After announcing in March 2024 that she had been diagnosed with cancer, Kate Middleton, Princess of Wales, has again spoken out about her illness—this time, with good news. “It is a relief now to be in remission and I remain focused on recovery,” Middleton announced on X on Jan. 14. The remission announcement comes a few months after she revealed in September that she had completed chemotherapy treatment. There's still a lot we don't know about the Princess's case, including what type of cancer she had. Here's what it means to be in remission from cancer. Defining "remission" Cancer remission means that doctors have successfully reduced the signs and symptoms of cancer—in some cases, to undetectable levels. "Remission quite simply means that at that point, there is no detectable sign that cancer is in the body on all of the tests we have done," says Dr. Sikander Ailawadhi, an oncologist and professor of medicine at Mayo Clinic. That doesn’t necessarily mean the cancer is completely gone, but it does mean that doctors can't find it after thoroughly testing for it. "The word remission is a very, very tricky word," says Dr. Marleen Meyers, professor of medicine and director of the survivorship program at the Perlmutter Cancer Center of NYU Langone Health. "The common use of the word—even among oncologists, if they say someone is in remission—is that it means we have knowledge that it could come back, but at the moment, there is no evidence of cancer." The way the term "remission" is used can vary "from person to person and, really, physician to physician," says Dr. Christopher Flowers, chair of the department of lymphoma and myeloma and head of the division of cancer medicine at the University of Texas MD Anderson Cancer Center. Read More: Why Are So Many Young People Getting Cancer? It’s Complicated The National Cancer Institute, for example, defines two types of remission: partial and complete. In complete remission, all signs and symptoms of cancer have disappeared, the agency says, while in partial remission, the cancer may be reduced but remain in the body. (It's not clear from Middleton's post which kind of remission her cancer is in.) If people remain in complete remission for at least five years, it could mean they have been cured of their cancer. "You have to have complete remission to be cured," says Dr. Larry Norton, an oncologist and medical director of the Evelyn H. Lauder Breast Center at Memorial Sloan Kettering Cancer Center, "but complete remission doesn't guarantee that you're cured." Can cancer return after remission? Cancer is notorious for recurring—even after remission—and some types are more likely to do so than others. "Certain kinds of cancers, such as glioblastoma multiforme [a brain cancer]—even if it's gone, it's going to come back very soon," says Ailawadhi. "Similarly, pancreatic cancer, bladder cancer, and ovarian cancers have a very high risk of coming back—despite treatment, despite complete responses, despite remission." Small numbers of cancerous cells that doctors can’t detect may start growing at any time. Most patients will continue to work with their doctors to monitor for any signs of these recurrences. "I tell my patients that remission is an important milestone on the cancer journey to know you are on the pathway to cure," says Flowers. "It's the most positive first step to be in remission." For now, the Princess says she is “looking forward to a fulfilling year ahead,” and thanked the staff at the Royal Marsden Hospital, where she was treated, for “looking after me so well during the past year.” The Princess has limited her royal duties since her diagnosis, but recently appeared at the family’s annual Christmas Day service in Sandringham and hosted the “Together at Christmas” carol service at Westminster Abbey in early December.

Body mass index (BMI) is one of the most ubiquitous yet controversial metrics in medicine. A crude measure of weight relative to height, BMI is commonly used to diagnose obesity—even though many experts and professional groups agree it’s an imperfect tool that on its own reveals very little about someone’s health. Among other issues, BMI does not differentiate between weight from fat versus muscle and was not designed to assess a diverse array of bodies. It’s time to do better than BMI, an international group of 58 experts from fields including obesity medicine, endocrinology, bariatric surgery, cardiovascular medicine, gastroenterology, and primary care argue in a proposal published Jan. 14 in The Lancet Diabetes & Endocrinology. In most cases, the experts write, clinicians diagnosing obesity should either augment or replace BMI readings with other body measurements, such as waist circumference, or tests that can objectively measure body fat. (Tests that precisely measure body fat are already available in some medical clinics, but they are used far less frequently than BMI because they are more costly and labor-intensive.) The proposal also calls for dividing obesity into two categories: clinical and preclinical. Under the group’s definitions, clinical obesity is accompanied by health problems tied to excess body fat, such as impaired organ function, reduced mobility, or difficulty carrying out day-to-day activities. People with preclinical obesity, meanwhile, do not have immediate weight-related health concerns. The former constitutes an illness, while the latter is a health risk to monitor, says Dr. Francesco Rubino, chair of metabolic and bariatric surgery at King's College London and chair of the expert commission. Rubino calls his group’s framework “the most radical change that has been proposed for the diagnosis of obesity.” He says it constitutes “a new diagnosis…that is meant to be objective and pragmatic enough to be globally relevant.” Clinicians are under no obligation to follow the group’s proposal, but 76 medical organizations around the world—including the American Heart Association, the American Diabetes Association, and the World Obesity Federation—have endorsed the report. “This new approach demands a fundamental change in how we treat obesity,” says Dr. Sahar Takkouche, an obesity-medicine specialist and associate chief medical officer at Vanderbilt University Medical Center who was not part of the expert panel. Implementing its recommendations won’t be seamless, Takkouche says. Machines that precisely measure body composition, for example, aren’t available in every doctor’s office, and insurance policies often lag behind evolving medical practices. But the approach outlined in the proposal offers “new hope for more effective care.” The proposed criteria could, for example, help clarify which patients are likely to benefit from treatments like drugs and surgery, Rubino says. While these may be good options for some people with clinical obesity, he says, people with preclinical obesity may not need intensive treatments, like ultra-popular anti-obesity drugs Wegovy and Zepbound. For some preclinical patients, monitoring alone might be appropriate, he says. "Obesity is nuanced. It’s a spectrum,” Rubino says. “It’s not a single thing.” That distinction alone requires a mindset shift, says Dr. Tirissa Reid, an endocrinologist, obesity-medicine specialist, and associate professor of medicine at Columbia University Irving Medical Center who was not involved in the Lancet proposal. Reid says she and most other obesity specialists already do much of the testing and analysis the report suggests. But, she says, it’s “a big deal” for a group of experts to further the idea that “excess body fat doesn't necessarily equate with illness automatically.” That message could both “reframe” the general public’s understanding of obesity, Reid says, and also help clinicians decide if, when, and how to treat patients. There has long been debate within the medical community about whether obesity should be treated as a disease. The U.S. Centers for Disease Control and Prevention and the American Medical Association both call obesity a disease, but some doctors argue that label is wrong—or at least overly simplistic. While many studies have shown that obesity is associated with chronic health problems including Type 2 diabetes and heart disease, there is less research to concretely prove it causes these conditions, says Dr. Lisa Erlanger, a clinical professor of family medicine at the University of Washington School of Medicine and president of the Association for Weight and Size Inclusive Medicine. Some people with obesity show no signs of chronic conditions, studies have found, and other research suggests weight stigma and inadequate health care are associated with many of the same issues frequently attributed to obesity. Erlanger says the new proposal—which, she notes, was authored by many people with ties to the weight-loss industry—looks like progress on the surface, but is flawed. It still assumes “any impairment occurring while you’re fat” counts as illness and encourages clinicians to use metrics, like waist circumference, that are “poor measures of how many of a person’s symptoms are actually caused by the number of their fat cells,” Erlanger says. In general, she says, the mainstream medical community is “uncurious” about whether obesity actually causes many of the complications it’s linked to, and whether weight loss is truly the best treatment for some of these problems. Habits like getting adequate exercise, nutrition, and sleep can have profoundly positive effects on overall health whether they affect weight or not, Erlanger says. A recent research review, for example, found that cardiorespiratory fitness is a better predictor of longevity than weight. It’s in part because of such debates in the field, Rubino says, that there’s a need for nuanced yet accurate methods of assessing obesity and its health effects—which, he says, his group has produced. “Disease should not be a matter of opinion,” he says. “It should be a matter of fact.”

Scroll through TikTok or Instagram and you’ll be inundated with protein-centric recipes. Maximizing protein is a huge trend right now on social media—and not just in the usual suspects, like your dinner or post-workout smoothie. High-protein coffee, desserts, snacks, and more are now on the table. High-protein recipes aren’t new, especially for gym-goers and proponents of a hearty breakfast, but they’ve exploded on social media over the past few years. Why is there such an emphasis on protein right now? And do you really need to focus on getting more? Here’s what experts say. Why is protein important—and why is it so hot right now? Protein is one of the body’s three macronutrients: those your body needs in the largest amounts in order to perform. “We need it for many functions, but particularly to build muscle, to build a lot of the tissues that we have in our bodies,” says Andres Ardisson Korat, a scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Unlike carbohydrates and fat—the other two macronutrients—protein doesn’t come with the same kind of cultural stigma. Branded Content XPRIZE at the 2025 TIME100 Summit: Making the Impossible, Possible By XPRIZE “I think people often view protein as ‘the healthiest macro’ in comparison to carbs and fat,” says Kylie Sakaida, registered dietitian, social media content creator, and author of the forthcoming cookbook So Easy So Good. Protein’s health halo, in other words, keeps people coming back for more. Sakaida, who shares recipes on Instagram, TikTok, and YouTube, has noticed more traffic and interest on her own videos when they feature higher protein. She attributes the rise in interest on these videos to people looking to manage their weight and get fitter. Read More: A Head-to-Toe Guide to Treating Dry Skin Americans’ obsession with protein isn’t new, but now, long-standing grocery brands are creating higher protein versions of their usual fare while a flood of new, smaller brands have entered the market selling high-protein everything. (You can now find high-protein chips, sweets, bread, and even ramen.) Chobani, a brand known for its naturally protein-rich Greek yogurt, launched a higher protein version of their single-serve yogurt in October, and is soon rolling out drinkable yogurt with 30 grams of protein—three times more than its standard drinkable yogurt. Niel Sandfort, chief innovation officer at Chobani, says the lean towards protein started in the late 2010s, and the company has seen steady growth in protein shakes, bars, and similar products. Its recently launched high-protein options were designed to appeal to athletes, but Sandfort was surprised to find that baby boomers, people in their 40s, and younger women were big buyers as well. American anxiety about weight loss—ramped into overdrive by powerful new weight-loss drugs—is probably also a factor driving increased interest in protein. “I think a lot of people are looking into managing their weight, and they’re being told to eat high-protein diets if they want to gain muscle and lose weight," says Sakaida. "Focusing on protein can help you feel more satiated and therefore can help you cut down on certain calories.”

Watching your home, belongings, and neighborhood disappear to a tremendous wildfire is physically and emotionally unimaginable. Even for people in Los Angeles currently living it. While many people who have lost everything aren’t yet able to fully process what they’re feeling, their emotions will evolve and intensify over the coming days, weeks, and months, says Nancy A. Piotrowski, a psychologist in Vallejo, Calif., who’s on the American Psychological Association’s Board of Scientific Affairs and counsels clients hit by natural disasters. The trauma can linger for a lifetime. “Initially, people are shocked and overwhelmed and feel grief, fear, and anger," she says. "They might be experiencing relief to be alive, or guilt if others they loved were hurt or died.” Some will simply feel numb, she adds. There are no perfect words to use when talking to someone who's been affected, but it's vital to show you care and offer support. First, what not to say: steer clear of the word “should,” which is judgmental, Piotrowski suggests, or “at least,” which sugar-coats the situation. It’s also not a good idea to insinuate that everything happens for a reason, or that your loved one should just focus on what they still have. We asked experts exactly what to say to friends or family members who lost everything—or close to it—in the Los Angeles fires. “I’m so sorry you’re going through this traumatic loss. What’s it been like for you?” Two days after evacuating to a hotel in Ventura, Calif., with her daughter, dog, and two cats, Dr. Carole Lieberman couldn't stop watching the news. She looked up from her phone, where she was refreshing the latest headlines, only to fix her gaze on the TV. Lieberman—a psychiatrist who had been living in a rental for the last six years, since her home was damaged in the 2018 Woolsey Fire—was in “panic mode” and couldn’t stomach eating breakfast for days. Read More: Understanding How Massive the L.A. Fires Are As the fires ravaged Los Angeles, lots of people reached out to make sure Lieberman was OK. She appreciated those who made it clear they truly wanted to understand what she was going through. She told her best friend about how she called the fire station about the Freddy Fire (“no one answered, of course”) and how she made the decision to evacuate along the Pacific Coast Highway in dangerous winds. Recounting the harrowing experience felt cathartic. “It really does help to share,” she says. “Be compassionate and empathetic, and ask about the person's story, because everybody has a story—or lots of stories.” “Please let me know how you’re doing when you can. No need to respond right now.” Don't underestimate the power of reaching out. Dr. Gary Small, chair of psychiatry at Hackensack University Medical Center in New Jersey, owns a house in the affected area, and a friend called to offer support. “He was really kind and said, ‘I’m sorry. Is there anything I can do to help?’” he recalls. “You don’t have to say a lot—just be real and sincere and offer help if it’s needed.” A “light check-in” can be the perfect way to approach your early communication, Piotrowski says. Otherwise, having to respond to well-intentioned messages can make long to-do lists even more daunting. “We know from research that sometimes social support feels like support,” she says. “Other times, it feels like pressure, or one more thing we have to respond to.” The way you word your message can ensure your loved one doesn’t feel like another assignment they don’t have time for just landed on their plate—and makes it more likely they’ll reach out once they’re able to do so. “Can I bring you some food or water or clothes or a book? What about supplies for your pets?” Rather than issuing a vague offer to help—or asking your friend if they need anything—focus on making specific offers, Piotrowski suggests. That might mean bringing them face masks that will help protect against the smoky air, toiletries, games or other entertainment for their kids, or a bag of dog food. “You’re prompting the person with ideas,” she says. “They might not remember offhand what they need, but they’ll recognize it if you ask them if they need it.” Read More: 11 Ways to Respond When Someone Insults a Loved One’s Disability She also recommends making clear that your offer to help won’t expire. "I'd like to be able to help you,” you might say. “If you need something, please let me know. It doesn't matter if it’s today, tomorrow, or six months from now. Let me know, and if I can't do it, I'll try to help find someone who can.” “You’re safe in my home. You can bring whoever you need to and stay as long as you’d like.” When Amber Robinson, a trauma therapist in Los Angeles, looked out her window last week, she had a 360° view of flames: There was a fire in every direction, including one about 7 miles from her home. The fires have had a personal and professional impact on her. As her friends and family members evacuated and were forced to make quick decisions about which belongings to take with them, her clients were grappling with the same situation. She’s devastated for everyone who lost their home—and has given a lot of thought to what she can say to show she cares. That includes welcoming friends in need into her home, if she ends up being in a position to do so. “It can be immeasurably helpful,” she says, especially since people who are displaced will likely feel as though they’re a burden to others. “If someone is able to invite you into their home with no expiration date, and just be there with you to sit and talk about it or not talk about it—just offering a safe space—that can be so comforting.” “Go ahead and cry or scream it out. I'm here.” Therapist Karen Stewart’s office overlooks the Palisades Fire—she’s less than 2 miles away from the worst of the blaze. She recalls seeing the fire growing on the mountains last week, and then watching in horror as the flames engulfed nearby buildings. She knows many people who lost everything: “All they have left is the clothes on their backs, the dogs in their car, a passport, and a few pictures,” she says. Stewart has learned that the best way to approach communication in such a vulnerable time is to make it clear that, while you might not know exactly what to say, you're there to listen. “Let them speak; let them cry, let them scream, let them sit in silence,” she says. “Hold the space for them, because they’re feeling literally and figuratively displaced.” “I wasn’t sure if you’d be comfortable taking money from me, but I sent a check to the Red Cross in your area. I hope you’ll reach out to them.” Depending on the nature of your relationship, you might decide to send your friend a gift card or some money to help offset their financial stress. If you think they’d have a hard time accepting that kind of gesture, make a donation to a local organization that’s helping those in need, and urge your friend to reach out, Piotrowski suggests. The money won’t go directly to them, of course, but knowing what you did might encourage someone who would otherwise resist help to tap into available resources—maybe accepting free meals, clothing, or baby supplies, for example. Either way, you can feel good knowing your donation will support people affected by the blazes, and your friend will likely appreciate what you’re doing for their community. Read More: 10 Boundaries Therapists Want You to Set in the New Year In general, directing your loved ones to helpful resources can be an effective way to show support, Piotrowski adds—especially if you’re in a better position to do extensive online research than they are. “I have an inkling of how you feel.” One of the worst things you can say to someone affected by the wildfires is that you know how they feel—unless, of course, you really do. If you try to compare losing a house full of memories to a much less significant loss, it’s not going to go over well, Lieberman says. But if you’ve suffered a comparable loss, it’s OK to tell your friend or loved one about it. As long as you emphasize that you know it’s not exactly the same situation, she adds, your friend might take some comfort in talking to you about how you worked through your grief. “Here are some good memories for you.” Kay Connors’ sister-in-law lost her home in last week’s fires—which means she lost not just physical items, but special family keepsakes and memories and all the other irreplaceable artifacts that make a life. Connors, a social worker in the psychiatry division at the University of Maryland Children’s Hospital, specializes in psychological first aid, which includes helping communities, families, and children who have experienced traumatic mass events. That training inspired different ways of showing support to her own family members. Read More: How to Break 8 Toxic Communication Habits “I texted my sister-in-law some family photos that she probably would have lost, just to cheer her up,” she says. “Like, ‘Here’s some good memories to focus on.’” As time unfolds, perhaps you could make a scrapbook or photo album for your loved one—a small way of helping them recover something sentimental they lost. “It’s OK to be angry.” Make it clear to people affected by the wildfires that they’re allowed to feel their feelings, whatever that looks like. “They’re allowed to be upset, they're allowed to be angry, they’re allowed to be confused, they're allowed to be scared,” Robinson says. Research suggests that validation helps people feel understood and accepted, and can even defuse intense emotions. “LA is a weird place to be right now,” she adds. “There’s a lot of anxiety, and there’s a lot of dystopian feelings, so leaning on each other and talking through fears and anxiety is important.” “I really care about you, and I wish I knew what to say. But I want you to promise me you’ll call 988 if you need to.” Researchers have found that suicide rates increase after natural disasters. Some people might be at heightened risk, Piotrowski says: “Imagine you’re an elder and you live alone, and everything’s gone. Or maybe you just went through a divorce, and you were finally getting back on your feet, and then bang, this happened.” It can feel like too much to endure. If someone tells you they no longer want to live, point them toward the 988 Suicide and Crisis Lifeline, Piotrowski urges. It’s available 24/7 via call, text, and online chat. “Can I give you a hug?” If you have the kind of relationship with someone that includes physical touch, now might be a good time to lean in for a hug. If it’s new for you, ask permission first, Piotrowski advises. Putting a gentle hand on someone’s shoulder can have an equally comforting effect, she adds, especially when they’re lost in their thoughts or so frozen in the moment that they’re unable to talk. “You don’t want to invade their physical space,” she says. “But that can bring people out of their mind and help them be back sitting right next to you.” Read More: 9 Things You Should Do for Your Brain Health Every Day, According to Neurologists “I’m here for you, and I’m not going anywhere.” The thousands of people who lost their homes in the Los Angeles wildfires will likely receive a lot of support early on. “I imagine there would be a ton of rallying around them in the first few days, weeks, or even months,” Robinson says. “But this is a long, long process, and a lot of times people tend to scurry—not intentionally—as time goes on.” The fires will create long-lasting trauma, she adds; she's worked with clients who lost their homes to wildfires and were still struggling with the experience years later. Making it clear that you’ll be there every step of the way, no matter how long that might be, is one of the best ways to provide support. That could simply mean checking in a few months down the road with a heart emoji or a quick text to let your friend know you’re thinking of them. “Something I say to my clients all the time is that grief is not linear, but neither is healing," Robinson says. “It will take time. But grief shared is grief lightened, and one of the most comforting things is having a community.

Norovirus is surging across the U.S., with case numbers higher now than they've been at the same time in more than a decade, according to the U.S. Centers for Disease Control and Prevention (CDC). There is no antiviral treatment for the miserable but thankfully short-lived illness, and no vaccine—yet. But scientists at Moderna are in the late stages of testing what could be the first such shot, using mRNA technology against the virus. Here’s what to know about norovirus and where things stand with the development of a stomach-bug vaccine. Why norovirus is raging right now “Commonly known as the stomach flu, norovirus has been around forever, and has become the leading cause of gastroenteritis or inflammation of the intestinal tract that causes vomiting and diarrhea,” says Dr. Edmund Milder, a pediatric infectious disease specialist at Rady Children’s Hospital and UC San Diego Health. There are nearly 50 different subtypes, or genotypes, of norovirus, with different ones circulating in different years. For the last decade or so, one version of the virus, called GII.4, has been responsible for most infections around the world. That changed last year when GII.17 became the dominant strain. That could partially explain the current uptick in cases, since most people who have been exposed to other types of norovirus would not have as strong immunity to this version, making them more vulnerable to disease. Branded Content XPRIZE at the 2025 TIME100 Summit: Making the Impossible, Possible By XPRIZE Norovirus symptoms For most people, the infection causes intestinal symptoms such as vomiting, diarrhea, and dehydration. Unpleasant as they are, these symptoms don’t typically require medical care or hospitalization, and they tend to last just a few days. But older people and infants often experience worse disease, and each year in the U.S. about 100,000 people are hospitalized and nearly 1,000 people—mostly the elderly and the very young—die from the infection, mainly due to dehydration after not being able to keep down food and water, according to the CDC. Is norovirus like other viruses? No—for many reasons. First, it doesn’t take much of the virus to make someone sick. For most viruses, people would need to be infected with thousands of virus particles in order to feel ill, but it only takes as few as 10 to launch the intestinal symptoms typical of norovirus infection. To make matters worse, the virus is encased in a particularly hardy cover that allows it to survive for days on surfaces like countertops and doorknobs. Hand sanitizer isn't effective in killing norovirus—you'll need to wash your hands for 20 seconds with soap and water to remove as much virus as possible—and the it also can’t be destroyed with high heat or cold temperatures. The most effective way to kill the virus on contaminated surfaces is by using a diluted solution of bleach and water, and allowing it to sit on a surface for at least five minutes before wiping. Why isn’t there a norovirus shot yet? The nearly 50 different versions of the virus mean that “each genotype requires a different immune response to provide protection,” says Dr. Doran Fink, therapeutic head of gastrointestinal pathogens and bacterial vaccines at Moderna. So any vaccine would have to be an educated guess as to which strains are likely to circulate in a given year—similar to the strategy behind updating the flu vaccine each season. How close are we to having a norovirus vaccine? Moderna is currently enrolling 25,000 people around the world in a phase 3 trial of the shot, after earlier testing showed encouraging results. In those studies, people vaccinated with the mRNA shot generated antibodies that in lab tests effectively blocked the norovirus protein in human gut cells; those given a placebo vaccine did not show the same antibody activity. To improve the chances that the vaccine would be well-matched to circulating strains, Moderna’s vaccine candidate includes three different norovirus types. “It would be great if there were some conserved regions of the norovirus protein that could be targeted, but that’s not the case,” says Fink. Instead, their thinking goes, taking this multivalent approach should provide good protection against severe disease. It's a strategy the company is also using on its multivalent mRNA flu vaccine. And the mRNA platform allows scientists to change and update viral targets more quickly, making it ideal for pivoting if viral strains change each season. Targeting more than one viral protein has shown in the recent past to be effective: one of the mRNA COVID-19 shots was a bivalent vaccine that worked against two different strains of the virus. Fink says Moderna expects to finish signing up volunteers in the spring, and plans to follow them for at least six months. But it may take longer to get a full report on how effective the vaccine is in the real world, since that would require having a certain number of people catch the virus to evaluate how they do. Testing the vaccine in different sites around the world should provide more data, however. Would a vaccine stop me from getting norovirus? Like the COVID-19 vaccine, the mRNA norovirus vaccine candidate is not designed to prevent people from getting infected. But it would theoretically help anyone immunized—especially the very young and elderly—from getting severely ill and being hospitalized. How can I protect myself from norovirus? Since there are no antiviral treatments or vaccines yet, the best way to avoid getting sick is by practicing good hygiene. Wash your hands often and avoid touching your face and mouth. If you do get sick, stay home to avoid infecting others, since you can still shed virus for anywhere from a few days to weeks after you feel better.

Several fires continued to ravage the Los Angeles region on Thursday, killing at least ten people and forcing thousands to flee their homes. Firefighters are still struggling to control the blazes, which have led to wildfire smoke that’s worsening the air quality in the region. Wildfire smoke can travel long distances and affect the air quality far beyond the immediate vicinity of the fire. In 2023, smoke from wildfires in Canada spread along the eastern coast of the U.S. and beyond, prompting officials to issue air quality warnings in places including New York, North Carolina, and Ohio. TIME spoke to experts about the dangers of wildfire smoke and how LA-area residents can best protect themselves. Read More: How to Help Victims of the Los Angeles Wildfires Grottoes bear the enduring touch of Tang Branded Content Grottoes bear the enduring touch of Tang By China Daily How does wildfire smoke affect your lungs? Wildfire smoke contains many pollutants, including tiny particles that can get into your lungs and even your bloodstream, says Sara Adar, a professor of epidemiology and global public health at the University of Michigan School of Public Health. Inhaling wildfire smoke can lead to symptoms like difficulty breathing, shortness of breath, and coughing, says Dr. MeiLan Han, a spokesperson for the American Lung Association and professor of medicine and chief of the Division of Pulmonary and Critical Care at University of Michigan Medicine. Wildfire smoke can also lead to other symptoms, such as a burning or stinging sensation in your eyes and a scratchy throat. Can you ‘flush’ smoke out of your body? Your body is able to break down some of the harmful smoke particles, and you may cough some of it out, but Han says there’s no safe way to intentionally “flush” the smoke out of your body. Some of the particles may never get broken down. Who is most at risk? While anyone can feel the effects of wildfire smoke, there are certain groups of people who are most at risk, such as children, older people, people who are pregnant, and people with chronic health conditions, particularly cardiac or respiratory conditions. Breathing in wildfire smoke can trigger flare-ups for people with chronic lung conditions, could lead to asthma attacks, and could even increase the risk of heart attacks and strokes for vulnerable populations, Han says. How long does it take to recover from wildfire smoke? It can vary from person to person, depending on what, if any, pre-existing health conditions they may have. For many people who are healthy and don’t have underlying health conditions, the short-term effects of wildfire smoke will likely resolve once they’re no longer exposed to the smoke, Han says. But for people most at risk, the effects of wildfire smoke could last longer—for instance, smoke exposure could trigger a flare-up of a chronic respiratory condition and the inflammation in that person’s lungs could be worse, so symptoms could last for a week or longer. How can you protect yourself? The best way to protect yourself against wildfire smoke is to stay inside with your doors and windows shut as much as possible to reduce your exposure, Han says. Adar also recommends running an air purifier, if you have one. If you have to go outside, wear an N95 or KN95 mask. If you’re driving, make sure your car is recirculating the air rather than bringing in air from outside, Han says. And if you have any pre-existing health conditions, make sure you have all your medications on hand in case you experience any kind of adverse reaction to the wildfire smoke. Does the air quality improve after it rains? Rain can help clear the air and improve air quality. Even when there isn’t an active wildfire, if an area is experiencing a drought, there can be more dust particles in the air that can contribute to increased air pollution and worsen air quality. How long can you be outside when the air quality is unhealthy? “It’s all kind of relative,” Han says. The effect of poor air quality varies from person to person, and depends on how bad the air quality is. But Han says: “If you’re going to be outside for a reasonable amount of time, I would consider wearing a mask.” Adar says researchers have not found evidence that there’s ever a safe level of exposure to the particles found in wildfire smoke. Both Adar and Han recommend that people check the Air Quality Index in their area to get up-to-date information. What are the long-term effects of wildfire smoke on your body? Research suggests that repeated exposure to air pollution, including wildfire smoke, can increase the risk of developing chronic respiratory conditions, Han says. Some studies suggest that wildfire smoke can also affect brain health; Adar and her colleagues studied the link between long-term exposure to air pollution and dementia in older adults in the U.S., and found that wildfire smoke was one source of air pollution that can have particularly harmful effects on the brain. Read More: Wildfire Smoke Is a ‘Public Health Threat’ That Can Have Lasting Impacts, Experts Say “Because of climate change, and the fact that we’re starting to see [wildfires] more and more, it’s becoming a very active area of research,” Han says of the long-term impacts of wildfire smoke exposure. “We need to think hard about how we can obviously try to prevent the wildfires, but [also] think about how we can protect air quality better moving forward, generally speaking, because it is becoming an increasing health concern—not just a one-off event.”

Any time a person catches H5N1, or bird flu, their infection is a chance for the virus to mutate in the wrong direction. When someone dies from the bird flu—as an elderly Louisiana man did on Jan. 6, becoming the first U.S. death from the disease—experts get especially concerned. Could this person's deadly infection signal that the H5N1 virus is becoming more adept at infecting people and causing severe disease in humans? Here's what experts say. A closer look at the recent death So far, 66 people in the U.S.—most of them farmworkers who spent time around infected cattle and poultry—have been infected with H5N1, but all have recovered after mild illnesses. Health officials get samples from these infected individuals in order to keep tabs on the virus, monitoring it for any signs that it might be mutating to become more adept at infecting people, spread more easily among people, or cause more serious disease. So far, there have been no indications that the virus is changing to allow it to jump from person to person. The Louisiana man was swabbed for samples of the virus in his nose and throat before his death. So were the sick chickens in his backyard, with which he was in direct contact. After analyzing these genetic sequences, scientists at the U.S. Centers for Disease Control and Prevention (CDC) found a few mutations that weren’t detected in infected chickens on the man's property, suggesting that the virus began changing after infecting him. Read More: We Are Not Safe from Bird Flu Until We Protect Farmworkers But the mutations weren’t sufficient to make the virus transmit more easily from one person to another, they concluded. The virus they identified was also detected in wild birds and chickens in the U.S. and in some human cases in the country and Canada, but it’s different from the strain responsible for the major outbreaks in dairy cows and chickens throughout country. The good news, according to the CDC analysis, is that they found no changes in the part of the viral genome that mutates to resist antiviral drugs, so current drug treatments should still be effective against this strain of H5N1.

Dr. Vivek Murthy served two terms as U.S. Surgeon General—first under former President Obama, then under President Biden. During his tenure, Murthy was a calm and reassuring voice during COVID-19, one of the biggest health challenges the country has faced in recent years. But most of the time, the "nation's doctor" highlighted public-health issues that usually fly under the radar: loneliness, gun violence, the dangers of social media, overwhelming parental stress. As he prepares to leave office, Murthy wrote a "parting prescription" for the country, reflecting what he feels Americans need most to become healthier and happier. In an interview (lightly edited for clarity and length), Murthy shared with TIME his learnings and his hopes for the health of the nation. TIME: Is a "parting prescription" a tradition for Surgeon Generals to leave behind? Murthy: It’s not a tradition that I’m aware of. But for me, this was important to do. I realized over two terms that there were critical questions I have been grappling with. What was driving the deeper pain, the unhappiness I was seeing for years across the country? Branded Content XPRIZE at the 2025 TIME100 Summit: Making the Impossible, Possible By XPRIZE I wanted to lay out some of the answers I have found and the path I hope we can travel down as a country to help us be healthier, happier, and more fulfilled. To me, this is the synthesis of the most important learnings that I have taken away from conversations with people all across the country, and from science and research that I have seen over my two terms. In your prescription, you focus on the need to rebuild a sense of community. How do you define community? Community is a place where we have relationships, help each other, and where we find purpose in each other. Those three elements are the core pillars of community. Community is also a place fueled by a core virtue: that’s love, which manifests in generosity, kindnesses, and courage. When you put these together, then you have a place where people find a sense of belonging and meaning. What I have found over my two terms is that for many people, that sense of community has eroded. We have millions of Americans struggling with loneliness: a third of adults and half of young people. People’s participation in both formal and informal service remains low. And more than half of young adults in a recent survey said they felt either low or no sense of meaning and purpose in their lives. To me, these are all red flags. They are warning signs telling us that the fundamental elements we need to live fulfilling lives are vanishing and getting weaker. If we don’t do something about them, it may not matter that we have the best policy proposals or are making big financial investments in communities. People won’t thrive the way they need to. What effect does that have on the public’s health? As community is deteriorating or diminishing in people’s lives, we are starting to see many different manifestations of that. Some involve mental health; others are physical-health related. We are also seeing that when people struggle with loneliness and isolation, it impacts their productivity and engagement at work, and also how kids do in school. When community is weak, we are more easily polarized, divided, and turned against each other. There is a lot of frustration and even anger now about inequities and barriers in the U.S. health care system, from drug pricing to coverage, as evidenced by the reaction to the fatal shooting of the UnitedHealthcare CEO. How do we address those challenges? One of the biggest challenges in any job, including a job like the Surgeon General, is picking which issues to focus on. We had to make some tough choices at the beginning about how to pick among many worthy issues. My thinking has been, where are we uniquely as an office positioned to be able to pull back the curtain on an issue, work out a strategy, and solve a problem? Where can our voice make a unique contribution? Read More: Even Small Amounts of Alcohol Can Cause Cancer, Surgeon General Says I saw very clearly in my first term that mental health was a profound challenge for the country, and it continued to get worse, particularly for young people. I knew coming into the second term that while COVID-19 was a major public-health emergency, the pandemic would make the mental-health struggles we were seeing even worse—so we needed to focus on that as much as possible. Part of what I tried to do was widen the lens through which we look at health by recognizing that mental health and social health are also part our well-being and impact each other, as well as our physical health. If we want people to be healthy and want to support their well-being, we’ve got to understand and support all three dimensions. You oversaw one of the biggest public health threats in our country’s history. Have any lessons from COVID-19 changed U.S. health care for the better? We learned a lot from the pandemic. The government learned a lot about how to produce and distribute vaccines much more rapidly than we thought perhaps ever possible. We learned how to work with industry to rapidly develop treatments and get them out to people. Where I have the greatest concern is that what we saw during the pandemic was that health misinformation spread rapidly, and many people didn’t know who to trust. But what we did find was that trust in friends, family members, and individual doctors, nurses, and local health departments often remained healthy, even though trust in larger institutions may have eroded. Read More: 10 Questions to Ask Yourself at the Start of a New Year To me, that means we have to invest a lot more in doing the hard work to build local connections between doctors, nurses, local health departments and hospitals, and the communities they serve. Those local relationships are going to become central to future pandemics, where misinformation will likely continue to swirl online. A lot of that is contingent on both the government and private sector being able to get accurate information out to people in a timely and trustworthy way. How can health officials rebuild the public’s trust in science and health institutions? We have to ask ourselves how we can do better so people don’t feel judged when they have a different point of view, and how we can be even more transparent with the reasoning behind decisions or recommendations. How do we build a stronger relationship with the public, and how do we do that not just during a crisis but in between? When we have a relationship with the public, they come to know people in institutions, how an institution functions, and how it makes decisions. It doesn’t guarantee that people will trust them, but it increases the chances significantly that when you do have a crisis, even if people disagree with a recommendation, they understand why you did it and are at least open to hearing about the reasoning behind the process. How can we as a country start to build community? When people are not invested in each other, it makes it hard to come together and advocate for and support the policy solutions that we need. If I don’t have children, and don’t know people who have children—or if I’m not caring for an aging parent or don’t know people who are—then I won’t go out to advocate for safer schools and home care. But if I am connected to my neighbors, friends, and family, then their concerns become my concerns. What’s next for you after you leave the Surgeon General’s office? I don’t 100% know what I’m going to do next. What I do know for sure is that the issues I worked on over the last two terms—and in particular, the question of how we rebuild community and the social fabric of our country and the world—will remain central issues to me. I see these as issues we have to address if we want to make the world more hospitable and more nourishing for our kids. I asked my kids, who are 6 and 8, what I should do after being Surgeon General. It probably says something about me that I’m looking for career advice from a 6 and 8 year old. They looked at me and smiled and said, ‘Papa, we think you should spend more time playing with us.’ I thought that was the right advice. Read More: What Makes a Friendship Last Forever? I find myself learning a lot by watching my kids. I find that kids, especially when they are really young, tend to be authentic, vulnerable, and also kind and generous. They also tend have an appreciation for the simple wonders in life. I realized that those are the things I want to recenter my life on as well. I want to rediscover the wonder of the simple things in life. I want to experience gratitude more and more in my day-to-day life. I want to figure out how to cultivate more generosity, love, and kindness in my own life—and figure out how to support and nurture that in world around me. There are a lot of big challenges we face as a country. But I think these moments of great change and uncertainty can also be powerful moments for us to ask the question: how can we live better lives, how can we make changes to create a better world for our children? Those are the questions I want us to grapple with now. If we do that, then I feel very optimistic that we have what it takes to create a community all us deeply need in our lives, and ultimately help us find the fulfillment we all seek.

Years ago, stress kept Hannah Eden up at night before her CrossFit events. Beating her competitors “meant everything,” she says. But having a baby changed her mindset. Training for a half-Ironman in Hawaii, she focused less on the competition, and more on her own performance. “I was so grateful just that my body could do this, eight months postpartum,” she says. Feeling less pressure, she excelled, finishing the June race at a surprisingly fast pace. “It was such an individual journey,” she says. Like Eden, I’ve been chasing my (far less impressive) personal records lately: I run a 5K at an empty high school track every weekend, stubbornly trying to beat my fastest time ever, which I set years ago. I check my pace and, if I’m near my personal record, I push through agony to try to break it. My quest for a “PR,” as it’s called, is more exciting than going through the motions at the gym, and the extra exertion is boosting my cardio. Despite the empty track, I’m not alone: TikTok and Instagram are full of posts on PRs for running, lifting weights, punching reflex balls, deep-sea diving, and everything in between. “PRs are absolutely trending right now,” Eden says. Meanwhile, fitness trackers, smart machines, and coaches help people choose the right PR goals and achieve them. “With self-quantification becoming more precise and accurate, people enjoy the feedback,” says Hengchen Dai, an associate professor who studies decision-making at UCLA. Findings from Dai and others are pointing to a new science of PRs and how to nail them. Why PRs boost motivation People become more motivated and excel more when they set specific goals. PR goals can work especially well because they’re precisely tailored to your ability. “A personal best is tuned to an almost perfect level of personalized difficulty,” says Ashton Anderson, a University of Toronto associate professor of computer science who’s studied PRs in chess. “Beating your PR is achievable, but by definition it’s difficult, since you’ve never done it before. This calibrated difficulty gives personal bests their motivational power.” With PRs, “you’re not seeking approval from a peer group,” says writer Oliver Burkeman, who emphasizes personally meaningful goals in his book, Four Thousand Weeks: Time Management for Mortals. “Like the stoics, you focus on what you can control, without tormenting yourself over what you can’t.” Read More: What to Expect at Your First Therapy Session Competition with others, by contrast, may distract rather than motivate. “If you don’t measure up, you could be improving but still feel like a failure,” says Andrew Martin, a researcher of motivation at the University of New South Wales in Sydney. Seeking a PR involves fewer unlucky breaks and clearer outcomes. (PR goals help students learn, too, Martin has found.) Of course, some people thrive on rivalries with others—think Larry Bird and Magic Johnson, or Roger Federer and Rafael Nadal. Both PR goals and external competition “can facilitate performance in the sports arena, classroom, and workplace,” says Andrew Elliot, a psychology professor at the University of Rochester. People with competitive personalities and higher skill levels may benefit uniquely by testing themselves against opponents. Elliot, for one, gets “tremendous enjoyment” from the challenges of his peers. Such competition and PRs aren’t mutually exclusive; it’s often helpful to get elements of both, studies show. Over the long haul, though, people who concentrate more on PRs may enjoy more intrinsic motivation, well-being, and steady devotion to their goals, Elliot says. “Social comparison can demotivate us and feel threatening, leading to burnout,” says Ilana Brody, a PhD student and Dai’s collaborator at UCLA. How to go for a PR Choose the activity PRs help with intrinsic motivation partly because they let people be creative. What you do and how you do it are totally up to you. BJ Fogg, a social scientist at Stanford University and author of Tiny Habits: The Small Changes That Change Everything, recommends choosing an area where you’re naturally proficient. Fogg is “terrible” at endurance races, so he goes for PRs involving shorter bursts. “I’m oddly good at one-minute sprint rowing,” he says. Or you could pick more of an uphill battle. Running 5Ks enticed me because I’d never shown much talent for it. Similarly, Eden wondered if finishing a half-Ironman just months after giving birth was hopeless. Barely able to run a mile at first, what intrigued her most was that the goal seemed nearly impossible. Read More: Should You Tape Your Mouth Shut When You Sleep? Such PR-striving enables self-discovery—separating self-imposed limits from what you’re truly capable of—and this is why many are drawn to them, suspects Eden, who helps people achieve PRs as an iFIT and NordicTrack trainer. “Doing hard things is becoming cool again,” she says. And many get ideas about what’s achievable by watching others on social media. “Maybe you don’t have the typical runner’s body shape, but you see someone who looks like you posting their time,” Eden says. Perhaps you’re a runner after all. Pick a benchmark After choosing the activity, set your sights on a specific measure. Beginners might pick a PR goal just slightly better than their previous best. Such a win garners social-media bragging rights, and it’s deeply satisfying—if the PR celebration dances are any indication. You can add a stretch goal for further improvement. Find stats on the performance of people your age and fitness level, and choose a measure reflecting these stats. It should seem like a step change beyond your current ability but feel just reachable with 2-3 months of dedicated training. “It makes a difference if you find your reference group, and then within that, you can have multiple levels to try for,” says Alex Karwoski, a Peloton instructor and former Olympic rower. Read More: What to Do if You Have Sleep Apnea “The goal should be challenging but realistic,” Dai says. People often appreciate round numbers, like going for an hour-mark in a marathon, because they’re easy to remember—plus they simply look more significant, Brody says. Another strategy is to identify new PR goals at the beginning of a week, month, or year—perhaps 2025?—especially after periods of subpar performance, Dai has found. “These moments really make people feel different from their past self, increasing their confidence to do better going forward,” Dai says. Game-day The day of your PR attempt, get fired up. Right before my 5K runs, I listen to Eric Thomas’s motivational speeches. His over-the-top style (“You have to want to succeed as bad as you want to breathe!”) cracks me up, but his voice echoes in my head as I run. And I push harder. Visualize success and dress the part. Research shows that visualizing peak performance can help enable the real thing. Dress like a champ expecting greatness—maybe gold shoes like Usain Bolt to achieve your PR for fastest walk ever. Write a letter of congratulations to your future self, another research-backed approach. Read More: What to Know About Orienteering, the ‘Thinking Sport’ The beauty of PRs is they happen in unexpected ways. Maybe you fell short of your PR for consecutive pushups, but your fitness tracker reveals another type of PR: pushups on a record-number of days that month. Fogg looks for these surprise PRs. “I’m tricking myself in a way because I’m only looking at the successes, but seeing the successes motivates me to keep going.” It’s also useful to focus on PRs for smaller activities that support an overall goal. Fogg wanted a new PR for pull-ups, so he created a “tiny habit” of hanging on the pull-up bar to build his grip strength. Some days, he’d hang for just 5 seconds, but most days he could do more, eventually managing a PR of 1 minute, 15 seconds. The additional strength enabled record pull-ups. “If you’re very consistent with doing a habit, you’ll make progress and achieve things you wouldn’t otherwise.” Celebrate After achieving a PR, celebrate to “help yourself feel successful,” Fogg says. Once you start looking for PRs, you may spot them everywhere, along with more opportunities to celebrate—like a PR for the slowest mile ever run while smiling the whole time. Or a PR for most attempts at a PR without achieving it. I didn’t beat my 5K time for a PR for a record 46 tries. On try 47, I succeeded, but I’m just as proud of my perseverance PR. Don’t celebrate so much that you start avoiding the activity. After a PR, people tend to quit while they’re ahead, fearing they’ll do worse next time, Anderson has found. This sacrifices the opportunity to build on momentum. Family record? Competing against yourself, instead of others, may seem like a recipe for loneliness. Fortunately, the “personal” part of PRs can be interpreted loosely; families or communities can strive for PRs together. After dinner, a family could team up to set its fastest time for clearing the table, dishwashing, and taking out the trash—and get a light post-meal workout in the process. I’m working on a father-son 5K PR with my nine-year-old (he runs 1K, I cover the rest). Karwoski’s fitness-oriented family tries to beat its previous times when circuit training together. Karwoski also competes in team relays, sharing “personal” records with his runner friends. Don’t push too hard A PR goal can be counterproductive if it threatens your self-esteem. “It’s strange how some people turn leisure into more work” by going for PRs in exercise, Burkeman says. Although he thinks many people probably benefit from PR goals without any downsides, Burkeman notes that the PR chase is inherently endless. “It’s always going to be true that, at any point, you haven’t exceeded your most recent personal best. If the goal always slips away, that’s a tough way to live.” Too much PR tracking can backfire, research shows. “Although measuring your behavior and progress can increase time spent on those actions, it can also undermine intrinsic motivation to succeed,” Brody says. Read More: Rock Climbing Is a Thrill. It’s Also Really Good for You Enjoy breaks for mental and physical recovery. Successful athletes “welcome distractions into their lives,” says Karwoski, the Olympic rower. “They do better long-term because of it.” An instructor can recommend training tips and milestones toward PRs. Some exercise machines connect to real-life coaches (like Karwoski and Eden) and AI coaches focusing on PR goals. Eden preaches “progressive overload”: gradually increasing training rather than ramping it up too quickly, which causes injuries. Fitness trackers like Fitbit build workouts based on people’s goals, fitness level, and stress. To avoid injury and burnout, rotate your PR goals seasonally. I find that fall weather is good for running PRs. In winter and summer, I shelter inside my gym for PRs in strength training, balance, and flexibility. Spring is ideal tennis weather, ripe for a most-matches-played PR. Seasons of life As people get older, it’s often harder to achieve PRs, but that can depend on how the PR is framed. At 61, Elliot’s muscle mass has declined, affecting his ability to exercise the way he used to. Now, he frames his goals around trying not to lose his capabilities, rather than setting PRs. These maintenance goals—trying to preserve old PRs as much as possible, rather than achieve new ones—are less motivating, research shows. “It’s not ideal,” he says. Fogg, who is also 61, knows he can’t do as many pull-ups as his teenage self. But he’s staying motivated by reframing the situation, looking to hit his PR for this decade of life. “Twelve pull-ups is my personal best for my 60s,” he says. So far. “Resetting the target is so important with age and as a mom,” Eden adds. Older amateurs may compensate by becoming more strategic about training. Anderson notes that chess players’ raw cognitive ability starts declining around ages 30-35. “But for nearly all amateurs, there’s so much strategy to pick up, they can still improve throughout their lives,” he says. As it applies to fitness, this would mean that PRs remain possible if people keep learning how to excel in their chosen activity.

A 13-year-old girl in Canada became so sick with H5N1, or bird flu, in late 2024 that she had to be put on a ventilator. Around the same time, a senior in Louisiana was diagnosed with the first "severe" case in the U.S. As bird flu continues to ramp up, many are wondering what tools—namely, vaccines—we have to fight it if such intervention becomes necessary. “Public-health and infectious disease folks around the world are watching bird flu very, very carefully,” says Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center and spokesperson for the Infectious Disease Society of America. “The concern is that this virus could acquire the capacity to attach to human cells and spread widely. That would be opening the door to a new pandemic for sure.” For that to happen, the H5N1 virus would have to develop the right mutations that allow it to more easily infect human cells—a process that could occur more easily if someone were to be infected with both seasonal flu and H5N1, for instance, allowing the two viruses to exchange genetic information and recombine into a strain that readily infects and spreads among people. Branded Content XPRIZE at the 2025 TIME100 Summit: Making the Impossible, Possible By XPRIZE Fortunately, that hasn’t occurred yet, but health officials aren’t waiting around. Work on a vaccine is underway to protect the public in the event of a pandemic, and earlier this year, Dr. Mandy Cohen, director of the U.S. Centers for Disease Control and Prevention (CDC), pointed to mRNA as a preferred platform for the shot since vaccines can be developed and distributed quickly. Here's the latest on the efforts to develop a new bird flu vaccine. Is there already an H5N1 vaccine? Several vaccines target H5N1, and the national stockpile has doses of all of them. These shots target different strains of H5N1 that were circulating when the vaccines were developed years ago, but health experts expect they would still provide some protection against severe disease. "Fortunately, current vaccine candidates neutralize the circulating strains in vitro," wrote health officials from the U.S. National Institute on Allergy and Infectious Diseases in a Dec. 31 editorial in the New England Journal of Medicine. A small number of healthy volunteers have been vaccinated with these H5N1 vaccines, and the antibodies they generated appeared to neutralize the circulating virus in lab tests. But these vaccines have not yet been tested in a clinical trial, since there have not been enough H5N1 infections in humans to compare vaccinated people to unvaccinated. What about an mRNA vaccine for H5N1? There isn't one yet, but several companies—including Moderna, Pfizer and GlaxoSmithKline (in collaboration with CureVac)—are working on such a shot. In July, the U.S. government’s Biomedical Advanced Research and Development Authority (BARDA) awarded Moderna $176 million to develop its updated mRNA H5N1 vaccine. All of the mRNA vaccine candidates are in early stages of testing in people for safety and efficacy. The shots rely on the same mRNA technology that was used to create COVID-19 vaccines. In recent weeks, scientists led by a team at the CDC reported that an mRNA-based H5N1 vaccine helped ferrets generate strong antibody responses against the virus and to survive a lethal dose that killed ferrets that hadn't received the vaccine. Read More: We Are Not Safe from Bird Flu Until We Protect Farmworkers Dr. Drew Weissman, director of vaccine research at Penn Medicine and a 2023 Nobel Prize winner for his work in pioneering mRNA technology for vaccines, and his colleagues also reported encouraging results with a vaccine they developed and tested in ferrets. The shot, which targeted the strain of H5N1 causing recent infections in chicken and cattle, prevented severe illness and death from H5N1 in the ferrets. Unvaccinated animals did not survive. “The real advantage of mRNA vaccines in the context of a pandemic is the ability to update the vaccines as needed,” says Scott Hensley, professor of microbiology at the University of Pennsylvania Perelman School of Medicine who worked with Weissman to develop the vaccine. “The beauty of mRNA is the ability within a moment’s notice to change the vaccine.” How soon could an updated vaccine be made available? While developing an mRNA vaccine would take just a matter of months, testing the shot in clinical trials would take longer. “We know the vaccines would be well tolerated and safe because they were in the context of COVID-19,” says Hensley. “But any new antigen needs to be tested.” In order to avoid delays in providing vaccines to the public in case of a pandemic, governments should be investing in conducting large-scale, late-stage clinical tests before a pandemic breaks out, Hensley says. “It would be investing in something that you’re not certain is going to cause a pandemic,” he says. “But it’s a decision that governments need to make. In my opinion, it would be money well spent when dealing with a virus that has the potential of this particular virus.” Another way to avoid that delay and reduce the number of people who become sick with a pandemic-level bird flu is by developing and distributing a more broadly targeted vaccine. Influenza comes in four main subtypes—A, B, C, and D—and two, A and B, cause most infections in people. (H5N1 is type A.) Hensley developed a vaccine candidate that can recognize all 20 of the A and B influenza subtypes—including H5N1—and found that it generated strong immune responses in mice and ferrets. In addition, when the vaccinated ferrets were exposed to slightly different influenza variants within those subtypes, they still produced good immune responses against them. Read More: What to Know About Walking Pneumonia While the vaccine didn't protect the animals from getting infected, they didn't get as sick. “What it does is prime the immune system to respond and clear the virus faster,” says Hensley. “So the idea would be to prime the population with this type of vaccine that would limit initial severe disease and death in case of a pandemic. That would buy some time for more specifically matched vaccines that could be developed and used as boosters. Schools wouldn’t have to close down, and people might still be infected but not dying.” The National Institutes of Health is sponsoring trials of this vaccine, which could change the way we vaccinate against flu and other emerging threats. Hensley says that if proven safe and effective, such a broadly targeted shot would ideally be given to young babies so their immune systems could be trained to recognize a wide range of influenza types early on. That would set them up for quicker and more effective immune responses to vaccines and infections as they got older. Who should get vaccinated against H5N1? Because the CDC says that the risk of bird flu is still low for the general public, there are no recommendations for anyone in the U.S. to get vaccinated against H5N1 at the moment. Some experts believe dairy workers and others who have close contact with animals likely to be infected, such as poultry and cattle, should be vaccinated to protect them from infection, but U.S. health officials have not made this decision yet, noting that a full understanding of the risks of H5N1 to people and the benefits of the vaccine aren't entirely clear. Finland has offered people at higher risk of exposure to bird flu—including those in the fur industry who handle wild boars and those in the poultry industry—a bird flu vaccine made by Seqirus, which uses a more traditional vaccine technology that includes an inactivated form of the virus.