things come in so many forms, and they're not regulated,” which is why she encourages her patients to avoid kratom. Changes in nail appearance Your fingernails are “an excellent place to see how your body is doing metabolically,” Brimhall says. Discoloration, ridges, and splitting nails can all reflect systemic health issues. Splinter hemorrhages, for example—or squiggly red lines under the nails—can indicate a heart infection called endocarditis. “You’re throwing little bacterial-originated clots into the bloodstream, and the capillaries of the nails are superficial enough and small enough that they're picking up those clots, and you can see them, like a window, right there around the nails,” she says. You might also notice signs of potential autoimmune disease. For example, tiny red or white spots around your nail bed—called periungual telangiectasias, or small, dilated blood vessels—can point to dermatomyositis or lupus. Meanwhile, if you experience “spooning of the nails,” which means they curve inward and take on a spoon-like shape, you might be experiencing hypothyroidism or anemia, Brimhall says. “Clubbing” of the nails, on the other hand, which refers to a widening and rounding of the fingertips and toenails, often clues doctors into inflammatory bowel disease or pulmonary issues. It’s also important to keep an eye out for a dark line that runs from the top to bottom of your nail. This type of discoloration is most prevalent in the thumb, index finger, and big toe, Basile says, and can indicate melanoma of the nail. Basile generally measures the line, and if it gets wider or becomes irregular at the base, recommends her patients get biopsied. Velvety skin If you have thick, darkened patches of skin on your neck, armpits, or groin that feel soft and smooth, you might have a condition called acanthosis nigricans. “Patients often come in because they don’t like it,” Basile says. “They’re like, ‘What is this?’” Unfortunately, “it’s very difficult to treat with topicals.” Acanthosis nigricans is often caused by insulin resistance, which can lead to Type 2 diabetes if not addressed. Basile urges patients to take it seriously—especially adolescents who are overweight and going through puberty. “It may be the first indicator that your body isn’t responding effectively to insulin,” Basile says. “It’s like your first chance to address that, and to motivate yourself to make lifestyle changes and enhance your diet and exercise habits.” Skin that glows or shines Glowy skin is in right now. But a sudden, unnatural sheen could indicate hormonal changes, skin infections, or even cancer. “When I’m doing a full-body skin exam, I’m looking for a certain sheen that can be consistent with basal cell carcinoma,” Brimhall says. “It’s often described as a pearly appearance, and we’ll see it right over the area that’s having [abnormal cell growth]. That can be a big clue that something concerning is going on.” Basal cell carcinoma—which is highly curable when identified and treated early—usually develops in areas exposed to sunlight, like the face, head, neck, arms, and legs. You may notice tiny blood vessels on the surface of a translucent bump, and it may eventually bleed or scab over. Itchy palms Your hands might very well become itchy during the long, cold winter because they’re dry. But if you’ve been persistently overcome with the urge to itch for months, it’s time to get curious—especially if the itchiness flares up at night and isn’t accompanied by a rash. “That could be a sign that you need to do blood work to check your liver function and bile acid, and make sure there's not an issue with your gallbladder,” Weimann says. “It's important not to ignore.” She usually refers patients with itchy palms to a hepatologist or their primary care provider for additional testing. A slow-healing wound Maybe you’ve been diligently taking care of a wound on your leg for months, applying Vaseline or Neosporin, and it’s not going away. Some people are simply slow healers. “But it does make me concerned: ‘Should I do a biopsy and investigate this for skin cancer?’” Weimann says. “A lot of dermatologists will do that for slow-healing wounds.” Read More: 9 Weird Symptoms Cardiologists Say You Should Never Ignore Squamous cell carcinoma, in particular, can show up as a wound that refuses to heal—in addition to symptoms like a firm, dome-shaped growth, or a sore that develops in an old scar. The earlier you start treatment, the better, so if you’re worried, call your doctor. Skin that feels like sandpaper If your skin becomes so dry that it starts to resemble sandpaper—laden with small, rough bumps—you could have a condition like keratosis pilaris, also known as "chicken skin.” It’s characterized by “these tiny little 1-millimeter bumps that are very close together,” Brimhall says. They’re particularly common on the upper arms, thighs, and butt, and while the bumps are typically painless—and can be treated with moisturizers and prescription creams—they’re sometimes a harbinger of more serious afflictions. “We know that if you have keratosis pilaris, you’re predisposed to atopic dermatitis, asthma, and seasonal allergies,” Brimhall says. “We want to make sure we’re watching for any of those signs and symptoms, so if they develop, we’re really on it.” Unexplained hair changes If you notice sudden graying or other changes to your mane, call your doctor instead of your hair stylist. You could be dealing with an underlying health issue or nutritional deficiency. “Sometimes when the body goes into survival mode, it’ll show up in changes in your hair, and that can include color change or hair loss,” Brimhall says. The autoimmune condition alopecia, for example, can cause hair to turn white or gray, before ultimately leading to bald patches. Another autoimmune condition, vitiligo, causes loss of skin pigment, which can show up as white or gray hair. In rare cases, melanoma can also lead to these changes, usually darkening the hair in the affected area. “It’s important to pay attention,” Brimhall says, “because your hair can indicate something deeper is going on.” Increased sensitivity to products that didn’t previously cause issues If you start to experience sensitivity in the area where you’re applying a certain product, you might have allergic or irritant contact dermatitis. On average, it takes five years to develop a topical allergy, Brimhall says. “Sometimes patients will say, ‘I've been using this for years,’ and we’ll say, ‘Well, we still need to do a patch test,’” she adds. “The other difficult thing about these conditions is it's often a delayed hypersensitivity—so you’ll put the product on, and the rash doesn’t appear for five to 10 days.” It might then linger for weeks or months. Brimhall often asks patients to make a list of products they were in contact with, even briefly, like the bar of soap they used while staying at a hotel a month prior. Then, she instructs them to eliminate all of their products, adding one back in at a time and, after two weeks, adding another. “That way we can really see what’s affecting your skin,” she says. It’s a painstaking process, but “the upside is, once we identify the chemical that's causing this reaction, we have a 100% cure—and that's 100% avoidance.
In the aftermath of the U.S. Supreme Court decision overturning Roe v. Wade in 2022, many states have moved to protect the right to abortion, and several have turned to a new tool to do so: abortion shield laws. The laws are intended to preserve abortion access by protecting multiple classes of people—abortion providers practicing in states where abortion is legal, as well as patients and people who help them access abortion—from civil and criminal actions taken by states with bans or restrictions on abortion. Now, these laws are being tested through two legal challenges in Texas and Louisiana, both involving a New York doctor. So what are shield laws exactly, and what does the future hold for them? TIME spoke to experts to find out. What are abortion shield laws? Abortion shield laws are “novel protections” enacted in 18 states and Washington, D.C., says Lizzy Hinkley, senior state legislative counsel at the Center for Reproductive Rights, which has helped draft some of these laws. The laws provide protections for doctors providing medication or in-clinic abortions in the shield state, according to Rachel Rebouché, dean and professor at Temple University Beasley School of Law. Every law is different, so the protections offered by each state vary, but can include the shield state refusing to comply with another state’s extradition order for a doctor who has provided reproductive health care that’s legally protected in the shield state, refusing to participate in another state’s investigation into the provider, and refusing to penalize the provider through professional discipline. Enterprises eye China’s huge consumer market Branded Content Enterprises eye China’s huge consumer market By China Daily Connecticut was the first state to pass an abortion shield law, in May 2022, in anticipation of the Supreme Court’s overturning of Roe. “What we were motivated by was, there is going to be an intense interstate conflict,” says Rebouché, who worked with colleagues to draft the state’s shield law language. “This is new territory,” Hinkley says. “Shield laws were a tool that states have been using in response to a change in how abortion rights are treated in the country. When there was still a federal protected right to abortion, states did not have to be concerned about whether a provider in their state was going to be criminalized for providing abortion care to a patient or resident of another state because states couldn’t criminalize that care. There was a right to abortion; there were guardrails that were federally protected.” Of the 18 states that have shield laws, eight of them—including New York—include protections for doctors who are providing abortion pills through telemedicine to patients in other states, according to Rebouché. About 63% of all abortions in the American healthcare system in 2023 were medication abortions, but anti-abortion activists and lawmakers have been trying to restrict access to the pills. After the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, the Biden Administration made efforts to increase access to abortion pills by allowing them to be prescribed via telehealth and received via mail, but reproductive rights advocates are concerned that the Trump Administration will roll back those efforts. Hinkley says telemedicine abortion has been “a lifeline” for many people who live in states that have banned or restricted abortion. Read More: How the Biden Administration Protected Abortion Pill Access—and What Trump Could Do Next What are the current legal challenges to shield laws? Texas, which has banned abortion in nearly all situations, filed a civil suit against New York-based Dr. Margaret Daley Carpenter for allegedly prescribing, via telemedicine, abortion pills to a 20-year-old woman in Texas. Texas alleges that the woman was hospitalized with complications. On Feb. 13, a Texas judge ordered Carpenter to stop prescribing abortion pills to Texas residents, and to pay a fine of more than $100,000. Carpenter and her lawyers didn’t respond to the lawsuit, given New York’s shield law that bars cooperating with other states’ investigations into providers. Louisiana, which also has a near-total ban on abortion, charged Carpenter with a felony for allegedly prescribing, via telemedicine, abortion pills to a minor who was pregnant. Louisiana officials claim that the patient was taken to the hospital after ingesting the pills because she was experiencing a medical emergency. New York Gov. Kathy Hochul said on Feb. 13 that she won’t extradite Carpenter to Louisiana—“not now, not ever”—per New York’s shield law. Louisiana can’t constitutionally prosecute Carpenter unless she’s physically present in the state for a court appearance, according to Rebouché. The cases represent the first time shield laws are being tested in court. “I think they point to what we can expect moving forward for intense interstate conflict,” Rebouché says of the two cases. “I don’t think it’s surprising; I think this is where we were always going to land, given that Dobbs returned abortion to the state and a third of the country prohibits abortion from the earliest moments of pregnancy or before six weeks, just as many states have codified abortion rights in their constitutions and their state laws.” Read More: Here Are Trump’s Major Moves Affecting Access to Reproductive Healthcare What does the future hold for shield laws? Because New York won’t cooperate with Texas and Louisiana, the future of the two cases is a little unclear. “Those [cases] raise really profound constitutional, structural questions about interstate relationships,” Rebouché says. “They’re bound to end up before the Supreme Court because there’s a long, complicated history of mediating disputes between states when they don’t agree on public policy, and that’s where we are now.” Hinkley says the intent of the legal challenges is to scare doctors who are providing abortion care, but that shield laws are working to provide access to people across the country. She adds that the laws “are squarely within states’ power to enact” and are constitutional. “I’m sure that there will be continued challenges to the shield laws,” Hinkley says, “but I can say with certainty that [shield laws] were drafted with good care and with these legal challenges in mind, and they stand on solid ground, both within what states are allowed to do, as well as what they’re not allowed to do.
The pandemic inspired new vigilance about germs, including more frequent and thorough house cleaning—changes that stuck with many of us years later. But while cleanliness is a virtue, germ fixation is not. Cleaning your house too thoroughly, or with the wrong kinds of products, can be harmful to health. Of particular concern is the overzealous use of potent disinfectants that kill 99% of common bacteria. “The pandemic has had a long-term impact, and people use stronger disinfectants now,” says Orianne Dumas, a respiratory epidemiologist at the French Institute of Health and Medical Research. “We’re cleaning more than we ever have, for both good and bad, depending on how people do it,” says Jill Heins Nesvold, senior director of indoor air quality at the American Lung Association. Here’s what researchers know about the risks and how to clean house effectively while protecting yourself and those around you. Grottoes bear the enduring touch of Tang Branded Content Grottoes bear the enduring touch of Tang By China Daily Concerning ingredients Studies reveal that the air inside our homes is more polluted than the air outdoors, and a portion of these toxins come from household cleaners. They contain scores of chemicals linked to health problems, including those that affect breathing. However, these risks depend on the dose. In 2023, the nonprofit Environmental Working Group researched 30 common cleaning products and found that all together, they contained 193 chemicals hazardous to health. Many are volatile organic compounds, or VOCs, such as acetone, methanol, and glycols like 2-butoxyethanol. These evaporate easily into the air, where they can be inhaled, trigger allergic reactions, and irritate the eyes, nose, and throat. Too much irritation can inflame and damage the airway, potentially resulting in breathing issues. Higher asthma rates have been observed in people who clean professionally and even in ordinary people exposed to these irritants as infrequently as once per week. There’s also an association with lung weakness. One study found professional cleaners have a 43% higher risk of developing chronic obstructive pulmonary disease than the general population. Dumas says that more research is needed to establish this COPD link in people who just clean their own houses, who have less exposure. Read More: Are ‘Broken Skin Barriers’ a Real Thing? The potential impacts go beyond the respiratory system. Once inhaled, VOCs can mimic the activity of hormones, disrupting the endocrine system. Such disruptions may increase cancer risk. As with COPD, some studies suggest higher cancer rates among cleaning professionals, but research hasn’t shown the same link among casual household users, Dumas notes. Overexposure can mean different things. Big doses of harsh disinfectants can disrupt health rapidly, while lower amounts used too frequently over the years can also be harmful. “You could use a cleaning product once per week for 10 years, or two times per day for one year, and get the same exposure,” Heins Nesvold says. “With a lot of use, you’ll have the effects more quickly.” Use just a few high-quality products To protect yourself while cleaning your house, start by using fewer products to limit contact with lots of chemicals. You could select a multi-purpose cleaner instead of the specialist approach: one for glass, another for the bathtub, a specific floor product, and so on. “Reevaluate your product arsenal to find places to cut back,” advises Samara Geller, senior director of cleaning science at EWG. Another easy swap: Instead of a kitchen-specific cleaner, use dish soap and water on your counters. “You don’t necessarily need a unique kitchen product,” Geller says. Disinfect only when necessary Don’t overdo it with bleach and other strong disinfectants. “Cleaning should not be synonymous with disinfection,” says Doug Collins, a chemist at Bucknell University who studies cleaning products. You want the cleaning horsepower of a disinfectant when up against serious filth like bacteria, viruses, mold, and fungi. That’s why hospitals use disinfectants daily. For your home, though, plain soap and water will often work just fine. “Soap is really good at grabbing greasy stuff,” Collins says. He suggests alcohol-based products—ones without added chemicals for killing germs—as another example of basic cleaners that do the job. Improper use of bleach is especially harmful. Bleach is a great disinfectant because it’s a strong oxidant, but this quality also makes it potentially dangerous. The body has antioxidants that “tamp down on bleach’s oxidative potential and counteract it,” Collins explains, but if you’re exposed routinely, “there’s leakage through that defense mechanism that can cause damage.” Read More: Is Intermittent Fasting Good or Bad for You? Collins’s two small children have a knack for turning his bathroom into a crud-filled wrecking zone. When they do, he reaches for bleach, but that’s the rare exception. “We do need to disinfect, but not every day, and maybe not even every week,” Dumas says. A few times per month only, recommends Asa Bradman, an environmental health scientist at the University of California, Merced. If there’s an immunocompromised person in the household, “that’s a different circumstance,” Geller says, warranting more disinfectant. Another example from Heins Nesvold: if an ill house guest sneezes repeatedly, a thorough cleaning is probably wise. When you disinfect, do so in a targeted manner. Focus on high-touch surfaces like faucets and doorknobs, advises Akiko Iwasaki, professor of immunobiology at Yale University. “While excessive use of cleaning products and disinfectants containing synthetic chemicals may harm the human body, when used properly, they can reduce transmission of infections,” Iwasaki says. Consider bleach alternatives You could opt for other bleach alternatives besides soap and alcohol, such as hydrogen peroxide. “We recommend hydrogen peroxide because it’s effective, and pure forms break down into water and oxygen,” Bradman says. It’s easy to remove from surfaces, he adds, whereas bleach often leaves an irritating residue lasting several days after cleaning. Vinegar breaks up dirt with less risk than bleach, too, though it’s not as powerful. Collins recommends distilled white vinegar and other acid-based cleaners like lactic or citric acid. You still have to be careful, though. Inhaling vinegar directly could cause “respiratory triggers,” says Bradman. Read More: 6 Things to Eat to Reduce Your Cancer Risk Avoid mixing products. Never combine bleach with vinegar, ammonia, or products that have hydrogen peroxide, such as toilet bowl cleaners. The resulting chemical reactions release gases that are toxic and damaging. One large exposure to chlorine gas—produced from mixing bleach and acidic cleaners—can cause reactive airways dysfunction syndrome (RADS), an irritant-induced form of asthma, Geller says. Follow directions on the bottle that spell out safety precautions, including dangerous mixtures. “It’s key to choose the right product for the right job and follow the label,” says Nicholas Georges, senior VP of scientific and international affairs for the Household and Commercial Products Association, which represents companies making these products. Go fragrance-free Products labeled fragrance-free may be preferable. This is a tricky one, as we often take satisfaction in cleaners with fresh scents, like pine or lemon—a reward for battling the dirt. However, some of the chemicals responsible for these smells, such as limonene, are the very VOCs that groups including EWG have identified as potentially problematic. Research shows that 35% of Americans using fragranced products report symptoms like breathing issues and migraines. Fragrance-free cleaners release fewer VOCs. “They’re healthier,” says Bradman, who steers clear of strong scents. Georges notes that companies perform risk assessments on cleaners to ensure safety and reduce liability. Products must meet fragrance-ingredient standards for protecting health developed by the International Fragrance Association. Try certified “green” cleaners Several organizations certify specific cleaning products as better for health. The American Lung Association and EWG recommend looking for cleaners certified as Safer Choice, a label created by the U.S. Environmental Protection Agency. “We’re big supporters of Safer Choice,” Georges says. In 2019, EWG developed its own EWG Verified certification for cleaning products. Specific ingredients can also be checked for toxicity against lists compiled by EWG and the EPA. Another consideration is whether a product is advertised as “green,” suggesting it uses natural ingredients. Separate studies by EWG and Bradman found that green products tend to have fewer hazardous VOCs. The quality of these products varies, though. “There’s a lot of diversity in these green products,” Dumas says. Some government regulations aim to control false product claims about being green, but there’s a lack of enforcement. Dumas has found that some green cleaners contribute to asthma risk, partly because natural ingredients aren’t necessarily good for you. For instance, some green cleaners include essential oils, which “may be natural, but could still be volatile” and therefore irritating, Bradman explains. Read More: Green Tea Is Even Better For You Than You Think Make sure to check the product’s chemical ingredients on its label and online. “Transparency is critical,” Georges says. When products have at least one chemical that’s an allergen—meaning it could affect people with sensitivities, such as asthma—the label has to disclose this, Georges explains. And the specific ingredients, both allergens and other ingredient types, must be listed on the company website or product-specific sites, in addition to on the label, he says. In its 2023 study, EWG found some chemicals in the air that weren’t listed on product labels. “Oftentimes the label is only scratching the surface of what’s contained in the formula,” Geller says. This discrepancy doesn’t necessarily mean that companies are being deceitful. Rather, it’s hard to predict the byproducts of chemicals once they’re “in the bottle and co-mingling,” Geller says. Another unknowable factor is what substances the chemicals will encounter after they’re released in people’s homes, such as particulate matter. These secondary reactions can form new substances like formaldehyde, a known carcinogen, Geller explains. Air things out People can further reduce their exposures by circulating the air during cleaning and immediately after. Open windows, run fans, and keep the HVAC system on. “Really get that air circulating to move the chemicals out of the space,” Geller says. Collins runs the bathroom fan for at least 15 minutes after he’s cleaned his kids’ mess. You can also reduce your chemical exposure by protecting your skin and airways while you clean. For heavy-duty cleaning, consider wearing gloves and an N95 mask. Limit use of sprays that contain chemicals called quaternary ammonium compounds, Collins says. These “quats” differ from VOCs in that they don’t evaporate quickly into the air, but when sprayed they’re easily inhaled, risking irritation and endocrine disruption. Even sprays without quats could harm health if they’re breathed in too much, so try spraying into a cloth first and then wiping surfaces with the cloth. This should reduce how much spray a person inhales, especially if they wear a mask, Collins says. Read More: 6 Health Myths About Oils Those who are especially sensitive to chemicals, including kids and people with asthma, should go outside during cleaning if possible. In a 2025 study, Dumas found that the overuse of cleaning products in daycares is associated with wheezing symptoms in children under age three. Bradman helped to develop a toolkit on safe cleaning protocols for daycare providers. Pregnant women, too, should take precautions, since some research shows a link between exposure during pregnancy and childhood asthma. If you’re craving that fresh-as-morning-dew smell after you tidy, you can create it without fragranced cleaners. Geller recommends simmering a pot of water with your favorite herbs and spices. Just don’t shy away from disinfectants when you’re looking to banish unhealthy mildews and other tough-to-clean causes of malodor. “The Lung Association isn’t anti-cleaning product,” Heins Nesvold says. “We just want people to be really knowledgeable about what they’re putting into the air they breathe.
Most of us are pretty adept by now at managing COVID-19, with an armor of past infections, vaccinations, self-tests, and antiviral medications like Paxlovid. In the latest study, however, researchers report that taking Paxlovid may not provide as much benefit as doctors originally thought—particularly for older people who are vaccinated. In a research letter published in JAMA on Feb. 20, Dr. John Mafi, associate professor of medicine at the David Geffen School of Medicine at UCLA, and his colleagues used Canadian data to explore what happened when people took Paxlovid. A Canadian health policy in 2022 allowed prescriptions for Paxlovid only for symptomatic people around age 70 in order to reserve the medication for those who needed it most. Older people are at higher risk of developing complications from COVID-19. The policy allowed the scientists to compare people in this age group who took Paxlovid to those who didn’t. Among the nearly 1.5 million people they studied, those who received prescriptions for the drug did not have significantly different rates of being hospitalized or dying from COVID-19 than those who didn’t get the drug. Most of the people studied were vaccinated. Restoring a city’s charm Branded Content Restoring a city’s charm By China Daily “Our main finding was that among vaccinated older adults, Paxlovid showed no statistically significant reduction in COVID-19 hospitalizations or on mortality,” says Mafi, the study’s lead author. That’s very different from the results that Paxlovid’s maker, Pfizer, first reported in 2022. In that study, Pfizer found that the drug reduced hospitalizations and deaths from COVID-19 by 89% compared to people receiving placebo. But the group they studied was mostly middle-aged and unvaccinated, which is a much different population than exists today. “Yet that 2022 Pfizer study was and continues to be used to support the assumption that the benefits of Paxlovid in unvaccinated adults also apply to vaccinated adults,” says Mafi. “That’s what is being used to justify its perceived effectiveness—and its list price at $1,650 per treatment course.” In a statement, Pfizer said it could not comment on a study in which it did not participate, but that the company "remain[s] confident in Paxlovid's clinical effectiveness at preventing severe outcomes, including hospitalization and death, from COVID-19 in patients at high risk of severe illness." Read More: Long COVID Doesn’t Always Look Like You Think It Does Paxlovid is meant to help those at high risk of developing complications from COVID-19, including the elderly, people with compromised immune systems, and those with multiple underlying health conditions. That remains a primary criterion for prescribing the medication, which is now available for anyone age 12 or older and who is at high risk of severe disease. Still, Mafi says there aren't strong data on how Paxlovid affects the disease course in people who are vaccinated. His findings suggest that the benefits are about four times smaller than those reported by Pfizer. “We are not saying that Paxlovid is useless,” says Mafi. “What this research is saying is that its effectiveness in older groups who are most vulnerable to COVID-19, but who are vaccinated, is far lower than what the earlier evidence from unvaccinated groups showed.” More research is needed, but doctors can consider this new information when deciding whether to recommend a patient take Paxlovid. Other important factors include a person's medical history, the medication's risk of relatively mild side effects, and Paxlovid rebound, in which people taking Paxlovid may test positive again after testing negative. Dr. Katherine Kahn, distinguished professor of medicine at UCLA and the study’s senior author, says that she will discuss the latest results with her patients, and “for generally health people, I’m not encouraging or discouraging [Paxlovid] if they meet the criteria for taking it,” she says. “But for people with higher risk of morbidity or mortality, we’re more likely to say we might consider [Paxlovid] at this time, even though we don’t know 100% if you will benefit.” The new study raises questions for future research. It doesn’t take into account, for instance, how past infections might cause the body to respond to Paxlovid. Mafi and Kahn say that they were also not able to delve more deeply into participants’ vaccination history—how many and which doses they received—or confirm whether they took Paxlovid within five days of their first symptoms, when the drug is most effective. But they are planning to access the individual-level data and do a more in-depth analysis of other factors that may impact how effective the drug is at reducing hospitalizations and deaths. “One of the conclusions of this study is the recommendation for more studies, of both older individuals and those who are vaccinated, of the effectiveness of Paxlovid,” says Kahn.
Raquel Willis isn’t afraid to take risks. She has organized large-scale marches to protest violence against Black trans lives and rallied outside the Supreme Court to support the trans youth at the center of the ongoing case U.S. v. Skrmetti, which will decide whether gender-affirming health care bans for minors are constitutional. Last December, Willis was arrested at the Capitol for staging a bathroom sit-in in defiance of a proposal to ban trans women from women’s restrooms on federal property. The title of her 2023 memoir, The Risk It Takes to Bloom, underlines her fearlessness. But to Willis, “a proud Southern, Black, trans, queer woman” from Augusta, Ga., the riskiest thing she’s done so far is choose to live authentically. “Our society is not primed to honor queerness or transness,” she says. Willis, 33, is the co-founder of Gender Liberation Movement (GLM), the grassroots collective responsible for the Brooklyn Liberation Marches that drew thousands of people in 2020 and 2021. In 2024, GLM organized an inaugural Gender Liberation March in Washington, D.C., in an effort to highlight the ways in which the fights for abortion and trans rights are connected. “For us, gender liberation is about bodily autonomy, self-determination, the pursuit of fulfillment, and collectivism,” she explains. “We want to be the glue between these different fights and get people talking about how restrictive ideas around gender impact us all.” The way Willis sees it, restrictions on choices surrounding our bodies pose a danger to everyone, no matter how you identify. “Many institutions have failed us and will continue to do so,” she says. Since President Trump’s Inauguration, a number of Executive Orders targeting trans and gender-nonconforming people have already been signed—one states that the U.S. will only recognize “two sexes, male and female.” But thinking of the long road ahead, Willis is trying to maintain a sense of calm. “We have to remember that communities on the margins have experienced struggles and hardships in every era. We’ll figure out solutions that serve us.” And, perhaps unsurprisingly, she adds, “I’m going to find ways to take risks to move us closer to collective liberation.”
Amanda Zurawski never set out to be an activist. But in 2022, when she was four months pregnant after years of trying, her life changed forever. She dilated too early, her water broke at just 18 weeks, and suddenly, her pregnancy was in distress. Zurawski’s doctors told her “with complete certainty” that she would lose the baby. If Zurawski, now 37, had lived in another state, or in another time, her doctors would’ve been able to give her standard medical treatment, in this case an abortion. She would’ve been able to heal and go on to have a healthy pregnancy. But Zurawski lived in Texas in the aftermath of the Supreme Court’s Dobbs decision. Her water broke the same week that Texas’ trigger law went into effect, banning abortion in almost all circumstances. Because her fetus still had a heartbeat, her doctors could not treat her miscarriage. “I had to wait until the baby died inside me or for me to be on death’s door before I could get care,” she says. She went into septic shock and was hospitalized for a week. “Now my reproductive organs are permanently compromised,” she says. After sharing her story publicly, Zurawski became the lead plaintiff in the Center for Reproductive Rights’ lawsuit challenging Texas’s abortion ban. That lawsuit, Zurawski v. Texas, inspired others around the country. Zurawski became the face of the abortion-rights movement, and her story became one of the most prominent examples of the dangers abortion bans pose to women’s health. In May 2024 the Texas Supreme Court upheld the ban. The decision felt like “a slap in the face,” Zurawski recalls. “It felt like they were trying to take away our voices, erase us from history, and silence us.” Zurawski refused to back down. She made dozens of campaign trips for President Joe Biden and then Vice President Kamala Harris over the course of 2024, warning about the dangers another Donald Trump presidency would pose to reproductive justice. After Harris lost, Zurawski was devastated. But she didn’t let herself wallow for long. “The anti-choice movement would want us to be tired, they’d want us to rest,” she says. “It’s not in my nature to give up. It can get worse, and it will, if we don’t continue to fight.”
