Spring’s warmer weather lures people outdoors – and into possible contact with ticks that spread Lyme disease.

Already, the 2026 tick season is booming. On April 23, the Centers for Disease Control and Prevention warned that emergency room visits due to tick bites are at their highest level since 2017. That may portend an especially severe season for Lyme disease and other tick-borne illnesses.

State health departments reported more than 89,000 cases of Lyme disease in 2023, the last year for which data is available. But public health experts believe that close to 500,000 people in the U.S. get Lyme disease every year.

As an infectious disease doctor with experience treating some of this infection’s long-term outcomes, I know that Lyme disease can be tricky because people often don’t notice tick bites and may overlook early symptoms of an infection. But left untreated, the infection can cause serious lingering – and even permanent – health issues.

Here’s what you need to know about Lyme disease to stay safe this season:

What causes Lyme disease?

Lyme disease, named after the Connecticut town where the disease was first identified in 1975, is caused by a group of bacteria called Borrelia – most often, the species Borrelia burgdorferi.

Deer ticks – also called black-legged ticks, and members of a group called Ixodes – transmit the disease after feeding on an infected animal, usually a bird, mouse or deer. When they then bite a person, they can transmit the bacteria into the person’s bloodstream.
Usually, the tick must attach for 24-48 hours to transmit the bacteria causing Lyme disease.

Where and when does Lyme disease occur?

Lyme disease can occur in most regions where deer ticks live.

These ticks are most active in late spring, summer and fall – usually April to November in most regions. They emerge when the temperature is above freezing. In years when winter is shorter, ticks can emerge earlier. And they may be active year-round in regions where freezing temperatures are rare.

Approximately 90% of U.S. cases are reported from states in the Northeast, mid-Atlantic from Virginia to eastern Canada, and Upper Midwest regions including Wisconsin, Michigan and Minnesota. A few cases occasionally pop up in California, Oregon and Washington.

Since 1995, the incidence of Lyme disease in the U.S. has almost doubled.

Warmer weather and changes in rainfall patterns now allow ticks to survive in new regions of the country – and for longer periods. But even in regions where ticks lived before, Lyme disease has become more common due to increases in deer populations. As woodland areas are increasingly being developed, it may be bringing the habitat of deer and mice closer to people, increasing the risk of transmission.

Lyme disease symptoms to watch for

Early symptoms of Lyme disease – fever, muscle aches and fatigue – generally emerge within three to 30 days after a tick bite. Another classic symptom in the first month is a target or bull’s eye rash at the site of tick bite, which occurs in about 70% to 80% of cases.

Other rashes following a tick bite can also occur. Some may be due to irritation from the bite, and not necessarily an infection.

If you know you’ve had a tick bite and experience flu-like symptoms – or if you see a bull’s-eye rash, whether you know you were bitten or not – it’s important to check with your healthcare provider about whether you should be treated with antibiotics.

A blood test for antibodies can help confirm the infection, but it can sometimes yield a false negative result, particularly in the first couple of weeks of the disease.

In most people, the rash goes away on its own. However, treatment may shorten its duration and is important for preventing other symptoms. A two- to four-week course of antibiotics can generally treat Lyme disease. Severe cases might require intravenous antibiotics.

A promising new vaccine for Lyme disease is currently being tested. In March 2026, Pfizer, the pharmaceutical company developing it, announced that in a late-stage study, the vaccine prevented the disease in 70% of people who received it.

Later Lyme symptoms

If left untreated, the bacteria that causes Lyme can spread, potentially causing longer-term symptoms. About 60% of people who get Lyme disease and don’t treat it can develop arthritis.

In rare cases, Lyme disease can also affect the heart and the nervous system. Inflammation in the brain or the tissues surrounding it, called meninges, can cause headaches and neck pain, as well as balance issues and memory and behavior changes. It can also cause nerve damage that results in numbness, tingling and muscle weakness.

These symptoms can appear right away or much later – sometimes months to years after infection. And in cases where the disease wasn’t promptly treated, late-stage symptoms can linger even after antibiotics kill the bacteria.

Scientists don’t fully understand why, but one intriguing study found that some particles from the bacteria’s cell wall leak into the joints and can persist after treatment, spurring ongoing inflammation and arthritis symptoms.

Another reason for Lyme’s long-term effects is that it can trigger autoimmune disease, which is when the immune system attacks its own cells. What’s more, because the nervous system may be particularly sensitive to damage caused by the bacteria and related inflammation, it may take an especially long time to heal. In some situations, the damage could be permanent.

Preventing Lyme disease

Until a vaccine becomes available, there are steps you and your family can take to help protect against Lyme disease:

• Use tick and insect repellents such as DEET and picaridin, which can be applied to skin, and permethrin, which is sprayed onto clothing, to keep ticks at bay. Treating clothing with permethrin may be especially beneficial, since the substance withstands several washes.

• Wear long-sleeve shirts and pants while you are gardening, hiking or walking through grass or woods to prevent tick bites. Wearing light-colored clothes makes ticks more visible, and tucking your pants into your socks can also prevent the little buggers from traveling from your pants, shoes and socks onto your legs.

• Remove your outdoor clothes immediately. Washing and drying clothes at high temperature can help kill any ticks that managed to hitch a ride. And a quick shower immediately after spending time outdoors can wash ticks off the skin before they have a chance to attach.

• If you spend time outdoors, perform daily tick checks, paying special attention to warm areas like your armpits, neck, ears and underwear line. If you find a tick attached, pull it off with tweezers, holding them perpendicular to the skin.

• If you find a tick that may have been on the skin for more than 36 hours, ask your healthcare provider whether a dose of preventive antibiotics – generally given within 72 hours of the bite – would be appropriate.

Lakshmi Chauhan receives funding from NIH.

Friends,

You can be Secretary of Defense (War) and cause the mightiest military in the world to be brought to its knees, and still keep your job in the Trump regime.

You can be in charge of public health and cause measles to reemerge as a major hazard to Americans, and still keep your job.

You can be illegally enriching yourself and your family as Commerce Secretary, and still keep your job.

But you’ll be fired for actively and unnecessarily getting bad press.

A few days ago, a senior White House official told Politico that FBI director Kash Patel’s bad press was “not a good look for a cabinet secretary” and had frustrated Trump. “It’s only a matter of time,” they said, before Patel is canned.

Like Kristi Noem, Pam Bondi, and Lori Chavez-DeRemer, Patel has been his own worse press agent.

He filed a $250 million defamation claim against The Atlantic magazine over its April 17 report claiming that his FBI colleagues were alarmed by his excessive drinking and unexplained absences. The report included claims that his security detail struggled to rouse him due to intoxication several times in the past year and that he drank heavily at a private club in Washington. Bureau employees expressed concerns that his behavior posed a threat to public safety.

I doubt it’s Patel’s excessive drinking and absences that are making Trump upset; it’s that they’re being reported, and that Patel has made them even bigger stories by suing The Atlantic over them.

Last week, Patel added to the drinking story when he erupted at NBC’s Ryan Reilly who asked Patel at a press conference whether, as The Atlantic also reported, he feared he had been fired when he was unable to log into his government computer.

“The problem with you and your baseless reporting is that is an absolute lie,” Patel shot back. “It was never said. It never happened. And I will serve in this administration as long as the president and the attorney general want me to do so.” Patel added, “you are off topic,” and “the answer to your question is you are lying.”

Worse yet, from Trump’s viewpoint, is that some of Patel’s drinking has been in the public eye. One video showed him drinking a beer, banging his fist on a table and celebrating with the US men’s hockey team at this year’s Winter Olympics in Italy.

Nothing gets Trump angrier than when one of his underlings is caught doing something stupid on videotape. After the video of Patel spread on social media, Trump called Patel to convey his discontent, Politico reported.

Soon after Patel sued the Atlantic, the New York Times reported that the FBI had been investigating Elizabeth Williamson. Williamson was the New York Times journalist who revealed that Patel had used a swat team to protect his country singer girlfriend, Alexis Wilkins, when she was invited to sing the national anthem at the annual convention of the National Rifle Association. And that Patel had “ripped into” the swat team’s commander when the team left after it became apparent there was no threat to her.

It’s not that Patel misused government funds on his girlfriend. Or that Patel exploded at the FBI swat team’s commander. Or even that Patel ordered an investigation of the journalist who reported this. No, it’s that all of this became a national story — twice. Such self-generated negative press infuriates Trump.

The same day that the Times reported on the FBI’s investigation of Elizabeth Williamson, NBC reported that a federal judge in Texas had tossed out a defamation case brought by Patel against former FBI assistant director-turned-MSNBC contributor Frank Figliuzzi. Patel had brought the case over Figliuzzi’s remark on “Morning Joe” that Patel had been “been visible at nightclubs far more than he has been on the seventh floor of the Hoover building.”

More self-generated negative press: Not that Patel has been doing the nightclub circuit and disregarding his job, but that he invited a story about it by suing Figliuzzi.

Similarly, it’s not that Patel has repeatedly wrongly accused people of federal crimes (announcing someone had been arrested for the murder of right-wing commentator Charlie Kirk when the real murderer hadn’t yet turned himself in, and that a person of interest had been detained in the Brown University shooting, only for that individual to be released hours later).

It’s that Patel’s wrong accusations were widely reported, making Patel — and, indirectly, Trump — look dumber than dirt.

Patel simply doesn’t know how to keep a low profile. Like so many others in the Trump regime, he made his name by promoting himself. As a frequent guest on right-wing programs before Trump appointed him FBI director, he pushed conspiracy theories about the “deep state,” the 2020 presidential election, and the January 6 Capitol attack.

But the occupant of the Oval Office doesn’t want his underlings engaging in self-promotion and vindictive lawsuits. If anyone’s going to be self-promotional and vindictive, Trump wants it to be himself.

Patel has been trying to win back Trump’s favor by escalating FBI investigations into Trump enemies. But so far, the investigations haven’t yielded adequate evidence to indict, another mark against him in Trump’s book.

A week ago Sunday, Patel promised that the Justice Department would soon make arrests related to the 2020 election, stating on Fox News’s “Sunday Morning Futures” that “We’ve got all the information we need, we’re working with our prosecutors at the Department of Justice under [acting] Attorney General Todd Blanche, and we are going to be making arrests, and it’s coming, and I promise you, it’s coming soon.”

Patel’s plea was obviously directed at Trump.

I doubt it will work. Patel will soon be locked out of his computer for good.

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On October 4, 1957, the Soviet Union launched Sputnik - and the United States lost its collective mind. Newspapers ran headlines about Soviet nuclear weapons raining from orbit, and schools held duck-and-cover drills. Eisenhower's approval rating cratered and the smartest people in Washington agreed that America had fallen behind, for good, the free world was in terminal decline, and their enemies were about to launch space-faring Nukes.

Then, eleven years and 8 months later, Neil Armstrong stepped onto the moon. One small step, etc.

Folks in 1957 had at least some reason to be afraid, and the fear was grounded in something real: you could measure the gap in rocket technology down to the pound of thrust. But the people who responded to that fear by building things (the Apollo program, the engineers who decided the problem was solvable) landed on the moon. The people who responded by predicting doom were forgotten before the decade was out.

I can't think of a better summary of the argument I'm trying to make here...

In the last 15 years, a specific kind of intellectual posture has taken hold everywhere. I've started calling it "competitive pessimism" - which might not be perfect, but it's the best I've got.

Whoever can list the most reasons something won't work gets treated as the smartest person in the room. If you say "I think this could go well," you get ~the look. That slight tilt of the head. Optimism is treated like a belief in astrology.

Pessimism reads as intelligence now.

Optimism reads as naivety.

This has gotten so baked into educated Western culture that most people don't notice they're doing it. But it's toxic, all the same.

Where this came from

The instinct has some logic to it, I'll be fair about that.

The 21st century opened with the dot-com crash, which wiped $5 trillion off the NASDAQ between March 2000 and October 2002. Then September 11th, and the Afghanistan War, and then the Iraq War. Then the 2008 financial crisis, which destroyed 8.7 million American jobs in eighteen months. Then Obama! And then Trump. Then a pandemic that killed over a million people in the US alone. Climate reports from the IPCC kept landing, each one worse. If you paid attention to any of this, bracing for impact started to look like base common sense.

The internet of course poured a gasoline on all of it. In 2012, Jonah Berger and Katherine Milkman at Wharton went through about seven thousand New York Times articles and tracked which ones readers actually emailed to their friends. The anxious // angry pieces won. The hopeful writing just sort of...sat there. The platforms didn't need an academic paper to work this out. Doom = clicks. Doom = ad revenue. Doom got you a booking on Joe Rogan. Pessimists built media empires, and optimists built water treatment plants in sub-Saharan Africa and nobody wrote a magazine cover about them.

Pessimism is useful and I won't be glib about that. You want a pessimist reviewing the specs on the I-35W bridge before it goes up. You want a pessimist reading your bloodwork. Risk assessment is a discipline that saves lives every single day. What happened over the last two decades is that risk assessment slid from being a discipline into being a disposition; worry stopped being something you ~did and became something you ~were.

And that's where the trouble started.

What the doomers predicted

In 1894, the Times of London published a calculation: at current rates of growth, the city's streets would be buried under nine feet of horse manure by the 1940s. The math was technically on the money: fifty thousand horses working in London at the time, each producing 15 to 35 pounds of dung per day, with a population growing...the arithmetic pointed one way.

What nobody at the Times knew was that Karl Benz, tinkering in a shop in Mannheim, had already patented a gasoline-powered vehicle eight years earlier. The car scaled up, the manure problem disappeared and a completely different set of problems showed up in its place.

Thomas Malthus did the same thing a century earlier, in his 1798 Essay on the Principle of Population. Population grows geometrically, food arithmetically, and therefore - famine is mathematically inevitable. He published this at the start of the Agricultural Revolution. Paul Ehrlich doubled down in 1968: "The battle to feed all of humanity is over," he wrote on page one of The Population Bomb, "In the 1970s hundreds of millions of people will starve to death."

Well, food production tripled instead.

Peak oil in 2005, same story; the doomsday logic was always internally consistent. The world just did not cooperate.

I know I'm cherry-picking here. Listing reversals is easy. Plenty of problems didn't get fixed. Plenty of hopeful people were dead wrong. But the doomers were also wrong, and the doomers didn't build anything while they were busy ~being wrong.

The optimists who failed at least generated attempts.

This is the asymmetry I keep snagging on.

Why it feels smart to be grim

In 1984, a psychologist at Berkeley named Philip Tetlock started cornering experts at conferences and asking them to make specific, testable predictions.

• Would the Soviet Union collapse within five years?
• Would inflation top 6%?

He accumulated tens of thousands of these forecasts from 284 political scientists, economists, and government advisors, and after twenty years he scored them all against reality. Most of the experts performed about as well as "dart-throwing chimpanzees" -- Tetlock's line, not mine. The very worst forecasters were the folks with One Grand Theory™️ who bent all incoming data to fit it.

Nobody puts the careful, uncertain forecasters on television.

"I see arguments on both sides and I'm not confident" doesn't fill a segment.

This is an ongoing complaint of mine.

And then there's the reputation factor. If you predict a catastrophe and you're wrong, nobody circles back to check - and your wrong call just dissolves. If you predict things will work out and they don't, that shit follows you around forever. The lopsidedness of the payoff alone is enough to push smart, careful people toward the darkest possible forecast even when the evidence is genuinely mixed.

Being wrong about doom costs you nothing.

Being wrong about hope costs you your career.

Hope as a decision

Cornel West split optimism and hope into two separate things...

• Optimism is a spectator sport, in his framing. You watch the data and decide whether the trend lines look good.
• Hope is a commitment to act as though improvement is possible, because without that commitment you guarantee it isn't. Nobody serious is claiming things will get better on their own. In fact, things can only get better if enough people act as though they might.

Every hospital that got built started with someone saying "we can treat those people." Every civil rights movement and every vaccine that reduced suffering began with someone who looked at a bad situation and decided to treat it as a problem to solve, and a problem that ~could be solved.

"What about the problems that didn't get solved? What about the optimists who were wrong?"

Well, what about them?

The optimists who were wrong still attempted something.

The pessimists who were right attempted nothing.

And the world runs on attempts, not on accurate // profound predictions of failure.

The permanent bracing costs

At the University of Pennsylvania, Martin Seligman spent decades studying what he called "learned helplessness." He found that people who explain bad events as permanent and personal, baked into the fabric of reality, are more likely to become depressed and less likely to keep trying. I should know. That about accurately describes my emotional state for most of my 20's.

The cultural pessimism that passes for intelligence has the same structure - if your default explanation for every problem is "systems are broken and people are selfish, so nothing will ever be different," you've adopted a worldview that is indistinguishable from despair, and you might call it realism but it produces the same behavior as hopelessness.

When pessimism becomes the default in public conversation, it starts building the world it claims to be describing. People who believe nothing can be different don't vote, don't volunteer, don't start companies, don't run for office, don't build the thing that might have mattered.

Pessimism at scale is a self-fulfilling prophecy.

Rebecca Solnit put it well in Hope in the Dark: "Hope is not a lottery ticket you can sit on the sofa and clutch, feeling lucky. It is something you do."

The stubborn, irrational case

In 1903, Simon Newcomb - a professor of mathematics at Johns Hopkins and probably the most credentialed scientist in the country - wrote a widely-read essay arguing that powered heavier-than-air flight was a practical impossibility. And on December 17 of that same year, Wilbur and Orville Wright flew four times at Kitty Hawk. The longest flight lasted 59 seconds and covered 852 feet. Newcomb never revised his position.

Pessimism is more accurate in the short term - almost always, I'll give it that. Things do go wrong in roughly the ways people predict they will. But optimism is more productive over decades. Optimism is the thing that generates attempts, and without attempts nothing changes.

Blind cheerfulness ignores evidence, crashes planes, builds the Humane AI Pin and bankrupts companies. Nobody wants that. But the choice to look at bad data and act anyway, because sitting still is the one move that guarantees the bad outcome, is a noble one.

The most dangerous idea I keep running into is that there is nothing to be done. It's the one idea that, if enough people hold it, comes true - and I refuse to treat that as a serious intellectual position. I refuse to let Quiet Quitting become the dominant intellectual model of our age.

I would rather be wrong about what we're capable of than right about why we shouldn't bother trying...

Friends,

The Justice Department has just launched a criminal investigation of Cassidy Hutchinson. Remember her?

Hutchinson was the young, courageous former White House aide whose testimony before Congress implicated Trump in the violence that erupted at the Capitol on January 6, 2021.

Not surprisingly, her testimony enraged Trump. So, the Justice Department is now accusing Hutchinson of having lied to Congress, which is a criminal offense.

It’s just the latest example of Trump’s vindictive and perverse use of the Justice Department to go after people he perceives to be his enemies.

Who’s been assigned to carry out this vicious investigation? Not anyone in the criminal division, which you might expect would have expertise in pursuing a criminal case. No, Todd Blanche, the acting attorney general, has assigned the case to the Civil Rights Division, which in normal times focuses on civil rights abuses like police misconduct and racial discrimination.

Blanche has given the case directly to Harmeet Dhillon, who runs the Civil Rights Division. Dhillon, an unblinking Trump loyalist, has emerged as an effective advocate for Trump’s agenda.

She’s also reputedly on the shortlist to be Trump’s next attorney general.

So, what do we know about Harmeet Dhillon?

Although she’s taken on the investigation of Cassidy Hutchinson, in January Dhillon refused to investigate the killing of Renee Good by an ICE agent in Minneapolis.

Dhillon’s decision not to investigate Good’s killing marked a sharp departure from past Civil Rights Division chiefs, who have always moved quickly to probe shootings of civilians by law enforcement officials.

Four senior DOJ civil rights officials resigned over Dhillon’s refusal to investigate.

Dhillon also refused to assign civil rights attorneys to investigate the subsequent Minneapolis shooting death by two federal agents of Alex Pretti. Instead, she tapped a lawyer who handles civil investigations involving workplace discrimination.

Yet a few weeks after Good’s killing, Dhillon took on the investigation of a group of people (including journalist Don Lemon) who had protested Good’s shooting by disrupting a service at Cities Church in St. Paul, Minnesota.

The protesters had targeted the church because a pastor there, David Easterwood, was identified as the local ICE field office director.

Dhillon characterized the disruption as a “desecration of a house of worship” and therefore a violation of federal civil rights laws. By April, nearly 40 people faced federal charges in this case of conspiracy against the right of religious worship.

Dhillon has also been the force behind condemning universities for allowing what she deems “antisemitic” protests — and withholding research funding unless they agree to explicit measures supposedly to prevent antisemitism.

Last summer, the The New Yorker published an extensive piece on Dartmouth College titled “How Dartmouth Became the Ivy League’s Switzerland,” claiming that Dartmouth President Sian Beilock had successfully avoided Dhillon’s ire — and the federal funding cuts that have threatened Harvard and Columbia — by adopting a “neutral” position on Trump’s attempt to take greater control of higher education.

Dhillon calls Dartmouth “one of the good guys” in higher education. (Rather than neutral Switzerland during World War II, a more accurate analogy for Dartmouth’s response to Trump under Beilock would be Britain under Neville Chamberlain, who appeased Hitler.)

I was a Dartmouth trustee in the 1980s when its president, James O. Freedman, who was Jewish, endured the antisemitic barbs of an ascendant right-wing student group headed by Dhillon, then a Dartmouth student. (Other members included Laura Ingraham and Dinesh D’Souza.)

In 1988, Dhillon, as editor of The Dartmouth Review, published a column depicting Freedman as Adolf Hitler under the headline “Ein Reich, Ein Volk, Ein Freedmann” — a play on a Nazi slogan, “One Empire, One People, One Leader,” but substituting and misspelling Freedman’s name for “Fuhrer.”

Using the analogy of Nazi Germany and the Holocaust, the column satirically described how “Der Freedmann” and his associates rid the campus of conservatives. The column referred to the “‘Final Solution’ of the Conservative Problem” and to “survivors” of the Dartmouth “holocaust” and described Dartmouth conservatives being “deported in cattle cars in the night.”

A drawing on the cover of the following issue of Dhillon’s Dartmouth Review also depicted Freedman, who had been critical of The Review, as Hitler.

I saw how much Dhillon’s publication hurt Freedman. As a Jew, he not only felt personally attacked but also worried about the effects of Dhillon’s publication on Jewish students at Dartmouth.

Granted, this was 1988. Dhillon’s history of publishing such antisemitic crap doesn’t necessarily cast her recent crusade against campus antisemitism as hypocritical. It’s possible that her undergraduate escapade into antisemitism caused her such remorse that she subsequently experienced a conversion of sorts and became committed to ridding universities of similar acts of bigotry.

But nothing in her history after Dartmouth or her official biography suggests such a conversion. The most probable explanation for her turnaround is simple ambition.

Dhillon grabbed the opportunity to become assistant attorney general in charge of civil rights and agreed to use the charge of antisemitism as a weapon to carry out the Trump regime’s war on prestigious universities — not because they’re hotbeds of antisemitism, but because the authoritarian right considers them hotbeds of leftist ideology.

JD Vance said in a 2021 speech titled “The Universities are the enemy,” that “we have to honestly and aggressively attack the universities in this country.” He never mentioned antisemitism.

Dhillon admits that her overall vision is not just slowing down civil rights in America but “turning the train around and driving in the opposite direction,” as she told the conservative Federalist Society after her appointment as head of the division.

She has eliminated federal oversight of police departments accused of discrimination, once the centerpiece of the Civil Rights Division’s work.

She has directed universities to end all types of affirmative action, once defended by the Civil Rights Division.

She is now suing states to acquire voter databases in an effort to disenfranchise minority voters. The Civil Rights Division once existed to protect their voting rights.

Harmeet Dhillon is no advocate for civil rights. She’s a legal hack for Trump’s cruel agenda of attacking Americans trying to stop ICE and Border Patrol agents from doing their worst, of seeking to destroy academic freedom in American universities in favor of Trump’s narrow view of what should be allowed, of undermining equal opportunity for people of color, and of prosecuting anyone — like Cassidy Hutchinson — with the courage and integrity to stand up against Trump’s despotism.

Harmeet Dhillon is the last person who should be running the Civil Rights Division of the Justice Department. She should never become attorney general — which means Trump will probably nominate her.

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A California company has recalled more than 3.1 million bottles of lubricating eye drops because it had not properly tested – and thus could not prove – whether the products were sterile.

These products are sold under several names at major retailers across the country. The company, K.C. Pharmaceuticals, initiated the recall on March 3, 2026.

I am a clinical pharmacologist and pharmacist who has assessed risks of poor-quality manufacturing practices and lax oversight for prescription drugs, eye drops, dietary supplements and nutritional products in the United States for many years. This recall is very large, potentially affecting over a million people. Using nonsterile eye drops that harbor bacteria and fungus can cause eye infections, which can become severe because the immune system has a hard time accessing the eyeball and fighting the microbes.

This is not the first time that a major recall has occurred in the eye drop market – and it is the second time since 2023 that the Food and Drug Administration has become aware of sterility issues at K.C. Pharmaceuticals.

Multiple products affected

Eight products are being recalled: Dry Eye Relief Eye Drops, Artificial Tears Sterile Lubricant Eye Drops, Sterile Eye Drops Original Formula, Sterile Eye Drops Redness Lubricant, Eye Drops Advanced Relief, Ultra Lubricating Eye Drops, Sterile Eye Drops AC and Sterile Eye Drops Soothing Tears.

These products are sold under different company names, including Top Care, Best Choice, Good Sense, Rugby, Leader, Good Neighbor Pharmacy, Quality Choice, Valu Merchandisers, Geri Care, Walgreens, CVS and Kroger.

Their expiration dates range from April 30, 2026, to Oct. 31, 2026. They were sold at stores including Walgreens, CVS, Rite Aid, Kroger, Harris Teeter, Dollar General, Circle K and Publix.

If you purchased an eye drop product since April 2025, check to see whether the name matches any of these. If it does, go to the FDA site, where you can see the exact lot numbers and expiration dates for those products.

How to tell whether your eye drops were recalled

You can determine whether your eye drop product is part of the recall by looking at two columns in the table. Column 2 of the table lists the names of the products, with one name per row. Column 5 provides the specific lot numbers of the affected products and their expiration dates. For example, recalled Sterile Eye Drops AC products – row 1, column 2 – have the lot number AC24E01 with an expiration date of May 31, 2026, listed in row 1, column 5.

If the product you purchased has the same name but a different lot number or expiration date than the ones listed on the FDA website, it is not subject to this recall and you can safely keep using it. If you find your product has been recalled, stop using it and bring it back to the store for a refund.

The FDA has not received reports of any infections as of early April. However, if after using one of these recalled products you experience redness in your eyes, eyelids stuck together, unusual eye discharge such as goo or pus, vision changes, eyelid swelling or eye pain itchiness or irritation, these symptoms could be due to an eye infection.

If you experience these symptoms, seek medical attention – and also, if possible, report your symptoms to the FDA.

A history of eye drop sterility issues

The FDA has many important public health roles: approving new drugs and medical devices; overseeing the manufacturing quality of prescription and over-the-counter drugs, dietary supplement and food products; and protecting the public from counterfeit medications.

With its limited personnel, the agency focuses its time on areas where the risks are greater. This means manufacturers of more dangerous products, or product types that were previously found to have issues, are inspected more frequently.

The FDA had inspected over-the-counter eye drop manufacturers only a few times before 2023, when cases of rare eye infections due to a drug-resistant Pseudomonas bacteria strain started occurring.

In total, 81 people from 18 states developed severe eye infections during the 2023 outbreak. Fourteen people experienced vision loss because of the product, an additional four people had their eyeballs removed and four people died.

The agency identified two products as the culprits: Global Pharma’s EzriCare Artificial Tears and Delsem Pharma’s Artificial Tears and Eye Ointment.

Later in 2023, the FDA issued recalls for Dr. Berne’s, LightEyez Limited, Pharmedica LLC and Kilitch Healthcare eye drop products for sterility issues. Kilitch Healthcare had serious quality lapses, in which the facility was filthy, employees were barefoot on the manufacturing floor and the company fraudulently passed products that failed sterility tests.

Repeated manufacturing problem

At the time, the FDA also inspected K.C. Pharmaceuticals and issued the company a warning letter. The FDA was concerned that the manufacturer failed to establish and follow appropriate written procedures designed to prevent microbiological contamination.

Although the agency did not request a recall, it did ask that the company immediately change its protocols and consult outside experts to prevent these issues from recurring.

The current massive recall of K.C. Pharmaceuticals’ eye drop products suggests lingering quality control issues in the manufacturer’s Pomona, California, plant that need to be urgently addressed. If the company had heeded the FDA’s recommendations, it would have detected the nonsterility issue before so many batches of the products were manufactured.

C. Michael White does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Defense Secretary Pete Hegseth’s conservative evangelical religious beliefs drew attention even before his confirmation hearings in January 2025. He is a member of the Communion of Reformed Evangelical Churches – CREC – whose beliefs have been influenced by a 20th-century movement called Christian Reconstructionism.

Many CREC leaders call for the implementation of biblical law and a theocratic state structured on Christian patriarchy. Theocratic states are ruled according to religious laws, which in the case of the CREC means a conservative evangelical understanding of Christianity.

The CREC website claims to have over 160 churches and parishes spread across North America, Europe, Asia and South America.

Hegseth’s use of religious language and prayers has raised questions about his religious beliefs in relation to his role as secretary of defense. At a prayer service on March 25, 2026, during the current war in Iran, Hegseth said, “Let every round find its mark against the enemies of righteousness and our great nation.” He went on to add: “Give them wisdom in every decision, endurance for the trial ahead, unbreakable unity, and overwhelming violence of action against those who deserve no mercy.”

As a scholar of the Christian right, I have studied the CREC. To understand Hegseth’s rhetoric, it is helpful to understand what the CREC is and its controversial leadership.

What is the CREC?

The CREC church is a network of churches across the globe. It is associated with the congregation of Doug Wilson, the pastor who founded Christ Church in Moscow, Idaho. Christ Church is the flagship church of the CREC and operates as a denominational headquarters. Wilson grew up in the town, where his father was an evangelical minister.

Wilson co-founded the CREC in 1993 and is the public figure most associated with the network of churches. Christ Church operates as the hub for Logos Schools, Canon Press and New Saint Andrews College, all located in Moscow.

Logos is a set of private schools and homeschooling curriculum; Canon Press is a publishing house and media company; and New Saint Andrews College is a university. All of these were founded by Wilson and associated with Christ Church. All espouse the view that Christians are at odds with – or at war with – secular society.

While he is not Hegseth’s pastor, Wilson is the most influential voice in the CREC, and the two men have spoken approvingly of one another.

Hegseth invited Wilson to give a prayer service at the Pentagon in February 2026. Wilson told the assembled military members, “If you bear the name of Jesus Christ, there is no armor greater than that. Not only so, but all the devil’s R&D teams have not come up with armor-piercing anything.” In other words, Wilson tied the success and safety of military members and their missions to a belief in Jesus Christ and the military’s enemies as agents of the devil.

As Wilson steadily grew Christ Church in Moscow, Idaho, he and its members sought to spread their message by making Moscow a conservative town and establishing churches beyond it. Of his hometown, Wilson plainly states, “Our desire is to make Moscow a Christian town.”

The CREC doctrine is opposed to religious pluralism or political points of view that diverge from its theology. On its website, the CREC says it is “committed to maintaining its Reformed faith, avoiding the pitfalls of cultural relevance and political compromise that destroys our doctrinal integrity.”

CREC churches adhere to a highly patriarchal and conservative interpretation of Scripture. Wilson has said that in a sexual relationship, “A woman receives, surrenders, accepts.”

Church-state separation

In a broader political sense, CREC theology includes the belief that the establishment clause of the Constitution does not require a separation of church and state. The most common reading of the establishment clause is that freedom of religion prohibits the installation of a state religion or religious tests to hold state office.

According to scholar of religion Julie Ingersoll, in this religious community there is “no distinction between religious issues and political ones.”

The CREC broadly asserts that the government and anyone serving in it should be Christian. For Wilson, this means Christians and only Christians are qualified to hold political office in the United States.

‘Church planting’

Scholar of religion Matthew Taylor explained in an interview with the Nashville Tennessean, “They believe the church is supposed to be militant in the world, is supposed to be reforming the world, and in some ways conquering the world.”

While the CREC may not have the name recognition of some large evangelical denominations or the visibility of some megachurches, it boasts churches across the United States and internationally.

Like some other evangelical denominations, the CREC uses “church planting” to grow its network. Planted churches do not require a centralized governing body to ordain their founding. Instead, those interested in starting a CREC congregation contact the CREC. The CREC then provides materials and literature for people to use in their church.

CREC controversies

As the church network has grown, it has drawn attention and scrutiny. In 1996, Wilson published a book positively depicting slavery and claiming slavery cultivated “affection among the races.”

Accusations of sexual abuse and the church’s handling of it have also brought national news coverage. Vice media’s Sarah Stankorb interviewed many women who talked about a culture, especially in marriage, where sexual abuse and assault was common. That reporting led to a podcast that details the accounts of survivors. In interviews, Wilson has denied any wrongdoing and said that claims of sexual abuse would be directed to the proper authorities.

Hegseth’s actions in May and June of 2025 as secretary of defense concerning gender identity and banning trans people from serving in the military, in addition to stripping gay activist and politician Harvey Milk’s name from a Navy ship, brought more attention to the CREC.

Hegseth’s religious rhetoric

As the Trump administration engages in military conflicts around the globe, Hegseth often uses religious language to justify them.

In a March 5, 2026, speech to South American and Central American leaders, Hegseth justified intervention in Venezuela, the blockade of Cuba and the attacks on boats across the region by invoking a shared Christian identity.

Hegseth said, “We share the same interests, and, because of this, we face an essential test – whether our nations will be and remain Western nations with distinct characteristics, Christian nations under God, proud of our shared heritage with strong borders and prosperous people, ruled not by violence and chaos but by law, order, and common sense.”

Hegseth’s comments about Iran since bombing began on Feb. 28 have also invoked religion. Some of these invocations align with Hegseth’s recurring references to the Crusades in the Middle Ages – a centuries-long holy war between Christians and Muslims. Hegseth has a tattoo that says “Deus Vult” – “God wills it” – the rallying cry of Crusaders, another with the Arabic word for infidel, and the Jerusalem cross, a prominent Christian nationalist symbol. He also published a book titled “American Crusade.”

In framing the use of overwhelming force in Iran, Hegseth said, “We’re fighting religious fanatics who seek a nuclear capability in order for some religious Armageddon.”

As long as Hegseth remains the secretary of defense, his affiliation with the CREC and religious language will likely provide insight into how these conflicts are managed at home and abroad.

This is an updated version of a piece first published on June 20, 2025.

Samuel Perry does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.