The company said it would cap the out-of-pocket cost of the diabetes drug at $35.Eli Lilly and Company said on Wednesday that it would reduce the price of its most commonly prescribed insulins and expand a program that caps monthly out-of-pocket costs for patients at $35 or less.It said the company was taking the action to “help Americans who may have difficulty navigating a complex health care system that may keep them from getting affordable insulin.”Insulin, a lifesaving drug that is usually taken daily, has grown increasingly expensive in recent years, and many diabetes patients ration their medicines or discontinue them because of the cost. More than 30 million Americans live with diabetes.It comes after years of mounting criticism from Americans who have said the drug should be more accessible. The criticism led to lawsuits and legislation.This is a developing story. Check back for updates.

LONDON — Piece by piece, the Covid-19 sanctuary was born on a hilltop in the town of Bedworth in central England. The process was meant to be a metaphor for a human life. Like bones fused over time, it grew taller as the memorial’s creators spent months joining intricate pieces of wood into a skeletal structure that finally stood on its own, 65 feet high.Then they burned it all down.There have always been monuments to commemorate the loss of life from calamitous events, such as the thousands of memorials dedicated to world wars, the Sept. 11 attacks, the Holocaust.“Sanctuary,” near Coventry, England, in May, before its creators burned it down.Andrew Boyers/ReutersThe structure was built of nearly 1,000 carvings of pine and birch arches, spires and cornices.Andrew Boyers/ReutersBut the Covid-19 pandemic, now in its third year, has presented a unique challenge for grieving families. It is not a singular event, in one location. As the death toll of more than six million worldwide continues to rise, communities and families are trying to keep up, building memorials at the same time that the tragedy is unfolding, its end not yet written.New monuments are being installed. Old projects are expanding. Photographs and biographies of Covid-19 victims in Malaysia and South Africa are updated online. Landscapes in villages and cities are transformed by remembrance, from a waist-high structure in Rajannapet, India, to spinning pinwheels fixed along a walkway in São Paulo, Brazil.Names are painted on a wall along the River Thames in London and on rocks arrayed in hearts on a farm in New Jersey. Thousands of fluttering flags were planted at the Rhode Island State House. Ribbons are tied to a church fence in South Africa.Bandung, Indonesia, in December 2021: A memorial dedicated to health care workers who died during the pandemic.Timur Matahari/Agence France-Presse — Getty ImagesShandong Province, China, in September 2020:A collection of 558 memorial tablets at a Taoist temple were inscribed with the names and hometowns of people who died.Tingshu Wang/ReutersWall Township, N.J., in October 2021: Mike Baronick saw his wife’s name during his first visit to a memorial wall. The wall began on a Jersey Shore beach before finding a permanent home on a community farm.Seth Wenig/Associated Press“People died alone in hospitals, or their loved ones could not even see them or hold their hands, so maybe some of these memorials have to do with a better send-off,” said Erika Doss, a University of Notre Dame professor who studies how Americans use memorials.“We really do need to remember, and we need to do it now,” Dr. Doss said. “Covid isn’t over. These are kind of odd memorials in that names are being added. They are kind of fluid. They are timeless.”It is not easy for the builders of these memorials to capture death. It is elusive and vast, like the airborne virus that claimed lives and left the question of how to make a physical manifestation out of a void.For the builders of the sanctuary in Bedworth, a former coal mining town, the answer was to turn away from their communal artistry of nearly 1,000 carvings of pine and birch arches, spires and cornices, and to reduce it to ash at sunset on May 28.New York in March 2021: Images of victims were projected over the Brooklyn Bridge as the city commemorated a Day of Remembrance.Kena Betancur/Agence France-Presse — Getty ImagesLima, Peru, in January 2021: A memorial to doctors who died of Covid-19.Paolo Aguilar/EPA, via ShutterstockRio de Janeiro in August 2020: People were silhouetted among crosses and balloons placed by members of the non-governmental organization Rio de Paz in tribute to Brazil’s Covid victims.Ricardo Moraes/ReutersWhat the moment needed, one organizer said, was an event of catharsis and rebirth, in which people who had seen the sanctuary standing can now go back and see it gone.“It will still be there in their mind,” Helen Marriage, a producer of the project, said. “Feel the emptiness, which is the same way you feel with this dead, loved person.”London in May 2021: Hearts painted on the National Covid Memorial Wall next to the River Thames.Daniel Leal/Agence France-Presse — Getty ImagesWall of HeartsOver a year after it started, new names are still being added to the thousands scrawled on hearts painted on a wall along the River Thames in London.A walk along its nearly half-mile stretch shows how death gutted generations and left few countries untouched. Arabic, Portuguese, Spanish and Urdu are among the languages in messages to “Grandpa,” “Mum,” “Daddy,” “Nana.”Uncle Joshua. My brother. My first friend.Their authors tried to understand death. “Angel wings gained too soon” was how someone described Sandra Otter’s death on Jan. 30, 2021. “Keep on Rocking” was the message to Big Pete.The virus claimed neighbors, comedians and drinking buddies, their stories told in marker on the wall. Dr. Sanjay Wadhawan “gave his life saving others.” Cookie is “still remembered at the post office.” To all London “cabbies, RIP.”Some tried to make sense of loss. Angela Powell was “not just a number.” One person wrote, “This was murder,” and another said, “They failed them all.” A woman named Sonia addressed Jemal Hussein: “Sorry you died alone.”The wall’s founders were citizens and activists, who started painting the empty hearts last year toward the end of one of Britain’s lockdowns. It is visible from Parliament across the river, to represent the more than 150,000 people who had Covid-19 on their death certificates in Britain.Soon, the hearts held countless names.“We have no control over it,” said Fran Hall, a volunteer who regularly paints new hearts and covers up any abusive graffiti that appears.“We could be painting one section, and people are adding hearts further down,” she said. “It is still happening. It is really organic.”Prague in March 2021: Thousands of crosses were drawn onto the pavement at the Old Town Square to commemorate the anniversary of the death of the first Czech Covid patient.Michal Cizek/Agence France-Presse — Getty ImagesShared GriefDacia Viejo-Rose, who researches society’s use of memorials at the University of Cambridge, said the “coming out” of grief over Covid-19 was compelling because so many suffered in isolation.“It became so much about what are the statistics of people dying, that we lost track of individual suffering,” she said. “We lost track of the individual stories.”People who are grieving will often seek solace at a memorial that is unrelated, she said.One day in June, Du Chen, a student from China who is studying at Manchester University, knelt to write in Mandarin on one of the painted hearts in London, to “wish everybody well.”“People are not just commemorating the people they have lost, but also the way of life before the pandemic,” he said.A family of tourists from Spain paused, saying their people suffered, too. Alba Prego, 10, ran her fingers along photographs attached to a heart mourning a California man, Gerald Leon Washington, who died at 72 in March.“The people who wrote that loved him very much,” she said.Around her, unmarked hearts awaited new names.With the death toll climbing, there will be more.Johannesburg in July 2020: Silva Cossa, a caretaker, tied ribbons onto a fence at St. James Presbyterian Church. The ribbons represent South Africans who have died from Covid.Themba Hadebe/Associated PressWhite RibbonsSpace is also being found for remembrance on a fence at St. James Presbyterian Church in Bedfordview, a suburb on the edge of Johannesburg. In early 2020, caretakers began tying white satin ribbons on the fence for people who died of Covid-19.By June 25, 2020, about three months after Covid-19 was declared a pandemic, they tied the 2,205th ribbon. By December, there were 23,827.In January 2021, the month with the highest average deaths in South Africa, the church said it would tie one ribbon for every 10 people who died.More than 102,000 people have died from Covid-19 in South Africa, although the rate has slowed, the latest figures show. In early July, the fence had 46,200 ribbons tied to it, said the Rev. Gavin Lock.Families “suffered huge trauma in not being able to visit loved ones in hospital, nor view the deceased, and in some cases not able to follow customary rites,” he said.Washington, D.C., in September 2021: An art exhibition blanketed the National Mall with more than 700,000 white flags, each representing a person lost to Covid.Kenny Holston for The New York TimesWhite FlagsIn Washington, D.C., more than 700,000 white flags, one for each person lost to Covid, were planted on 20 acres of federal land. From Sept. 17 through Oct. 3, 2021, mourners wandered through the rustling field, writing messages and names on the flags.“I miss you every day, baby,” a woman whispered as she planted a flag, in a moment captured in a documentary published by The New York Times.By May 12 this year, when the death toll in the United States reached one million, President Biden ordered flags to be flown at half-staff for four days at the White House and in public areas.The white flags have kept going up.Suzanne Brennan Firstenberg, the artist behind the installation, “In America: Remember,” said a memorial using new flags was being planned for New Mexico in October. In June, thousands were planted at the State House lawn in Providence, R.I., to commemorate the 3,000 people who died of Covid-19 there.“What we are seeing is this push for handling it at the state and local level, because no one sees it happening at the national level,” Ms. Firstenberg said.“The plane is still crashing,” she said. “And it is super hurtful to families to not somehow acknowledge that the pain is still there.”Visitors at the exhibit in Washington, D.C., in September 2021.Patrick Semansky/Associated Press

Severe storms flooded parts of the facility in Sturgis, Mich., which went offline in February over contamination concerns, exacerbating a nationwide formula shortage.Abbott Nutrition, which worsened a baby formula shortage in the United States when it temporarily shut down a Michigan plant in February because of the presence of bacteria, said it had again stopped production at the plant, this time because of flooding during a severe storm.The company said on Wednesday that it was forced to stop production of its EleCare specialty formula in Sturgis, Mich., one of Abbott’s five manufacturing sites, after severe weather moved through southwestern Michigan on Monday, flooding parts of the plant.The company said that it was assessing damage and cleaning the plant, which would delay production and distribution for a few weeks, but that it had sufficient supplies of EleCare and most of its specialty and metabolic formulas to meet demand until new formula is available.“These products are being released to consumers in need in coordination with health care professionals,” it said.Robert M. Califf, the commissioner of the Food and Drug Administration, said that the agency had been informed about the stoppage but that it was not expected to have much impact, given increased imports of formula as well as production by Abbott and other manufacturers.Read More on the Baby Formula ShortageUnderstand the Shortage: With just a handful of companies making infant formula for the U.S. market, the shutdown of an Abbott Laboratories plant had an outsize effect.Premature Babies: Many newborns who spend time in the NICU rely on specialized formula to thrive once they come home. As the shortage continues, their parents can’t find it anywhere.Pumping for the Cause: In New York City, the shortage has prompted a huge volunteer effort, with some mothers donating their excess supply of breast milk to help other parents.An Emotional Toll: The shortage is forcing many new mothers to push themselves harder to breastfeed, with some even looking for ways to start again after having stopped.“While this is an unfortunate setback and a reminder that natural weather events can also cause unforeseen supply chain disruptions, I want to reassure consumers the all-of-government work to increase supply means we’ll have more than enough product to meet current demand,” he said in a statement on Twitter.The storm disrupted power and caused wind damage, the Sturgis Journal reported, and the city’s municipal airport recorded 1.5 inches of rain.The stoppage at the plant was the latest twist in the baby formula shortage in the United States, which started earlier this year, when pandemic-related supply chain issues, including a scarcity of some ingredients, made it difficult for parents to find formula.In February, the problems were exacerbated when Abbott recalled batches of its Similac, Alimentum and EleCare formulas and shut down the Sturgis facility after the F.D.A. received four consumer complaints of bacterial infections related to the formulas. Three of the complaints concerned Cronobacter sakazakii, a bacterium that can cause severe, life-threatening infections or inflammation of the membranes that protect the brain and spine.At least two babies died, although Abbott has said that there was no evidence its formula caused any known infant illnesses.After the shutdown, Abbott said it increased production at other manufacturing plants in the United States and at one in Ireland.Navigating the Baby Formula Shortage in the U.S.Card 1 of 6A growing problem.

A shipment that arrived on Sunday was the first of two intended to address shortages in the United States. Another shipment is set to arrive this week, the White House said.A shipment of infant formula intended to fill a nationwide shortage arrived in the United States from Europe on Sunday, and a second flight was expected to bring additional supplies in the coming days, the Biden administration said.The shipment, equivalent to about 500,000 eight-ounce bottles, contained a hypoallergenic formula for children with cow’s milk protein allergy, the White House said in a statement. It provides enough formula to take care of 9,000 babies and 18,000 toddlers for a week, Tom Vilsack, the agriculture secretary, said in televised remarks at the airport in Indianapolis, where the shipment arrived on a military plane from Ramstein Air Base in Germany.“This shipment of formula serves a critical medical purpose and will help infants with specific dietary needs requiring specialized formula,” Mr. Vilsack said on Twitter.A second shipment, which is expected to arrive this week, would bring the supply of formula up to the equivalent of 1.5 million eight-ounce bottles of three formulas, which would later be distributed from a Nestlé facility in Pennsylvania.U.S. troops moved pallets of baby formula at Ramstein Air Base in Germany on Saturday.Thomas Lohnes/Getty ImagesThe transports are part of a series of measures taken by the Biden administration to address the shortage of infant and toddler formula that had threatened to become a political and public health disaster, as frustrated families searched depleted supermarket shelves.President Biden invoked the Defense Production Act last week to increase production and authorized the use of Defense Department planes for “Operation Fly Formula” to respond to the crisis.In February, Abbott Nutrition, which controls 48 percent of the formula market in the United States, voluntarily recalled some of its most popular brands — Similac, Alimentum and EleCare — after four babies were hospitalized with bacterial infections. At least two babies died, although the company said this month that there was no evidence its formula caused any known infant illnesses.Abbott also shut down its plant in Sturgis, Mich., and the Food and Drug Administration warned consumers not to use the recalled brands that were produced there.Shelves normally meant for baby formula sat nearly empty on Sunday at a store in downtown Washington, D.C.Samuel Corum/Agence France-Presse — Getty ImagesThe effects of the closure of the Sturgis plant have been widespread, with stores limiting purchases of formula and parents desperately seeking supplies or trying to make formula at home, which pediatricians discourage. The shortage has also been exacerbated by supply-chain woes and labor shortages associated with the pandemic.The statement from the White House said the pallets of formula that arrived on Sunday were “prioritized because they serve a critical medical purpose” and were in short supply because of the plant closure in Sturgis.In another step to address the acute shortages, the F.D.A. announced last week that it would relax some of its regulations to encourage new suppliers to provide formula. The United States normally produces about 98 percent of the formula it consumes, with imports coming primarily from Mexico, Ireland and the Netherlands.

The pod, known as Sarco, was conceived as a way for people to end their lives without involving a doctor. A plan to introduce it in Switzerland has raised alarm even among right-to-die advocates.For years, a sleek, pod-shaped suicide machine called Sarco has been a striking sight at museums and funeral conventions.Now the creator of the pod is saying he is ready to take it beyond the showroom and make it available for 3-D printing next year in Switzerland, which has permissive laws on voluntary assisted suicide.The announcement by the inventor, Dr. Philip Nitschke, has unsettled even some of the most ardent right-to-die advocates, inflaming the debate.Dr. Nitschke, an Australian doctor who has been a supporter of assisted voluntary suicide for decades, said this month that he hoped to start sharing the 3-D printing program for the machine, which is designed to cause death as it fills with nitrogen, replacing the oxygen inside.He said he was aiming to introduce it in Switzerland in early 2022 after a lawyer hired by his nonprofit organization, Exit International, found no conflict with Swiss law. But the announcement, which he made in interviews and on the organization’s website, added to a growing debate over whether the online distribution of suicide information and materials encourages people to end their own lives when they might not otherwise seek to do so.In Britain, where an assisted dying bill is being reviewed in Parliament, Dr. Stephen Duckworth, the founder of Disability Matters Global, wrote in The Independent that he was “appalled” by Sarco.Dr. Duckworth, who has pressed for safe laws emphasizing personal choice and control of the dying process, added that he could not support it, “nor am I aware of any credible assisted-dying campaigner who does.” Sarco, he said in an interview, would “deprive users of human connection and replace it with a lonely virtual-reality experience.”He also raised concerns about safety. “What if it is accessed by someone not in their right mind?” he said. “Or a child? Or if it is used to abuse others? What if it doesn’t result in immediate or peaceful death and the individual is left alone without any recourse to call for help?”Dr. Charles D. Blanke, an oncologist and a professor at the OHSU Knight Cancer Center in Portland, Ore., who has studied data on physician-assisted dying, said breathing in nitrogen causes a rapid death. But he cautioned that it is untested, including as an alternative to lethal injection in capital punishment.“It is not at all clear that nitrogen inhalation would bring a peaceful death,” he said, contrary to Dr. Nitschke’s claim that death comes quickly after a brief euphoria.The law in Switzerland, where about 1,300 people sought help from right-to-die organizations in 2020, requires confirmation that people seeking to end their own lives are of sound mind and reached the decision without pressure from anyone with “selfish” motives. Then a doctor writes a prescription for sodium pentobarbital, the lethal medication used there.Sarco would bypass that step because it does not require a prescription for a drug.Some Swiss right-to-die organizations have distanced themselves from Sarco. Exit, which offers living wills, counseling and end-of-life care, and is unaffiliated with Dr. Nitschke’s similarly named nonprofit, said it does not see Sarco as an alternative to physician-assisted suicide. Another group, Lifecircle, said “there is no human warmth with this method.”Dignitas, a clinic near Zurich, said sodium pentobarbital “is approved and supported by the vast majority of the public and politics.” Pegasos Swiss Association said it was in discussion with the Sarco team but wanted further clarification about the device.Others who have studied the ethics of voluntary assisted suicide welcomed the debate that Sarco has inspired. Thaddeus Pope, a bioethicist at the Mitchell Hamline School of Law in St. Paul, Minn., said the debate about Sarco could lead to a new way of looking at end-of-life options, including by legislators.“That might be bigger or more important than the actual Sarco itself,” he said, adding that Dr. Nitschke was “illustrating the limitations of the medical model and forcing us to think.”“There are a lot of people that live with illnesses or conditions that they don’t want to live with, but they don’t qualify for medically aided dying where they live,” he said. “If he really goes forward with it, this may get the nonmedical approach to hastening death some more attention.”Dr. Nitschke, 74, has years of experience with assisted suicide. In the 1990s in Australia, he developed a machine that allowed his terminally ill patients to initiate their own deaths by administering a lethal medication with the touch of a computer key. This was the same era when Dr. Jack Kevorkian was promoting — and being prosecuted over — an assisted suicide device in the United States.Dr. Nitschke said he was inspired to create Sarco by the death in 2012 of Tony Nicklinson, a British man who suffered from so-called locked-in syndrome and whose request for help in ending his life had been rejected by a panel of judges.He said he had taken steps to ensure that anyone using Sarco would be doing so voluntarily. Users can initiate the nitrogen flow only after stating their name and where they are, and that they know what is about to happen. That process is filmed, he said, and a copy is provided to the coroner.“You say goodbye to everybody and climb in,” Dr. Nitschke said. “The idea is you are going, and they are staying.”Dr. Nitschke worked with designers in the Netherlands, where he lives, to produce a Sarco prototype in 2017 that has since been exhibited in museums and funeral fairs in Amsterdam and Venice.A model is currently on display at the Museum for Sepulchral Culture in Kassel, Germany, as part of a suicide exhibit. The curator, Tatjana Ahle, said most visitors were uncomfortable with the idea of using a futuristic pod for suicide.She said they “seemed to feel that this was inappropriate and dangerously aestheticizing death and trivializing it in its scope.”If you are having thoughts of suicide, in the United States call the National Suicide Prevention Lifeline at 800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources. Go here for resources outside the United States.

It’s Time to Get a Flu ShotChristine HauserReporting on the flu season ��Can the flu shot be given with other vaccines, such as one for Covid-19?Yes. The C.D.C. says the flu vaccine may be administered at the same time as a vaccine against Covid-19.Reactions to the vaccines are generally similar when they are given simultaneously as when they are administered alone.Common reactions to the flu vaccine can be a sore arm, and some people might get a little tired, experts say.

The ’90s-era supermodel said side effects from a fat-freezing procedure caused her to become depressed and turned her into a recluse after “not looking like myself any longer.”Linda Evangelista, the supermodel made famous in the 1990s, said she had become “brutally disfigured” and “unrecognizable” after a cosmetic body-sculpting procedure that had turned her into a recluse.In an Instagram post on Wednesday, she referred to filing a lawsuit, saying that she was taking “a big step towards righting a wrong that I have suffered and have kept to myself for over five years.”She added: “To my followers who have wondered why I have not been working while my peers’ careers have been thriving, the reason is that I was brutally disfigured by Zeltiq’s CoolSculpting procedure which did the opposite of what it promised.”Ms. Evangelista, 56, said that after the fat-freezing procedure she developed paradoxical adipose hyperplasia, a side effect in which patients develop firm tissue masses in the treatment areas.She said the cosmetic procedure left her “permanently deformed even after undergoing two painful, unsuccessful, corrective surgeries.” She said she had not been told of the risk.“PAH has not only destroyed my livelihood, it has sent me into a cycle of deep depression, profound sadness, and the lowest depths of self-loathing,” she wrote. “In the process, I have become a recluse.”Ms. Evangelista, who was known as one of the five top supermodels in the 1990s, detailed her story on Instagram, where she has 912,000 followers and where thousands of people commented or expressed support. Her story was also widely covered in international and national media outlets.Ms. Evangelista filed a lawsuit on Tuesday against Zeltiq Aesthetics Inc., in the U.S. District Court for the Southern District of New York. The suit said she was seeking compensatory damages of $50 million for her distress and loss of work, promotions and public appearances.Representatives for the company did not immediately respond to requests for comment on Thursday. A lawyer for Ms. Evangelista was not immediately available for comment.The lawsuit said Ms. Evangelista had seven treatments from August 2015 through February 2016 to break down fat cells in her abdomen, flanks, back and bra area, inner thighs, and chin. Within a few months, she developed “hard, bulging, painful masses under her skin in those areas,” it said, and was given a diagnosis of PAH in June 2016.The filing said her quality of life, her career and her body “were all ruined in 2016 after she was permanently disfigured” by the procedure and the multiple attempts at corrective surgery that followed.“Ms. Evangelista enjoyed a wildly successful and lucrative modeling career from 1984 through 2016, until she was permanently injured and disfigured by Zeltiq’s CoolSculpting System,” the lawsuit said.The suit accused the company of having “intentionally concealed” the risks or “failed to adequately warn” about them, and said Ms. Evangelista developed depression and a fear of going outside.Ms. Evangelista had full body liposuctions after the diagnosis by a doctor referred to her by Zeltiq in 2016 and 2017, but the procedures were unsuccessful and resulted in scarring, the lawsuit said.“Ms. Evangelista was promised a more contoured appearance; instead, the target fat cells actually increased in number and size and formed hard, bulging masses under her skin,” it said.According to CoolSculpting, its procedure has been cleared by the Food and Drug Administration for the treatment of visible fat bulges.In response to questions, the F.D.A. said in an email that it could not comment on litigation, but that it was “committed to ensuring medical devices are safe and effective and that patients can be fully informed when making personal health decisions.” It said that it monitors reports from consumers of adverse events after a device reaches the market and would “take action where appropriate.”Cryolipolysis, the name of the nonsurgical fat-freezing procedure, uses cold temperature to break down fat cells, according to the American Society of Plastic Surgeons.It is mostly used by patients who want to reduce a specific fat bulge that they have been unable to diminish through other means. Generally, the area of concern is “vacuumed” into the hollow of an applicator, where it is subjected to cold temperature.The surgeons’ society said the complication rate was low, with less than 1 percent of patients who may develop paradoxical fat hyperplasia, which is an unexpected increase in the number of fat cells. The side effect is more common in men than in women, the society said.Ms. Evangelista also said that the public scrutiny of her appearance had harmed her emotionally. “I have been left, as the media has described, ‘unrecognizable,’” she said.Jonah E. Bromwich

The ’90s-era supermodel said side effects from a fat-freezing procedure caused her to become depressed and a recluse after “not looking like myself any longer.”Linda Evangelista, the supermodel made famous in the 1990s, said she had become “brutally disfigured” and “unrecognizable” after a cosmetic body-sculpting procedure that had turned her into a recluse.“Today I took a big step towards righting a wrong that I have suffered and have kept to myself for over five years,” she wrote in an Instagram post on Wednesday.“To my followers who have wondered why I have not been working while my peers’ careers have been thriving, the reason is that I was brutally disfigured by Zeltiq’s CoolSculpting procedure which did the opposite of what it promised.”Ms. Evangelista, 56, said after the fat-freezing procedure she developed paradoxical adipose hyperplasia, a side effect in which patients develop firm tissue masses in the treatment areas.She said the cosmetic procedure left her “permanently deformed even after undergoing two painful, unsuccessful, corrective surgeries.” She said she had not been told of the risk.“PAH has not only destroyed my livelihood, it has sent me into a cycle of deep depression, profound sadness, and the lowest depths of self-loathing,” she wrote. “In the process, I have become a recluse.”Although Ms. Evangelista’s Instagram post mentioned a lawsuit, it was unclear whether one had been filed or where.According to CoolSculpting, the procedure has been cleared by the Food and Drug Administration for the treatment of visible fat bulges.According to the website of Allergan Aesthetics, a global pharmaceutical company whose brands include CoolSculpting, the procedure may cause an enlargement in the treated area about two to five months after treatment, requiring surgical intervention for correction.Neither Allergan Aesthetics nor the F.D.A. immediately responded to a request for comment on Thursday.

At least two judges in Ohio have made receiving Covid-19 vaccinations a condition of probation. While judges have leeway in setting such rules, it’s a murky area, experts said.As cases of coronavirus infections rise in Ohio, some judges have attached unusual conditions for those released on probation: Get a Covid-19 vaccine or face being sent to prison.On Aug. 4, Judge Christopher A. Wagner of the Court of Common Pleas in Hamilton County told Brandon Rutherford, who was convicted on drug offenses, that as part of his release on “community control,” or probation, he must receive the vaccination within 60 days.“I’m just a judge, not a doctor, but I think the vaccine’s a lot safer than fentanyl, which is what you had in your pocket,” the judge told Mr. Rutherford, 21, according to a transcript provided by the judge’s office on Monday.“I’m going to order you, within the next two months, to get a vaccine and show that to the probation office,” the judge said. “You violate, you could go to prison.”On June 22, another Court of Common Pleas judge, Richard A. Frye in Franklin County, gave Sylvaun Latham, who had pleaded guilty to drugs and firearms offenses, up to 30 days to receive the vaccination, according to court records. If Mr. Latham violated that condition and others, he could go to prison for 36 months. Mr. Latham agreed to be vaccinated, the records show.The sentences were a unique breakthrough in the public health debate taking place in the United States about how civil liberties intersect with mask and vaccination mandates.The judges’ decisions go to the heart of how personal freedoms are being examined through the lens of public health in a pandemic. David J. Carey, the deputy legal director of the American Civil Liberties Union of Ohio, said he saw no “clear cut” violation of civil rights.“It is a potentially murky area,” he said. “There is certainly a legitimate concern around ordering someone to do something that pertains to their bodily autonomy. They need to have a compelling reason to have to do so.”“The question here is whether there is such a compelling interest, and whether it pertains to the purposes of probation,” Mr. Carey added. “Judges do have a lot of leeway in imposing conditions on behavior while on probation. But that leeway is not unlimited. They still need to establish it has a clear connection to a person’s individual case.”In Ohio, as in the rest of the country, private businesses can impose their own requirements on employees and patrons. Federal government employees are required to be vaccinated or face regular testing, but state and local government institutions set their own rules. In Ohio, more than 800 school districts and other local entities function independently, Dan Tierney, a spokesman for Gov. Mike DeWine, said on Monday.Mr. DeWine said Ohio was a state that exemplified the dual risk of infection. “Those who are vaccinated are safe, those who are not vaccinated are not safe,” he said.Asked about his decision, Judge Frye said in an email on Monday that he had issued vaccine orders three times so far, and none of the defendants raised medical or religious objections.“Ohio law allows judges to impose reasonable conditions of probation, intended to rehabilitate the defendant and protect the community,” Judge Frye said. He said that, based on medical evidence, the vaccination would protect others and keep those on probation safer as they search for or keep jobs.Sharona Hoffman, a professor and co-director of the Law-Medicine Center at Case Western Reserve University’s School of Law, said it was unusual to pair sentencing with the vaccine.“Judges get creative in order to keep people out of jail,” she said. “They impose all sorts of sentences and, again, this is to the benefit of the person. And if you are going to be out in the community, you can’t run around infecting people with Covid.”In some states, such as Georgia, judges have offered reduced sentences if defendants get vaccinated, WSB-TV in Atlanta reports. Early this year, prisoners in Massachusetts were offered the possibility of reduced prison sentences for receiving the vaccine, but the decision was later rescinded.Michael Benza, a senior instructor at Case Western’s School of Law, said he believed other judges in other states were setting similar conditions for probation, but he was not certain it was a broad practice across the country..css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-9s9ecg{margin-bottom:15px;}.css-uf1ume{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;}.css-wxi1cx{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;-webkit-align-self:flex-end;-ms-flex-item-align:end;align-self:flex-end;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:’See more’;}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 auto;overflow:hidden;}.css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}By adding vaccination to conditions that included employment, the judges were staying within the probation order, he said, but added: “I think the problem for this type of order is if the defendant would challenge it, I think there is a significant chance that order would be found to be improper. It is a compulsion for a medical procedure.”In court, Mr. Rutherford told the judge, “no, not really,” when asked whether he was scared about inoculation. “I just never went to get it,” Mr. Rutherford said, according to the transcript.Carl Lewis, the lawyer for Mr. Rutherford, could not be reached on Monday. But Mr. Rutherford, speaking to WCPO 9 News recently, said he did not want to be vaccinated.Brandon Rutherford was ordered by a judge in Ohio to receive the Covid-19 vaccine as a condition of his probation.WCPO“I don’t plan on getting it. I don’t want it,” he said. “So, for him to tell me that I have to get it in order for me to not violate my probation is crazy because I’m just trying to do what I can to get off this as quickly as possible, like finding a job and everything else, but that little thing can set me back.”Judge Wagner, in response to questions on Monday, said in an email that “judges make decisions regularly regarding a defendant’s physical and mental health, such as ordering drug, alcohol, and mental health treatment.”He added that Mr. Rutherford was in possession of fentanyl, “which is deadlier than the vaccine and COVID 19.”

An essential tool. An inspiration for artists. A public nuisance. The humble shopping cart has been all of these in the decades since it was invented. But what does it reveal about our character?The next time you go to the grocery store, consider the ordinary shopping cart as something more than a rattling basket blocking your parking space.In the 1930s, an American grocer named Sylvan Goldman invented the precursor to the modern day shopping cart, using a folding frame that was fixed on a set of wheels. He hoped that people would buy more groceries if they did not have to carry heavy baskets as they browsed.And they did.But over the decades, the shopping cart has evolved from its mundane existence as the centerpiece of every grocery store run.Like the Campbell’s Soup can, it has become an unlikely icon in a subculture that celebrates the common object.Shopping carts have been the focus of books and films, and their use examined in magazine columns and classrooms as tools to explain how humans behave in public. They have found a dubious niche on the internet as the stars of a YouTube show, followed by half a million people. They have even inspired musicians: The steady clacking of a cart rolling down a street was the inspiration for both the sound and the words in Neil Young’s 1994 song “Safeway Cart.”They are also a nuisance. Legislators and store owners across the United States have struggled with how to prevent the carts from being stolen, left in handicapped parking spots, discarded on sidewalks, abandoned at bus stops or tipped into creeks.Shirley Yu for The New York TimesAn Enduring Cultural ArtifactIn 2005, a cart infiltrated the British Museum, when the artist Banksy paired one with a cave man on a piece of fake prehistoric rock art — and then secretly installed the rock in a gallery, unnoticed for days.Another Banksy creation, the painting “Show Me the Monet,” incorporated discarded carts in nature. It sold at auction for about $10 million in December.John H. Lienhard, a history of technology professor at the University of Houston, described shopping carts as a “flash of genius” that altered American life during an episode of his public radio show, “The Engines of Our Ingenuity.”Decades after that 1995 broadcast, Dr. Lienhard is still trying to explain how the utilitarian origins of shopping carts broadened into cultural appeal.“They mirror us,” he said in an interview. “We want to walk. We want to carry. And now we aid our walking and carrying. And then our walking and carrying becomes mentally associated with wheeling.”“That means the technology of the commonplace is terribly important,” he said.Far From the SupermarketThe 2009 film “Cart” illustrates what Dr. Lienhard called the “symbiotic relationship” of humans and shopping carts.In the film, a shopping cart is given a mind of its own, navigating the perils of city streets as it searches for a boy who has left his jacket in the basket. The cart then saves the boy’s life by blocking an oncoming car.Jesse Rosten, the director, said the idea arose when he and a friend spotted an overturned cart in a parking lot. A sad song was on the radio as they drove past it, adding to the potential for cinematic melancholy.“We laughed the whole way home, imagining back stories for this down-and-out cart who was struggling against the world,” he said. “We’ve all seen abandoned shopping carts out in the world, and the film is one take on how carts end up where they do.”Portraits of carts in the wild are also captured in the 2006 book “The Stray Shopping Carts of Eastern North America: A Guide to Field Identification.”The Buffalo artist behind the book, Julian Montague, spent seven years photographing carts in dumpsters, in alleys, on lawns, wherever they turned up. “It is a weird object,” he said.“Somebody can take it someplace and chop the wheels off, or take laundry to the basement,” he said. “Unlike a plastic bag, it has multiple lives.”Shirley Yu for The New York TimesCarts as a Test of CharacterSome people steal them. Others leave them wherever they like.Private companies have gotten creative. In California, stray carts are reported on hotlines to companies that specialize in repatriating them to their store lots.At the supermarket chain ALDI, shoppers unlock carts with a quarter, which is returned when the carts are. Some customers leave the quarter in the cart for the next person to use.“We’re always amazed at the ‘pay-it-forward’ spirit that happens in our parking lots,” said Kate Kirkpatrick, communications director at ALDI. “As a result, we rarely run into issues with carts not being returned.”On many days, Seth Sanders, 20, a clerk at Safeway in Bellingham, Wash., can be found dodging cars as he rounds up carts that people have left in parking spaces or shoved aside in the massive lot.About a quarter of customers do not bother to return their carts, he estimated, which means he spends a lot of time doing it for them, in between bagging groceries, cleaning and finding items for customers.Mr. Sanders has wrangled carts in the cold, in the rain, and in the smoke from wildfires. One customer, in a hurry, shoved a cart in his direction with such force that it hurt his leg.“I want to say it is almost kind of selfish,” he said. “It is kind of a test of character. It is our job to pick up after people, but if it is the smallest thing you can do to help out, I feel like it is not a lot to help out a little bit.”Shirley Yu for The New York TimesEnter the Vigilantes …Of course, shopping cart slackers have their reasons.In a 2017 column in Scientific American, the anthropologist Krystal D’Costa explored why people failed to return carts. It “hit a nerve,” she wrote in a follow-up.In more than 2,000 comments on the magazine’s Facebook page, some said they were afraid to leave children unattended, or struggled with a disability, or feared making someone’s job obsolete. Within the past year, the so-called Shopping Cart Theory has become an article of faith on Reddit and other social media sites. The theory posits that the decision to return a cart is the ultimate test of moral character and a person’s capacity to be self-governing.It is a theory fully embraced by the video vigilantes known as The Cart Narcs, self-appointed enforcers who confront shoppers trying to leave without returning their carts. The series has about 500,000 followers on Facebook and YouTube.The Shopping Cart Theory has even reached academia — if middle school counts as academia. Students at the Lausanne Collegiate School in Tennessee were recently asked by Greg Graber, the school’s director of social and emotional learning, to analyze it in a class on critical thinking.One student said anyone who noticed a wayward cart should just return it. Another warned against rushing to judgment. Mr. Graber agreed.“It seems to be a popular belief now that people who leave their shopping carts in places are lacking in values and morals,” he said. But that belief “does not allow for growth or grace.”… and Here Come the LegislatorsIn April, the Shopping Cart Theory was cited in coverage of a proposed state law that would fine shoppers who did not return their carts.Paul Aronsohn, a disability ombudsman for New Jersey, had approached State Senator Kristin Corrado with the idea. He said the state needed to deter shoppers who abandon carts in the wide spaces designated for people with disabilities.Senator Corrado introduced Senate Bill No. 3705, which would impose a fine of $250 for doing so.“Apparently it is a pet peeve to a lot of people,” she said.One person who would benefit is Kelly Boyd, 41, of Hamilton Township, N.J., who has used a wheelchair since she was 9. When she drives her van to the store and lowers a ramp to disembark in her motorized chair, she often finds a cart blocking her way.So Ms. Boyd said she has to nudge it out of the way with her van, or drive to a remote part of the lot where she can use two spaces to get out. That has led to angry notes left on her car and confrontations with other drivers.“Everything I do as a person with a disability takes longer and then to have to deal with that is more frustrating,” Ms. Boyd said. “It is surprising how some people do not care.”This is not the only state legislation tackling shopping cart nuisances. Some places, like Los Angeles and Clark County, Nev., require wheels that lock when a cart is taken far from a store. Some cities in Washington impose fines on stores for wayward carts, and other cities are taking note.Last year the board of supervisors in Fairfax County, Va., met to address “the visual clutter” of stray carts with a proposal to impose $500 fines on people who wheel them off store property.“It is a real problem,” Jeffrey C. McKay told his fellow supervisors during the session. But others on the board argued that it would penalize people who are struggling economically and use the carts to get food home or carry their belongings.One of the supervisors, Dalia A. Palchik, said that had been her childhood experience.As immigrants from Argentina in 1989, Ms. Palchik said, she and her three siblings often accompanied their mother to the store and then pushed the cart to their rental house on the edge of Fairfax City. They had no car available.The memory came flooding back during the discussion. “It was one of those things I was ashamed of as a kid,” she said in an interview. “Why are we criminalizing people trying to get to the grocery store?”The ordinance is still under consideration.