A 2022 legal settlement established requirements to protect the health of minors detained at segments of the southern border. It ends nine days after Donald Trump takes office.A court-ordered system for protecting the health of children detained at the southern border, put in place two years ago after several children died in custody, is set to expire nine days after Donald J. Trump takes office with plans to intensify the deportation of migrants.The system, part of a July 2022 legal settlement between the government and lawyers representing migrant children in custody, set detailed protocols for detaining minors at Customs and Border Protection facilities in the Rio Grande Valley and El Paso sectors. It required agents to provide them with access to emergency care and basic hygiene items — showers, toothbrushes and blankets for sleeping, for example. It forbade agents to separate children from their parents for extended periods of time.At the center of the reform was a new position: an independent pediatrician who was assigned to visit the facilities and work with staff members to improve them. That monitor role is set to phase out even sooner than the overall agreement, on Dec. 27.Despite notable improvements, reports from the pediatrician — the so-called juvenile care monitor — showed that the conditions still sometimes fell short. Now, medical experts worry that, with the settlement expiring and the monitoring role set to disappear, conditions could worsen under an administration far less friendly to immigrants.“This is not a bureaucratic shift — this should be everyone’s concern,” said Marsha Griffin, a pediatrician practicing on the southwest border who has visited the facilities. “This is a law enforcement agency with a law enforcement mentality, tasked with running a trauma-informed day care center. You just feel like screaming. Someone needs to watch them.”A spokeswoman for Customs and Border Protection said that the agency had undertaken “extensive measures” in the past two years to “significantly expand and enhance its support efforts” for all people in custody — and particularly for children. She said the agency developed trauma-informed behavioral health training for employees, for example, and worked to better integrate pediatricians into the medical care process for minors in custody. It also issued a formal policy to define when agents could separate children from their parents.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Most Americans, including doctors, have no memory of the devastating diseases that routinely threatened children until the 1960s.Some of President-elect Donald J. Trump’s picks for the government’s top health posts have expressed skepticism about the safety of childhood vaccines. It’s a sentiment shared by a growing number of parents, who are choosing to skip recommended shots for their children.But while everyone seems to be talking about the potential side effects of vaccines, few are discussing the diseases they prevent. It has been half a century or more since many of the inoculations became routine in the United States, and the experience of having these illnesses has been largely erased from public memory. Questions today about the risk-benefit ratio of vaccines might just be a product of the vaccines’ own success.Here is what people should know about six once-common illnesses that vaccines have contained for decades.MeaslesMeasles, a viral infection often spread by a cough or sneeze, is extraordinarily contagious: Nine out of 10 people around an infected person will catch measles if they have not been vaccinated. Measles can be contracted in a room up to two hours after a person with the disease has left it.Measles is not a mild illness, particularly for children under 5. It can cause a high fever, coughing, conjunctivitis and rashes, and if it leads to pneumonia or encephalitis — brain swelling — it can quickly become lethal. Before the vaccine was licensed in the United States in 1963, almost every child had contracted measles by age 15. Tens of thousands of measles patients were hospitalized each year, and between 400 and 500 of them died.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

When it comes to weeding out corporate influence, Robert F. Kennedy Jr.’s ideas often align best with some of Trump’s loudest critics.There is no denying the bromance between President-elect Donald J. Trump and Robert F. Kennedy Jr., two men with famously big egos and a desire to expose what they view as a corrupt federal bureaucracy.But if Mr. Kennedy is confirmed to lead the Department of Health and Human Services, several of his key priorities may run counter to those of an administration with a game plan bent on deregulation. Mr. Trump’s choice for White House chief of staff, Susie Wiles, comes from a lobbying firm that represented the very industries that Mr. Kennedy hopes to disrupt.Over the past two decades, Mr. Kennedy, a lawyer and longtime environmentalist, has turned his passion toward health issues, many of which — apart from his questioning of vaccine safety — traditionally align better with the Democratic Party he left behind. When it comes to tearing down corporate capture among the giants — Big Pharma, Big Ag, Big Food, among others — Mr. Kennedy’s ideas echo those of some of the incoming Trump administration’s loudest critics.Michelle ObamaMr. Kennedy, who recently criticized Mr. Trump’s penchant for fast food, has been clear about his plans to go after ultra-processed foods that contribute to the growing rates of diabetes and obesity in the United States. Those goals sound familiar to anyone who lived through the Obama administration, when Michelle Obama started the Let’s Move! campaign as first lady to encourage healthier diets and lifestyles among children.Ms. Obama was a driving force behind former President Barack Obama’s creation of a task force on childhood obesity. Under his administration, federal agencies released updated nutrition labels and the ubiquitous “MyPlate” icon that replaced the food pyramid. Most consequentially, she championed the Healthy, Hunger-Free Kids Act, which increased funding and raised nutritional standards for school lunches. The vegetable requirements and rules for sodium and flavored drink products under that law, signed in 2010, were dialed back under the first Trump administration.Gavin NewsomThe week before the election, Mr. Kennedy declared the “first thing” he would do as part of the Trump administration would be: “Tell the cereal companies, ‘Take all the dyes out of their food.’” But in California, Gov. Gavin Newsom has already beaten him to it.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

An analysis of newly released 19th-century census records offers more insight into the conflict’s costs.Faded ink. Inconsistencies. Fires. The deadliest conflict in American history, the Civil War, also had some of its worst-kept records, making the true number of casualties seem forever elusive.For decades, historians have cobbled together clues. But thanks to a newly released set of census records spanning three decades, researchers have landed on a firmer estimate of lives lost: 698,000.The analysis, published this week in The Proceedings of the National Academy of Sciences, also suggested that the Confederate states fared much worse than the Union, with a mortality rate more than twice as high. The granular nature of the census data means that researchers who build upon the work will be able to better understand the long-term impact of the war in the hardest-hit regions.Caroline Janney, a history professor at the University of Virginia who was not involved in the research, said that she was intrigued by the census-based methodology and excited that the state-by-state data is likely to have other rich information, such as migration patterns among the newly freed population.But she warned against interpreting modern social and political dynamics too readily through the lens of the Confederate death toll.“There’s a reason that it’s still with us, there’s a reason that the memory still lingers,” she said. “Those deaths very much did shape their respective societies, but in a far more complicated and nuanced way than sheer numbers can represent.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

We explore America’s childhood death rate.If I drew you a graph that showed the death rate among American kids, you would see a backward check mark: Fewer kids died over the last several decades, thanks to everything from leukemia drugs to bicycle helmets. Then, suddenly, came a reversal.Child mortality rate

If every emergency room in the United States were fully prepared to treat children, thousands of lives would be saved and the cost would be $11.84 or less per child, researchers found.The morning after Phyllis Rabinowitz brought her newborn daughter home from the hospital, she knew something was terribly wrong. The baby, Rebecca, had thick mucus, trouble breathing and lethargy unlike anything Ms. Rabinowitz had seen in her first child.But during multiple visits to the emergency room, doctors told Ms. Rabinowitz that Rebecca had a common cold and sent them home. At nine days old, Rebecca died; her parents learned from an autopsy that the cause was a viral infection that could have been managed had she been admitted.More than 80 percent of emergency departments in United States hospitals are not fully prepared for pediatric cases, a new study finds, despite the fact that children make up about 20 percent of visits each year.The new analysis, published Friday in the journal JAMA Network Open, estimated that if every emergency department in the United States had the core features of “pediatric readiness,” more than a quarter of the child deaths that follow E.R. visits could be prevented, a figure that equates to thousands of young lives each year.Even in the most ill-prepared states, the cost to ready every emergency room would be less than $12 per child living there, the researchers found.“You can now find your state and see: How many children who would otherwise die could we expect to save if we implemented universal pediatric readiness at a high level?” said Dr. Craig Newgard, who was the lead author on the paper, and is the director of the Center for Policy and Research in Emergency Medicine at Oregon Health & Science University.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Robert F. Kennedy Jr., who has long voiced doubts about vaccine safety, has hopes of influencing federal health policy. Could he finally get the chance?“Make America healthy again!”Robert F. Kennedy Jr. looked out into the crowd in Glendale, Ariz., on Saturday at his first major campaign event for his onetime rival, former President Donald J. Trump, and talked up their future together — one he hopes will finally bring his long-held agenda for public health to fruition.“He’s going to end the chronic disease epidemic,” said Mr. Kennedy, who has for years expressed doubts about the safety of vaccinating children and has pushed conspiracy theories about the inner workings of federal health agencies. “And he wanted my help to do it.”As a candidate polling in the single digits, Mr. Kennedy had no path to the White House. But now, as an ally of Mr. Trump’s who has already been named to the transition team that would advise on personnel and policy priorities, he has very real opportunities to exert influence and gain power in a field where he has long been considered a fringe voice.Historically, members of a winning candidate’s transition team often end up in prestigious positions themselves. Mr. Trump said in an interview with CNN that he “probably would” appoint Mr. Kennedy to a role in a second Trump administration.In an interview on Tuesday, Mr. Kennedy confirmed that Mr. Trump “asked me to be involved in the administration at a high level.” He said they had not discussed the specific role yet, given the “legal constraints” of doing so before the election.“We’ve talked about the sort of general role in looking at corruption across the agencies, having some kind of portfolio that would look atunraveling corruption — and particularly in the agencies that I’ve had a lot of litigation experience with,” Mr. Kennedy said, citing several federal agencies, including the Food and Drug Administration, National Institutes of Health, Environmental Protection Agency and C.D.C. “And public health: in doing what needs to be done to end the chronic disease epidemic. So those are the two areas that he’s asked me to be involved with.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

An outbreak in the conflict zone could reignite a global plague, experts fear.In July, health officials made an unsettling discovery in Gaza: Poliovirus, a global scourge, was found in samples of wastewater. This month, the news got worse. A 10-month-old baby contracted polio and is now paralyzed in one leg.It’s the first confirmed case of polio in Gaza in 25 years. Now international agencies are sending more than 1.6 million doses of oral poliovirus vaccine to the conflict zone in an ambitious effort to immunize 640,000 children under age 10.Israel has agreed to three pauses in military operations, starting Sunday, to facilitate the campaign.Health officials had been warning for months that the conflict in Gaza could eventually give way to major regressions in infectious diseases. Transmission of poliovirus — which attacks the nervous system and can lead to spinal and respiratory paralysis, and in some cases death — may already be widespread, some experts fear.Here’s what you should know.How could there be polio in Gaza?Of the three naturally occurring “wild-type” viruses, only Type 1 remains; Type 2 and Type 3 have been eradicated.But there is another form to worry about: so-called vaccine-derived poliovirus. This form now accounts for most outbreaks worldwide.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

For many, Covid is increasingly regarded like the common cold. A scratchy throat and canceled plans bring a bewildering new critique from friends: You shouldn’t have tested.Jason Moyer was days away from a family road trip to visit his parents when his 10-year-old son woke up with a fever and cough.Covid?The prospect threatened to upend the family’s plans.“Six months ago, we would have tested for Covid,” said Mr. Moyer, 41, an academic administrator in Canton, Ohio. This time they did not.Instead, they checked to make sure the boy’s cough was improving and his fever was gone — and then set off for New Jersey, not bothering to tell the grandparents about the incident.In the fifth summer of Covid, cases are surging, and the Centers for Disease Control and Prevention has reported “high” or “very high” levels of the virus in wastewater in almost every state. The rate of hospitalizations with Covid is nearly twice what it was at this time last summer, and deaths — despite being down almost 75 percent from what they were at the worst of the pandemic — are still double what they were this spring.As children return to schools and Labor Day weekend travel swells, the potential for further spread abounds. But for many like Mr. Moyer, Covid has become so normalized that they no longer see it as a reason to disrupt social, work or travel routines. Test kit sales have plummeted. Isolation after an exposure is increasingly rare. Masks — once a ubiquitous symbol of a Covid surge — are sparse, even in crowded airports, train stations and subways.Human behavior is, of course, the reason that infections are soaring. But at some point, many reason, we need to live.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

It’s the fifth summer of Covid, and most people seem eager to move on. We want to understand the pervasiveness of the ignorance-is-bliss attitude.Covid cases are surging, but in contrast to summers past, our lives seem to be carrying on with all of their scheduled programming.Covid is still a serious threat to people who are immunocompromised or elderly, but for many others, a positive Covid case seems to be regarded much like the common cold of the before times, and some are abandoning their once-meticulous methods of testing and isolation in favor of a more laissez-faire attitude.The Times is trying to assess how people are thinking about their own transition into a life where the disease is by some standards endemic. On days when you haven’t felt very well, have you bothered to test for Covid, or decided it didn’t really matter what respiratory condition was behind it? If someone in your household has come down with Covid, did you go to work, school or the gym anyway, despite your exposure? Have you found yourself purposely skipping a Covid test for fear of having your social or vacation plans canceled?Please respond by Monday, Aug. 19. We won’t publish any part of your response without following up with you first, verifying your information and hearing back from you. And we won’t share your contact information outside the Times newsroom or use it for any reason other than to get in touch with you.