When scores of dead and dying sea animals began washing up on L.A.-area beaches just weeks after January’s devastating fires, the timing seemed suspicious.

Harmful algae blooms had sickened marine life in each of the three years prior. But the especially high number of animal deaths this year prompted several research teams to investigate whether runoff from the fires may have accelerated algae growth to particularly dangerous proportions.

The evidence available so far suggests that this year’s algae bloom would have been just as deadly if the catastrophe on land hadn’t happened, multiple scientists said this week.

“Some of the fire retardants have nutrients in them, like ammonia or phosphate, that can fuel the growth of phytoplankton and the growth of organisms in the ocean. And we do see some spikes in those nutrients early on, immediately post-fire,” said Noelle Held, a University of Southern California microbiologist and oceanographer who has tested ocean water along L.A.’s coastline regularly since January. “But those increases are completely dwarfed by the major shift that happened in the ocean between the end of February and the beginning of April — the upwelling event.”

Upwellings occur when winds push warmer surface waters from the coastline out to sea, allowing colder, nutrient-rich waters from deeper in the ocean to rise up and take their place. These surges occur naturally in Southern California in winter and spring and contain elements like nitrogen and phosphorus that feed microbes (algae included). They often precede harmful algae blooms, though scientists are still trying to figure out the precise balance of factors that lead to sudden explosions in toxin-producing algae species.

Four different algae species were present in this year’s bloom. The two most dangerous produce powerful neurotoxins that accumulate in the marine food chain: Alexandrium catenella, which produces saxitoxin, and Pseudo-nitzschia australis, which produces domoic acid.

The toxins accumulate in filter-feeding fish, and then poison the larger mammals who eat them.

Scientists have known from the beginning that the fires didn’t initiate this year’s bloom. This is the fourth harmful algae bloom in as many years, and levels of toxin-producing species were rising before the Palisades and Eaton fires began. But the acceleration of marine wildlife deaths in the weeks after the fires led some to wonder whether L.A.’s disaster on land was also worsening the crisis in the sea.

However, based on the data available, fire pollution appears to have influenced the ocean’s chemistry far less than this year’s upwelling effect did.

“The only thing we could say is that [the fires] added some nutrients to an already nutrient-rich environment,” said Dave Bader, a marine biologist and the chief operations and education officer for the Marine Mammal Care Center in San Pedro. Runoff from the fires added fewer nutrients over the course of the bloom than sewage treatment facilities did, he said.

Beginning in February, hundreds of dolphins and sea lions started washing up on California beaches, either dead or suffering from neurotoxin poisoning symptoms such as aggression, lethargy and seizures. A minke whale in Long Beach Harbor and a gray whale stranded on Huntington City Beach also succumbed to the outbreak. Scientists believe countless more animals died at sea before the outbreak abated in May.

The year’s bloom was the deadliest for marine mammals since a 2015-16 outbreak that killed thousands along the Pacific coast between Alaska and Baja California.

Similarly, this year’s outbreak stretched from Baja California in Mexico to Bodega Bay in Northern California. The sheer geographic extent of the damage suggests that L.A.’s fires played a minimal role, said Clarissa Anderson of UC San Diego’s Scripps Institution of Oceanography. She directs the Southern California Coastal Ocean Observing System, or SCCOOS, which monitors algae blooms.

The only sign that L.A.’s waters could be unhealthier than other coastal stretches this year was an unusually high spike of Pseudo-nitzschia in March at the Santa Monica Pier, Anderson said. But even that wasn’t significantly higher than readings elsewhere along the coast.

Just as January’s firestorms occurred outside of Southern California’s typical fire season, this harmful algae overgrowth appeared earlier in the year than have previous blooms. As climate change has shifted the timing and intensity of the strong wind events that drive upwellings, “we’re coming into a future where we unfortunately have to expect we’ll see these events with recurring frequency,” Bader told Los Angeles Mayor Karen Bass in June. “The events that drove the fires are the events that drove the upwelling.”

The first cases of West Nile virus this year have been recorded in Los Angeles County, with four people hospitalized between July and August, officials said.

The Los Angeles County Department of Public Health on Wednesday announced that patients from the Antelope Valley, San Fernando and central Los Angeles were infected with the virus, hospitalized and are now recovering.

“The first human cases of West Nile virus are an important reminder that we all need to take steps to prevent mosquito bites and mosquito breeding,” said Dr. Muntu Davis, L.A. County health officer, in a statement.

“Mosquitoes thrive in hot weather, increasing the risk of bites and mosquito-borne diseases.”

West Nile is spread by the bite of infected mosquitoes. Those who have contracted the virus may suffer from a variety of symptoms, including fever, headache, nausea, body aches and a mild skin rash.

The virus can attack the nervous system and lead to meningitis, encephalitis, paralysis and, in rare cases, even death.

Risk is acute in adults 50 years of age or older and for those with chronic health conditions.

It is believed the mosquitoes carrying the virus are in L.A. County, though not all are carriers, according to health officials.

Davis encouraged residents to use insect repellent, get rid of standing water around their homes and install or repair windows to reduce exposure to mosquitoes.

Environmental Protection Agency-registered sprays contain DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone and are proven safe and effective, even for pregnant and breastfeeding women, according to health officials.

Also avoiding areas at dawn or dusk when mosquitoes congregate is key to avoid getting bitten.

An individual should consider wearing long-sleeved shirts and long pants when venturing to an area known for mosquitoes.

Mosquitoes tend to lay eggs in places with standing water.

The health department recommends emptying and scrubbing places where water accumulates, including tires, buckets, pet bowls, planters and rain barrels.

Birdbaths and wading pools should be cleaned weekly, while pools should be cleaned and chlorinated regularly.

The health department said over the last five years, L.A. County (minus Pasadena and Long Beach, which report to their own agencies) has averaged about 56 West Nile virus cases per year. The number of infected people, however, is expected to be much higher since most impacted individuals suffer mild symptoms and don’t file a report with the county, according to the health department.

The Greater Los Angeles County Vector Control District reported 132 cases last year, with Northridge (eight), Lake Balboa (seven) and Porter Ranch (seven) producing the most recorded infections. There were two deaths in the county and 12 in the state in 2024, according to state figures.

About three-quarters of reported cases in L.A. County have had severe disease and approximately 10% of patients with severe West Nile virus die from complications.

There is no specific treatment for West Nile virus disease and no vaccine to prevent infection.

“Detecting West Nile virus in our district is a reminder that this virus has been present in California — and right here in our community — for over 20 years,” Brenna Bates-Grubb, community outreach specialist for the Antelope Valley Mosquito and Vector Control District, said in a statement.

“It’s part of our local environment and continues to reappear year after year,” she added. “With the recent rains and more in the forecast, conditions are ideal for mosquitoes to breed.”

It’s a bad look when Robert F. Kennedy Jr. is ahead of you on scientifically sound health policy — women’s health, to make matters worse — but that’s exactly what happened to Gov. Gavin Newsom last week.

Ouch.

In a Cabinet meeting, Kennedy went on a six-minute-plus grovel to Trump. That’s pretty standard for these increasingly weird meetings, but the secretary of Health and Human Services specifically praised the president for ending a “20-year war on women by removing the black box warnings from hormone replacement therapy.”

As much as it shocks me to say it, RFK Jr. has a reasonable point.

A couple of days later, appearing onstage at the New York Times’ DealBook Summit, Oscar-winning actor Halle Berry took an unexpected and harsh shot at Newsom for vetoing a bill on menopause treatment.

“But that’s OK,” she said of Newsom killing the Menopause Care Equity Act (AB 432), which she had lobbied to pass and which had strong bipartisan support in the Legislature.

“Because he’s not going to be governor forever, and with the way he has overlooked women, half the population, by devaluing us in midlife, he probably should not be our next president either,” Berry said. “Just saying.”

The two events show just how complicated and controversial menopause care has become in the past few years, as women not only talk about it more openly, but demand care that for, well, basically always, has been denied or denigrated as unnecessary.

Looking a bit deeper, this seemingly out-of-the-blue menopause moment gets to the heart of an insurance problem that, male or female, most Americans have an opinion on: How much power should insurance companies have to deny care that a doctor deems reasonable?

To keep it simple, menopause is a phase that all women go through when their fertility ends, meaning 50% of the population deals with it. It has specific and life-altering symptoms — most of which can be treated, but often aren’t because many doctors aren’t trained in menopause care (or perimenopause, which comes first), and the science is too-often overlooked or misunderstood.

The result is that way too many women stumble through menopause not understanding what is happening to them, or that there are excellent, scientifically backed treatments to help.

A prime example of that is the “black box” warning that has been on many hormone replacement drugs since the turn of the millennium, when one large but flawed study found that such drugs might increase the risk of cancer or other diseases.

A black box warning is the most serious caution the Food and Drug Administration can put on a medication, and its inclusion on hormone replacement theory, or HRT, put a severe chill on its use.

Twenty years of subsequent research not only revealed the flaws in that first analysis, but also showed significant benefits from HRT. It can protect against cognitive decline, decrease heart disease and alleviate symptoms such as hot flashes, among many other benefits.

In early November, the FDA removed those warnings from many HRT drugs. The result will likely be greater access for more women as doctors lose a hesitancy to prescribe them, and women lose fear of using them.

“The misconceptions around the risks have been overblown for decades, fringing on dogma over real science and have led to population-level missed opportunities for life improvements for our aging women of the developed world,” wrote Michael Rodgers, chairman of the Santa Clara County Health Advisory Commission, on a public comment about the change.

While Rodgers is right, insurance coverage and doctor know-how remain problems for women seeking care — ones that the Menopause Care Equity Act hoped to address.

The bill would have required private insurance companies to cover FDA-approved menopause treatments and rewarded doctors who took voluntarily continuous education classes on menopause topics. That final version had already been watered down from earlier proposals that would have mandated coverage of even more treatment options (such as non-FDA approved compounded hormones) and made menopause training required for doctors.

But Newsom seemed to take issue with a part of the bill that banned insurance companies from applying “utilization management” to menopause treatments — and here’s where we get back to agreeing with RFK Jr.

Utilization management, or UM, is basically when insurance companies get to decide what a patient needs and what they don’t — the pre-approvals, the reviews and the denials, which all too often seem to be far more about cost than care.

Now artificial intelligence is getting in on the utilization management business, potentially meaning it’s not even a human deciding our treatments. UM is a multibillion-dollar industry that, under the premise of keeping healthcare affordable, too often does so by denying care.

Which is why Assemblymember Rebecca Bauer-Kahan (D-Orinda), the author of the California bill, put in a prohibition against UM.

“The standard is ‘medically necessary‘” when it comes to insurance coverage, Bauer-Kahan points out.

“When you talk about menopause, that’s a really fuzzy term, right? I mean, I will survive in the short term without any treatment,” she said. “So what is ‘medically necessary’ is this very vague thing when it comes to menopausal care.”

In his veto message, Newsom said the UM prohibition “would limit the ability of health plans to engage in practices that have been shown to ensure appropriate care while limiting unnecessary costs.”

But the truth, and problem, with menopause care is that it is specific to the individual woman. Like birth control pills, a treatment that works for one woman might cause side effects for another. There is often a lot of trial and error to find the right path through menopause, and women need to be able to have the freedom and flexibility to work one-on-one with their doctor. Without interference.

In June, Kennedy called out prior authorization across the healthcare industry as a problem, and announced shortly after that he had received a pledge from many large insurance companies to reform that process by 2026, removing the need for prior authorization from many treatments and procedures and streamlining the process overall.

If that reform comes to pass, it will indeed be terrific — I am hopeful — but also, let’s wait and see. Those changes are supposed to begin in January.

Back in California, Newsom has also pledged to do something about menopause coverage in January, when he announces his budget proposal. In his veto message, Newsom said he would go this route — adding it into his budget package — rather than work on a new bill in the regular legislative session. This remains the plan, though no details are yet available.

Apparently, someone forget to mention it to Berry.

The budget has increasingly become a catch-all for legislation the governor wants to get done with less fuss because the budget and its trailer bills always pass at some point, and it can be an easier route for him to control.

Newsom has made it a core part of his policies, and his presidential campaign, to be a backer of women’s rights, especially around reproductive care — and equity for women is a cause championed by his wife, First Partner Jennifer Siebel Newsom.

But the governor also has long been hesitant to pass legislation that has costs attached (the menopause bill could raise individual premiums by less than 50 cents a month for most private-pay consumers). With federal cuts, increasing premiums and the generalized hot mess of healthcare, his caution is not unwarranted.

But also, in this case, maybe it is misguided. The only real opposition to the California bill came from insurance companies. Go figure.

Bauer-Kahan said she has been in touch with the governor’s office, but remains committed to pursuing a law that limits utilization management.

“I am happy to hear that we are going to hopefully achieve this, but it needs to be achieved in a way that actually meaningfully makes a difference for getting the menopausal care women need,” she said.

Newsom’s October veto made barely a ripple. Thanks to Berry’s punch, his January proposal will be not just noticed, but scrutinized.

If he does eliminate the restrictions on UM, he’ll need to answer the broader question that action would raise — how much power should insurance companies have to override the decisions of doctors and patients?

It would be strange days if January saw Kennedy and his chaotic and questionable Department of Health and Human Services offering better healthcare options for women than the state of California.

And stranger still if Newsom puts a price tag on the well-being of women.