Science
In Southern California, many are skipping healthcare out of fear of ICE operations

Missed childhood vaccinations. Skipped blood sugar checks. Medications abandoned at the pharmacy.
These are among the healthcare disruptions providers have noticed since Immigration and Customs Enforcement operations began in Southern California earlier this month.
Across the region, once-busy parks, shops and businesses have emptied as undocumented residents and their families hole up at home in fear. As rumors of immigration arrests have swirled around clinics and hospitals, many patients are also opting to skip chronic-care management visits as well as routine childhood check-ups.
In response, local federally qualified health centers — institutions that receive federal funds and are required by law to provide primary care regardless of ability to pay — have been scrambling to organize virtual appointments, house calls and pharmacy deliveries to patients who no longer feel safe going out in public.
“We’re just seeing a very frightening and chaotic environment that’s making it extremely difficult to provide for the healthcare needs of our patients,” said Jim Mangia, president of St. John’s Community Health, which offers medical, dental and mental health care to more than 100,000 low-income patients annually in Southern California.
Prior to the raids, the system’s network of clinics logged about a 9% no-show rate, Mangia said. In recent weeks, more than 30% of patients have canceled or failed to show. In response, the organization has launched a program called Healthcare Without Fear to provide virtual and home visits to patients concerned about the prospect of arrest.
“When we call patients back who missed their appointment and didn’t call in, overwhelmingly, they’re telling us they’re not coming out because of ICE,” said Mangia, who estimates that 25% of the clinic’s patient population is undocumented. “People are missing some pretty substantial healthcare appointments.”
A recent survey of patient no-shows at nonprofit health clinics across Los Angeles County found no universal trends across the 118 members of the Community Clinic Assn. of L.A. County, President Louise McCarthy said. Some clinics have seen a jump in missed appointments, while others have observed no change. The data do not indicate how many patients opted to convert scheduled in-person visits to telehealth so they wouldn’t have to leave home, she noted.
Patients have also expressed concerns that any usage of health services could make them targets. Earlier this month, the Associated Press reported that the U.S. Department of Health and Human Services shared the personal data of Medicaid enrollees with the U.S. Department of Homeland Security, including their immigration status. No specific enforcement actions have been directly linked to the data.
“The level of uncertainty and anxiety that is happening now is beyond the pale,” McCarthy said, for patients and staff alike.
County-run L.A. General Medical Center issued a statement on Thursday refuting reports that federal authorities had carried out enforcement operations at the downtown trauma center. While no immigration-related arrests have been reported at county health facilities, “the mere threat of immigration enforcement near any medical facility undermines public trust and jeopardizes community health,” the department said in a statement.
Los Angeles County is among the providers working to extend in-home care options such as medication delivery and a nurse advice line for people reluctant to come in person.
“However, not all medical appointments or conditions can be addressed remotely,” a spokesperson said. “We urge anyone in need of care not to delay.”
Providers expressed concern that missing preventative care appointments could lead to emergencies that both threaten patients’ lives and further stress public resources. Preventative care “keeps our community at large healthy and benefits really everyone in Los Angeles,” said a staff member at a group of L.A. area clinics. He asked that his employer not be named for fear of drawing attention to their patient population.
Neglecting care now, he said, “is going to cost everybody more money in the long run.”
A patient with hypertension who skips blood pressure monitoring appointments now may be more likely to be brought into an emergency room with a heart attack in the future, said Dr. Bukola Olusanya, a medical director at St. John’s.
“If [people] can’t get their medications, they can’t do follow-ups. That means a chronic condition that has been managed and well-controlled is just going to deteriorate,” she said. “We will see patients going to the ER more than they should be, rather than coming to primary care.”
Providers are already seeing that shift. When a health team visited one diabetic patient recently at home, they found her blood sugar levels sky-high, Mangia said. She told the team she’d consumed nothing but tortillas and coffee in the previous five days rather than risk a trip to the grocery store.

Science
Why Isn't China Catching Up With Elon Musk’s Starlink?

China’s two biggest networks have deployed less than 1 percent of their planned satellites, records show, a measure of how far they are falling behind Elon Musk’s company SpaceX for dominance in space communications.
Satellites in low Earth orbit, up to 1,200 miles above the planet, are increasingly seen as essential for driverless cars, drone warfare and military surveillance. China regards Starlink as a military threat, and Chinese companies have invested heavily in two huge networks, with nearly 27,000 satellites planned between them.
One reason for the unexpectedly slow pace is that the Chinese companies have not cleared a key engineering hurdle.
The first network, or megaconstellation, Qianfan, was scheduled to have about 650 satellites in space by the end of the year. But records show that the company behind the network, Shanghai Spacesail Technologies Co., has put only 90 satellites in orbit since its launches began in August.
The other megaconstellation, Guowang, is even farther behind. Despite plans to launch about 13,000 satellites within the next decade, it has 34 in orbit.
SpaceX has about 8,000 Starlink satellites in orbit and is expanding its lead every month, according to data from U.S. Space Force and CelesTrak, a nonprofit group that gathers space data.
Chinese officials are alarmed by SpaceX, which they viewed as inextricably linked with the Pentagon even before Mr. Musk’s short-lived position in the Trump administration. Researchers for the People’s Liberation Army predict that the network will become “deeply embedded in the U.S. military combat system.” They envision a time when Starlink satellites connect U.S. military bases and serve as an early missile-warning and interception network.
Though Starlink is intended for civilian use, it has become essential for communications and coordinating drone strikes in the war in Ukraine. And SpaceX has contracts with the U.S. government to build and launch satellites, some for espionage and others for targeting enemies and tracking missiles. SpaceX also launches satellites built by other defense contractors.
China’s space agencies and its aerospace companies did not respond to requests for comment.
China, like the United States, recognizes the national security value of being in space. But the government is also encouraging commercial space interests and says it expects to create a $344 billion market.
“Exploring the vast universe and building a space power is our unremitting space dream,” China’s top leader, Xi Jinping, said last year, according to government news media.
It has not gone smoothly.
China hasn’t solved a key rocket problem. SpaceX has.
One of the major reasons for China’s delay is the lack of a reliable, reusable launcher. Chinese companies still launch satellites using single-use rockets. After the satellites are deployed, rocket parts tumble back to Earth or become space debris.
But SpaceX’s workhorse rocket, the Falcon 9, is partly reusable. The rocket’s bottom portion, containing the main engines, returns to Earth upright, intact and ready to be deployed for other missions. That drastically reduces costs and speeds up the time between launches.
This is the innovation that propelled SpaceX far ahead of competitors. Falcon 9 rockets have been used in about 500 missions, according to SpaceX.
But six years after the Falcon 9 began launching Starlink satellites, Chinese firms still have no answer to it.
Reusable rockets must withstand extreme heat during their return to base. They also have to be stable and under control with engines that can restart in different aerodynamic conditions, said Jonathan McDowell, an astrophysicist at the Harvard-Smithsonian Center for Astrophysics who tracks objects in space.
“The question is not just recovering them,” Dr. McDowell said, “but recovering them in a good enough state to launch them again.”
The lack of a reusable rocket is not the only limitation. Manufacturing satellites is a complicated and time-consuming endeavor, and establishing a steady launch cadence is tricky even with reusable rockets. It took SpaceX years to work out the kinks. But experts said that the race for a reusable rocket was central to the future of the Chinese low Earth orbit constellations.
One Chinese government-funded model, the Long March 8, was meant to be reusable. But its developer, China Academy of Launch Vehicle Technology, abandoned that plan. An improved version, the Long March 8R, could “grow up” to be a reliable Falcon 9 equivalent, Dr. McDowell said.
The government has tested nearly 20 rocket launchers in the Long March series.
Another potential launcher alternative is the Zhuque-3, made by the Chinese firm Landspace. The launcher conducted a liftoff-and-recovery test last year and, in another test this June, its engines fired for 45 seconds.
A third alternative, the Tianlong-3, had a setback last year. The rocket took off briefly during what was supposed to be a static test and exploded upon impact.
While the Chinese firms could have a technological breakthrough as early as this year, it will still take them time to get to a reliable cadence, said Andrew Jones, a journalist who has monitored Chinese space launches for the past decade.
“They have to work out the kinks,” Mr. Jones said.
That hasn’t stopped China from marketing its satellite services.
Chinese space companies are drumming up business in countries where governments are wary of relying on Starlink satellites or looking for better prices.
Shanghai Spacesail Technologies Co. says it is negotiating with 30 countries over contracts for access to its Qianfan megaconstellation.
The company signed a deal to provide internet in Brazil last year, soon after a Brazilian judge froze Starlink’s local assets in a dispute with another Musk-owned company, X. Spacesail has other agreements to provide internet in Thailand and Malaysia and has set up a local subsidiary in Kazakhstan.
Its services, however, are yet to come online. In fact, 13 of its 90 satellites did not reach the correct height of orbit, for unclear reasons. This means that they are most likely not functional, Dr. McDowell said.
The satellite internet contracts now under negotiation could become an important feature of economic diplomacy “in a world that is moving from free trade to a more protectionist and more autonomy-based order,” said João Falcão Serra, a research fellow at the European Space Policy Institute.
A country’s decision to sign contracts with Starlink could be seen as “a message to the U.S. and to China” about where its allegiances lie, he said.
There could still be a record number of Chinese launches this year.
Private and government-run companies in China conducted more than 30 launches in the first half of the year, a faster cadence compared with last year.
The missions have put about 150 satellites and two spacecrafts in space, according to official announcements and data compiled by U.S. Space Force. That includes launches into low, medium and farther orbits.
Still, Chinese companies will need to pick up the pace. This is especially true for the megaconstellations, which risk losing the right to operate on their radio frequencies.
A constellation has to launch half of its satellites within five years of successfully applying for its frequencies, and complete the full deployment within seven years, according to rules set by the International Telecommunication Union, a United Nations agency that allocates frequencies.
The Chinese megaconstellations are behind on these goals. Companies that fail to hit their targets could be required to reduce the size of their megaconstellations.
Still, experts say that it is unwise to write them off. Satellite launches in China tend to accelerate in the second half of the year. And a technological breakthrough could radically transform the landscape.
This year and next could signal the transition from Starlink’s dominance to a more competitive field, Dr. McDowell said.
Joy Dong and Chris Buckley contributed reporting. Additional work by Scott Reinhard.
Science
Eaton fire could wipe out California's $21-billion wildfire fund, documents show

Damage claims from the Eaton wildfire in Altadena could wipe out the $21-billion fund California created to shield utilities and their customers from the cost of wildfires sparked by electric lines, according to newly released state documents.
Investigators are seeking to determine whether Southern California Edison’s equipment sparked the Jan. 7 inferno, which killed 19 people and destroyed 9,000 homes. If Edison is found responsible, “the resulting claims may be substantial enough to fully exhaust the Fund,” state officials who administer the wildfire fund wrote in a draft annual report to the Legislature.
The seven-member state Catastrophe Response Council, which oversees the fund, is scheduled to meet Thursday to discuss how potential damage claims from the Eaton fire could affect it.
Concerns are already emerging that, should Edison be found liable, it would have little incentive to keep damage claims from becoming excessive since the utility itself would be spared from covering most of the costs.
“Are we impressing on the utilities that they need to settle claims with diligence?” wrote one of the council members, according to meeting materials released ahead of Thursday’s meeting. “Since the claims they settle are just passed on to us, they don’t have much incentive to keep claims low.”
Asked for comment on that statement, Edison spokeswoman Kathleen Dunleavy said that officials “need to be wise and cautious about how this money is spent.”
“We agree that the wildfire fund should go to those directly affected by wildfires,” she said.
The council member who raised the concern wasn’t identified by name.
Wade Crowfoot, California’s secretary of Natural Resources, holds one of the nine council seats. His spokesman, Tony Andersen, said Crowfoot is “engaged very closely” on the wildfire fund issue, but had no additional comment at this time.
Other council members include Gov. Gavin Newsom, other state leaders and their appointees.
According to the state documents, the insured property losses alone could amount to as much as $15.2 billion, according to materials released ahead of a Thursday meeting.
That amount does not include uninsured losses or damages beyond those to property, such as wrongful-death claims. An earlier study by UCLA estimated losses from the fire at $24 billion to $45 billion.
Newsom and legislative leaders are now talking about how to shore up the fund. The Times reported last month that one option under discussion behind closed doors is to have electricity customers pay billions of dollars more into the fund.
The remains of a home that burned down in the Eaton fire are shown in May 2025.
(David Butow / For The Times)
Newsom and lawmakers created the wildfire fund in 2019, saying it was needed to protect the state’s three biggest for-profit utilities from bankruptcy if their equipment sparked a catastrophic fire. Newsom said at the time that the legislation, known as Assembly Bill 1054, would “move our state toward a safer, affordable and reliable energy future.”
Six years later, however, utilities’ electricity lines continue to be a top cause of wildfires in California. And in 2024, the state had the second highest electric rates in the country after Hawaii.
Edison said in April that a leading theory of the cause of the Eaton fire is that one of its decades-old transmission lines, last used in 1971, somehow became reenergized and sparked the fire. The investigation into the cause of the fire is continuing.
Already lawyers have filed dozens of lawsuits against Edison on behalf of families who lost their homes, nearby residents who say they were harmed by toxins in the smoke and governments that lost buildings and equipment.
Under the 2019 law, Edison would be allowed to settle those lawsuits. Then the state fund would reimburse the company for all or most of those costs.
The Palisades fire, which also ignited Jan. 7, isn’t covered by the wildfire fund because Pacific Palisades is served by the Los Angeles Department of Water and Power, a municipal utility.
Newsom’s staff didn’t respond to questions about how the fund’s life could be extended and whether he believed AB 1054 should be amended so that excessive settlements or attorney fees aren’t allowed to deplete the fund.
One idea being debated is to have the 30 million Californians served by Edison, Pacific Gas & Electric, and San Diego Gas & Electric pay billions of dollars more into the fund. That plan could involve extending a monthly surcharge of about $3 on electricity bills beyond its planned expiration in 2035.

Workers inspect and prepare for the process of removing a Southern California Edison tower in Pasadena in May 2025.
(William Liang / For The Times)
Officials at the California Earthquake Authority, which serves as administrator of the wildfire fund, say they are also worried that attorney fees could eat up a large portion of the money.
Attorneys can receive 30% to 40% of the victim settlements, according to a 2024 study. An additional 10% to 15% can go to lawyers defending the utility from fire claims, the study said. That means as much as 50% of settlement amounts could go to legal fees, the paper said.
The consolidated lawsuit against Edison in Los Angeles County Superior Court lists more than 50 law firms involved in the litigation.
Officials at the Earthquake Authority say the Legislature may have to change the 2019 law to limit attorney fees or give priority to some settlements over others.
For example, Wall Street hedge funds have been offering to buy claims that insurance companies have against Edison. The funds are gambling that they can get more from the state’s wildfire fund in the future than they are paying insurers for the claims now.
Council members discussed in May whether AB 1054 should be amended so that claims from Californians who lost their homes be given precedence over those owned by Wall Street investors trying to profit from the fire.
Science
What to know about chronic venous insufficiency — President Tump's health diagnosis

Earlier this week, President Trump was diagnosed with chronic venous insufficiency, or CVI, after he noted mild swelling in his lower legs. White House physician Dr. Sean P. Barbabella in a memo July 17 said the swelling prompted a full medical evaluation, including ultrasound tests and blood work. Those confirmed CVI, a condition the doctor described as “benign and common — particularly in individuals over the age of 70.”
Barbabella said he found no other signs of more serious cardiovascular issues like blood clots and declared the president to be in “excellent health.”
What is chronic venous insufficiency?
“CVI is when the veins of the body do not work well,” said Dr. Mimmie Kwong, assistant professor of vascular surgery at UC Davis Health, when veins cannot transport blood effectively, causing it to pool, especially in the legs.
CVI is one of the most common vein problems in the U.S. and worldwide, affecting “about one in three adults in the United States,” Kwong said.
That translates to more than 30 million people in the U.S., most often older adults, according to Dr. Ali Azizzadeh, a professor and director of Vascular Surgery at Cedars-Sinai and associate director of the Smidt Heart Institute. He noted the condition is more common in women.
As people age, the veins, such as in their legs, may have a harder time returning blood to the heart, he said.
What causes CVI?
The valves in the veins of the legs are supposed to keep blood moving in one direction: back toward the heart. But when those valves are damaged or weakened, they can stop working properly, leading blood to flow backward and collect in the lower legs.
Individuals who stand or sit for extended periods, or those with a family history of vein issues, may be at a higher risk of developing the condition.
“When the calf muscles are active, they pump the veins that return blood from the legs to the heart,” Azizzadeh explained. “With prolonged inactivity of those muscles, blood can pool in the legs.”
What does CVI feel like?
While CVI isn’t always painful, it can cause discomfort that worsens as the day goes on.
The mornings may feel the best: “The legs naturally drain while you are lying down and sleeping overnight,” said Azizzadeh, “so they will typically feel lightest in the morning.”
As the day progresses and blood starts to pool, people with CVI may experience swelling, heaviness, aching or a dull pain in their legs. The symptoms tend to worsen after prolonged periods of standing or sitting.
If swelling worsens, thickening, inflammation or dry skin can result, with more severe cases developing wounds that do not heal and can even result in amputation, Kwong said.
FILE – President Donald Trump speaks to the media as he leaves the White House, July 15, 2025, in Washington. (AP Photo/Manuel Balce Ceneta, File)
(Manuel Balce Ceneta/AP)
How is CVI treated?
Treatment is more manageable when problematic veins are closer to the surface of the skin, Kwong said. It’s more problematic when deep veins are affected.
The first line of treatment is usually simple lifestyle changes. “We suggest CEE: compression, elevation, and exercise,” Azizzadeh said. Wearing compression stockings can help push blood out of the legs; elevating the legs allows gravity to help drain blood from the legs toward the heart, and regular walking forces calf muscles to pump blood throughout the body.
For people with more serious cases, doctors may recommend a minimally invasive procedure that uses heat to seal off the leaky veins. Common treatments include ablation techniques, surgical removal of veins (phlebectomy), or chemical (sclerosant) injections. “All of these therapies aim to cause the veins to shut down, so they no longer cause the CVI,” Kwong said.

President Trump, left, reaches to shake hands with Bahrain’s Crown Prince Salman bin Hamad Al Khalifa.
(Alex Brandon / Associated Press)
In Trump’s case, the condition appears to be mild and manageable, his doctor said. Barbabella emphasized there was no cause for concern and that the president remains in good overall health. But for millions of Americans living with CVI, recognizing the symptoms and knowing how to manage them can make a big difference in day-to-day comfort and long-term well-being.
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