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Last September, as Hurricane Helene barreled toward the coast of Florida, Andrew Hazelton was in a plane flying into the eye of the storm. The plane was collecting crucial data to help understand the path and intensity of the hurricaneand Hazelton was simultaneously watching to see how the real-time data matched what scientific models predicted. At the time, he was working at a NOAA lab at the University of Miami; in October, he was promoted to another NOAA job focused on helping the governments computer models of hurricanes continue to get even better. (NOAA, the National Oceanic and Atmospheric Administration, is in charge of tracking, predicting, and responding to hurricanes, among many other things, from deep sea exploration to climate research.) At the end of February, Hazelton became one of hundreds of NOAA employees to lose his job through cuts pushed by DOGE, the so-called Department of Government Efficiency. The team was already short-staffed, Hazelton says. Now it will be even harder to do the work. Theyre going to do their best to try to continue the missionNOAA is very mission-focused on protecting laws and property. That’s what we want to do. But when you lose expertise, you lose people. Any one person can only do so much during the day. So fewer tests will get run, and there will be less expertise to make improvements. And itll degrade the forecast over time. Andrew Hazelton As hurricane forecasts improve, that translates directly into saving lives. When Hurricane Andrew hit Florida in 1992, causing around $27 billion in damage, most forecasts could happen only a day or two in advance of a hurricane. Now, forecasts five days in advance can be as accurate. “That has a lot of implications,” Hazelton says. “That means that the forecast ‘cone’ that people see is smaller. People who are under harm’s way can get out sooner and prepare better. But it also means that people who aren’t going to be as directly affected don’t have to close their business or close their school.” The modeling is on track to eventually provide accurate forecasts seven days in advance. That’s because of the work of scientists like Hazelton, who has a PhD in meteorology, and was part of the team helping the models continually improve. Though he was fired because he was a probationary employeemeaning that hed been in his current role for less than a yearhe had already been working in NOAA labs at universities for nearly a decade. Most probationary employees were in a similar position, he says, and had been working with NOAA at universities or as contractors for years, even if they were relatively early in their careers. Youre losing people who are motivated to improve themselves and build their career, build your organization, hungry, all of those thingsbut also have that experience, he says. Youre not getting rid of people who havent really done anything. NOAA is expected to potentially fire more than 1,000 additional employees. In total, that would mean losing around 15% of its staff. As a result, the U.S. will have less information about the weather at a time when climate change is making it more extreme. Hurricanes, for example, come with stronger winds, higher storm surges, and more rainfall as the planet heats up. The lack of data is going to degrade the forecastfor all sorts of weather, Hazelton says. “So these improvements that we’ve become accustomed to are going to be harder and harder to come by. It’s possible we could even see the forecast get worse again. That would result in more deaths and loss of property and loss of life.” The forecast improvements that we’ve come to take for granted, he says, have been the result of investments over decades. And those investments were already efficient: NOAAs improvements in hurricane forecasting have saved an estimated $7 billion since 2009, or 20 times as much as the agency spent on its forecasting system Though the current administration has a vision of privatizing weather data, its worth noting that private weather companies rely heavily on sources from NOAAa system that cant easily be replaced. This basic forecast and lifesaving datawatches and warningsis something I don’t think the private sector can really replicate, Hazelton says. At least not easily.
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E-Commerce
For the first time in more than 40 years, a new hormone-free intrauterine device (IUD) is coming to market in the U.S.and its designed with patients comfort in mind, both during the insertion process and once its in place. The new IUD, called Miudella, comes from the pharmaceutical company Sebela Womens Health Inc. It was approved by the Federal Drug Administration (FDA) in late February, and is the second hormone-free IUD to be approved since 1984, when the copper-based option Paragard first became available. With the addition of Miudella, there will now be six IUD options available in the U.S. Not only does this advancement provide patients seeking a hormone-free IUD with more than one option, it also marks a potentially major improvement in IUD design. By reducing insertion pain and post-insertion bleeding and cramping, Miudella is addressing two potential side effects of IUD placement that many women feel have long been overlooked. A new option in an ultra-limited market According to Kelly Culwell, a board-certified OB-GYN and head of research and development at Sebela Womens Health, bringing an IUD to market, especially in the U.S., is a very expensive and time consuming proposition. Because of those barriers, she says, many pharma companies simply choose not to invest as much in studying womens health. There really isnt a generic IUD, and the reason for that is its a very time-intensive and cost-prohibitive development process, especially for companies that arent really putting a lot of money or time or effort into womens health development, Culwell explains. A lot of the bigger pharma companies are focusing on things that could bring in a lot more money; things like oncology or neurologyso there just hasn’t been a lot of innovation [in womens health overall]. These factors have resulted in a limited selection of IUD options in the U.S. compared to places like Europe, Culwell saysdespite the fact that IUDs are considered to be one of the most effective forms of birth control, preventing pregnancy 99% of the time or more. Currently, there are four hormonal IUDs on the market (three of which were made by the same company) and one hormone-free IUD. Hormonal IUDs work by releasing a progestin hormone into the body, which thickens the cervical mucus and prevents sperm from entering the uterus. For patients who are sensitive to hormones, though, this might not be the best option. These patients may want to opt for a hormone-free IUD, which uses copper to prevent pregnancy. The metal is toxic to sperm, killing them before they can make it through the uterus. The only currently available hormone-free IUD, Paragard, has a copper wire wound around the entire T-shaped structure of the device. But theres a major drawback to that design: Copper can initiate an uncomfortable inflammatory response in the patient, resulting in side effects like cramping and heavy bleeding. Miudella, which has been in development for about 15 years, seeks to improve on both this existing hormone-free IUD model and the construction and delivery of IUDs more generally. [Image: Sebela Women’s Health Inc.] Designing a more flexible IUD To start, Miudellas developers wanted to find a way to decrease the amount of copper on the device in an attempt to lessen the side effects caused by the metal. In the past, Culwell says, other companies have attempted a similar strategy, but found that lowering the dose of copper reduced the IUDs effectiveness. After extensive trial and error, the Miudella team found that placing copper strategically on three key points of the device could maintain effective pregnancy prevention rates while lowering the copper dose to less than half that of Paragard. The Miudella has copper placed right at the bottom of the IUD, which is at the internal part of the cervix, and then at the top of the arms, which is at each of the tubal openings, Culwell says. You don’t necessarily need copper throughout the entire uterine cavity, you just really need copper at the key places where the sperm will be going by, to basically prevent them from making their way to the egg. Miudella also bucks the standard material construction of IUDs. Currently, all of the IUDs on the market in the U.S. use a rigid, plastic T-frame that holds one stiff position. To account for the varying anatomies of the uterus, Miudella has swapped that plastic frame for one made of nitinol, an ultra-flexible metal alloy commonly used for procedures like cardiac stents and orthopedic implants. Nitinol is super elastic, Culwell says. It has shape memory properties, so it actually can conform nicely to varying sizes and shapes of uterus. A uterus can be narrow, it can be short, it can be wide, and so having something that’s not just a rigid T allows for some conformity there. Aiming for a less painful insertion process The nitinol frame allowed Miudellas developers to make some changes to the actual IUD insertion process, which can be painful for some womenso much so that, in 2022, TikTok saw an outpouring of stories from women who felt that their pain during the procedure had not been properly addressed. Just last August, the Centers for Disease Control and Prevention (CDC) issued its first-ever recommendation that patients should actually be counseled on pain management before the procedure, as well as permitting the use of topical lidocaine during the process. To increase patient comfort, Miudellas developers invented a new insertion tube designed for more gentle insertion. Because of nitinols compressive properties, the tube can be manufactured about a millimeter narrower than Paragards insertion tube. Additionally, while other IUD insertion tubes have a flat, blunt end, the Miudella tube comes with a tapered tip. [Photo: Sebela Women’s Health Inc.] To have it more tapered so that it would be more comfortable for the insertion process is actually a challenge, Culwell says. It’s a bit difficult to create this tapered tip that you could reproduce consistently, because then you also have to be able to get the IUD out without much resistance and force. There was a lot of experimentation on getting the tip of the insertion tube to be able to be nice and tapered, but also to allow easy passage of the IUD. In fact, there’s a proprietary way that that tapered tube is designed: It has slits in the side that decrease friction during the deployment process. Most other IUDs, due to the rigidity of their plastic frames, have to be loaded by the practitioner within five minutes of placement to hold their shape. In the case of Paragard, the device has to be manually loaded with the fingers by pushing the two arms of the IUD down into a tubetypically while the patient is actively waiting in the stirrups. The added benefit of Miudella’s unique tube and nitinol frame is that the device can be pre-loaded before it even arrives at the doctor’s office. Currently, Miudella has been approved for use up to three years, whereas Paragard is approved for up to 10. Culwell notes that the team at Sebela is in the process of studying Miudellas effectiveness for up to eight years of use. In her own practice as an OB-GYN, Culwell says, shes glad to see that the CDC has started to offer more guidance on pain management during IUD placement. Still, she believes that women have historically not been listened to when it comes to pain in particular, and that the pharma industry needs to invest more in innovating with patient comfort in mind. We’re continuing, as a community, to do more and more research on pain management for IUD inserts, Culwell says. I think it lagged behindfor way too long, but there was no research done on IUD pain. So, I think continued innovation and then continued informed consent and making sure that we really offer patients pain management techniques are key, because IUDs are terrific methods for people who want them, but it can’t be torture to get them in. That shouldnt be the trade-off.
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In late February, the federal government abruptly cut funding to dozens of organizations that fight housing discrimination across the country, threatening their survival and dealing a setback to civil rights enforcement efforts in the United States, fair housing advocates say. More than 160 groups nationwide rely on federal funding to investigate and file complaints on behalf of people who think they have been denied housing because of disability, race, sex, national origin, religion, or because they have children. In some states, including California, fair housing organizations also represent people who suspect they’ve been discriminated against because they pay rent with government housing assistance, like Section 8 vouchers. I was shocked, said Caroline Peattie, executive director of Fair Housing Advocates of Northern California, who received notice that her organizations grant funding had ended abruptly. Housing discrimination is illegal under the landmark Fair Housing Act of 1968. But the law has no teeth if advocates dont have the resources to enforce it, Peattie said. The current administration appears to have targeted fair housing programs for deep cuts, despite their relatively low cost. Housing advocates worry the cuts will mean they wont be able to pursue discrimination cases and that some fair housing groups will have to cease operating altogether. Peattie received a notice from the federal Department of Housing and Urban Development that said HUD is terminating this award because it no longer effectuates the program goals or agency priorities. This affects us, and our ability to be a viable organization that can provide housing services to communities that we serve, Peattie said. There was no warning whatsoever. Last month, Fair Housing Advocates of Northern California was among 78 grantees that got sudden notice that theyd no longer receive funding, said Nikitra Bailey, executive vice president of the National Fair Housing Association, whose members include fair housing groups nationwide. The total cost of the canceled grants is estimated at $12.1 million, Bailey said, or less than a half-percent of Housing and Urban Developments total $255 billion budget for fiscal 2025. A HUD spokesperson wrote in an email, The Department is responsible for ensuring our grantees and contractors are in compliance with the Presidents Executive Orders. If we determine they are not in compliance, then we are required to take action. Trumps executive orders have targeted programs that mention diversity, equity, inclusion, and accessibility across the federal government. However, fair housing advocates arent sure how their programs conflict with the orders. The HUD spokesperson didnt explain why the canceled grants might have violated executive orders and didnt answer a follow-up email asking for specific examples of noncompliance on the part of the agencies whose contracts were canceled. Peattie said she had not been notified that her organization was noncompliant. Housing discrimination is especially common in cities like New York and Los Angeles where vacancy rates are low and competition for apartments is stiff. So our concern, Peattie said, is that as things get tighter in the rental markets, we will start to see more cases of housing discrimination. The budget cuts send a message, said Jasmine Perry, a home health aide in the San Francisco Bay Area, who was denied housing and filed a discrimination complaint through Fair Housing Advocates of Northern California nearly two years ago. It gives the people who denied me the okay to keep doing what theyre doing and to do it more. Its really sad, Perry said. Landlords repeatedly rejected Perrys rental applications as she searched for an apartment in Santa Rosa, north of San Francisco. Perry, who is Black, suspected discrimination based on her race or because she planned to use a Section 8 rent subsidy to pay her rent. Section 8 is the nations largest housing assistance program for low-income peopleit provides a subsidy that tenants can use in any apartment, provided rents dont exceed limits set by local housing authorities. Perry finally obtained the voucher after 11 years on a waiting list, and she had just 90 days to use it before it expired. She turned to Fair Housing Advocates of Northern California, which investigated and found that the management of one apartment building where she was rejected welcomed applicants without subsidies while discouraging those with them. Perry won a $37,000 settlement from the building management. She said her experience with filing a discrimination complaint showed her that I have rights. I can exercise my rights. Bailey of the National Fair Housing Association would not say how her group would respond to the funding cuts. However, some members of the organizations leadership are currently appealing to members of Congress to restore the funding. Even groups that have not received notices of grant cancellations are on edge. In Southern California, the Long Beach-based Fair Housing Foundation told Capital & Main in an email that its funding remained intact. Likewise, funding had not been cut at the Fair Housing Council of Orange County. But the groups David Levy wrote, We are still monitoring the situation as we believe we could still get a notice of cancellation. And Levy worries about funding for the coming year. The grant cancellations have now called into question whether the new administration will fund [fair housing] grants at all. In an email to Capital & Main, a HUD spokesperson said, The Department will continue to serve the American people, including those facing housing discrimination or eviction. When the Department puts out a notice of funding opportunity (NOFO) any eligible organization is invited to apply. But the administration has given other indications that fair housing programs could be on the chopping block at Housing and Urban Developmentand employees of the department are also stressed. An internal documentobtained by the American Federation of Government Employees Council 222, which represents HUD workers, and viewed by Capital & Mainshows the agency plans to slash fair housing staff positions within the agency by more than 75%. Union president Antonio Gaines said the document is unofficial, and is derived from multiple sources that have proven to be reliable in the past. In early February, a web page describing the types of discrimination covered under the Fair Housing Act disappeared from the HUD website. It was replaced with a page not found message but the page is currently accessible on the Internet Archive Wayback Machine. There is a perpetual state of fear, anxiety, fear of retaliation or reprisal, anxiety, every other distressful terminology that you can use can be applied to the environment, Gaines said. By Robin Urevich, Capital & Main This piece was originally publihed by Capital & Main, which reports from California on economic, political, and social issues.
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