How climate change could affect when and where people travel

• October 20, 2023

By Sam Kemmis | NerdWallet

Travelers encountered many weather surprises this summer, from wildfires in Europe to knee-deep mud at Burning Man. Indeed, it was the hottest summer on record around the globe, according to the European Union’s Copernicus Climate Change Service.

“The dog days of summer are not just barking, they are biting,” said U.N. Secretary-General António Guterres in a prepared statement published Sept. 6. “Our planet has just endured a season of simmering — the hottest summer on record. Climate breakdown has begun.”

Shifting weather patterns are raising questions about where, when, how and whether tourists will travel.

For example, does it still make sense to visit Italy in July, despite high temperatures, large crowds and minimal air conditioning? Or should “peak” travel season move to the more hospitable autumn or spring months?

Tourism destinations are starting to take note — and get worried — about the toll climate change could take on this enormous industry.

Hot destinations

Escaping to the Spanish coast for the summer used to sound like a dream. This year it turned into more of a nightmare for Mediterranean travelers. The coastal city of Valencia, Spain, saw temperatures reach 116 degrees Fahrenheit in August, a record high. That came amid Spain’s limits on air conditioning use in public spaces, leaving tourists to sweat it out.

These trends are only likely to get worse, driving travelers away from hot beachside destinations in Europe, according to a July report from the European Commission’s Joint Research Centre. Southern coastal regions such as Greece, Italy and Spain are expected to see a drop in tourism if temperatures continue to increase.

On the other hand, colder destinations in Northern Europe could actually see more vacationers. Denmark, France and the United Kingdom could receive more tourists because of higher temperatures, according to the report. Greenland, which is mostly covered with ice, is expecting to see far more tourists in the coming decades, with a new airport set to open in 2024.

Closer to home, many popular destinations have already been affected by rising temperatures. The namesake glaciers of Glacier National Park have lost an average of 40% of their size between 1966 and 2015, according to the National Park Service. Florida’s coral reefs were bleaching and dying under the stress of record ocean temperatures this summer.

Peak travel seasons

Summers are for vacations — that’s a truth so universally acknowledged as to be almost self-evident. Families travel while kids are out of school, and office workers flee to vacation in ideal weather.

Yet, as summers continue to warm, these vacations could give way to “shoulder season” alternatives in spring and autumn months. In other words, tourists could change when (rather than where) they visit.

Indeed, this change may already be taking place. Short-term rental analytics platform AirDNA reported that occupancy rates at mountain and lake destinations in October 2022 were nearly as high as 2019’s peak occupancy (in July), bucking the typical sharp downward trend after the summer.

Cherry blossoms in Japan are flowering 11 days earlier than they used to, according to a 2022 report in the journal Environmental Research Letters. This has shifted the tourist-attracting cherry blossom festival from April into March.

Changes in flexible working conditions, as well as pent-up demand from the pandemic, could also be contributing to the rise of shoulder season travel.

Yet as more travelers take stock of changing weather patterns, they will likely adjust their schedules to avoid stifling summer heat. The European Commission’s Joint Research Centre estimates that southern coastal regions could lose as much as 10% of tourists during peak summer months.

A climate catch-22

A changing climate will affect how and when tourists travel. Yet this causation runs the other way, as well: Tourism is itself affecting the climate.

Tourism accounts for about 8% of global emissions, according to some estimates. A single trans-Atlantic flight would require an acre of forest to absorb its carbon emissions. Although the airline industry is racing to reduce emissions, it lags far behind other major emitters, such as passenger vehicles, in making meaningful change.

What does that mean for airline passengers? Either they must begin reducing the number of miles they fly, or governments may begin imposing restrictions in order to reduce emissions.

For example, France has already banned short-haul domestic flights for routes already serviced by rail. That is, if travelers can get there in less than two and a half hours on a train, they can no longer fly. Similar bans could appear throughout Europe as countries get more aggressive on combating climate change.

Some advocates have even proposed a frequent flyer tax that scales with the number of flights a traveler takes — an effort to curb these large carbon footprints.

Whether these or similar measures take off in coming years or not, this much is clear: The days of unfettered jet-setting could be coming to an end.

This article was written by NerdWallet and was originally published by The Associated Press.

The article How Climate Change Could Affect When and Where People Travel originally appeared on NerdWallet.

​ Orange County Register 

Sailor suicides spark effort to change Navy’s mental health culture: ‘God forbid more families have to go through this.’

• October 20, 2023

Editor’s note: If you or someone you know is struggling with thoughts about suicide, please contact the national suicide and crisis lifeline by calling or texting 988. There is also an online chat at 988lifeline.org.

Kody Decker’s Navy service began in 2018 with excitement and anticipation for the future.

“Look at his smiling face,” said Kody’s father, Robert Decker, motioning to a framed photo in his Chesapeake home. “That was during boot camp. The kid was very excited.”

A tri-folded flag given to the family at Kody Decker’s funeral now sits on the mantel in the living room. Next week, Oct. 29, will be the anniversary of the 22-year-old’s death.

A wave of suicides among sailors has brought the tides of change to the Navy. The service is undertaking a massive effort to change the way it treats sailors experiencing mental health crises.

“I am often asked what keeps me up at night,” said Adm. Daryl Caudle, commander of U.S. Fleet Forces. “The answer is the health and welfare of our sailors. There is nothing more impactful to the Navy than to lose one of our own through suicide.”

Fleet Forces, at Naval Station Norfolk, has taken the lead of the Navy’s cultural shift following another year of elevated sailor suicides, which came in at 79 across the service last year, according to Defense Department data. The count represents a 14.5% increase from 69 suicides in 2021. The highest tally in recent previous years was 80 suicides in 2019, and the lowest was 62 in 2016. This includes active and reserve members.

“There’s a difference seeking help for a broken leg and seeking mental health — let’s face it,” Caudle said.

The stigma of seeking help for mental health is not unique to the Navy. It is a reality of society.

Around 1 in 5 U.S. adults experience mental illness, according to a 2021 study by the National Alliance on Mental Illness. But less than half receive treatment. The stigma of seeking help is often a barrier to care. This can include public perceptions, discriminatory behavior, labeling and fear of reprisal in the workplace.

It is a barrier, Caudle said, the Navy is working to lower.

“I know it’s hard to ask for help when you are struggling, but suffering in silence is certainly not the answer,” Caudle said in a message to sailors during a recent suicide prevention event. “Seeking help is an act of strength, not weakness.”

Suicide, the Department of Defense and the Centers for Disease Control and Prevention have found, is more common among men aged 18-25 — the primary demographic starting a Navy career.

While the Navy’s suicide rates are comparable to those in the general male population, suicide clusters among sailors linked to the same command have brought the service under scrutiny in recent years.

At least seven of the sailors who died by suicide in 2022 were assigned to two Hampton Roads-based installations — the USS George Washington and the Mid-Atlantic Regional Maintenance Center.

Kody Decker, an electronics technician, served aboard the USS Bataan based out of Naval Station Norfolk from December 2019 to August 2022. He was subsequently diagnosed with adjustment disorder and reported to the Norfolk maintenance center on limited duty.

He died by suicide two months later on Oct. 29.

___

‘Getting help was frowned upon’

Decker’s family and a sailor who knew him said he was targeted by leadership for requesting time off. The bullying worsened, they said, when he sought mental health treatment on Aug. 1, 2022.

“First, it was public and indirect — kind of like throwing shade — but it was in the air,” said a former sailor, who agreed to be interviewed by The Virginian-Pilot on the condition of anonymity because he fears reprisal.

The former sailor, who was assigned to the Bataan from 2020 to 2022, said leadership eventually became comfortable speaking more directly about Kody Decker, even talking about him around other junior sailors.

“They thought he was using what he was going through and all the appointments as a way out of work,” the former sailor said.

A portrait of Kody Decker, a 22-year-old sailor who died by suicide in 2022, sits on the mantel in the Decker’s Chesapeake family home on April 12. (Stephen Katz / The Virginian-Pilot)

A Navy investigation into Decker’s death reported the climate in his department on the Bataan was a contributing factor to his mental health stressors. According to the investigation report released in May, sailors described the command as “high operational tempo” even when the ship was in port with no time off.

The suicide investigation did not look into whether Decker was the target of hazing or unfair treatment while he was assigned to the Bataan, said Lt. Cmdr. David Carter, public affairs officer for Naval Surface Force Atlantic.

But the investigation did explore if Decker was targeted while at the Norfolk maintenance center where he was assigned when he died. No evidence of hazing was found. The investigation did not define hazing or unfair treatment.

Both expectant parents in late 2021, the former sailor and Decker had grown close at work and in their personal lives.

“We quickly became close friends, brothers even,” the former sailor said.

Working in the same department, the former sailor witnessed many of Decker’s interactions with leadership aboard the Bataan. And given their personal relationship, the two often vented to one another.

“We never had leadership. We had a chain of command. It’s like having a boss and a leader — two totally different things,” the friend said.

The former sailor said Decker was stressed about missing the birth of his son in January 2022. As the due date approached, Decker asked a chief about beginning paternity leave. The chief’s response, the friend said, was that Decker would not begin leave until his wife “was on the table with her legs open, giving birth.”

The remark, the former sailor said, was sickening.

“Kody was furious. But mentally you succumb to the realization that you have to take it,” his friend said. “It is frustrating, but it is our reality.”

Snap, emotional responses to harsh leaders were kept in check by a 45-day restriction that could prevent junior sailors under disciplinary action from leaving the ship, the former sailor said. He also said crew members under disciplinary action could have their common access cards confiscated by the department chief. This prevented sailors from accessing email while underway and meant they were unable to contact family unless the chief gave them permission to do so.

The sailor’s allegation, Naval Surface Force Atlantic said, is not consistent with the Bataan’s official policy. From 2020 to 2022, only the commanding officer, via nonjudicial punishment or for pretrial restraint, could impose restrictions on crew members in accordance with the Uniform Code of Military Justice and Manual for Courts-Martial. At the time, the security department was authorized to confiscate the common access cards of crew members on restriction, as ordered by the commanding officer. But in August 2022, the command’s restriction policy was updated in accordance with Department of Defense policy to remove any and all authority to confiscate the access cards of crew members on restriction.

The former sailor said Decker expressed he was “beyond stressed” due to leadership aboard the Bataan during conversations spanning about eight months. And on Aug. 1, Decker requested mental health treatment from the ship’s medical team. Decker told the medical team he was not experiencing suicidal thoughts at the time, the Navy’s investigation reports.

“Getting help was frowned upon, to say the least. If you needed signatures to take time off for an appointment, the higher ranking chiefs or officers in charge have a condescending attitude, like a personal grudge against you,” the former sailor said.

Decker turned to his dad, Robert Decker, for guidance on how to work with difficult leaders. 

“I told him, if you have got bad leadership, you just keep your head down, you keep grinding. You do your job and you go home,” Robert Decker said.

But his father was unaware of how bad things were.

“But I didn’t know. I did not fully understand,” Robert Decker quietly said. His gaze lingered on his son’s smiling portrait from boot camp atop the mantel.

The ship’s medical officer planned to enter a referral for a mental health appointment for Kody Decker, according to the Navy’s investigation. The report does not say if that referral was ever put in the system. On Aug. 10, Kody Decker drove himself to Naval Medical Center Portsmouth. He was admitted for an inpatient mental health evaluation because he was suicidal.

Kody Decker completed five days of inpatient treatment and on Aug. 31, he reported to the Mid-Atlantic maintenance center on limited duty. Two months later, the Decker family was planning Kody’s funeral.

“I had lunch with him, his wife and my grandson that day. There were no signs,” Robert Decker said, his words trailing off as he wiped tears from his eyes.

Following Kody Decker’s death, Robert Decker said he has witnessed the very culture and the deep-seated stigma the Navy is trying to break down.

“I see the comments and the stories published online. People saying, ‘This generation — what’s wrong with them? They are not tough.’ And I am thinking to myself, they are tough. They are just different,” Robert Decker said.

Robert Decker, a high school football coach, has learned to approach each kid as an individual, finding out “what makes them tick.” He said the Navy should follow suit.

“The way I coached in ’91, I cannot coach today. It was hardcore. It was in-your-face intense. You do that to these kids today and they are shutting down,” Robert Decker said. “I understand the Navy — and the military — is a war machine. But you cannot take a blanket way of doing things and think that you are going to get the best out of them.”

___

Moving away from ‘do as I say or else’

In April 2022, three sailors connected to the USS George Washington died by suicide within a week while the carrier was undergoing an extended overhaul at Newport News Shipbuilding. Less than eight months later, the Norfolk-based Mid-Atlantic Regional Maintenance Center reported four suicides within 28 days.

In May 2022, the Department of Defense established the Suicide Prevention and Response Independent Review Committee. The committee was comprised of 10 subject matter experts and military veterans, who explored how to prevent suicide among service members.

The committee found that the younger generation, ages 18-25, have different motivations to work and expectations of their employers. They prefer open communication and continuous feedback, quick responses to questions, have an urgent sense of immediacy and are “unlikely to readily accept organizational policies that limit the sharing of information.”

This is true of the incoming workforce for the military, the committee’s report says.

Improving communication across generations is key for the Department of Defense to prevent suicide, the report says. It suggests Navy leaders move away from the “do as I say or else” style of leadership.

Younger personnel display more openness toward help-seeking and self-disclosure of their struggles. Older personnel, by comparison, were more likely to view help-seeking and self-disclosure of struggles as indicators of low resilience, the report says.

Fleet Master Chief John Perryman, who enlisted in the Navy in 1994, said he doesn’t think the qualities of a good leader have changed.

“What has changed is sailors’ willingness to put up with bad leaders,” Perryman said during a recent Fleet Forces meeting with reporters to discuss the Navy’s cultural shift.

Perryman — alongside Caudle — outlined the Navy’s efforts to tackle the stigma of seeking mental health care and how the service is reinforcing that message to leaders at all levels.

“The ability to make those decisions on an individual sailor or Marine basis rests on that leader’s ability to really know their sailors and to demonstrate that they really genuinely care about them,” Perryman said.

But, Perryman said, the Navy has run into senior leaders who “are not comfortable operating in that space.” Those leaders will default to sending that person to medical for mental health treatment or will haphazardly attempt to handle it themselves.

“If I don’t have a pre-existing relationship with you, why would you trust me to try to help you through whatever difficulties you have?” Perryman said.

___

Playbook implores leaders to get personal

Guiding sailors from the deck plate to the most senior positions are two newly implemented programs: the Brandon Act in May and the Navy’s Mental Health Playbook in February.

The Brandon Act allows service members to seek help confidentially for any reason at any time and in any environment — in the hope that would prevent the stigma associated with seeking such treatment.

Adm. Daryl Caudle, commander, U.S. Fleet Forces Command, speaks regarding mental health in the Navy during a press conference at U.S. Fleet Forces Command in Norfolk on Sept. 25. (Kendall Warner/The Virginian-Pilot)

“The Brandon Act legislated what good leadership looks like,” Caudle said. “I think good commands were already doing this.”

The Mental Health Playbook is meant to educate leaders within any size chain of command by detailing scenarios and outlining possible paths forward. It requires leaders to set conditions by creating a climate of trust and respect with open, two-way communication and encourages them to use empathy and have conversations that go beyond professional performance.

“But a playbook is not worth the paper it’s written on if we don’t put it into practice,” Caudle said. “And that’s a responsibility throughout the chain of command.”

Leaders can’t take a hands-off approach where they are more comfortable interacting via emails and text messages, Caudle said.

“When it comes to the subject we are talking about — mental health — I don’t think that is good enough. That is not even close to being good enough,” Caudle said.

He wants to see a more personal leadership style become the standard for the Navy, from petty officers to the most senior military officials.

“They have to actually know their sailors. They need to know where they live, their family members, their kids’ names, their financial situation,” Caudle said, in order to pick up on day-to-day differences a sailor is exhibiting.

On. Sept. 28, the secretary of defense approved a “5 Lines of Effort” campaign based on the Suicide Prevention and Response Independent Review Committee’s recommendations that is meant to strengthen the department’s suicide prevention strategy.

The first line of the effort is to foster a supportive environment by investing in taking care of “people priorities,” improving morale through facilities to enhance quality of life and empowering leaders to improve schedule predictability. The second line is to improve the delivery of mental health care by expanding programs to recruit and retain more mental health professionals and increasing appointment availability. The third line is to address stigma and other barriers to care by expanding nonmedical counseling for suicide prevention, mental health services in primary care and telehealth services for mental health.

The department plans to fully implement the campaign by the end of fiscal year 2030.

___

‘Talking to me didn’t hurt their career’

In the meantime, nonmedical resources are available to sailors who are struggling with a mental health crisis, clashing with a leader or just need someone to talk to. These resources are bound by confidentiality and are not logged in a sailor’s file.

Aboard the USS George Washington, just down the corridor from the aft mess deck where junior enlisted personnel eat and have access to Wi-Fi, is Terrance Levine’s office.

A sailor holds a sign advertising the hotline number for the suicide and crisis lifeline during a press conference regarding mental health in the Navy at Fleet Forces Command in Norfolk on Sept. 25. (Kendall Warner/The Virginian-Pilot)

“Hey, how you doing?” Levine says to a sailor in passing during a recent underway.

Affectionately dubbed Talk Boss, Levine is a deployed resiliency counselor. He reported to the Washington in May after it left Newport News Shipbuilding. Deployed resiliency counselors are civilian licensed clinicians assigned to aircraft carriers and large-deck amphibious assault ships. They offer confidential, short-term, nonmedical counseling for all sailors attached to the ship.

The resiliency counselor program supports two counselors on every carrier and amphibious ship in the fleet. On the East Coast, 10 of 22 positions were vacant as of Oct. 17, according to Navy Installations Command, which oversees the Fleet and Family Support Program that provides nonmedical mental health counseling for sailors and family members.

“I see sailors that maybe are having work-related problems, family issues, maybe an email they received from home while deployed saying, ‘I don’t want the marriage or the relationship.’ So, they are coming to me for that engagement. My job is to patch them up, get them to work through it and return them back to the mission,” Levine said.

But, a lot of sailors, he said, still have concerns that talking to him will impact their work life.

Around 35% of service members believe receiving mental health care would negatively impact their careers, according to the Defense Health Agency’s Psychological Health Center of Excellence. Fears include being perceived as weak or less competent or receiving blame or different treatment from leaders for seeking mental health care.

Levine relies on word of mouth to break down that stigma.

“From what I have been told by these same sailors is that talking to me didn’t hurt their career. And they are talking to other sailors, saying that if you have a problem, go to the Talk Boss, go to psych, seek out the resources,” Levine said. “I see more people really taking control of their mental health and seeking the help that they need.”

Another resource available to sailors is the Command Religious Ministries Department.

The Navy is working to increase the presence of chaplains on ships based in Norfolk from 37 to 47, the Associated Press reported in March. Previously, chaplains were routinely deployed only on the largest aircraft carriers, which have up to 5,000 personnel.

“In my opinion, from my experience, I don’t think that we’re seeing an increase of issue. I think we are seeing an increase in education, an increase of resources being developed and implemented and pushed into our sailors’ lives in a good way,” said Marlin Williams, a chaplain aboard the USS George Washington.

Chaplain Marlin Williams sits for a portrait in the faith center aboard the USS George Washington (CVN-73) off the coast of Florida on Sept. 15. “It ripples into the leadership, the whole command , and the whole fleet when people hear of the death,” Williams said of the suicides on board. (Billy Schuerman / The Virginian-Pilot)

The ministries departments are diverse groups of religious clergy who are also naval officers and of various denominations. The chaplains provide pastoral counseling — not mental health counseling — but they often have advanced degrees in counseling.

“What we bring to the table, whether someone has a faith community or not, is that sense of greater purpose bigger than oneself,” Williams said.

The chaplains are able to offer sailors absolute confidentiality. He said this applies when sailors express suicidal thoughts.

“The ability to come in and talk to someone knowing that whatever you say is going to be held in confidence opens up an amazing door to healing for someone,” Williams said.

Williams checked in aboard the Washington at the start of January. By the end of the month, another Washington sailor died by suicide.

“That was tragic,” Williams said. “It ripples through the whole command and, quite honestly, it ripples into the fleet.”

For Williams, suicide is personal. Two of his brothers have died by suicide.

“There is a sense of hopelessness. Making sure I articulate there is hope — that is not a 5-minute conversation. That is not a 10-minute conversation. That is a journey,” Williams said.

Williams seeks a personal connection that lets sailors know they’re heard and cared for, he said. That’s the same leadership style Caudle, with Fleet Forces, wants to become standard across the Navy.

___

‘God forbid more families have to go through this’

After Kody Decker’s death, his friend and fellow sailor separated from the Navy a year before his contract was scheduled to end. He cited his own mental health struggles.

“The Navy can either be really good — amazing enough that you want to retire with them. But if you get dealt a bad hand, which comes down to the leadership that runs the show, it can lead to things like this: depression, anxiety, suicide,” the former sailor said.

Since the start of October, Robert Decker has been bracing himself.

“It’s like I’m standing on the shore and I’m looking at the ocean and I can see the storm coming,” Robert Decker said. “The winds are picking up now. Oct. 29 is coming, and it’s going to be hell.”

Over the past 12 months, the family has experienced their first holiday, his child’s first birthday and major milestones without Kody Decker.

“This will be the last big first,” Robert Decker said, slowly exhaling a deep, shaking breath.

Robert Decker wipes tears from his eyes on April 12 while talking about his son Kody, a 22-year-old sailor who died by suicide in 2022. (Stephen Katz / The Virginian-Pilot)

In the midst of the grief, Decker said this year has also brought much-needed change and an improved awareness of mental health struggles to the service and the general public.

“Being angry at the world, being angry at an institution is not the answer. I am not happy with them, but I am happy that they are willing to address their problems,” Robert Decker said, quietly adding, “It cost me a son, unfortunately.”

Moving forward, Robert Decker said he would like to see a more personal leadership style standardized across the service. For the leaders who are unwilling to change, he hopes the Navy will weed them out, beginning with those who work closest with junior sailors.

“Leaders have got to be willing to adjust,” Robert Decker said. “I pray they do. God forbid more families have to go through this.”

Caitlyn Burchett, caitlyn.burchett@virginiamedia.com

​ Orange County Register 

Biden’s influence turns Israel’s ground war plans into ‘something different’

• October 20, 2023

Ethan Bronner and Henry Meyer | Bloomberg News (TNS)

Last Saturday, with Israel still in shock from the deadly attack by Hamas a week earlier, the military said it was preparing “coordinated strikes from the air, sea and land” to eradicate the group in Gaza.

But by midweek, military spokesmen were suggesting that a ground offensive “might be something different from what you think.” It could start later and last longer, unfolding in unexpected ways, they said.

In between was a series of unprecedented visits by top U.S. officials, including the secretaries of state and defense and President Joe Biden. Wrapped in their embrace of Israel’s pain after the deadliest attack in decades and promises to send warships and weapons was a message of caution about how to respond.

The U.S. shares Israel’s goal of destroying Hamas’s military infrastructure in Gaza. That’s only possible with a ground invasion, since the group, designated by the U.S. and EU as a terrorist organization, has spent decades building networks of tunnels and other emplacements.

But the U.S. influence is already shaping the way that assault will be conducted – particularly how to limit casualties among the 2 million civilians who live in Gaza – and the government’s planning for what happens when it’s over, according to Israeli officials and people close to the government.

Three senior Israeli officials, speaking on condition of anonymity, say the role and influence of the U.S. in this war against Hamas are deeper and more intense than any exerted by Washington in the past.

The U.S. has grown increasingly concerned that Israel’s invasion could draw in Iran-backed Hezbollah. That could open a second front in the war and sparking a broader conflict that would draw the U.S. in further and demolish the Biden administration’s efforts to stabilize the region by making peace between Israel and key Arab countries.

“President Biden is focused on reducing the chance of this war spreading to another front,” Foreign Minister Eli Cohen said in an interview. “This is his main goal.”

Prime Minister Benjamin Netanyahu said after Biden’s visit that an agreement had been reached on “cooperation that will change the equation in all theaters.” On Air Force One on the way back to Washington, Biden said he’d spoken with the Israelis about various “alternatives” regarding the ground war because of concern over civilian casualties and an expansion of the conflict.

In an Oval Office address Thursday night, Biden appealed to Americans to support Israel and Ukraine, arguing that Hamas and Russia “both want to completely annihilate a neighboring democracy.”

Israelis teared up watching Biden’s statements and warm hugs of survivors. But his sympathy was paired with a warning.

“Justice must be done,” Biden said. “But I caution that, while you feel that rage, don’t be consumed by it. After 9/11, we were enraged in the United States. While we sought justice and got justice, we also made mistakes.”

In a first, Biden and Blinken sat in on Israel’s war cabinet meetings, helping Netanyahu, Defense Minister Yoav Gallant and opposition leader Benny Gantz assess and plan.

The night before Biden’s visit, there was a deadly blast at a Gaza hospital. Arab governments quickly embraced Hamas’s claim that Israel was behind the attack and protesters took to the streets across the Mideast. But Biden endorsed the Israeli account which blamed a failed rocket launch by a militant group.

Even as the U.S. has sent two aircraft-carrier groups to the eastern Mediterranean and put troops on alert, Biden and other officials have underlined the importance of limiting civilian casualties. In Tel Aviv, the U.S. president pushed Netanyahu’s government to allow humanitarian aid into Gaza, where civilians are trapped with dwindling supplies of food and water and subject to regular Israeli airstrikes. The first shipments from Egypt could come as early as Friday, according to U.S. officials.

“Biden is determined that there is a need to defeat Hamas, but he also wants to keep the strategic alliances and peace treaties between Israel and Arab countries and widen them, to deepen the American leadership in the Middle East,” said Major General (Reserve) Amos Gilead, a former top Defense Ministry official. “That’s why the humanitarian dimension is so important.”

U.S. officials have said they hope to continue efforts to normalize relations between Israel and Saudi Arabia, though the war with Hamas threatens to derail them. That deal would include U.S. security guarantees for both countries. What has emerged this week with the U.S. is a de facto version of such a pact, a top Israeli official indicated.

Michael Oren, a former ambassador to Washington for Netanyahu, said Biden is pushing Israel to use more caution both when it goes into Gaza on the ground and as it responds to increasing attacks from Iran-backed Hezbollah in Lebanon.

“This puts Bibi in a difficult position,” Oren said. “The bill for this one will come due the day after the war,” he said. The U.S. will likely press Netanyahu to bring Palestinian Authority President Mahmoud Abbas into Gaza and restore efforts for a two-state solution, he said.

On Wednesday, Cohen suggested that Israel is likely to seek to create a buffer zone around Gaza, rather than occupying the territory completely.

The plan for the war is closely held and still in formation but the initial goal is reflected in the fact that Israel ordered 1.1 million Palestinians to evacuate the northern part of the strip, which includes Gaza City.

“It’s an impossible situation. Israel wants to provide security to its citizens and restore deterrence and in order to do so, it seems for Israel unavoidable that it will continue to kill a lot of civilians,” said Mairav Zonszein, senior analyst on Israel at the International Crisis Group.

Still, Netanyahu’s government is receptive to the U.S. message, according to Manuel Trajtenberg, executive director of the Tel Aviv-based Institute for National Security Studies, a think tank. Israeli troops will stage a ground operation into the north where Hamas is headquartered and where they will likely hold the ground, with a more surgical approach in the southern part, he said.

“Israel needs legitimacy for a long time because this is not going to be a short operation,” he said.

Israel is likely to send in specialized forces trained in urban warfare, backed by regular troops and with close air support, to go from door to door to door and try to eliminate or capture Hamas leaders, according to Bilal Saab, a former Pentagon official responsible for military cooperation in the region.

“Israel’s generals are under no illusion that they can ‘wipe out Hamas,’” said Bilal, now a senior fellow at the Middle East Institute in Washington.

—With assistance from Tony Capaccio.

©2023 Bloomberg News. Visit at bloomberg.com. Distributed by Tribune Content Agency, LLC.

​ Orange County Register 

Israel’s defense minister gives more details on plans for Gaza

• October 20, 2023

By Alisa Odenheimer, Bloomberg News

Israel’s defense minister gave more details about the country’s military plans for Gaza on Friday, implying it has no intention of running the territory after its operations wind down.

Israel aims to disentangle itself from Gaza and to create a “new security reality” in the region, Yoav Gallant said to the parliamentary foreign affairs and defense committee in Tel Aviv.

It’s unclear from his comments who Israel expects to run Gaza if and when the military achieves its aim of wiping out Hamas, the Iran-backed terrorist group that killed around 1,400 Israelis during an attack on Oct. 7. Hamas has been designated as a terrorist organization by the United States, Canada and the European Union.

Israel has launched mass airstrikes on Gaza, which is now ruled by Hamas, since then and is widely expected to launch a ground invasion. Thousands of Palestinians have been killed.

The objectives of the campaign include destroying Hamas’s military and governing capabilities, Gallant said, as well as the complete removal of Israeli responsibility for the Gaza Strip.

“There will be three stages,” the defense minister said. “We are now in the first stage – a military campaign that currently includes strikes, and will later include maneuvering, with the objective of neutralizing terrorists and destroying Hamas infrastructure.”

The second phase will involve operations at a lower intensity, with the objective of eliminating “pockets of resistance,” he said. The final stage will “require the removal of Israel’s responsibility for life in the Gaza strip.”

©2023 Bloomberg News. Visit at bloomberg.com. Distributed by Tribune Content Agency, LLC.

​ Orange County Register 

Medicare premiums will increase slightly in 2024, but you should see cost savings in the drug plans

• October 20, 2023

Medicare open enrollment season started Oct. 15 and ends Dec. 7, and this year there will be more plan choices, more benefit offerings, and potentially some cost savings on medications.  For the millions of seniors on Medicare,  there also will be more reason to scrutinize your existing plans and weigh your options.

During open enrollment, you can make changes such as join, switch, or drop a private insurer’s Medicare Advantage plan for 2024 or a Medicare Part D prescription drug plan. When you are 65, there are two routes you can go: A Medicare Advantage plan offered by a private insurer, which includes hospital care, physician care, prescription drug coverage and other benefits. Or, Original Medicare, provided by the federal government, which includes hospital care and physician care, and pair it with a Part D drug plan.

This year there are more reasons to do your homework and consider your options.

“Plans change every year,” said Bob Rees, vice president of Medicare Member Loyalty for eHealth insurance agency. “Look beyond monthly premiums at the full cost and determine if your plan is changing. You may not be required to change plans, but look to see if your out-of-pocket costs are changing, and that may be a good reason to make a switch.”

What’s new with Medicare Advantage?

Centers for Medicare & Medicaid Services expects more people to enroll in Medicare Advantage plans in 2024, estimating enrollment at approximately 50% of Medicare eligible seniors, compared to approximately 48% for 2023.

While premiums, deductibles, co-pays and out-of-pocket maximums for Medicare Advantage plans differ greatly, every person with Medicare Advantage coverage must pay the Medicare Part B premium (part of Original Medicare) in addition to their private plan’s premium. If enrollees choose to stay in their plan, most will experience little or no premium increase for next year. In Florida, the average premium will increase slightly by 79 cents.

But there are more than premiums to consider.

In choosing among Medicare Advantage plans, an important determinant in 2024 is whether your doctor and preferred hospital will continue to accept your Medicare Advantage plan.  Becker’s Healthcare reports a growing number of hospitals and health systems nationwide are pushing back and dropping the private plans altogether. The reason: Excessive prior authorization denial rates and slow payments from insurers. You also will want to see if your primary care doctors and specialists are in the network, and look at whether a plan includes dental and vision coverage.

“If you keep it simple and ask ‘Are my doctors in network? Are my hospitals in network?’ — by doing that you will eliminate half the plans,” said Evan Tunis with Florida Health Insurance in Coral Springs. “Once you are done with that, ask, ‘Am I okay with an HMO or do I want bigger access to doctors and hospitals, and in that case maybe I need to go with a PPO.’”

Also in 2024: Your plan must notify you if your provider is leaving the network so you have time to choose a new plan. You’ll get this notice if it’s a primary care or behavioral health provider and you have gone to that provider in the past three years.

For the last few years, Medicare Advantage plans have added more supplemental benefits that change yearly, such as dental, vision, meal delivery or gym memberships. Jenny Chumbley Hogue, an analyst for medicareresources.org, said that trend will continue in 2024. “There are going to be even richer benefits,” she said. “If those things are important to you, then it’s important to look at the options.”

However, experts say don’t pick a plan just because of a benefit like dental or vision. It’s more useful to find a plan that covers your cover your health care providers and your medications.

Saving on drug costs

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Where you likely will see big differences in 2024 is in the drug plans, also known as Medicare Part D. Your Annual Notice of Change for a Part D plan will arrive in the mail  and say how much the insurer will pay for prescriptions as well as rules regarding which pharmacies are included. The notice also will break out the costs of buying prescriptions via mail order versus at a retail pharmacy.

Florida will offer 21 stand-alone Medicare prescription drug plans, according to Centers for Medicare & Medicaid Services, Of those, 81% of people with a stand-alone Medicare Part D option will have access to a plan with a lower premium than what they paid in 2023.

The average Part D plan’s premium will decrease slightly, from $56.49 in 2023 to an expected $55.50 in 2024. Many plans will have improved benefits for drug coverage costs, including a $35 cost-sharing limit on a month’s supply of insulin and  free adult vaccines recommended by the Advisory Committee on Immunization Practices, including the shingles and COVID-19 boosters.

Not every drug plan’s premium will decline.

“It will depend on the prescription drug plan, but we anticipate that while some carriers will decrease their premiums, others will nearly double their rates,” said Chumbley Hogue with medicareresources.org.

Chumbley Hogue said beyond just looking at the premium, check your prescriptions to see what tier of coverage they are and how much your out-of-pocket costs will be at various pharmacies.  If a medication falls into a different tier within a plan in 2024, that could make it  significantly more costly for you.

Three major changes in Part D drug plans will go into effect in 2024:

People with Medicare prescription drug coverage who fall into the catastrophic phase of the prescription drug benefit won’t have to pay anything out of pocket during that phase for covered prescription drugs.
Everyone qualifying for Medicare’s Extra Help subsidies won’t pay anything for Part D premiums and deductibles and will pay a reduced amount for generic and brand-name drugs. You’ll be eligible for Extra Help if your 2023 income was under $21,870 ($29,580 for a couple) and have less than $16,660 in resources other than a primary residence, vehicles and personal possessions (below $33,240 for married couples). If you meet the thresholds, you’ll want to sign up for Extra Help when enrolling in a Part D plan. Enrollees can save nearly $300 per year, on average, according to estimates.
In the deductible phase, Part D enrollees pay 100% of their drug costs up to  $545 in 2024 compared to $505 in 2023. Not all Part D plans charge a deductible, but some do.

Traditional Medicare

Florida’s seniors enrolled in Original Medicare will receive better mental health care coverage in 2024. You pay nothing for your yearly depression screening if your doctor or health care provider accepts assignment.  New this year, Medicare will cover mental health services provided by marriage and family therapists and mental health counselors as well as intensive outpatient program mental health services.

During the pandemic, seniors were able to have their telehealth appointments covered by Medicare. This will continue for now. You can still get telehealth services at any location in the U.S., including your home until the end of 2024.

For 2024, Medicare is prohibited from covering weight loss drugs, worth noting with the popularity of Ozempic and Wegovy. There are efforts underway to change that, but it won’t happen in 2024. However, Medicare is covering acupuncture, up to 12 visits in 90 days for chronic lower back pain and an additional eight visits if you are showing improvement.

If you have Original Medicare and want a supplemental plan, also known as Medigap, Tunis said there are some well-priced plans available in South Florida this year. He suggests shopping around.

“Look for a carrier who has been in South Florida a decent amount of time,” Tunis said. “You don’t want a carrier who has only offered supplemental insurance one or two years. If they know the market, they are not going to be shocked if one year claims outnumber premiums. You want that rate stability with a company that has has been here.”

Cindy Krischer Goodman reports on health for the South Florida Sun Sentinel. She can be reached at cgoodman@sunsentinel.com.

​ Orange County Register 

A historic housing construction boom may finally moderate rent hikes

• October 20, 2023

By Tim Henderson, Stateline.org

An unprecedented surge in the nationwide construction of new housing — mostly apartments — may finally be making a dent in fast-rising rents that have been making life harder for tenants.

More than 1.65 million housing units were under construction last year, the highest annual number since federal record-keeping started in 1969. This year, the number was even higher — almost 1.7 million in September.

Meanwhile, the typical annual rent increase nationally fell to zero in June for the first time since the pandemic began, after peaking at 17.8% in 2021, according to Apartment List, a rent information aggregator and research firm. In September, rents fell 1.2%.

Vacancy rates are rising, said Alexander Hermann, a research associate at the Joint Center for Housing Studies at Harvard University.

“You’ve had this huge rush to build apartments in the last couple of years, and projects are bigger and bigger. It’s more common now to be building 50 or more units,” he said. “You can start to see where new supply is coming online, you see starker and stronger rent decreases.”

Federal statistics, which don’t track active construction below the regional level, show that construction hasn’t been higher in the Northeast since 1987 or in the Midwest since 2005, and it’s at all-time highs in both the West and South. A growing share of the country’s housing construction is in the South, up from 40% in 2017 to 46% in 2022.

In some places, rents are falling back a little, but they’re still plenty high compared with just a few years ago. In Texas, Austin has seen rents drop more than 6% for the fiscal year ending in September to $1,734 for a two-bedroom — but that’s still up almost 20% from 2020, according to Apartment List.

Austin’s rent decreases are the most in the Sun Belt, according to Apartment List, while its surrounding metro area is issuing more housing permits than any other large metro — “signaling the important role construction plays in managing long-term affordability.”

Travis County, which includes Austin, increased its housing units by more than a third between 2012 and 2022, creating 169,700 new units in that time as its population swelled by almost 230,000, according to a Stateline analysis of census estimates.

Among the arrivals to Austin in the past decade is K.N., a single father who asked to be identified only by his initials because he doesn’t want his children’s schoolmates to hear about his problems. K.N., a tech programmer who moved from San Francisco a decade ago, said his increasingly high rent may force him to move.

The landlord for his two-bedroom townhouse has asked for annual $100 rent increases in recent years, and just asked for another $200, K.N. said, upping his monthly housing costs with utilities to around $2,500.

“It would reduce my disposable income to basically zero, and that’s not wise with all the extras kids need in school,” K.N. said. “I’d have to pinch pennies to the point that it would cause anxiety. Being housing poor is something I’m trying to avoid.”

Despite a good income, K.N. said, he might have to move farther from his children’s school, which now is within walking distance. He moved to Texas in the first place partly to save money on rent in hopes of buying a house. But he says he sees apartment construction everywhere in Austin.

His observations match reality: Last year, Austin built 24 million square feet of apartment buildings alongside 8.7 million square feet of single-family housing, according to city records.

It’s a similar story nationally, with nearly 1 million apartments under construction as of September. By comparison, there were 914,500 apartments under construction in 2022 and 736,900 in 2021.

The number of single-family homes being built is also high, though the pace has slowed in the past two years. There were about 694,000 homes under construction in September, down from about 736,000 at the end of 2022 and 750,500 at the end of 2021. The last time construction was so high was in 2006, when about 748,000 single-family homes were under construction during the housing bubble before the Great Recession.

The new supply is already having an effect.

Rents dropped in 71 of the nation’s 100 largest cities in the year ending in September. That eclipses the most recent large decrease, in June 2020, when 65 cities had year-over-year declines, according to Apartment List. In early 2022, rents were rising year over year in all 100 cities.

Apartment List said in an October report that construction is one reason vacancies are rising, combined with a decline in remote work as more companies call employees back to the office, which has led to fewer renters in “Zoom towns” in states such as Arizona, Idaho and Nevada.

Other areas with big recent drops in rents are also mostly in the South and West, where construction is at all-time highs. The Austin metro area dropped 6%; Portland, Oregon, dropped 5%; and Atlanta, Las Vegas, Orlando, Phoenix, Salt Lake City and San Francisco all dropped by 4% in the past year as of September.

Some of those areas are, like Austin, just beginning to see modest drops in average rents but remain much pricier than just a few years ago. The Miami metro area, for instance, has had the nation’s biggest jump in rents since 2020, at 40%. Orlando, Florida, rose 32% over the same time, according to Apartment List.

In the past six months, rents dwindled just 1% in each city.

“Recent gains in housing supply have helped to slow rental prices and housing costs, although I would be cautious about calling rent decreases of 1% very significant,” said Randy Deshazo, director of economic development and research at the South Florida Regional Planning Council. Soaring prices are particularly painful in the region, he said, because affordability, in terms of housing costs compared with income, is the worst in the country.

In some parts of the Northeast and Midwest, where the construction boom hasn’t been quite as robust, rents have continued to rise in the past six months as of September. Rents were up by 7% in Providence, Rhode Island, for example. During the same period, the increase was 5% in Boston, New York City and Hartford, Connecticut.

Estimates of the nation’s housing shortage, which many experts blame for high rents, vary. Fannie Mae last year estimated that there were 4.4 million too few units in large metro areas, and Realtor.com this year pegged the shortage at 2.3 million units. About 1.4 million units were finished in 2022, the most since 2007, and another nearly 947,000 were finished in 2023 through August, according to a U.S. Census Bureau construction survey.

Permits issued from mid-2022 to August 2023 point to likely large increases in housing in Utah, Idaho, Florida, Texas, South Dakota, North Carolina, the District of Columbia, South Carolina, Arizona, Tennessee, Georgia and Colorado.

Those states could all see housing stock grow by about 2% above census estimates for mid-2022, the latest available, according to a Stateline analysis.

Nationwide, the number of permits issued in 2023 is down compared with a peak in late 2021 and early 2022, even as the numbers remain high in some states. That’s one reason most analysts expect some kind of slowdown from the recent torrid pace of building, said Hermann, of Harvard’s Joint Center for Housing Studies.

South Dakota’s building permits have fallen back from a 48% surge in 2020 followed by a 24.8% increase in 2022. This year they dropped 37% in the second quarter.

Even so, South Dakota had one of the highest rates of new building permits between mid-2022 and August 2023 — more than 2% of its existing units, or almost 9,000 new housing units, if they all get built.

The initial pandemic boom was “likely induced by more work-from-home options and increased demand for space and land, of which South Dakota has an abundance,” said Aaron Scholl, an assistant economics professor at Northern State University in Aberdeen, South Dakota, who worked on a Dakota Institute report on real estate in September.

The recent decline likely points to stagnation in the state’s housing market and eventually its whole economy, Scholl said.

“Building permits are often a leading indicator for not only housing market demand, but the overall economic landscape,” Scholl said. “As the housing market cools, I’d expect the economy to do so as well.”

Stateline is part of States Newsroom, a national nonprofit news organization focused on state policy. Read more Stateline coverage of how communities across the country are trying to create more affordable housing.

©2023 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

​ Orange County Register 

OC judge tosses charges against Newport Beach doctor, girlfriend

• October 20, 2023

By PAUL ANDERSON

Signaling an end to the long-running, politically charged prosecution of a Newport Beach hand surgeon and his girlfriend who were initially accused of drugging and sexually assaulting a series of women they met in bars or other settings, a judge said Friday, Oct. 20, he will dismiss most of the remaining charges in the case.

Orange County Superior Court Judge Michael Leversen dismissed felony charges of poisoning and sale of phencyclidine against Dr. Grant Robicheaux, 43, and Cerissa Riley, 36.

Robicheaux, however, is expected to plead guilty to felony counts of possession of an assault weapon and four misdemeanor counts of possession of a controlled substance, including GHB, more commonly known as the date-rape drug. Riley no longer faces any criminal charges.

It was not immediately clear when Robicheaux will enter his plea to the weapon and drug charges. Leversen said he would agree to a stipulated sentence.

Barring further developments, the judge’s decision marks a winding down of a case that began five years ago in the heat of a re-election bid by then-District Attorney Tony Rackauckas, who held a widely covered news conference to announce the charges. The case quickly became a target of then-DA candidate Todd Spitzer, who criticized Rackauckas’ handling of the case and questioned why Rackauckas did not move faster to file it.

After he was elected, Spitzer called for an internal review of the case, assigned two new prosecutors and then moved to dismiss all of the charges. That drew protests from several of the alleged victims, and an Orange County Superior Court judge refused to toss the case.

Spitzer’s office was eventually recused from the case and the Attorney General’s Office took over.

‘Swingers’ or predators? Judge to decide if case against Newport Beach doctor can go to trial

Robicheaux initially faced charges involving five alleged victims and Riley three alleged victims, but a prior Orange County Superior Court judge granted a motion from prosecutors to reduce the charges. There were initially a total of 13 accusers, some who prosecutors had planned to use as witnesses to show a pattern of behavior at trial.

By the time the case got to a preliminary hearing, there were two alleged victims.

After a roller-coaster ride of various court rulings, dismissals and refiling of charges, only one alleged victim remained in the case — a woman who initially began chatting with Robicheaux via the Bumble app and said she trusted him because he was a doctor who once appeared on a TV show on Bravo.

Leversen tossed out sexual assault charges following a July preliminary hearing, which left only the poisoning and drug possession charges remaining against the pair.

With those charges tossed out on Friday, attorneys and the judge were still meeting to determine what sentence Robicheaux could face on the remaining counts against him, and when his plea might be entered. The timing is complicated by the fact the alleged victim in the poisoning counts is in the Israeli military and serving in the war against Hamas.

Attorneys said the woman wants to address the judge if a plea deal is struck in the case.

This is a developing story. Please check back for updates.

​ Orange County Register 

Red meat tied to higher risk for type 2 diabetes, plant-based protein may lower risk: Harvard study

• October 20, 2023

Have you been trying to cut back on red meat? It could help you avoid a serious disease that affects tens of millions of people across the U.S.

People who eat two servings of red meat a week may have a higher risk of developing type 2 diabetes compared to people who eat fewer servings, and the risk increases with greater consumption, according to a new study from Harvard T.H. Chan School of Public Health.

The Harvard researchers also found that replacing red meat with healthy plant-based protein sources — such as nuts and legumes — or modest amounts of dairy was tied with a lower risk of type 2 diabetes.

“Our findings strongly support dietary guidelines that recommend limiting the consumption of red meat, and this applies to both processed and unprocessed red meat,” said first author Xiao Gu, a postdoctoral research fellow in the Department of Nutrition.

Type 2 diabetes is a major risk factor for cardiovascular and kidney disease, cancer, and dementia.

While previous studies have found a link between red meat consumption and type 2 diabetes risk, this study now adds a greater level of certainty about the association.

The researchers analyzed health data from 216,695 participants from the Nurses’ Health Study (NHS), NHS II, and Health Professionals Follow-up Study. The participants were asked about their diet in food frequency questionnaires every two to four years, for up to 36 years. During this time, more than 22,000 participants developed type 2 diabetes.

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The scientists found that consumption of red meat — including processed and unprocessed red meat — was strongly linked with increased risk of type 2 diabetes.

Participants who ate the most red meat had a 62% higher risk of developing type 2 diabetes compared to those who ate the least.

Every additional daily serving of processed red meat was linked with a 46% greater risk of developing type 2 diabetes, and every additional daily serving of unprocessed red meat was associated with a 24% greater risk.

The researchers also estimated the potential effects of substituting one daily serving of red meat for another protein source. They found that substituting a serving of nuts and legumes was linked with a 30% lower risk of type 2 diabetes, and substituting a serving of dairy products was associated with a 22% lower risk.

“Given our findings and previous work by others, a limit of about one serving per week of red meat would be reasonable for people wishing to optimize their health and wellbeing,” said senior author Walter Willett, a professor of epidemiology and nutrition.

The researchers also said swapping red meat for healthy plant protein sources would help reduce greenhouse gas emissions and climate change, and provide other environmental benefits.

The red meat and type 2 diabetes study was published on Thursday in The American Journal of Clinical Nutrition.

​ Orange County Register