Happy Monday from Atlanta! I just tried to convince thousands at a public health conference that it’s time to reimagine systems—not just defend the status quo. I’m happy to report that tomatoes weren’t thrown my way. This is my fourth state in five days, and the highlight is actually seeing the seasons change and meeting a lot of you in person. I couldn’t be more excited to see my girls (and survive another round of the KPop Demon Hunters soundtrack).
Top: Plenary stage with Mike Osterholm; From the bottom left: Met YLE reader Krisandra Allen at the conference. Fall leaves in Idaho. My daughter welcoming me home at the airport.
This week’s Dose runs the gamut: from what’s really going on with lead in protein powders (and whether you should be worried), to a refreshing burst of leadership as 15 governors join forces to strengthen public health collaboration, to falsehoods swirling around mammograms. We’ll wrap with an infectious disease weather report and a quick note for dog owners on an FDA recall.
Let’s go!
Consumer Reports found lead in protein powders. How bad is it?
Last week, Consumer Reports released an analysis revealing elevated lead levels in several popular protein powders and shakes. Google searches for “lead in protein powder” spiked 300%, and influencers lit up social media. Depending on which news source you read, it was either a five-alarm fire or no big deal.
So what’s actually going on? Lead is everywhere—soil, food, water, and air. Thankfully, overall exposure has dropped dramatically since the 1970s, and modern lab tests can now detect vanishingly small amounts (down to parts per billion). But detection does not necessarily equal danger.
How bad is bad?That’s where things get tricky because not everyone agrees:
California limit: 0.5 mcg/day. This number comes from a very conservative calculation: regulators took the “no observable effect” level for reproductive harm for inhaled lead exposure in workplaces and divided it by 1,000. Many experts argue that this threshold is unrealistic. It’s also not linked to adverse health outcomes.
FDA’s limit: 2.2 mcg/day for kids, 8.8 mcg/day during pregnancy, and 12.5 mcg/day for other adults based on blood lead levels, toxicology data, and a built-in 10x safety factor.
European Union limit: Allows up to 3 mg/kg (3 ppm) in food supplements—roughly 90 mcg per 30-gram scoop of protein powder. In this case, the FDA is far more cautious than Europe (and that’s not usually how things go).
Back to the report: of the 23 protein supplements they tested, two-thirds exceeded “Level of Concern.” One brand (Naked Nutrition Vegan Mass Gainer) hit nearly 16 times the limit. But because Consumer Reports used California’s exceptionally strict benchmark, those numbers sound scarier than they really are.
The average American already gets 5.3 mcg of lead daily from food and the environment. That’s another reason California’s cutoff doesn’t make much sense. Still, some products identified in the report could push intake close to the pregnancy (8.8 mcg) or adult (12.5 mcg) daily thresholds.
What this means for you: Don’t worry too much. While the FDA continues to reduce lead exposure through programs like Closer to Zero and the Total Diet Study (that is, if the funding continues), there are several things we can do in our own homes, especially for parents of kids and during pregnancy.
Check to see if your protein supplement (or any supplement, really) has third-party testing for heavy metals (like USP or Informed Sport).
Advocate for more pre-market regulatory oversight in the supplement industry (which has very little, if any at all) by writing to your local representative.
Eat a diet that includes a variety of nutrient-dense foods, which helps limit exposure to specific food sources and ensures we get an array of protective nutrients.
Prioritize getting your protein from whole food sources.
Big thanks to YLE’s Megan Maisano—Registered Dietitian Nutritionist— for writing this section.
Fourteen states and Guam join forces to launch Governors’ Public Health Alliance
Governors from 14 states and Guam announced the creation of the bipartisan Governors’ Public Health Alliance, which is a new effort to strengthen coordination and collaboration across state lines.
Why do we need this? In the U.S., authority over health rests with the states, not the federal government. Health (encompassing both health care and public health) is not only the highest budget item for a state but also the primary reason for state bankruptcy. In other words, governors hold enormous power over your health.
Today, though, federal support is shifting fast, funding is drying up, and states are being forced to get creative. States must decide whether to maintain their public health departments (due to funding cuts), how to continue purchasing vaccines (if the federal government stops recommending them), whether to negotiate drug prices (like insulin), and more. We saw a similar challenge during the pandemic with bulk purchasing of PPE.
In general, the more coordinating, collaborating, and innovative thinking, the better.
However, I’m growing increasingly concerned about the partisan gaps in public health. Although some Republicans are on the advisory board and the initiative was framed as bipartisan, no Republican-led states have joined. This worries me for my friends in red states, like Texas, but it also has implications for everyone, as diseases don’t care about borders.
What this means for you: If your state is included, you can rest assured your governor is talking to others, which is a helpful step toward innovative solutions. You could argue it was needed before this moment, too. Public health has been siloed for far too long.
Mammograms save lives. They’ve been wrongly targeted.
Happy Breast Cancer Awareness month! Unfortunately, this month has driven some influencers to post false claims about the harms of mammograms. So let’s clear this up.
Breast cancer is the second leading cause of cancer death in women in the U.S., and accounts for 1 in 3 new cancers among women each year. (It affects men too, just at lower rates.) There is strong scientific consensus in support of routine mammograms to prevent breast cancer and detect it early:
Regular mammograms starting at age 40 are recommended for everyone, but may have even greater benefit for Black women, who are 40% more likely to die from breast cancer than white women and more likely to have aggressive cancers, younger.
There’s some critical nuance here:
With each mammogram, breast tissue is exposed to a small amount of ionizing radiation. But! We’re exposed to this type of radiation every day in our natural environment. At high doses, radiation exposure can change DNA and cause harm, but the amount of radiation exposure during a mammogram is about the same as flying from California to New York.
Organizations disagree on whether mammograms every year or every other year are optimal. Screening recommendations are based on evaluating science to maximize benefit (lives saved) while reducing patient worry, unnecessary costs, and diagnosing and treating cancers and pre-cancers that ultimately wouldn’t cause health problems—also called “overdiagnosis.” This is a balancing act.
Mammograms are just one tool for detecting cancer, and women with dense breasts or high risk for cancer (e.g., family history, known genetic predispositions, or other key risk factors) may benefit from additional screening, such as through an MRI.
For more, see YLE’s deep dive on breast cancer screening recommendations.
Infectious disease “weather report”
In the U.S., flu and RSV are still quiet. CDC data is still on pause because of the government shutdown, so we’re continuing to reference PopHive data. RSV activity is still low but growing in southern states, like Louisiana and Texas.
However, Covid-19 is having a moment in the U.K., with hospitalizations increasing exponentially after a 10-month lull. This isn’t driven by a dramatic variant, but rather by a lack of immunity building up over time. Flu might also be increasing, which suggests it’s coming soon (as expected) for the U.S.
The FDA recalled Raw Bistro frozen beef dog food for possible Salmonella contamination. The recalled products were sold directly to consumers and to select distributors between Sept. 1 and Sept. 17 in California, Colorado, Illinois, and Minnesota.
Salmonella can make dogs sick, just like humans. Contaminated food can cause illness days later in dogs. And dog owners can get sick from handling contaminated food or dog bowls.
What this means for you: Check the lot numbers on your dog’s food, and toss it if they are included in the FDA recall notice. Sanitize bowls if they held contaminated food, wash your hands, and watch for warning signs in your dog: lethargy, vomiting, diarrhea, and loss of appetite. If you notice these signs, take your pet to the vet.
That’s it for this week! Share your fall leave pics in the comments below so that I can continue to live vicariously through you.
Love, YLE
Your Local Epidemiologist (YLE) is founded and operated by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, wife, and mom of two little girls. YLE is a public health newsletter that reaches over 400,000 people in more than 132 countries, with one goal: to translate the ever-evolving public health science so that people are well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below:
At the South Louisiana Ice Processing Center in Basile, detainees say they were forced into hard labor – and sexually assaulted and stalked by an assistant warden
‘It is for my daughter and my family that I have endured everything that I have in this detention facility for the past 28 months.’ Illustration: Rita Liu/The Guardian
A Google Maps screenshot of the South Louisiana Ice Processing Center (SLIPC) in Basile, Louisiana.
Photograph: Google Maps
A spokesperson for Geo categorically denied the allegations detailed in the complaints.
Photograph: Patrick T Fallon/AFP/Getty Images
Queer and trans immigrants at a detention facility in south Louisiana have alleged that they faced sexual harassment and abuse, medical neglect and coerced labor by staff at the facility, and that they were repeatedly ignored or faced retaliation for speaking out.
In multiple legal complaints, immigrants detained at the South Louisiana Ice Processing Center (SLIPC) in Basile, Louisiana, said they were recruited into an unsanctioned work program that forced them to perform hard manual labor for as little as $1 per day. Detainees also alleged that queer people were targeted by an assistant warden who stalked, harassed and sexually assaulted them.
Three current and former detainees who spoke to the Guardian said that, between 2023 and 2025, they endured months of abuse from an assistant warden named Manuel Reyes and his associates. In their complaints to the Department of Homeland Security (DHS) and Immigration and Customs Enforcement (Ice), the detainees also said that they faced retaliation for reporting the abuse to authorities, alleging that Reyes and other staff beat them and denied them medical treatment.
“I was treated worse than an animal,” said Mario Garcia-Valenzuela, one of the detainees. “We don’t deserve to be treated like this.”
Garcia-Valenzuela, a trans man detained at SLIPC, has alleged that, as part of the unsanctioned work program, Reyes forced him to move heavy cabinets and cinder blocks, and to clean using industrial-strength chemicals without gloves or protective gear. When Garcia-Valenzuela complained of injuries from the work program, he said, Reyes and his associates forcefully stripped him naked and mocked him.
Kenia Campos-Flores, who is trans and non-binary, told the Guardian that they suffered from persistent migraines and chest pain after exposure to cleaning chemicals they were made to use during unofficial, overnight work shifts. Campos-Flores also alleged in a complaint they were persistently sexually harassed by Reyes, who entered their dorm and stole possessions including their boxers.
Another trans detainee, Monica Renteria-Gonzalez, complained that a stripper chemical he was told to use to clean the facility floors seeped through his fabric shoes and burned the skin of his feet. On more than one occasion, while Renteria-Gonzalez was bent over cleaning, he said, Reyes came up from behind and inappropriately touched him. The assistant warden also told Renteria-Gonzalez he was watching the detainee through security cameras, including while he was showering.
A fourth detainee, identified by the pseudonym Jane Doe, is a cisgender, queer woman who said that Reyes forced her to perform oral sex on him on a “near daily basis” between February and May 2024, threatening to kill her if she refused, according to her complaint.
Doe, who was deported to the Dominican Republic in January this year, has chosen not to share her name or speak publicly because she fears that Reyes will make good on his threat to find and harm her, her lawyer said.
Taken together, the detainees’ stories present a troubling pattern of mistreatment and abuse inside SLIPC, their attorneys said. Though the alleged abuse took place across two presidential administrations, advocates worry that conditions inside detention facilities could further deteriorate amid the Trump administration’s present push to arrest and detain a record number of immigrants. Trans and queer immigrants in detention are especially vulnerable, advocates said, given that the administration is also moving to roll back key civil rights protections for LGBTQ+ people in federal custody.
The detainees’ allegations are detailed in four separate administrative complaints filed under the Federal Tort Claims Act, which allows individuals to sue the government for injuries caused by federal employees. The government has six months to adjudicate the complaints, or the claimants could move forward with a federal lawsuit. They were submitted in September by Robert F Kennedy Human Rights, the American Civil Liberties Union (ACLU) of Louisiana and the National Immigration Project. Those groups have also submitted a civil rights complaint to the DHS oversight bodies, including the office for civil rights and civil liberties (CRCL), on behalf of the detainees.
“This was a sadistic late-night work program,” said Sarah Decker, a senior staff attorney with RFK Human Rights. “It was designed to target vulnerable trans men or masculine-presenting LGBTQ people, who [Reyes] coerced into participating.”
When detainees tried to report their abuse, Decker said, Ice officials repeatedly disregarded them. Officials dismissed multiple reports of abuse in accordance with the federal Prison Rape Elimination Act (Prea), Decker said, as well as complaints to the Ice office of inspector general (OIG), the department charged with oversight of Ice.
“These people screamed for help. They filed grievances. They filed complaints under the Prison Rape Elimination Act, they filed verbal complaints through the office of the inspector general. They did everything to get help,” Decker said. “And they were systematically ignored, and complaints were buried.”
The Guardian attempted to locate Reyes though multiple means, including public records and social media searches and were unable to contact him. Reyes is not facing criminal charges for the alleged sexual abuse at the facility.
He is no longer employed at SLIPC, Decker said – he left the facility in July 2024. But, Renteria-Gonzalez and Garcia-Valenzuela, who remain detained at SLIPC, told the Guardian other staff at the facility have continued to retaliate against them, placing them in solitary confinement and denying them full access to medical care.
The DHS and Ice did not respond to the Guardian’s queries about the detainees’ allegations, nor did the agencies address whether any of the detainees’ Prea complaints were investigated.
‘It’s devastating and heartbreaking, everything that they do to us in here’
Located about 90 miles (145km) from the Gulf coast in the rural town of Basile, Louisiana, SLIPC was once a correctional facility. But in 2019, it opened as an Ice detention facility, operated by Geo Group, one of the largest private prison and surveillance firms in the US.
Over the past several years, the detention center, which houses mostly women as well as a few trans people, has attracted a string of allegations of civil and human rights violations, medical neglect and poor hygiene. In 2022, an internal inspection by the office of the immigration detention ombudsman – an independent office within the Department of Homeland Security – found that the facility had insufficient medical staffing, and had been inconsistent in addressing the medical and mental health needs of detainees. A 2025 report by the Yale Law School also found that detainees were “left hungry, cold, and in an atmosphere detainees describe as abusive”.
A Google Maps screenshot of the South Louisiana Ice Processing Center (SLIPC) in Basile, Louisiana. Photograph: Google Maps
“It’s devastating and heartbreaking, everything that they do to us in here,” said Renteria-Gonzalez, who first arrived at the facility in May 2023. “We struggle on a daily basis.”
He said his decision to remain in detention while his immigration case is under review – rather than accept deportation – has been painful.
Renteria-Gonzalez came to the US when he was 12 and has been in the country for 31 years. His eight-year-old daughter is a US citizen. “It is for my daughter and my family that I have endured everything that I have in this detention facility for the past 28 months,” he said. “It’s so that I can make it back home to her.”
Renteria-Gonzalez said Reyes first recruited him to participate in the late-night work program in September 2023, according to his complaint. Reyes would often come into his dorm late at night – at around 2 or 3am – to wake him up for his night shift.
“It’s like he lived [at the detention center] 24/7,” Renteria-Gonzalez told the Guardian.
Each recruit worked alone, during different times or in different parts of the detention facility – meaning they were often alone with Reyes, the detainees allege. During these times, Renteria-Gonzalez said, he would watch them work and probe them with invasive and inappropriate questions. “It made me feel uncomfortable,” he said. “He used to sit on his phone and asked us for personal information to look us up on Facebook and stuff.”
Sometimes, he said, Reyes entered detainees’ dorms late at night for no particular reason, and would take their used underwear and personal hygiene products. On other occasions, Renteria-Gonzalez alleged in the complaint, Reyes would stalk him as he went to and from the showers and ask invasive questions: “And after, he would say: ‘Tell me what were you doing in the shower?’”
Twice, Renteria-Gonzalez said, Reyes came up behind him and touched him inappropriately. Another SLIPC officer, according to Renteria-Gonzalez, began to sexually harass him as well, sending him explicit notes and showing him pornographic images of herself.
“I just felt overwhelmed,” he said. “I thought enough was enough.”
Eventually, he realized he wasn’t alone.
After being detained at SLIPC in February 2024, Garcia-Valenzuela said he also found himself trapped in Reyes’s unofficial work program.
Mario Garcia-Valenzuela. Photograph: Mario Garcia-Valenzuela
Garcia-Valenzuela had fled to the US in 2014 from Mexico, where he was tortured by members of a drug cartel. “I have no choice, that’s why I’m fighting,” he said. “Because I know that as soon as they deport me, I’m going to be handed over to the cartels and I’m going to be tortured and killed – ripped into pieces.”
But in SLIPC he faced a new kind of horror. He alleged that on more than one occasion he was told to move heavy metal filing cabinets back and forth across a room. When he struggled to lift the furniture, Reyes would taunt him, he said, saying: “If you think you are a man, I’m going to treat you like a man.”
In the spring of 2024, Garcia-Valenzuela reported sexual harassment on the basis of his gender, in accordance with Prea. He said he felt targeted due to his gender identity and wanted the fact he is transgender removed from his file, as a measure of protection. But an Ice officer responded that “even if we take off your transgender marker, there is no hiding that you are transgender”, noting Garcia-Valenzuela’s physical appearance, he said. To Garcia-Valenzuela’s knowledge, no follow-up investigation into Reyes was conducted.
Renteria-Gonzalez’s complaints were dismissed as well, Renteria-Gonzalez said.
A spokesperson for Geo categorically denied the allegations detailed in the complaints.
“GEO strongly disagrees with these baseless allegations, which are part of a long-standing, politically motivated, and radical campaign to abolish ICE and end federal immigration detention by attacking the federal government’s immigration facility contractors,” said Christopher V Ferreira, a Geo group spokesperson.
Ferreira added that “GEO has comprehensive policies in place for the reporting and investigation of all incidents that occur at the Center, including instances of assault and/or sexual assault. These policies are governed by standards and requirements established by the US Department of Homeland Security.”
Geo did not respond to questions about Reyes’s employment status at SLIPC.
Harsh retaliation
The detainees who filed complaints against Reyes and other SLIPC staff said that they faced harsh retaliation for doing so.
When Jane Doe filed a Prea complaint with Ice using a paper form and through the phone hotline, detailing that Reyes had sexually assaulted her, she received no response, according to her legal complaint.
But afterwards, Reyes redoubled his efforts to stalk her, the complaint alleges – and forced her to perform oral sex on him, saying he had her cornered in the facility’s “camera blind spots” where no one would see them.
When she attempted to resist, Reyes told her he had found her mother’s home address in the Dominican Republic, Doe alleges in the complaint, and told her that if she were deported, he would follow her to her family’s residence where “you won’t have any protection”.
A spokesperson for Geo categorically denied the allegations detailed in the complaints. Photograph: Patrick T Fallon/AFP/Getty Images
Jane Doe said Reyes and other staff also blocked her from accessing medical treatment for her epilepsy, even as her seizures became more severe and frequent during her time in detention, the complaint states. He repeatedly cornered Doe as she was en route to the medical center to receive treatment, and told her he would watch her on cameras while she was receiving medical evaluation. On one occasion, he told Doe he was “masturbating to her because he saw her body in medical condition when she was in an observation cell”, the complaint alleges.
“We feel so vulnerable, impotent,” Renteria-Gonzalez said.
After he reported that Reyes had sexually assaulted him, Renteria-Gonzalez said, Reyes burst into his housing unit and yelled, “You should have never put my name on it!”, in reference to the complaint to Ice. Renteria-Gonzalez said he was then placed in solitary confinement for two weeks.
After Renteria-Gonzalez reported harassment from another officer, his complaint was dismissed as “unsubstantiated” and the officer came back and told him: “They can’t do nothing to me,” according to the complaint.
Meanwhile, Garcia-Valenzuela said he was repeatedly sent to solitary confinement, he believes in retaliation for speaking out. He said staff at the detention center falsely reported that he had attempted self-harm, and needed to be placed under suicide watch, even though he had not in fact tried to hurt himself.
At one point, while Garcia-Valenzuela was in the medical isolation unit, officers delivered him a meal that consisted of a few potatoes and a few grains of cereal. There was no spoon provided, he said, and there was a note that instructed him to eat it “like a dog”.
Shortly after that incident, he said, a doctor at the facility suddenly – without explanation – stopped providing him access to medication for hand pain that had been exacerbated by his working in Reyes’s night-shift program.
He has avoided making further complaints. He tries not to speak to or make eye contact with staff, and avoids leaving his dorm. He limits trips to the restroom, he said. And rather than go to the cafeteria to warm up his food and eat, he takes his meals cold, and dines in bed. “I have to stay in the back-most corner of my bed, and eat there,” he said.
“I don’t ever feel at ease.”
Trans people in federal custody under threat
The allegations of abuse at SLIPC come at a time when the health and safety of trans people in federal custody is especially under threat, advocates say.
On the first day of his presidency, Donald Trump unveiled a flurry of executive actions targeting trans rights, rolling back anti-discrimination protections and mandating that people in immigration detention be placed in facilities based on their sex assigned at birth.
On 16 January – the last day of Joe Biden’s administration – Ice reported that 47 trans people were in Ice detention facilities around the country and that 69 had been arrested since the start of the fiscal year. As soon as Trump took office, the agency began omitting data on the number of transgender people in immigration detention from its reports.
“The government is essentially refusing to acknowledge the existence of trans people, let alone their humanity,” Decker of RFK Human Rights said.
Although a federal judge has blocked enforcement of Trump’s ban on transgender healthcare in federal prisons, Decker told the Guardian that inside detention centers, guards and staff have been emboldened to deny healthcare to trans clients, or retaliate against them for requesting care.
“I worry that the situation will only get worse from here for trans people,” she added.
The administration also closed the civil rights division of the DHS, as well as the ombudsman office overseeing immigration detention, arguing that the staff in these congressionally mandated divisions were “internal adversaries that slow down operations”.
The divisions included employees tasked with regularly visiting detention centers, investigating complaints and preparing reports for Congress. Detainees facing discrimination, neglect and abuse now have even fewer options for recourse, Decker said.
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It’s a scary, difficult moment to speak out, said Campos-Flores, a 37-year-old single parent of two children who came to the US from El Salvador when they were 11 years old.
During the seven months that Campos-Flores was detained at SLIPC, they would call their parents every day, just to reassure them that they were still alive. Periodically, they would beg their family and their lawyer to find ways to get them out. “I asked them to try to book me into another facility,” they said. “It was too much – just too much.”
In November 2024, they were deported – and immediately they felt a sense of relief to be freed from Reyes, they said. But they couldn’t stay away from their children, who are US citizens – so they crossed back into the US and were again apprehended.
They are currently detained at a different correctional facility in Louisiana, serving a criminal sentence for illegal re-entry. But after finishing their sentence, it is likely they will be transferred back to SLIPC before deportation – and face the same officers who harassed them, or ignored their complaints.
“But I have my 12-year-old son. He is also gay, he likes boys, and I don’t want him to experience anything like what I have experienced,” they said. They want to fight for his rights, too, they said.
‘It is for my daughter and my family that I have endured everything that I have in this detention facility for the past 28 months.’ Illustration: Rita Liu/The Guardian
A Google Maps screenshot of the South Louisiana Ice Processing Center (SLIPC) in Basile, Louisiana.
Photograph: Google MapsA spokesperson for Geo categorically denied the allegations detailed in the complaints.
Photograph: Patrick T Fallon/AFP/Getty Images
Scottie's Playtime 