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The people of El Paso, Texas, are resilient. Living in the middle of the harsh Chihuahuan Desert, the city has no other choice. On average, 15 days every year spike over 100 degrees Fahrenheit. The city gets little relief with annual rainfall of just about 9 inches. It's one of the hottest cities in the country.One of its prime sources of water is the Rio Grande. Typically the river can supply as much as half of the city's water needs. But climate change is making that increasingly difficult and is pushing the city to look for new sources of water. Now, El Paso is on track to become the first large city in the United States to treat its sewage water and send it directly back into its taps.Increasing temperatures will make the dry region even more vulnerable to drought, according to the federal government's most recent national climate assessment. Already challenged with balancing the demands of about 700,000 thirsty El Pasoans along with agriculture and industry needs, El Paso must also face the fact that climate change is literally drying up one of its major sources of water.Analyzing tree ring records, scientists have been able to reconstruct the climate history of the region as far as the late 1500s and have found that as temperatures have risen, the amount of snow melting and feeding the Rio Grande has dropped."We're getting less runoff now than we would have gotten as recently as the '80s or '90s," said J. Phillip King, a professor of civil engineering at the University of New Mexico. King has tracked the river's water levels for the past 27 years as an adviser to the Elephant Butte Irrigation District. The district manages the water distribution of some 90,000 acres of farmland along the Rio Grande Valley in New Mexico and Texas.King told CNN Chief Medical Correspondent Dr. Sanjay Gupta that there is simply less snowmelt coming from northern New Mexico and southern Colorado to feed the river. Since 1958, the amount of early April snowmelt going into the Rio Grande has dropped 25% due to less snowpack and evaporation.What's happening in the Rio Grande is not unique. It's a phenomenon happening throughout the Western United States.King called the Rio Grande a harbinger of what's to come. "You know we've already gotten critically low here, and you can think of the Colorado as a few years away from a similar fate," he said.Drought isn't anything new for the 1,800-mile long river. The Rio Grande has survived severe and sustained droughts, King said. But an increase in temperature is pushing both a warmer and dryer climate. And that means not only potentially less snowfall but a greater chance for water to evaporate.The federal government projects that temperatures could rise an additional 8 degrees Fahrenheit in the region by 2100.The dwindling reserves are apparent at Elephant Butte Reservoir, just outside of Truth or Consequences, New Mexico. The reservoir there sits right on the Rio Grande and forms the largest recreational lake in the state. It holds water for farmers from north of El Paso up to Colorado. It has a capacity of about 2 million acre feet, King said. Currently, it's hovering around 3% to 4% of its full capacity. Buildings that were built as offices during the dam's construction in the early part of the 20th century were previously submerged in the 1980s. Now, they serve as lookout points to a nearly empty basin. 3399

The Pittsburgh Steelers have placed four more players on the COVID-19 list, including quarterback Ben Roethlisberger. According to the Associated Press, a player is added to the reserve/COVID-19 list if they have tested positive for the virus or have been in close contact with someone who has it.The move comes a day after tight end Vance McDonald went on the list after testing positive following a 24-19 win at Dallas that pushed the Steelers to 8-0. Running back Jaylen Samuels, offensive lineman Jerald Hawkins, and linebacker Vince Williams joined Roethlisberger on the list Tuesday.According to ESPN, the players are considered high-risk contacts, so they must isolate for five days after their last contact with McDonald, and they can't be at the team's practice facility during those five days.The team will test the players throughout the week before they are deemed eligible to play against the Cincinnati Bengals on Sunday, ESPN reported.According to ESPN, Roethlisberger has been seen not wearing a mask when talking to McDonald while on the sidelines. The teammates also have lockers close to each other. Roethlisberger has not tested positive, ESPN reported.For the first time in the team’s history, the Steelers are 8-0. 1244

The presence of a Asian giant hornet nest, also known as murder hornets, has been confirmed in Washington state.“The rumors are true - our entomologists located the first-ever #AsianGiantHornet nest in the U.S. late yesterday,” a tweet from the Washington State Department of Agriculture reads. It also includes a video of the nest. 340

The photos from doctors came quickly and in succession: blood-stained operating rooms, blood-covered scrubs and shoes, bullets piercing body parts and organs.The pictures on Twitter were an emotional response to a smackdown by the powerful gun industry lobby, which took issue with the American College of Physicians' call late last month for tighter gun control laws. The recommendations included bans on "assault weapons," large capacity magazines and 3D-printed firearms."Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves," the National Rifle Association tweeted.Physicians across the United States seized on the phrasing, taking to Twitter with 22,000 comments and the hashtags #thisismylane and #thisisourlane, posting photos of their encounters with gun violence and offering their own personal stories of treating such wounds.The debate gained new urgency this week with the shooting death of an emergency room doctor outside the hospital where she worked, as physicians argue shootings are a public health crisis that they must play a key role in trying to stem. Dr. Tamara O'Neal was killed Monday outside a hospital in Chicago in what police say was a dispute with her ex-fiance. The shooter and two other people — a responding police officer and a resident in the hospital's pharmacy — also died."It just shows that not only is this is in our lane, but this happens to us," said Dr. Joseph Sakran, a trauma surgeon at Johns Hopkins Medicine in Baltimore who as a 17-year-old was shot in the throat by a stray bullet fired during a dispute at a high school football game.Sakran created a Twitter account @ThisIsOurLane which in just two weeks has attracted nearly 15,000 followers. They include Dr. Peter Masiakos, a pediatric trauma surgeon in Boston, who wrote "The Quiet Room" just hours after the mass shooting at a church in Sutherland Springs, Texas, about breaking the news that a loved one has died."We need to start talking about this as a public health issue. Politics aside, we have a problem that no other country has, and we shouldn't," Masiakos said.About 35,000 people each year are killed by guns in the United States, and about two-thirds are suicides. That's about 670 people per week and among the largest number of civilian gun deaths in the world.The world's highest rate of gun deaths is in El Salvador with a rate of 72.5 per 100,00; the rate in the U.S. is 3.1 per 100,000. Among all European countries, the rate never breaks 1 gun death per 100,000, according to Small Arms Survey, a Switzerland-based research organization that examines firearms and violence."These are not just statistics. These are people, mothers, fathers, brothers, sisters that are being killed," Sakran said. "The worst part of my job is having to go out and talk to these families and to tell them that their loved one is never coming home."It's not the first time that medical professionals have taken on powerful industries: auto companies over seat belts, Big Tobacco over cigarettes and toys that posed choking hazards. It's also not the first time that the gun lobby has pushed back against the medical community or researchers it considers to be biased. In the 1990s, Congress barred the Centers for Disease Control from conducting research that advocated or pushed for gun control; while it didn't ban research from being conducted, it did have a chilling effect.More recently, the NRA backed legislation in Florida — eventually overturned in court — that would have barred doctors from asking patients about guns in the home.Dr. Stephanie Bonne, a trauma surgeon in New Jersey, was in the hospital when she saw the dispute playing out on Twitter."I was reading this, and I was like 'Stay in my lane', are you kidding me? Gun violence is something I deal with every day. We're mopping it up in the hospital every day," she said. "My second sort of reaction is maybe people ought to see what this lane is really all about."Bonne works at a Level I trauma center — the top-level hospital for treating the most serious cases. Her hospital sees about 600 gunshot wounds each year, and she described the toll that unfolds: medically, psychologically and financially."It's always tragic and it's always preventable," Bonne said.Dr. Judy Melinek, a forensic pathologist in the San Francisco Bay area, examines the dead. She took to Twitter to push back at the gun lobby, posting: "Do you have any idea how many bullets I pull out of corpses weekly? This isn't just my lane. It's my (expletive) highway.""The chutzpah, the gall is what really got to me," Melinek told The Associated Press. "The NRA seems to think they've cornered the market on expertise when it comes to guns. And that's not correct."She's conducted about 300 autopsies involving gunshot wounds, about half of those suicides. She's seen the damage from bullets and believes more and better research would help prevent gun violence.Would GPS tracking on firearms or high-tech trigger locks make firearms safer, for example?Dr. Arthur Przebinda, director of the gun rights advocacy group Doctors for Responsible Gun Ownership, said the pushback from physicians is largely driven by more liberal forces within medical academia and based on ignorance about firearms.He described it as old, tired debate that shows a knee-jerk bias against firearms. Rather than stripping away constitutional rights, physicians should focus on finding ways to study the underlying causes of violence, he noted."These virtue-signaling physicians would be in their lane if they pursued better surgical techniques, better postoperative treatments. They are in the wrong profession if they want to cure society's ills," Przebinda said. "If that was their life's calling, they should have pursued a career path in psychology, criminology or the clergy."___This story has been amended to correct the first name of Dr. Judy Melinek. 6087

The pandemic is coinciding with flu season, which is a potentially dangerous scenario doctors and nurses have given much thought to as the winter months approach.“How much is [the flu] going to play into things, and is it just going to make everything worse?” said Dr. Michelle Barron. “Is it going to comingle with COVID, and actually make people double sick or doubly ill?”Dr. Barron is the senior medical director of infection prevention and control at one of Colorado’s largest hospitals. She says staff has come up with contingency plans to deal with an influx of patients who might be battling serious flu symptoms.“We’ve been really encouraging our patients to get their flu shots and make sure they have that on their list,” she said. “We understand that there are some years that you’re debating whether or not it’s worth it, and we’re like this is the year you need to get it.”The CDC estimates around 196 million flu shots are available this year, a 13 percent increase from last year’s record-setting dosage of 175 million. It is an important number as last year 400,000 people were hospitalized for the flu, a potential burden hospitals have prepared for as bed space is now at a premium.“We’ve already surpassed the numbers of the first surge, so now, we’re like what’s next,” said Maddie Smith, a nurse at UCHealth in Colorado.Smith works in the hospital’s COVID ICU. She says while her unit has not reached a tipping point, it is expecting more flu patients to come in. Her unit has made plans to allocate more bed space to the seriously ill, regardless of cause, and treat them with whatever drugs are necessary. The good news, she says, is the flu has been treated for years, so doctors have a good plan of attack, and the measures we have taken to reduce the spread of COVID-19 are having a positive effect on the spread of the flu.“We usually are able to use the southern hemisphere as a good way to figure out what our flu season is going to look like,” said Dr. Barron. “They actually had a pretty mild flu season but COVID hit at the exact same time.”Dr. Barron says 3 to 5 percent of COVID-19 patients have had co-infection with another virus, showing complications are possible as flu season hits its stride, but not guaranteed.“I don’t think it’s anything that we can’t manage that we already haven’t thought about,” said Dr. Barron. 2367