Even as the H5N1 virus evolves, gaps remain in the nation’s contingency plans for human testing, scientists say.The first step in combating any infectious disease outbreak is detection. Without widespread testing, health officials have little sense of who is infected, when to treat patients and how to monitor their close contacts.In that sense, the bird flu outbreak plaguing the nation’s dairy farms is spreading virtually unobserved.As of Monday, the virus had infected 157 herds in 13 states. But while officials have tested thousands of cows and are monitoring hundreds of farmworkers, only about 60 people have been tested for bird flu.Officials do not have the authority to compel workers to get tested, and there is no way for workers to test themselves. In the current outbreak, just four dairy workers and five poultry workers have tested positive for H5N1, the bird flu virus, but experts believe that many more have been infected.The Covid-19 pandemic and the mpox (formerly monkeypox) outbreak in 2022 revealed deep fissures in the U.S. approach to testing for emerging pathogens. Those failures prompted federal agencies to move toward policies that would allow rapid scaling of testing during an outbreak.But progress has been sluggish, interviews with more than a dozen academic and government experts suggest.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.

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Mental health experts have said that the 988 hotline for mental health emergencies is still a work in progress, in need of more funding, coordination and awareness.More than 10 million calls, texts and chat messages have been answered by counselors working for the National Suicide Prevention Lifeline’s three-digit hotline in the two years since it debuted, federal officials said on Tuesday.The three-digit number, 988, was introduced in 2022 as a way to simplify emergency calls and help a metastasizing mental health crisis in the United States, accelerated by the Covid-19 pandemic and the social environments of younger Americans. The hotline previously used a traditional 10-digit number.“People who felt like they didn’t have any other options got what they needed,” Andrea Palm, the deputy secretary of the Health and Human Services Department, said at a news briefing on Tuesday. The 988 line, Ms. Palm said, had resulted in “countless stories of real people whose lives have been changed forever.”The 988 network has been a rare instance of bipartisanship in federal health policy. President Donald J. Trump in 2020 signed the law establishing the new number, and the Biden administration has implemented and expanded the network of more than 200 call centers, which typically operate around the clock.A growing number of adults in the United States have reported feeling more anxious. Federal officials on Tuesday cited a 2022 national survey that found that more than 12 million adults and nearly 3.5 million adolescents had seriously considered suicide in the previous year. Roughly one in five adolescents reported symptoms of depression or anxiety in a federal survey of teen health from 2021 to 2022.The condensed phone number was meant to function as a more memorable option for emergency calls, similar to 911. Yet only around a quarter of Americans are at least somewhat familiar with 988, according to a poll released this week by Ipsos and the National Alliance on Mental Illness.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.

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These days, the toilet paper aisle is crowded with products that claim to be more sustainable, from bamboo and recycled material to products with “forest-safe” labels. But are they really better for the environment? And can you cast aside the paper altogether?Today, we’ll try to get to the bottom of it.Please don’t flush the forestIf you’re in the United States, the roll in your bathroom right now most likely comes from somewhere in North or South America. It could be a blend of trees from the United States Southeast and the boreal forest of Canada, or maybe from eucalyptus grown in Brazil.Those sources present several environmental problems. Chipping away at the planet’s old, intact forests and replacing native woodlands with vast monocultures is terrible for biodiversity. It’s also bad for the climate because big, mature trees store a lot more planet-warming carbon than saplings planted in their place. Logging projects have also displaced Indigenous communities around the world.So, the best way to lessen the environmental impact when nature calls is to reduce the amount of conventional toilet paper your household uses.If you’re looking to do that without really changing your bathroom routine, your best bet is probably T.P. made from recycled material.Recycled paper keeps trees in the ground and requires fewer resources to produce. Based on anonymized data from paper mills across the United States, the Environmental Paper Network, a nonprofit group, estimates that tissue from 100 percent recycled material requires about half as much water and 37 percent less total energy than using virgin fiber from freshly cut trees. And, it produces roughly 70 percent less greenhouse gases.Have a question for reporters covering climate and the environment?We might answer your question in a future column. We won’t publish your submission without contacting you, and may use your contact information to follow up with you.

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Millions of parents have paid to bank blood from their infants’ umbilical cords. But storage companies have misled them about the cells’ promise.Pregnant women are bombarded with advertisements — on social media, in childbirth classes, even in their doctors’ offices — urging them to bank the blood in their baby’s umbilical cord and gain “peace of mind.”Private banks claim that the stem cells inside the blood are a powerful tool to have on hand in case a child one day becomes seriously ill. They charge several thousand dollars upfront for storage plus hundreds more every year thereafter.But an investigation by The New York Times found that leading banks have consistently misled parents about the technology’s promise. The few parents who try to withdraw samples often find that they are unusable — either because their volume is too low or they have been contaminated with microbes.Here’s what parents should know about cord blood banking.Cord blood is often marketed as an up-and-coming medical technology. In reality, its use is declining.In the 1990s, transplant doctors saw cord blood as a promising new source of stem cells for patients with sickle cell anemia and leukemia who could not find suitable matches from their families or bone marrow donor registries.The major cord blood banks — Cord Blood Registry, ViaCord and Cryo-Cell — told The Times that the cells they store had saved children’s lives and that no one knew what scientists may one day discover.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.

Millions of pregnant women get the pitch through their OB-GYN: Put a bit of your newborn’s umbilical cord on ice, as a biological insurance policy. If your child one day faces cancer, diabetes or even autism, the precious stem cells in the cord blood could become a tailor-made cure.Many families are happy to pay for the assurance of a healthy future. More than two million umbilical cord samples sit in a handful of suburban warehouses across the country. It’s a lucrative business, with companies charging several thousand dollars upfront plus hundreds more every year thereafter. The industry has grown rapidly, bolstered by investments from medical device companies, hospital partnerships and endorsements from celebrities like Drew Barrymore and Chrissy Teigen.But the leading banks have consistently misled customers and doctors about the technology’s promise, an investigation by The New York Times found. Doctors rarely use cord blood anymore, thanks to advances that have made it easier to transplant adult stem cells. And the few parents who try to withdraw cord blood samples often find that they are unusable — either because their volume is too low or they have been contaminated with microbes.When the first cord blood banks opened three decades ago, doctors were optimistic about turning the stem cells, otherwise discarded as medical waste, into a powerful new treatment for patients with leukemia and other blood disorders. Private banks promised peace of mind for anxious parents-to-be, knowing the cells would be ready and waiting if their child ever got sick.That potential has not materialized. Just 19 stem-cell transplants using a child’s own cord blood have been reported since 2010, according to the Center for International Blood and Marrow Transplant Research. Newer research has led many doctors to abandon cord blood in favor of adult stem cells.Yet private banks trumpet the cells’ lifesaving possibilities, and legions of their sales representatives peddle cord blood as if it were at the medical vanguard. They woo customers in hospital pregnancy classes and offer obstetricians free lunches, gift cards and payments of up to $700 for each sample.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.

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