The Centers for Disease Control and Prevention listed on Monday 27 types of testing that have been suspended.  Andrew Nixon, an HHS spokesman, called the pause temporary and attributed it to “a routine review to uphold our commitment to high quality laboratory testing.”  “We anticipate some of these tests will be available through CDC labs again in the coming weeks. In the meantime, CDC stands ready to support our state and local partners to access the public health testing they need.”

Go to the CDC ID Laboratories page to see the tests which have been suspended:

https://cdc.gov/infectious-diseases-labs/php/test-directory/index.html

Note that the CDC is in an interregnum.  Jay Bhattacharya, MD, PhD. is the current acting director of the Centers for Disease Control and Prevention (CDC) after Susan Monarez was canned.

https://s3.documentcloud.org/documents/27926757/cms-memorandum-on-dietary-guidelines.pdf

This memorandum reminds hospital providers of their obligations related to patient food and nutrition services. On January 7, 2026, HHS and USDA released the Dietary Guidelines for Americans, 2025–2030 (DGAs), which place heightened emphasis on diet quality — including limiting ultra-processed foods, sugar-sweetened beverages, refined carbohydrates, and added sugars, while prioritizing whole and minimally processed foods. These updates reflect the latest federal nutrition policy and are encouraged to be used to inform patient nutrition services and related hospital protocols. Given the scale of Medicare’s investment in inpatient care, CMS has a responsibility to ensure that hospital food and nutrition services support high-quality, evidence based care and improved health outcomes.

Hospitals must comply with Conditions of Participation at 42 CFR §482.28, including ensuring menus and diets meet individual patient nutritional needs in accordance with recognized dietary practices, qualified dietitian oversight, maintenance of a current therapeutic diet manual, and integration of dietary services into Quality Assessment and Performance Improvement (QAPI) processes. As consistent with 42 CFR §482.28 and CMS guidance, hospitals should review and revise food and nutrition service policies, standard menus, therapeutic diet protocols, and food procurement practices to align with the 2025–2030 DGAs.

Discussion:
Diet Quality and Health Outcomes

The United States spends approximately $5 trillion per year on health care. Ninety percent of those expenditures are on patients with chronic disease. Since Medicare represents approximately 40% of health care spending on chronic health conditions in the United States, the impact on American taxpayers and the Federal deficit is significant.

Given these dynamics, it is an urgent priority for hospitals who treat Medicare patients to ensure their policies and practices provide those patients with high-quality and clinically appropriate dietary options. Emerging high-quality epidemiologic evidence strengthens the case for prioritizing minimally processed, whole foods in institutional settings. Large prospective cohort studies and updated systematic reviews have found that higher intake of ultra-processed foods is associated with increased risks of cardiovascular disease, type 2 diabetes, and all-cause mortality. For example, an updated 2025 dose–response meta-analysis found a 15% higher risk of all-cause mortality among individuals with the highest ultra-processed food intake.

A growing body of peer-reviewed evidence further demonstrates that diet quality—not simply caloric adequacy—substantially affects cardiometabolic outcomes, mortality, and chronic disease progression. High consumption of sugar-sweetened beverages has been associated with increased risk of type 2 diabetes, cardiovascular disease, and mortality in large prospective cohort studies and meta-analyses. Similarly, ultra-processed foods, including sweetened beverages and processed meats, have been associated with increased risk of diabetes and cardiometabolic disease.

Conversely, higher intake of whole grains and fiber-rich foods have been associated with lower risk of type 2 diabetes and improved long-term health outcomes. Replacement analyses further demonstrate improved outcomes when sugar-sweetened beverages are replaced with water, coffee, or tea.

Read the entire CMS CCSQ memo in pdf format at the hyperlink, above.

https://thehill.com/policy/healthcare/5808929-healthcare-concerns-top-issue/

Health care polling as top issue for first time since 2020: Gallup
By Sophie Brams - March 31, 2026

Americans are more concerned about the availability and cost of health care than any other domestic issue, with it reclaiming the top spot for the first time since 2020, according to a new Gallup poll.

The poll, released Tuesday, found that 61 percent of the 1,000 adults surveyed said they worry a “great deal” about accessing and affording health care, while 23 percent expressed a “fair amount” of concern.

That is compared to 51 percent of respondents who said they were concerned a “great deal” about the economy and 50 percent who said the same about inflation — two issues that dominated public anxiety over the past several years, according to the survey.

Easing worries about the economy, inflation and Social Security meant health care reemerged as Americans’ leading concern, where it ranked consistently between 2015 and 2020 before being overtaken by economic issues during former President Biden’s term.

The percentage of people highly anxious about economic issues grew in the early months of President Trump’s second term but has since returned to 2024 levels, Gallup noted.

Those core issues were separated by just 1 percentage point in 2025, but the cost of health care now leads by 10 points, according to the survey.

The poll also found that what people were the most anxious about varied by political affiliation, with 80 percent of Democrats and 66 percent of independents expressing a “great deal” of concern about health care and 55 percent of Republicans saying they are greatly concerned with illegal immigration.

The poll was conducted March 2-17. It has a margin of error of plus or minus 4 percentage points.

The fresh polling comes as tens of millions of Americans are grappling with the rising cost of health care and insurance following the expiration of ObamaCare subsidies.

The enhanced premium tax credits, first enacted during the COVID-19 pandemic and later expanded under the Biden administration, expired at the end of 2025 over the objection of Democrats, resulting in higher out-of-pocket costs and fewer Americans enrolling in coverage.

The House passed legislation in January to extend the subsidies for three years, but negotiations have stalled in the Senate.

Separate West Health/Gallup polling conducted earlier this month found that many Americans have changed their habits to afford health care, with roughly one-third of 19,535 respondents cutting back on expenses elsewhere.

https://www.michigandaily.com/news/research/michigan-medicine-study-shows-emoji-usage-increasing-in-electronic-health-records/

Michigan Medicine study shows emoji usage increasing in electronic health records
By Sarayu Bongale - March 29, 2026

A Michigan Medicine study published Jan. 14 analyzed 218.1 million clinical notes from 1.6 million patients’ electronic health records and found that both clinicians and patients used emojis more often in medical records from January 2020 to September 2025. Out of all the notes analyzed during this time period, 372 distinct emojis appeared across 4,162 notes from both patients and health care professionals.

In an interview with The Michigan Daily, David Hanauer, clinical associate professor of pediatrics and learning health science at Michigan Medicine, said the idea originated from him noticing emoji use in electronic health records and wanting to raise awareness about the increased usage.

“It was mostly out of interest, just trying to explore if anything was there at all,” Hanauer said. “Our understanding had been that emojis and other symbols are actually not supposed to be used in a medical record, so we were wondering: Were there any there at all, and how often were they being used, and which ones?”

Hanauer said the growing use of diverse emojis in EHRs risks misinterpretation and confusion.

“Most of the concerns that people have is that it’s hard to understand from an emoji what is being conveyed,” Hanauer said. “Maybe a smiley face is pretty obvious to most people, but there’s a lot of different faces with nuances and other symbols. I think there can be a lot of miscommunication, misinterpretation.”

In an interview with The Daily, Kim Ford, health information business systems analyst lead on the revenue cycle mid-service team at Michigan Medicine, said the risk of misinterpretation increases across age groups, as different generations may understand and use emojis in different ways.

“If you have older patients who may not be familiar with emojis, it’s almost like a foreign language to them,” Ford said. “(For) our younger generation — or those people that have grown up with technology — it’s a second language for them that they understand very well. That’s my biggest concern.”

Hanauer said the growing variety of emojis may present a barrier to communication specifically for individuals with poor eyesight

“For older people, having small emojis might actually be hard for them to see and make out, so they might see its face but they can’t tell what the specific expression is,” Hanauer said. “I think we found over 300 different kinds of emojis being used. That’s a lot of different symbols that people would have to understand what they mean.”

Hanauer said he worries emoji misinterpretations can lead to bad patient care outcomes.

“We hope that doesn’t happen, but I think because of that concern, there’s probably going to be a little bit more oversight ,” Hanauer said. “I don’t think we would easily be able to find a circumstance in which there was actually some sort of better or negative outcome from an emoji being misinterpreted.”

LSA sophomore Leah Beel, a medical assistant at American Family Care in Ann Arbor, told The Daily she believes that the EHRs are supposed to be objective and emoji usage detracts from that.

“From my experience, EHRs are used to get quick information and try to communicate with each other in a fast and reliable way,” Beel said. “The only thing I would use is an exclamation point, which, even then, is kind of out there. It’s a good thing that emojis can show enthusiasm or certain reactions, but I also think to a degree — it’s not unprofessional but just someone might take it the wrong way. My perspective on EHR is that you write very objectively.”

Elizabeth Rossmann Beel, a pediatric anesthesiologist at Texas Children’s hospital, said emojis can be an easier way for health care professionals to communicate.

“It’s a way to react to something without putting as much effort into it, or into making that person who’s reading it feel like they need to reply,” Rossmann Beel said. “I think it can cut down a little bit on the burden of replying to and responding to messages in the EHR, which is nice. However, it’s definitely more casual, and so sometimes that’s not the best tone to be setting in a medical record.”

Ford said she plans to use the information from this study to learn more about the impacts of emojis on patient outcomes and potentially create regulations.

“Maybe emojis are an acceptable means of communication,” Ford said. “The other piece is, should there be a governance process around what emojis can be used? And in what situations? I need to think a little bit about what their structure might look like — what department should be involved in reviewing and approving those, what should be the process to submit an emoji for consideration for use? There’s a lot of pieces to the governance process that need to be figured out there.”

Refreshing commentary from the macro-economic side rarely expressed openly. Growers and manufacturers are assumed to be speaking from self-interest. Too often, whistle-blowers seem easy to dismiss as hysterical.

https://www.dailysignal.com/2026/03/20/the-truth-about-glyphosate-genuine-concerns-and-sobering-realities/

The Truth About Glyphosate: Genuine Concerns and Sobering Realities

Miles Pollard   |   March 20, 2026

The use of the agricultural input glyphosate may be one of the most hotly contested issues within public health right now. For some, glyphosate is proof that modern agriculture is poison. For others, it is an example of anti-science panic.

Both reactions avoid the hard truth: glyphosate is a critical agricultural input with contested cancer literature, collapsing public trust, and a set of policy tradeoffs that are too often ignored.

The large scale skepticism of glyphosate safety started in 2015 when the WHO’s International Agency for Research on Cancer classified glyphosate as probably carcinogenic (Group 2A), based on “limited” evidence in humans alongside animal and mechanistic evidence.

However, this legitimate concern is based more on potential theoretical hazards rather than an assessment of real-world exposure levels. Regulating agencies ask a different question: whether a substance poses an unacceptable risk when used as labeled.

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In the U.S., the Environmental Protection Agency has maintained that glyphosate is “not likely to be carcinogenic to humans.” However, it has since withdrawn its 2020 interim decision following U.S. Court of Appeals Ninth Circuit litigation and is now revisiting parts of its analysis.

Across the pond, the European Food Safety Authority said in 2023 that it found no “critical areas of concern,” and the European Commission renewed glyphosate’s approval through 2033. Similarly, the European Chemicals Agency concluded that the available evidence did not justify classifying glyphosate as carcinogenic, mutagenic, or reprotoxic.

As for the studies used to justify such decisions, one of the strongest prospective cohorts in the debate, the Agricultural Health Study. The study followed more than 54,000 licensed pesticide applicators in North Carolina and Iowa. An analysis from 2018 found no overall association between glyphosate and non-Hodgkin lymphoma but did report some evidence of increased acute myeloid leukemia risk in the highest exposure groups.

Later, a pooled AGRICOH analysis from 2019 covering more than 316,000 farmers and agricultural workers in France, Norway, and the U.S. similarly found no association, though it reported a borderline elevation for diffuse large B-cell lymphoma among long-term users of glyphosate.

When looking at meta-analyses, which are literature reviews of several studies to ascertain patterns, the data is still contested. In 2019, a meta-analysis of the Agricultural Health Study’s highest exposure cohort found a 41% increased relative risk of non-Hodgkin lymphoma.

However, in 2020 another meta-analysis and its follow up in 2021 came to more restrained conclusions, cautioning readers about the literature’s publication bias but confirming that diffuse large B-cell lymphoma cannot be ruled out.

An honest summary of the literature neither exonerates nor condemns glyphosate. High exposure individuals, like farmers with specific lymphoma subtypes, are worth monitoring.

This scientific uncertainty should give policymakers pause. Glyphosate has become the most used pesticide (specifically as an herbicide) in the US, sprayed on over 100 crops.

U.S. glyphosate usage has risen from less than 5,000 to over 80,000 metric tons per year between 1987 and 2007. This more than 15-fold increase was accompanied by the deployment of glyphosate-tolerant crops and reduced tillage practices.

Most prevalent among these was Roundup by Monsanto, which was purchased by Bayer in 2018. Whatever one thinks of glyphosate and Bayer’s acquisition of Monsanto, banning such a prevalent pesticide may create regrettable substitutions.

In fact, Bayer actually stopped selling glyphosate-based Roundup for the U.S. residential market in 2023, citing ongoing litigation issues rather than safety concerns. As of February, 2026 the company has paid $11 billion for civil suits. Some Roundup formulations were replaced with diquat dibromide, which is banned in the EU due to its higher toxicity.

According to the U.S. Agency for Toxic Substances and Disease Registry, glyphosate’s chronic intake threshold is 1 milligram per kilogram of body weight per day while the European Food Safety Administration sets their threshold at 0.5 milligram per kilogram of body weight per day.

Comparatively, diquat dibromide’s threshold is between .002 and .005 milligram per kilogram of body weight per day, which is 100-500 times lower than glyphosate. However, it is worth noting that actual formulations containing diquat may be substantially lower than glyphosate, mitigating some risk.

Evidence aside, the decision to restrict glyphosate usage also depends on safe, efficient, and effective alternatives. One important insight to consider is how glyphosate itself replaced more dangerous pesticides used prior to its introduction.

Agent Orange, the infamous defoliant used during the Vietnam War, contained one of glyphosate’s predecessors, 2,4,5-T. This compound was unfortunately contaminated with dioxin, a potent neurotoxin, due to inconsistent chemical treating. Dioxin’s threshold is .0000000007 milligram per kilogram of body weight per day, which is around a billion times more toxic than glyphosate.

This formulation has thankfully been banned since the mid-1980s, accompanying glyphosate’s rise in popularity. Glyphosate was detected in about 81% of Americans, with an average concentration of 0.000411 mg/liter of urine, which is thousands of times lower than the chronic intake threshold.

This is not to dismiss concerns over glyphosate toxicity, as many have raised questions about glyphosate’s effect on the gut microbiome. Others also have germane concerns about glyphosate mixed with other “enhancing” chemicals that increase toxicity.

Neither extreme should dominate the debate. Advocating for banning or restricting a well-used pesticide may lead to alternative pesticide regimes with more chemical alternatives, more over-applications, more tillage and soil erosion, or higher costs shifted onto families.

Glyphosate’s path forward demands nuanced, evidence-based policy including rigorous ongoing monitoring (especially for high-exposure populations), innovation in alternatives, transparent risk communication, and balanced regulation that takes these genuine concerns seriously and analyzes the realities of tradeoffs soberly.

Nina Warken: „Ergebnisse der FinanzKommission Gesundheit werden Grundlage der bislang umfassendsten Finanzreform der gesetzlichen Krankenversicherung“

Die von Bundesgesundheitsministerin Nina Warken eingesetzte FinanzKommission Gesundheit (FKG) hat ihren ersten Bericht fristgerecht am heutigen 30. März 2026 übergeben.

=====================================================================

Nina Warken: "Results of the Health Finance Commission become the basis for the most comprehensive financial reform of statutory health insurance to date“

The Health Finance Commission (FKG) appointed by Federal Health Minister Nina Warken submitted its first report on time today, March 30, 2026.

It is not only Britain’s National Health Service (NHS) cratering government finances.  The Germans spend so much on health care that their Navy has no serviceable vessels and their Army has maybe 60 tanks.  The German health care system looks a lot like the U.S. ObamaCare system with public & private insurance companies paying ostensibly independent medical services providers.  The Germans attempt to provide free health care for all though this model, but everyone involved is being eaten alive financially.

FinanzKommission Gesundheit just released their first report on the German health care system and boy is it a smoker.  Its 483 pages make 66 recommendations, none of which will be implemented by the determined Socialists in Germany:

https://www.dw.com/en/66-ways-to-fix-germanys-costly-health-care-system/a-76597471

https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/F/FinanzKommission_Gesundheit/FinanzKommissionGesundheit_Erster_Bericht_20260330.pdf

https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/F/FinanzKommission_Gesundheit/Management_Summary__Erster_Bericht_der_Finanzkommission_Gesundheit_.pdf

66 ways to fix Germany's costly health care system
By Ben Knight - 30 Marz 2026

A special commission has presented a raft of proposals aimed at curbing Germany's spiraling health care costs. But whether the government can impose them is another matter.

A commission of experts presented a 66-point plan on Monday that is meant to lower the ever-growing health insurance contributions that Germans have to pay into the system.

Germany's health care system is one of the most expensive in the world, with state health insurers alone spending around €1 billion ($1.15 billion) per day on health care — a number that is expected to rise even more in the next few years. Meanwhile, Germans' insurance contributions to those state health insurers rose by an average of around 3% this year, on top of a 2.5% rise in 2025.

But despite the rising contributions, state insurers' expenses are increasing even more rapidly. At the press conference, the commission held up a graphic — from the state insurers' association, the GKV — which showed that at the current rate, the shortfall between state insurers' income and expenses would increase from €15.3 billion in 2027 to €40.4 billion in 2030.

The 66 recommendations presented on Monday were designed not only to close that gap, but to make even more savings. The 10-member commission, which included experts from the fields of economics, medicine and social law, was specifically charged with coming up with too many recommendations as the government is unlikely to be able to implement all of them, if only for political reasons.

"I'm grateful that the commission has presented us with a well-filled toolbox, from which we will now take the best tools," Federal Health Minister Nina Warken of the conservative Christian Democratic Union (CDU) said at the press conference. "It's important for me to emphasize that there will be no one-sided reforms that will burden the insured. We will not shake the cornerstones of a health care system based on solidarity."

More taxes, fewer operations

The commission's 480-page report included proposals such as:

• A rise in taxes on spirits and tobacco.
• A new tax on sugary drinks. Commission member Ferdinand Gerlach, director of the Institute for General Practice and a doctor himself, said experience in other countries had shown that when sugar taxes are introduced, manufacturers tend to reduce the sugar content of their products voluntarily.
• A new measure requiring plannable operations — such as knee replacements — to only be carried out once the patient has received an independent second opinion from another doctor who has no economic stake in the decision. Germany carries out more such operations than many other EU countries.
• Patients pay more contributions for prescribed drugs. At the moment, health insurers pay for most prescription drugs.
• Breadwinners' spouses with no children under 6 would no longer be insured automatically. This is seen as a particularly controversial recommendation, and Bavarian State Premier Markus Söder, for instance, has already said he would not implement it.
• The federal government, rather than health insurers, should pay for the health care of unemployment benefits recipients. This alone would save insurers €12 billion a year, the commission said. But such a proposal is likely to meet some political opposition, as the government is currently also trying to cut costs in the unemployment benefits system.

Eugen Brysch, chair of the German Foundation for Patient Protection (DSP), an organization that protects patients' rights, said the 66 proposals could all have been found lying in the filing cabinets of various health care organizations, but that it was up to the government to agree on a clear plan.

"It's time for the government to show its colors," Brysch told DW in a statement. "The financial gap needs to be addressed. Sustainable health insurance can't be done by a financial commission, only by the government, and for that they need a unified concept."

Brysch predicted, for example, that the proposal to have the government pay the health insurance for the unemployed would lead to a political row in the coalition government.

The ins and outs of the German health care system

Germany has a dual health care system funded by employees' and employers' contributions to health insurers. Health insurance is mandatory for the entire population, and state insurers, which cover around 90% of the population, are not allowed to refuse anyone insurance. Around 10% of the population opt for private insurance, which often offers more cover.

But in the past, critics have raised concerns that hospitals and doctors are incentivized to recommend expensive and unnecessary treatment, burdening the health insurance companies and driving up contributions.

Health Minister Warken promised that the commission's proposals would be examined quickly and that her department would draw up a draft bill to present to the Cabinet by the summer.

https://record.umich.edu/articles/four-projects-receive-nearly-4-5m-in-lsa-research-initiative/

Measuring, Modeling, and Mapping Microplastics in the Atmosphere of Michigan
The harmful effects of microplastics in water and on land have been the topic of many scholars’ research in recent years, but little is known about its impact in the air.

This team will research how microplastics pollution in the atmosphere has impacted residents in Michigan, and how racial, economic, and geographic disparities have played a role in exposure levels. The research will help inform how to better address this issue and promote environmental justice.

Project team: Anne McNeil, Andrew Ault, Ambuj Tewari, Paul Zimmerman, Allison Steiner and Mary Starr

Total award: $2 million

More at Michigan Advance:

https://michiganadvance.com/2026/03/29/scientists-may-be-overestimating-microplastics-in-the-environment-and-the-culprit-is-lab-gloves/

Scientists may be overestimating microplastics in the environment – and the culprit is lab gloves
By Anne McNeil, University of Michigan and Madeline Clough, University of Michigan - March 29, 2026

It seems like every day a new study finds tiny plastic particles called microplastics where they should not be: in our bodies and our food, water and air.

Yet finding and identifying microplastics is extremely challenging, especially given their small size. One microplastic can range from as large as a ladybug to as small as an eighth of a red blood cell.

In addition, it can be hard for researchers to avoid unintentionally contaminating their samples, because these plastics are practically everywhere. As a result, much of this research may be overestimating the number of microplastics.

In a new study published in March 2026, our team found that, even when following established protocols, using certain methods to measure environmental microplastics can potentially contaminate the results.

Microplastics are tiny plastics shed from plastic waste. They are found in the environment, waterways and even the human body.

The study

We are chemists at the University of Michigan working in a collaborative team. We set out to understand how many microplastics Michiganders were inhaling when outside, and whether that depended on where they lived.

When preparing our samples, we followed all the standard protocols while conducting our research – we avoided plastic use in the lab, wore nonplastic clothing and even used a specialized chamber to reduce potential contamination from the laboratory air.

Despite these precautions, we found plastic counts in the air that were over 1,000 times greater than previous reports. We knew these numbers didn’t seem right, so what happened?

The culprit: Lab gloves

After a long path to pinpointing the contamination source, we found that laboratory gloves, which the scientific community recommends using as a best practice, can transfer particles to the surface of our samples – in this case, small metal sheets used to collect material depositing from the air. Moreover, the particles led to an overestimation of microplastic abundance in our study.

Here’s how: The particles, which we identified as stearate salts, are used to help the gloves cleanly release from their mold during the manufacturing process. When gloves are used to handle laboratory equipment, the particles are transferred to anything they touch. Stearate salts are similar to soap molecules – if you eat a lot of them, they’re probably not good for you, but they’re not harmful in the environment in the same way that microplastics are.

While not microplastics themselves, stearate salts are structurally similar to polyethylene, the type of plastic most often found in the environment. This structural similarity makes it difficult to distinguish them using the most common tools scientists use to determine whether a particle is plastic.

Researchers use vibrational spectroscopy to identify microplastics, which entails measuring how the particle interacts with light to produce what scientists call a chemical fingerprint.

Because polyethylene and stearate salts have very similar structures, they also interact with light in a similar way.

As a result, at least some of the time, the particles from gloves are incorrectly identified as microplastics. As more researchers rely on automated methods to speed up their analyses, glove residue may be increasingly mistaken for microplastics, leading to higher reports of microplastics in the environment than in reality.

How widespread is this contamination?

To investigate how prevalent this contamination might be, we looked at different glove types. We mimicked the touch between seven types of gloves while handling laboratory equipment and counted the number of microplastics we would incorrectly attribute to the environment if we followed the most common approaches.

We found that gloves can contribute over 7,000 particles per square millimeter that are misidentified as microplastics. This finding means that researchers could be unknowingly overestimating microplastic abundance in the environment when handling their samples with gloves.

Even more concerning, we found that the particles were largely less than 5 um in size. Microplastics in this size range have larger impacts on human and ecosystem health because they can more easily enter cells. By inflating microplastic counts in this size range, using laboratory gloves may jeopardize the studies that inform future policies and regulations.

Moving forward

To avoid contamination, we suggest scientists avoid glove use while conducting microplastic research. If that is not possible – for example, with biological samples where the researchers must wear gloves to protect themselves – we recommend a glove made without stearates, such as those designed for electronics manufacturing. To recover older, potentially contaminated datasets, we have developed methods to help differentiate the chemical fingerprints.

Science is an iterative process. New areas of research, including environmental microplastics, introduce new challenges to the scientific community. In addressing these new challenges, we will encounter setbacks, such as unforeseen contamination.

While we had to discard our initial dataset, we expect the lessons we learned about glove contamination to reach other scientists. In addition, we plan to continue our research on Michigan’s atmospheric microplastic contamination – but this time without gloves.

It’s important to note that even if the microplastic abundance in the environment is lower than researchers originally thought, any amount of microplastics can be troublesome, given their negative effects on human health and ecosystems.

Anne McNeil is a Professor of Chemistry and Macromolecular Science and Engineering at the University of Michigan. Madeline Clough is a Ph.D. Candidate in Chemistry at the University of Michigan.

The Makhteshim, Israel factory of ADAMA group was destroyed yesterday by fallout from a missile interception.  The destroyed facility made more than 120 active ingredients for agricultural crop protection and pharmaceuticals:

https://thehill.com/policy/healthcare/5805149-iran-war-pharmaceutical-supply-chain/

Pharmaceutical supply chains get tangled in war with Iran
By Joseph Choi - March 29, 2026

As President Trump’s war in Iran rages on, it’s posing a growing threat to the pharmaceutical supply chain and risks spiking the prices of many drugs, particularly those that depend on petrochemicals.

The war in Iran and the effective closure of the Strait of Hormuz have caused energy prices to jump and disrupted supply chains for a range of industries. While the Middle East is not a major pharmaceutical producer like China or India, there are still products that originate from the region, and many drugs rely on petrochemicals to be made.

“If the instability really persists, you’ll probably see lead times, transportation costs that can impact direct items that we need for our medicines, including the key starting materials into active pharmaceutical ingredients,” Gerren McHam, vice president of external affairs at the API Innovation Center, told The Hill.

The U.S. Pharmacopeia (USP) issued a risk assessment report of the Middle East conflict, finding that the impact is currently limited. The region is responsible for only 0.3 percent of active pharmaceutical ingredient (API) production and 0.6 percent of oral solid dose production, with most of this concentrated in Jordan and Israel.

There are, however, a handful of drugs that those two countries have a significant hand in. Jordan produces about half of the world’s amoxicillin oral suspension and the same amount of API for etomidate, a fast-acting anesthetic. Seventy-three percent of API for flumazenil, a medication used to reverse the effects of benzodiazepines, is produced in Israel and Jordan.

Health care experts say there are alternative treatments for all these medications, and providers are well prepared to work around any potential shortages.

“There are therapeutic alternatives. We’ve actually weathered some drug shortages of those products in the recent past anyway, so we are familiar with some mitigation strategies if needed,” Michael Ganio, senior director of pharmacy practice and quality for the American Society of Health-System Pharmacists, told The Hill.

Ganio noted that Israel is also the sole supplier of some drugs but added that these are “niche orphan drugs” and opined that the impact would still be limited if the conflict affected these medications.

Pharmaceutical production aside, the Strait of Hormuz is a critical trade route, and that has observers more concerned, especially if the conflict drags on for much longer.

“Much larger impact is disruption of airspace and waterway trade routes — tough to quantify but we know a high volume of ingredients from India need to go west to Europe for final manufacturing. Logically that supply chain is vulnerable,” the USP noted.

The organization highlighted the Red Sea, separated from the Strait of Hormuz on the western coast of Saudi Arabia, as being a much higher source of risk, as it sits along the same trade route that India uses to the transport large volumes of API and finished doses to the U.S. and Europe.

Houthi rebels in Yemen on Friday threatened to enter the war to support Iran. The group could likely shut down the Bab el-Mandeb Strait on the Red Sea, much as Iran has done with the Strait of Hormuz, throttling another key shipping corridor.

India is a major global producer of generic drugs, which make up the vast majority of prescriptions in the U.S. With margins for these medications already paper thin, the added pressure of higher energy costs and a more treacherous trade route could price producers out of the market.

Ganio called this potential pressure on generic drug imports “almost an indirect tariff.”

Petrochemicals, derived from oil, are a key starting material for most medications. If heightened energy prices continue far into the future, those cost increases are likely to be passed on to consumers.

A 2011 analysis of the pharmaceutical industry’s reliance on petroleum estimated that 99 percent of pharmaceutical feedstocks and reagents are derived from petrochemicals, and there are relatively few substitutes for these materials.

As of Friday, the cost of crude oil has risen above $100 a barrel, with projections that it could go far higher if the war continues for weeks or months.

Petrochemicals aren’t directly going into the composition of drugs, but they are needed for production.

“Things that aren’t directly in the medications, but they’re needed in the chemical synthesis pathways,” Ganio said. “So, there may be some drugs that are based on a petrochemical, smaller hydrocarbons potentially.”

And as with almost all products, these chemicals need to be shipped around the world. Still, those familiar with the pharmaceutical supply chain aren’t alarmed yet.

“At the moment, in terms of the U.S., there’s no indication that the conflict is having anything directly impacting the supply chain, or availability of medicines,” McHam said.

“This is a reminder of how exposed we are with our pharmaceutical supply chain, specifically generics; especially those key materials that go into those medicines,” McHam added. “Because the real risk may not be today, but it raises a broader kind of bipartisan concern. The next event of disruption, if it’s more concentrated or is a critical part of our supply chain, what will happen?”

"Emergency Medical Technicians (EMTs) are the “unhealthiest” Medical Technician profession.  They have the highest turnover rate among Technician occupations at 42 percent and the lowest Wage rank with only 19.5 percent growth from 2013 to 2023. EMTs are the only type of Medical Technician that makes less than Michigan’s median hourly wage ($17.34 vs. $22.57), and Paramedics, despite having the highest Wage rank of the Medical Technician occupations, barely earn more than Michigan’s median hourly wage ($22.98 vs. $22.57)."

The resultant Emergency Medical Services (EMS) shortages are most acute in rural areas of Michigan:

https://bridgemi.com/michigan-health-watch/providers-face-extreme-shortage-of-paramedics-emts-in-rural-michigan/

https://www.mhc.org/_files/ugd/24abcc_06a02541eebb4735b526ea5d9af2e294.pdf

Providers face ‘extreme shortage’ of paramedics, EMTs in rural Michigan
By Eli Newman - March 27, 2026

• Michigan’s EMS agencies face a staffing crisis driven by low wages, high burnout and a training pipeline that can’t keep pace with vacancies
• Industry experts estimate more than 500 vacancies in the state
• Investment in training programs varies with economic conditions, an expert says

Paramedics and emergency medical technicians, or EMTs, face a harsh reality in Michigan — shrinking revenue has left emergency medical service agencies grappling with multiple financial issues at once, with staffing being their top expense.

Despite the state investing millions of dollars in grants to train workers, staff shortages that began at the onset of the COVID-19 pandemic continue to strain EMS agencies, especially in rural communities.

“The fact that they exist is only due to the need and the willingness of people to get involved in this line of work,” said state Rep. Dave Prestin, R-Cedar River, who volunteers as a paramedic on a rescue squad that covers 1,000 square miles of the Upper Peninsula.

EMS is not considered an “essential” service in Michigan, just like most of the country, according to the National Conference of State Legislatures. Without the designation, funding becomes discretionary — local governments have the option whether or not they want to fund their ambulances.

The state has more than 29,000 EMS providers working across nearly 800 life support agencies statewide, according to the Michigan Association of Ambulance Services. Industry experts say there are more than 500 vacancies for paramedics and EMTs.

Low wages, high turnover

The field is notorious for burnout. Paramedics and EMTs regularly handle the state’s worst medical traumas and receive wages similar to fast-food workers.

EMTs are considered to be in the “unhealthiest” medical technician profession in the state, by the Michigan Health Council, a health care research nonprofit — below dental hygienists, surgical technologists and occupational therapy assistants. The ranking reflects the profession’s low wages and high turnover rate.

The health council said paramedics, who receive more advanced training than EMTs and are ranked as the most paid medical technician, “barely” earn more than Michigan’s median hourly wage.

Stress is cited as a primary reason for leaving the profession for both EMTs and paramedics. First responders are at higher risk than the general population for suicide.

Time and energy

The training of EMTs and paramedics is tied to the boom and bust cycle of the economy, according to Angela Madden, executive director of the Michigan Association of Ambulance Services.

Investment in education goes up when the “economy tumbles,” she said, but in a boon, people are more likely to take an hourly job with decent pay that forgoes the extra effort — factory and restaurant workers can begin working immediately without spending “money and time and energy” training to be a first responder.

EMS agency leaders describe a steady attrition rate of paramedics and EMTs quitting for better pay, pursuing careers in nursing or as other health care professionals, if not leaving the field altogether.

The state had roughly 4,700 employed EMTs and 3,250 employed paramedics in 2024, according to a Michigan Health Council workforce index.

Going to work

Tri-Hospital EMS in St. Clair County has worked to address a lack of first responders in its communities by integrating its own in-house training through the support of state grants and local millages. The scholarship program covers tuition and provides a wage for enrollees to come to class.

Without outside support, those seeking careers in EMS are on their own to fund their education and find jobs.

EMTs require several weeks of training. Paramedics can take anywhere from 10 to 14 months to get licensed and state lawmakers have recently worked to lower the cost for accreditation exams. Courses can cost thousands of dollars.

Cummings said he learned that people are not willing to go through that first responder training “just for the sake of going to school” — they want clear outcomes.

“If you take one of our programs, you’re pretty much in line to be hired by us and work in the field and actually earn an income,” he said.

While Tri-Hospital EMS has developed a sustainable model of recruitment and retention in St. Clair County, Cummings said other agencies elsewhere in the state are still reeling from the ongoing staff vacancies that began in the years after the pandemic.

“There’s still a pretty extreme shortage of paramedics across the state of Michigan, in particular in the rural areas,” he said. “Those areas lack sufficient training programs in which to produce those paramedics. That’s one of the reasons why there’s such a shortage in the rural market.”

https://www.wlns.com/news/19000-corewell-health-patients-affected-by-data-breach/

https://askphc.com/dataincident2024dataownersnoticenotice-of-data-incident/

19,000 Corewell Health patients affected by data breach
By Shajaka Shelton - March 27, 2026

• Name
• Address
• Phone number
• Email address
• Social Security/taxpayer ID number
• Driver’s license/state ID/passport number
• Financial account/payment card information
• Online account credentials
• Digital signature
• Biometric data
• Date of birth
• Medical treatment, diagnosis, or billing information
• Prescription information
• Date of service
• Patient ID number
• Encounter ID number
• Provider name
• Patient account number
• Medical record number
• Medicare/Medicaid number
• Health insurance information