Science
What the New C.D.C. Guidelines Mean for You

The Facilities for Illness Management and Prevention relaxed a lot of its Covid-19 tips this week, shifting sharply away from a number of of the precautions, together with quarantines and social distancing, which have lengthy outlined the pandemic.
The transfer was prompted by the truth that many Individuals now have some immunity to the coronavirus — by a mix of vaccination and former an infection — and by the provision of vaccines, booster pictures and antiviral medicines that may cut back the chance of extreme illness.
A part of the general public well being company’s aim in issuing the brand new steering was to streamline the suggestions and assist individuals handle their very own danger, officers stated. However the tips are nonetheless complicated and comprise loads of nuance.
Listed below are solutions to some frequent questions on what the rules imply for you.
Do I nonetheless have to face six toes away from strangers?
The C.D.C. has not deserted the concept of social distancing completely — as an alternative, the company suggests maintaining a distance from others as one in all many methods that folks can use to assist cut back their danger.
The previous tips really useful that individuals who weren’t up-to-date on their vaccinations “keep no less than six toes away from different individuals” in indoor public areas.
Now, the company recommends that folks “could need to keep away from crowded areas” or preserve a distance from others so as to reduce their publicity to the virus. This precaution could also be particularly necessary for people who find themselves at excessive danger for extreme Covid-19, the company famous.
Do I nonetheless should put on a face masks?
The final masks tips haven’t modified. The C.D.C. nonetheless recommends that everybody age 2 and older put on a well-fitting masks in public indoor areas when the native Covid-19 group degree is excessive. People who find themselves at excessive danger for extreme illness must also put on a masks when their communities are on the medium degree, in keeping with the rules.
Almost 40 % of counties throughout america are at a excessive group degree, in keeping with the C.D.C.
What ought to I do if I’ve been uncovered to the virus?
As a precautionary measure, the C.D.C. used to advocate that individuals who weren’t up-to-date on their vaccinations and had been in shut contact with somebody with Covid-19 keep residence for no less than 5 days, a apply generally known as quarantining. (Individuals who have been up-to-date on their pictures didn’t must quarantine in the event that they have been asymptomatic, in keeping with the earlier tips.)
The quarantine suggestion has disappeared, one of many greatest adjustments within the new steering.
“Quarantines are kind of a blunt instrument,” stated Jennifer Nuzzo, the director of the Pandemic Heart on the Brown College Faculty of Public Well being. “I do suppose we’ve got to shift in how we take into consideration controlling this virus.”
Now, individuals who have been uncovered to the virus can proceed with their each day routines no matter their vaccination standing, so long as they continue to be asymptomatic. Nonetheless, they need to put on a well-fitting masks for 10 full days, monitor themselves for signs, take additional security measures round susceptible individuals and get examined no less than 5 days after publicity.
In case you use an at-home antigen take a look at, it’s possible you’ll want to check your self repeatedly. To scale back the chance of false unfavourable outcomes, individuals who don’t have any signs ought to take no less than three exams, every 48 hours aside, in keeping with a brand new suggestion from the Meals and Drug Administration. Individuals who do have Covid-19 signs ought to take no less than two exams 48 hours aside.
“Your viral load grows after you get contaminated,” stated Dr. Michael Mina, a former Harvard epidemiologist who’s now the chief science officer for eMed, which sells at-home exams. “It goes up, and that takes time.”
What ought to I do if I take a look at optimistic for the virus?
Isolate at residence for no less than 5 days, and hold your distance from others in your family. This suggestion has not modified.
In case you remained asymptomatic throughout your time in isolation — or in case your signs are bettering and you’ve got been fever-free for no less than a day — you may go away isolation after Day 5, in keeping with the rules.
Beforehand, the C.D.C. really useful that folks with Covid-19 put on a masks for 10 full days. Underneath the brand new tips, individuals can take away their masks sooner in the event that they take a look at unfavourable on two speedy antigen exams, taken no less than 48 hours aside. Others ought to proceed to masks for 10 days.
Individuals who expertise reasonable to extreme sickness, or have compromised immune methods, ought to isolate for no less than 10 days, the company stated.
If signs return after isolation, individuals ought to begin their isolation durations over, in keeping with the brand new tips.
What does this imply for faculties and places of work?
In concept, the brand new tips might free many colleges and companies from among the restrictive measures which were tough to implement, together with navigating a distinct algorithm for vaccinated and unvaccinated individuals. Quarantines have been particularly disruptive and divisive in faculties.
Underneath the brand new tips, youngsters who’ve been in shut contact with somebody who has Covid-19 don’t want to remain residence, and faculties don’t must administer frequent exams so as to hold these youngsters within the classroom, an strategy generally known as “take a look at to remain.” Contact tracing and routine surveillance testing of asymptomatic individuals are not needed in most settings, the C.D.C. stated.
In actuality, the brand new tips could not change a lot at many colleges, which had more and more been transferring away from these measures. Massachusetts, for example, dropped its quarantine necessities for asymptomatic youngsters in Could.
Nonetheless, some districts and officers do take their cues from the federal steering, which might immediate some localities to loosen up their guidelines for the approaching educational 12 months.
“We welcome these tips,” Randi Weingarten, the president of the American Federation of Academics, stated in an announcement on Thursday. “Each educator and each dad or mum begins each faculty 12 months with nice hope, and this 12 months much more so. After two years of uncertainty and disruption, we’d like as regular a 12 months as doable so we will focus like a laser on what youngsters want.”
In an electronic mail to The New York Occasions on Friday, the New York State Division of Well being stated it was reviewing the brand new C.D.C. suggestions and would challenge its personal back-to-school steering “quickly.”
New York Metropolis’s Division of Well being and Psychological Hygiene stated on Friday that it was additionally reviewing the brand new federal tips and nonetheless finalizing plans for the approaching faculty 12 months.
The C.D.C.’s tips stated faculties which can be experiencing outbreaks could need to briefly undertake further precautions, together with surveillance testing, contact tracing, mask-wearing and open home windows and doorways to enhance air flow.

Science
Antelope Valley residents say they are fed up with rampant dumping, official inaction

Eric Eller likes to ride his dirt bikes through the canyons, dry riverbeds and rocky outcroppings of the Antelope Valley in the high desert north of Los Angeles.
Eller’s an off-the-grid kind of guy with a “Mad Max” vibe — living in a house on a remote plot of land next to a jury-rigged trailer where he tinkers with the remnants and pieces of gutted automobiles, motorcycles and other mechanical debris.
But Eller’s isolation was obliterated last June when dozens of big dump trucks began snaking up the dirt road behind his house and discarding their loads into the nearby dry river canyon. The caravan of waste-haulers continued in the days that followed, often arriving after sundown or in the dark hours before dawn.
Two months later, the convoys abruptly stopped. But not before the makeshift dump’s surface had been camouflaged with dirt and mulch — much of which has since blown away, revealing a 30-foot-deep noxious stew of chopped-up concrete, plastic tampon applicators, faded plastic children’s toys, toothbrushes, syringes, empty caulking tubes, two-by-fours, faded books, weathered Styrofoam pipe insulation, plastic bucket tops and more.
EL MIRAGE, CA – APRIL 18: A truck leaves the Circle Green mulch dump site near El Mirage on Friday, April 18, 2025. (Myung J. Chun / Los Angeles Times)
Across the Antelope Valley, waste trucks are hauling garbage in from the Greater Los Angeles area and Central Valley towns such as Bakersfield, and then dumping it at makeshift sites. Letters, bills and envelopes visible at several of these waste sites in April showed addresses in Pacoima, Los Angeles and Van Nuys, among other cities.
“Illegal dumping has been a problem in the Antelope Valley for decades,” said Chuck Bostwick, a senior field deputy for Los Angeles County Supervisor Kathryn Barger, who represents much of the area. “But it’s gotten worse in the last two or three years, markedly worse.”
In some cases, such as the site behind Eller’s home, the waste sites are flat-out unauthorized. No landowner has given permission to dump at the site, and the waste consists of construction, household and medical debris.
But in others cases, the waste-haulers have the landowners’ permission to dump — but are disposing waste that should be going to landfills equipped to handle household and industrial waste, lawsuits claim.
In one lawsuit filed in U.S. District Court in Los Angeles, residents claim that major residential waste-hauling companies including Athens Services, California Waste Services and Universal Waste Systems are dumping hazardous substances without authorization.
The suit claims these companies are disguising the construction and demolition debris as “green waste by unlawfully covering this waste with highly flammable wood chips and other organic waste.”
Eric Casper, the president of California Waste Services, said in an email that his company has “never engaged in dumping waste of any kind, at any time, in the Antelope Valley — legal or illegal. Nor anywhere else.”

A sneaker among the trash dumped at Adobe Mountain near Lancaster, CA. Locals say this was a canyon before it was filled in to hold trash. Photographed on Friday, April 18, 2025.
Athens Services also denied any illegal dumping, saying in a statement that California’s organics recycling law “encourages sending compostable material to third parties such as farmers and other property owners for beneficial use. This is the material that Athens Services produces and distributes.”
Universal Waste Systems and other companies named in the suit didn’t respond to requests for comment, nor have they filed responses to the federal suit.
Residents say there are more than 100 dump sites scattered throughout the valley — from Lake Los Angeles to the Antelope Valley California Poppy Reserve and north to Mojave — that they contend are unauthorized.
Some of these sites cover hundreds of acres and extend dozens of feet deep. And residents worry that what they can see — from the roads or their homes — is just the tip of a malodorous and malignant iceberg, and that there are probably dozens more they haven’t yet identified.
They complain they are plagued by the toxic, sour and rotten-egg like smells emanating from the discarded trash that cooks in the hot sun and then wafts across their properties.
They also note that the flammable mulch and other materials in the dump, combined with a broiling desert sun, makes for an acute fire risk.
Between 2020 and 2024, the Los Angeles County Fire Department responded to 42 mulch or trash-related fires in the Antelope Valley, ranging from a quarter-acre to 22 acres, ultimately costing taxpayers roughly $1.6 million to extinguish, according to Los Angeles County documents.
Ashley Mroz, who lives in the Antelope Valley community of Neenach, said a mulch-covered dump site spontaneously combusted near her home last summer.
“It had been smoldering for days and days,” said Mroz, one of the plaintiffs in the federal court suit. “We could not even go outside. The smell was so horrific.”

Trash dumped at Adobe Mountain near Lancaster, CA. Locals say this was a canyon before it was filled in to hold trash. Photographed on Friday, April 18, 2025.
And the scourge has spread beyond the dump sites: Shredded plastic debris can be seen hanging from roadside Joshua trees and creosote bushes. While a midday view across the arid landscape reveals a sea of glimmering, reflective glass shards, like the tips of cresting waves over a vast, brown ocean.
According to Antelope Valley residents and the federal suit, property owners in some cases have given permission — and received payments for — waste to be dumped on their land. Not only do these sites pose a nuisance to the neighbors who live adjacent to or near them, in some cases the material being dumped includes industrial and household waste that can leach into the groundwater.
In its statement, Athens pointed out that property owners sometimes give permission to accept material from multiple waste companies.
“To the extent there are any instances of noncompliant material, we are confident the evidence will demonstrate that it came from another source,” Athens said.
Encounter in Adelanto
On a blustery day in April in the high desert town of Adelanto, local residents watched as two dump trucks offloaded their waste into a San Bernardino county-certified organic waste dump site that is surrounded by eight- to 10-foot high berms of mulch-like waste laced with shredded plastic, insulated wires and chopped-up, plastic children’s toys.
Through a break in the berm, the residents could see that the ground around the recently dumped haul glittered in the sunlight with broken glass, while stalks of what appeared to be insulated wires and rigid plastic stood sentry across the 138-acre expanse.
Two men sitting in a silver GMC pickup truck who were watching the disposal drove over to the gawking residents.
When the residents asked who they were and what the trucks were dumping, the men declined to answer and referred questions to the owner of the property, which The Times later determined to be Kevin Sutton, the owner of a company called Circle Green Inc. Sutton didn’t respond to requests for comment.
As neighbors and a Times reporter and photographer drove away from the site, the silver pickup followed for several miles, tailgating and swerving erratically. The truck turned around only when the small caravan came across a handful of heavily armed California Fish and Game law enforcement agents parked alongside the road.
“It’s the Wild West out here,” said Kristina Brown, a Lancaster property owner who is a party to the federal suit.
A convenient dumping ground
The Antelope Valley’s proximity to Los Angeles and its vast stretches of wild desert make it a prime target for unauthorized dumping.
Sitting at roughly 3,000 feet above sea level, and surrounded by the Tehachapi, Sierra Pelona and San Gabriel mountains, the valley is also divided by jurisdiction — with Los Angeles, Kern and San Bernardino counties all claiming some territory.
“For decades, our illegal dumping was small-time stuff,” said Bostwick, Supervisor Barger’s field deputy. “It was somebody who had a sofa they couldn’t be bothered to take to the dump or they didn’t want to pay, so they dumped it out in the desert. There was commercial dumping then, but it was small time as well.”
But then the state’s waste laws changed, he said.
Starting in 1989, California began requiring municipalities to divert 50% of their waste away from landfill and toward more sustainable waste management solutions, such as recycling and compost. And as Bostwick noted, the vast open spaces of the Antelope Valley beckoned.
In 2022, lawmakers implemented Senate Bill 1383, which initially mandated the diversion of 50% of all food and organic waste away from landfills, but increased to 75% on Jan. 1, 2025. Another 2020 law closed a loophole that had allowed waste companies to dump green waste in landfill, but not have it counted against them. As a result, the need for dumping grounds increased again.
Cities, counties and towns that fail to meet the diversion rates risk fines of up to $10,000 a day.

Mounds of dumped loads at this location south of E. Avenue M in Lake Los Angeles. The mounds contain mulch, trash and construction debris. The site was found by a resident who followed a truck onto the dirt roads. Photographed on Friday, April 18, 2025.
Residents, lawmakers and experts say while the spirit of these laws is noble, in many areas of the state, the infrastructure to handle the diverted waste is lacking — especially in Southern California, where there is not nearly enough farmland or water to handle the increased volumes of green waste leaving the region’s cities and suburbs.
As a result, waste companies and haulers — trying to keep costs down and maintain city contracts — are tempted to dump the waste wherever they can, while local governments are reluctant to crack down on violations, Bostwick said.
State regulations have made “disposal much more expensive and hard to deal with, and so that’s increased the financial incentives for companies or individuals to just dump illegally,” he said.
There’s also very little enforcement.
According to Los Angeles County data, while taxpayers spent roughly $1.3 million between 2017 and 2018 to mitigate illegal waste disposal in the region, that number jumped nearly fourfold in 2022-2023, when taxpayers had to foot $4.46 million to mitigate the problem.
At the same time, the number of cases filed with the Environmental Crimes Division of the district attorney’s office decreased from 15 in 2019 to three in 2023.
In February, CalRecycle, the state’s waste agency, finalized emergency orders they say should empower local law enforcement agencies to stop the illegal disposal. Previous regulations only allowed for action against the owner of land where the disposal was occurring. The new orders allow enforcement officials to target parties that are dumping the materials and the facilities that provided the material.
The orders came after officials from the state agency came to visit the area in October 2024 — prodded by Brown, Mroz and other local residents, many of whom have spent years calling state and local officials about the problem.
Enforcement of these orders, however, is the responsibility of the county, said Lance Klug, a spokesman for the state waste agency.
“Local enforcement agencies can best speak to their enforcement actions to date, and any anticipated next steps, now that emergency regulations are in effect,” he said.
The Los Angeles County Board of Supervisors adopted a measure last year requiring mulch suppliers to take back any contaminated or illegal waste dumped on private land. The measure, which was sponsored by Barger, also directed county agencies to require “stringent record keeping for all land application operations regarding the origin of all incoming loads and testing results from all mulch suppliers.”
County officials couldn’t immediately provide numbers recently when asked how many enforcement actions had been taken.
“There’s literally no enforcement,” said Brown, who worries that the situation is only going to get worse.
Last month, Eller was riding his dirt bike when he stumbled upon a 60-acre expanse of freshly dumped construction debris, medical waste and compost on a plot of land miles away from any major road.
The tire marks from dump trucks hadn’t yet been blown away by the incessant gales of the high desert. No fences or berms were erected to contain the site, making it impossible to see from the road or along the horizon.
He said it feels like they are living in a real-life game of whack-a-mole: As soon as he and his neighbors identify and report one site, the haulers move onto another.
And they say they feel abandoned by regulators, who they say are doing nothing to stop it.
“It feels like we’re screaming into the wind,” Brown said.
Science
At the Biennale in Venice, a Fantasy Island Imported from Mexico

Mexico City’s small urban farms — known locally as chinampas — practice a sort of agriculture in reverse: instead of bringing water to land as most farms do, chinampas bring land to water.
The chinampas in use today go back about a thousand years, to when Aztec farmers began building rectangular fields on top of vast lakes and growing food for what was then the city of Tenochtitlan. There were tens of thousands of chinampas at one point, arranged in strict grids with narrow canals between them, though many were destroyed or abandoned (along with the rest of the Mesoamerican metropolis) after Hernán Cortés and his invading Spanish soldiers rearranged the civic order in 1521.
But working chinampas continue to exist in the southern Mexico City neighborhood of Xochimilco — despite continuing encroachment by developers and competition from factory farms — operating mostly as family businesses that produce heirloom lettuce, radishes, dahlias and other crops. Lately, the farms’ irrigation-friendly ways are getting fresh attention in a world rocked by climate change and suffering from widespread droughts.
Could other places around the globe borrow the idea of creating “floating islands,” as the fields are sometimes called, which are engulfed by water? A team of Mexican designers, landscapers and farmers believes the ancient technology may be widely adaptable, enough that they will recreate a chinampa for their country’s pavilion at this year’s Architecture Biennale in Venice.
“Chinampas have a simple and intelligent design, created in a collective way that benefits not only people but all of the surrounding living beings, too,” said Lucio Usobiaga, a team member who has spent the last 15 years defending the remaining chinampas through a nonprofit he founded called Arca Tierra.
Mexico’s pavilion is a neat fit for the biennial’s main exhibition, “Intelligens. Natural. Artificial. Collective,” which is intended to show design projects that address climate change in creative ways. The chinampas are at once man-made and organic and can succeed only if there is cooperation among farmers, policymakers and the growing number of tourists who float through on popular canoe tours, gazing at fields of corn and flocks of egrets and pelicans.
Promoting the chinampa as an inspiration for eco-friendly design was an obvious choice for the biennale, team members said. “Venice is also built on water and has the same kind of vulnerabilities that Xochimilco has,” noted Ana Paula Ruiz Galindo, a founder of the design firm Pedro y Juana.
They pointed out that Venice and Xochimilco were added to the list of UNESCO World Heritage sites in the same year, 1987, and both places are island communities navigable by boats and working to balance the positive and negative aspects of tourism.
Venice has its iconic gondolas, while Xochimilco has its trajineras, flat-bottomed vessels, decorated in bright colors and fake flowers that take visitors on party-themed excursions. Both boats are operated by pilots who push them along channels using long poles.
As for how to recreate a chinampa on-site, that took some imagination. And compromise.
The Aztecs constructed their islands over time, using reeds and branches to make fences in the mucky lake bottom. These formed boundaries for multiple layers of sediment and decaying vegetation (and sometimes human sewerage) until the islands rose far enough above water to be farmed. In addition to growing crops like corn, beans and squash — using the traditional milpa agricultural method that naturally preserves nutrients in soil — they planted trees on the corners of the islands to stabilize the land.
Mexico’s pavilion, inside the biennale’s Arsenale complex, will feature a stripped-down version, much smaller than the 500 square meters (0.12 acres) of a typical chinampa. The exhibition will be enhanced by videos produced in Mexico City featuring real chinamperos, as the farmers are called, and bleachers will be installed along the walls. Artificial lighting will replace sunshine.
In the center will be a working garden planted with vegetables, flowers and medicinal herbs. (The crops were started in an Italian nursery and transferred to the Arsenale by boat in mid-April.) They will mature during the biennale, which continues through Nov. 23.
“By the end of the biennale, we will be able to harvest corn and make tortillas,” said Mr. Usobiaga. “Before that, we can harvest beans, squash, tomatoes and chiles.”
Visitors will learn about special seed cultivation techniques that are unique to chinampas and will have the chance to plant seedlings themselves.
In a nod to local agriculture, the chinampa will also employ a version of vite maritata, a practice established in ancient Etruscan agriculture that calls for planting grapes around trees, which serve as a natural trellis system for the vines. The exhibition team sees a link between the two forms of agro-forestry, combining trees and crops into one ecosystem.
“We are going to see this dialogue between two ancient cultures that both have a lot to say about how we can move forward,” Mr. Usobiaga said.
The exhibition team members said they wanted to be careful not to overly romanticize chinampas because they are not easy to duplicate on a scale that could feed a large population today. The farms work in Mexico City because they sit on a lake that lacks an outlet to another body of water, making water levels relatively easy to control. The opposite is true, of course, in Venice, which is on a lagoon close to the sea and always under threat from flooding.
Also, the economics of small farms — high production costs, low yields because of their size — make it difficult to turn a profit. Farmworker wages are generally too low to support people in urban areas, and the backbreaking work of planting and harvesting has lost prestige.
“This is a big problem here, that people, especially young people, don’t want to work the soil on chinampas anymore,” said María Marín de Buen, the team’s graphic designer.
Even in Xochimilco, many chinampas lie fallow because their owners cannot make a living. Some have been turned into soccer fields, which are rented out to the community; others are event venues where people celebrate weddings or birthday parties. Officially, the land is restricted from development, as well as from cattle grazing and the hunting of endangered animal species, though these things happen with alarming frequency.
Still, the team sees something inspirational at play: a connection between nature and the built environment, between existing water resources and the need to construct houses and schools. Architects who visit the biennale may not go on to design large swaths of farmland, but they can replicate the idea on a smaller scale using whatever conditions exist, said Jachen Schleich, a team member who is a principal of the Mexico City architectural firm Dellekamp + Schleich.
“Even if somebody does this in his backyard, he can at least feed his family, or the people on the four floors of his building, Mr. Schleich said. “It could be like a micro-intervention in the landscape or a public space.”
Science
Trump's pick for surgeon general quit medical residency due to stress, former department chair says

President Trump’s choice of Dr. Casey Means, a Los Angeles holistic medicine doctor and wellness influencer, as his nominee for surgeon general appears to mark another attempt to defy establishment medicine and longstanding federal policy.
Trump portrayed Means — a 37-year-old Stanford medical school graduate and author who describes herself on LinkedIn as a “former surgeon turned metabolic health evangelist” — in his announcement as fully in sync with Robert F. Kennedy Jr.’s mission to “Make America Healthy Again.”
“Casey has impeccable ‘MAHA’ credentials, and will work closely with our wonderful Secretary of Health and Human Services, Robert F. Kennedy, Jr., to ensure a successful implementation of our Agenda in order to reverse the Chronic Disease Epidemic, and ensure Great Health, in the future, for ALL Americans,” Trump said in a statement on Truth Social.
Some have raised questions about Means’ credentials. Although she graduated from medical school, she is not an active doctor licensed to practice medicine.
After graduating from Stanford, Means was nearly 4½ years into a five-year physician residency to be a head and neck surgeon at Oregon Health & Science University when she dropped out.
“During my training as a surgeon, I saw how broken and exploitative the healthcare system is and left to focus on how to keep people out of the operating room,” she says on her website.
Dr. Paul Flint, a former chair of Otolaryngology/Head and Neck Surgery at Oregon Health and Science University, said Means resigned from the residency because of anxiety.
After four years of training, Means came to him and Dr. Mark Wax, the residency program director, and said she wasn’t sure it was the right job for her.
“She wasn’t even sure she wanted to be in medicine,” Flint said. “She wanted to do something different. She wanted to resign.”
Flint and Wax urged Means to think about it more and offered her three months paid time off.
“She was under so much stress,” he said. “She did that, came back and decided she wanted to leave the program. She did not like that level of stress.”
Flint said Means was competent, a good resident. “But there was a lot of anxiety around this,” he said of the role of the surgeon. “You become much more responsible the more senior you get.”
Did he think Means would make an effective surgeon general?
“I don’t know,” Flint said. “Time will tell.”
According to public records from the Oregon Medical Board, Means’ medical postgraduate license was granted in 2014 and shifted to inactive status in 2019.
Some who know Means question whether she is completely aligned with Kennedy.
Robert Lustig, professor emeritus of pediatrics in the division of endocrinology at UC San Francisco, who is a friend of Means, told The Times he was shocked and surprised.
“What’s surprising to me is that she wanted the job, because she had difficulties adopting RFK’s full portfolio,” Lustig said, citing Kennedy’s controversial pronouncements on vaccines and fluoride in public water supplies. “She didn’t want to be part of the administration, in part because she couldn’t accede to those views. So what has changed is not clear.”
Means did not respond to requests for comment. Still, she attended a January confirmation hearing at the U.S. Capitol for Kennedy and celebrated in February when he was sworn in, saying on an X post that “his vision of the future aligns with what I want for my family, future children, and the world.”
Over the last year, she has raised public concerns about some vaccines. In August, she spoke out on X against CDC guidelines that all infants should receive a dose of hepatitis B vaccine at birth.
“There is growing evidence that the total burden of the current extreme and growing vaccine schedule is causing health declines in vulnerable children,” she wrote in an October newsletter, linking to a blog about vaccines and autism. “This needs to be investigated.”
“I have said innumerable times publicly I think vaccine mandates are criminal,” she said on X in November.
But when Lustig spoke to Means four weeks ago, he told The Times, Means had left her home in Pacific Palisades, worried about toxic air and water after the L.A.-area wildfires, and had moved to Hawaii. He said she wanted to start a family and did not express interest in working with Kennedy at the time.
“I know that her views are not his — that’s why she didn’t accept it earlier,” Lustig said. “If you’re an employee, you have to take the whole portfolio. You don’t get to choose parts of it, and she was uncomfortable.”
The president announced Means as his pick a day before his initial choice for the position, New York family physician and Fox News contributor Janette Nesheiwat, was scheduled to have a hearing with senators Thursday.
Trump has yet to explain why Nesheiwat was replaced as his nominee, but he said she would work at the Department of Health and Human Services in “another capacity.”
Asked by a reporter Thursday why he picked a nominee for surgeon general who never finished her residency and is not a practicing physician, Trump said: “Because Bobby thought she was fantastic. She’s a brilliant woman who went through Stanford. … I don’t know her.”
The U.S. surgeon general is known as “the nation’s doctor.” According to the Department of Health and Human Services, the role is to provide Americans with “the best advice on how to improve their health, by issuing advisories, reports and calls to action to offer the best available scientific information on crucial issues.”
Lustig said he had no doubt Means — whom he got to know by advising Levels Health, a digital metabolic health company she co-founded — would bring a different perspective to the U.S. government.
“Here’s the problem: We have an epidemic of chronic disease and there are no medicines that fix any of these diseases,” Lustig said. “They’re not fixable by drugs. They’re fixable by food. And the reason is because all of these diseases are mitochondrial diseases, and we don’t have drugs that get to the mitochondria.
“We have to change the food supply,” he added. “There is no option. Casey knows that. So as surgeon general, she would be able to make that case.”
In that sense, Lustig agreed with Trump, who said, “Dr. Casey Means has the potential to be one of the finest Surgeon Generals in United States History.”
“I think she’s a terrific person,” Lustig said. “She will bring a very different mindset to the office.”
But Lustig said he believed Kennedy was flat-out wrong on vaccines.
“I know why he’s wrong on vaccines,” he said. “I understand where his brain is, because I got a half-hour with him on the phone, one on one. But I cannot alter my integrity to match that — and I thought that Casey couldn’t either.”
Means is an unorthodox pick for a president famed for his diet of Big Macs and Diet Cokes.
Her website features pictures of broccoli and almonds. Her Instagram page shows bright bowls of tofu scrambles with heirloom tomatoes, avocado and beet sauerkraut.
Her newsletter recounts how, at the age of 35, after she moved to L.A., she embraced the “woo woo (aka, the mystery),” set up a meditation shrine in her home and sought relationship advice from trees.
Means was raised in Washington, D.C., the daughter of mildly religious, Republican parents. Her Californian-born father, Grady Means, a retired American business executive and government official, served in the White House as assistant to Vice President Nelson Rockefeller, led the Food and Nutrition Task Force to reform the food stamp program and provided oversight to the National Health Insurance Experiment.
Casey Means earned a bachelor’s degree in human biology with honors at Stanford and went on to graduate with a doctor of medicine degree in 2014. But Lustig said she dropped out of her residency in Oregon, disillusioned.
“The reason she quit was because she saw that the same patients were coming back with the same problems, and her mentors, the faculty at Stanford, when she would ask, ‘Why is this happening?’ would say, ‘Shut up and operate,’” Lustig said.
“She had a crisis of confidence that she was actually not helping the problem, or was actually part of the system that was actually making the problems.”
But that’s not how some people who knew Means when she was a resident surgeon in Oregon remember it.
“She didn’t mention metabolic health, she didn’t mention any of that,” said one person with whom she discussed her work regularly at that time and who declined to be named for fear of retaliation. “She was scared of accidentally hurting someone in surgery. She just didn’t want to mess up. She genuinely cared about her patients — she wanted them to be healthy and well — and I think her heart in that is genuine. But she was not talking about what she’s talking about now.”
Means’ recent rhetoric about the medical profession, they said, was disappointing.
“She’s claiming doctors are just trying to cut and make money, but she’s making money too,” they said. “Surgeons, they’re trained to be the last resort and actually help with solving after something’s gone wrong. If she wanted to help preventatively, she was in the wrong field, so I’m glad she went elsewhere. … But to be upset with a system that is trying to help when it does get down the line is very strange.”
In 2019, Means co-founded Levels Health, which works to “empower individuals to radically optimize their health and well-being by providing real-time continuous glucose biofeedback.”
Two years later, her break with establishment medicine became more intense — and more personal — when her mother was diagnosed with Stage 4 pancreatic cancer.
“What put her over the edge was when her mother passed away of pancreatic cancer, and it was missed,” Lustig said. “She had all the symptoms and signs of metabolic syndrome in her and none of her doctors addressed any of them.”
Means served as Levels Health’s chief medical officer until last year, when she and her brother, Calley, published a 400-page diet and self-help book titled “Good Energy: The Surprising Connection Between Metabolism and Limitless Health.”
In August, she catapulted to mainstream fame — particularly on the right — when Tucker Carlson featured her and her brother on his podcast for a show titled “How Big Pharma Keeps You Sick, and the Dark Truth About Ozempic and the Pill.”
“The system is rigged against the American patient to create diseases and then profit off of them,” Means told Carlson.
Over the last few months, Means and her brother, who now serves as a White House health advisor, made public appearances at “Make America Healthy Again” events.
In September, she addressed a U.S. Senate roundtable on chronic disease, listing all the things she didn’t learn in medical school: “For each additional serving of ultra-processed food we eat,” she said, “early mortality increases by 18%.”
Critics were quick to take to X to mock her statistics.
“I’ve easily had 1000 bags of chips in my life,” said Brad Stulberg, adjunct clinical assistant professor of health management and policy at the University of Michigan’s School of Health. “If this is true, it means my mortality risk has increased by 18,000 percent. That seems unlikely.”
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