The Brief

The Food and Drug Administration says it is removing the black box safety warnings from all hormone therapy creams, pills and other treatments prescribed to ease the symptoms of menopause and perimenopause.

The prominent warnings said these therapies could raise the risks for some cancers, dementia, heart attacks and strokes. That, FDA Commissioner Marty Makary told CBS News' Norah O'Donnell, scared women from using drugs that could in fact improve their health.

"We now have a more nuanced understanding, and we want to put that fear machine in its proper context and let people know that there are tremendous long-term health benefits," Makary said.

The FDA convened an expert panel in July to discuss removing them from at least low-dose vaginal estrogen. The agency then opened a docket to solicit comments from the public and received nearly 3,000 by the Sept. 24 deadline.

In its formal comment, the American College of Obstetrics and Gynecology, or ACOG, wrote that it has "long encouraged" the agency to reevaluate warning labels on low-dose estrogen products administered vaginally, but it considers those separate from systemic estrogen products that deliver the hormone throughout the body, such as pills and patches.

Doctors had gone back and forth about the risks versus benefits of hormone replacement therapy for years. In 2002, researchers rang the alarm about them because a long-term study called the Women's Health Initiative found that hormone therapy was associated with increased risk of cancer and stroke. Since then, additional research has shown those risks were overstated, and the therapy can instead reduce heart disease when prescribed earlier.

Although doctors have pushed to have the black box warnings removed, they say the special panel the FDA convened in July deviated from the usual process for making such changes and lacked the rigor of the usual approach.

"While we appreciate the FDA Expert Panel's interest in reevaluating the label warnings on hormone therapy, a brief panel such as the two-hour July 17th Expert Panel should not be considered an adequate substitute for an advisory committee meeting," ACOG wrote in its formal comment to the agency.

FDA advisory committees are made up of independent experts who evaluate scientific presentations, discuss and debate the evidence on a given topic and then vote on recommendations for the FDA. The agency doesn't always follow its committees' recommendations, but it usually does.

"Forgoing the advisory committee process runs counter to the Agency's stated goal to increase transparency." ACOG writes. "Therefore, ACOG urges the FDA to delve deeper into the benefits of low-dose vaginal estrogen for [genitourinary syndrome of menopause] GSM and systemic estrogen therapy for vasomotor symptoms by convening separate advisory committee meetings, including opportunities for public engagement, before making decisions on possible labeling changes for these distinct menopausal hormone therapy options."

In an email to NPR, the agency shared several studies in support of its decision. The studies showed that these hormone therapies reduced the risk of Alzheimer's disease, heart attack and hip fracture. The findings aren't new, however, and were published between 1980 and 1996. The agency also cited an analysis of 30 studies from 1966 through 2003 that showed starting hormone replacement therapy earlier could save lives. It was published in 2004.
Copyright 2025 NPR

Two months past a statutory deadline, California’s top fire safety regulator published a report Monday on whether and how the state should legalize mid-rise apartment buildings with a lone staircase.

If this doesn’t sound like riveting news, you may have missed the brewing battle between pro-housing advocates and firefighting professionals over the cause of “single-stair reform” and whether America’s fire-averse building standards are standing in the way of more affordable, higher quality urban living.

The report, published by the Office of the State Fire Marshal, takes a fairly dim view of the “single stair” cause, but offers a few policy recommendations to state legislators should they move forward with the idea anyway.

At least one Democratic legislator appears intent on doing just that with legislation aimed at rewriting the state building code.

In California, as in much of North America, apartment buildings over three stories are required to have at least two staircases. This rule is meant to give residents multiple ways out in the event of a fire. But a coalition of Yes in my Backyard activists, architects and urbanists argue that much of the world does just fine with single-stair apartment blocks and that the state’s restrictive stairwell regs make it more difficult and costly to build modestly sized apartments on small city parcels.

Though modern safety measures, such as automatic sprinkler systems, smoke detectors and self-closing doors reduce the risks associated with smoke and flame, they “do not fully substitute for the redundancy of two independent stairway” which “is important for maintaining safety in the face of unforeseen failures,” the report read.

If state lawmakers opt to change the law anyway, the report recommended that single-stair apartment buildings max out at four stories, rather than three, and that they be subject to additional safety rules. The state should not consider going up to six stories — the current standard in New York City, Seattle, Honolulu and Culver City — without a second fire marshal study, the report concluded.

In its section on financial implications, the report also evaluated three mid-rise apartment projects and found that a second staircase made up between 7.5% and 12% of estimated total construction costs.

Though the findings mirror those contained in an earlier draft of the report CalMatters obtained in February, they came as a disappointment to some supporters of looser staircase requirements.

“As to be expected from this group,” said Bubba Fish, the Culver City councilmember who spearheaded that city’s single stair ordinance last year, in a text message. He called the four story max “ridiculous,” noting that even with that modestly relaxed requirement, California’s building code would remain out of step with much of the world.

The report is more than two months tardy, missing the January 1 deadline set by a 2023 bill authored by Milpitas Democratic Assemblymember Alex Lee.

Lee said that his office was still reviewing the report’s findings late Monday afternoon. But in a written statement, he expressed enthusiasm for future changes to the building code.

“Stairway requirements can have a profound effect on what does and does not get built in our neighborhoods, Lee said. “With the development of modern fire mitigation measures, it is critical that we re-evaluate our building codes and unlock previously undevelopable properties to build more housing."

Last month, Lee introduced a bill with the express intent of allowing “housing buildings with 4 or more stories to have a single stair entry and exit,” but which so far includes no additional detail.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

The United States evacuated diplomats as attacks intensified across the Middle East, with drones striking the U.S. Embassy in Saudi Arabia, while President Trump signaled the conflict with Iran could turn into an extended war.

Israel said it sent ground forces across the border into southern Lebanon and bombed Beirut suburbs as fighting with the Iran-backed group Hezbollah resumed after more than a year.

The U.S. and Israel kept up their attacks in Iran, where the death toll rose Tuesday to 787 people, according to the Iranian Red Crescent Society. Explosions were heard in Iran's capital of Tehran and other parts of the country.

Trump said Monday that the war could last four to five weeks, but could go longer than that.

In a social media post, Trump said that the U.S. had a "virtually unlimited supply" of munitions. "Wars can be fought 'forever,' and very successfully, using just these supplies," Trump wrote.

Israeli Prime Minister Benjamin Netanyahu told Fox it would not lead to an "endless war."

The war has so far killed six U.S. service members, according to the Pentagon, which warns that more casualties are expected.

Ten people in Israel have died since Iran began retaliating with missile attacks there.

Here are more of the key updates NPR is reporting on.

To jump to specific areas of coverage, use the links below:

U.S. Embassies | Americans evacuate | Lebanon | U.S.-Israeli strikes on Iran | Strait of Hormuz | Global natural gas

U.S. Embassy in Saudi Arabia hit

The U.S. Embassy in Saudi Arabia Tuesday urged Americans to avoid the compound after the Saudi Defense Ministry said the diplomatic post had been attacked by two drones.

Saudi Arabia's Foreign Ministry called it "a flagrant Iranian attack" in the Saudi capital of Riyadh.

There were no immediate reports of injuries. The Defense Ministry said the drone strikes caused "limited fire and minor damage" to the U.S. Embassy.

The State Department has ordered evacuations of diplomatic missions in several Middle Eastern countries.

This comes after an Iranian attack on the U.S. Embassy in Kuwait on Monday. The embassy said on social media Tuesday that it was closing until further notice.

In Jordan, the State Department said Tuesday it had evacuated its large embassy in the Jordanian capital Amman after threats against it.

Iran has been striking Gulf countries like the United Arab Emirates that are normally considered safe in retaliation to U.S. attacks that started Saturday. Iran has also hit commercial targets after warning that it would attack American interests across the region.

Amazon said Monday that two of its data centers in the UAE and one of its centers in Bahrain were hit by drones, affecting their operations.

— Jane Arraf and Hadeel Al-Shalchi

Americans urged to leave several countries

The State Department urged Americans to leave more than a dozen countries and territories in the Middle East because of the conflict, even as options to leave narrowed with flight cancellations and airport closures.

Americans need to "DEPART NOW from the countries below using available commercial transportation, due to serious safety risks," Mora Namdar, the State Department's assistant secretary for consular affairs, said in a post on X.

The countries and areas included:

• Bahrain
• Egypt
• Iran 
• Iraq
• Israel 
• Jordan 
• Kuwait 
• Lebanon
• The West Bank and Gaza 
• Oman
• Qatar
• Saudi Arabia 
• Syria 
• United Arab Emirates
• Yemen
  

— Ayana Archie

Israel resumes strikes in Lebanon, targeting Hezbollah

The Israeli military said soldiers were "operating in southern Lebanon" as it continues strikes against Hezbollah, including in the Lebanese capital.

Israel and Lebanon signed a ceasefire in November 2024 but Israel has continued almost daily strikes since then. Iran-backed Hezbollah had refrained from attacks until Sunday, when it launched strikes in retaliation for the killing of Iranian Supreme Leader Ayatollah Ali Khamenei.

The Israeli military said Tuesday it targeted what it called Hezbollah command centers and weapons storage facilities in Beirut's southern suburbs.

"Let me be clear: this is not a ground maneuver into Lebanon. It is a tactical step to create an additional layer of security for the residents of northern Israel," said Israeli military spokesperson Lt. Col. Nadav Shoshani describing the Israeli troop movements.

Thousands of Lebanese streamed out of Dahya, the suburb where Hezbollah, a political party as well as paramilitary group designated a terrorist organization by the U.S. and some other Western countries, is based.

They joined what the government says are at least 30,000 Lebanese fleeing Israeli strikes in south Lebanon and in Beirut. Shelters were so over-crowded some families resorted to laying out blankets on sidewalks of the corniche, Beirut's sea-side.

The Lebanese government says 52 people have been killed in Israeli airstrikes since Saturday.

— Jane Arraf

U.S. and Israel continue to strike Iran

In the Iranian capital, residents heard the sound of explosions overnight. There were no immediate reports of what had been hit.

Israel's military said it struck Iran's intelligence ministry and state broadcaster. The Israeli authorities also said that they are now focusing on targeting Iran's missiles and launchers.

Iranian missile strikes on Israel have significantly decreased. Israel says Iran may be rationing munitions gearing up for a long war.

An official in the region who spoke on condition of anonymity tells NPR Israel thinks it can achieve its war goals in two weeks total. Israeli officials say they want to create the conditions for Iranians to topple their government.

In Iran's southern city of Minab, a mass funeral was held for 165 people — most of them young girls — killed in an attack on a girls school Saturday. Many of the bodies had been buried under rubble.

The U.S. military said it was looking into reports of missiles hitting the school. The Israeli military said it was unaware of its forces operating in the area.

Some in the large crowd attending the funeral chanted "Death to America," "Death to Israel" and "No surrender."

Iran's Red Crescent Society said Tuesday at least 787 people have been killed in attacks on 153 cities across the country.

Ten people have been killed in Israel since the start of the conflict, according to Israeli officials.

— Daniel Estrin and Jane Arraf

Iran says it closed the Strait of Hormuz

Iran continued to threaten ships near the Strait of Hormuz, the narrow waterway vital to Gulf oil exports.

"The Strait of Hormuz is closed. Anyone who wants to pass, our devotee heroes in the IRGC navy and the army will set those ships on fire," security official Brig. Gen. Ebrahim Jabbari, said Monday. "Don't come to this region."

In a sign of the vast repercussions of the war, Japan's Foreign Minister Toshimitsu Motegi told an Iranian envoy that Iran must reopen the waterway.

Global natural gas supplies greatly reduced

In addition to the effect of the closure of the Strait of Hormuz on oil supplies, about 20% of the world's liquified natural gas, or LNG, is shipped through the Strait. On land, Iranian strikes hit Ras Laffan, the world's largest LNG export plant in Qatar. State-owned QatarEnergy says it has shut down LNG production.

Many countries are somewhat insulated from the disruptions in oil flows because they have oil in strategic reserves. But natural gas is a different story, says Anne-Sophie Corbeau,  a global research scholar at the Columbia University's Center on Global Energy Policy. Gas storage levels are particularly low because it's the end of winter.

" This is absolutely massive," Corbeau says. "It's going to impact everybody who is importing LNG."

Oil prices have risen since trading opened Monday, and so have natural gas prices in Asia and Europe. Energy experts say that higher gas prices and reduced LNG flows out of the Persian Gulf is highly profitable for LNG exporters elsewhere, including in Australia, Indonesia, Malaysia and the U.S. The U.S. is the biggest exporter of LNG and is set to open a new LNG terminal in Texas soon.

— Julia Simon

Jane Arraf and Hadeel Al-Shalchi reported from Amman, Jordan; Daniel Estrin reported from Tel Aviv, Israel; Ayana Archie from Washington; Julia Simon from San Francisco.
Copyright 2026 NPR

This first week of March will bring warm temperatures, plenty of sunshine and some windy conditions.

Coastal communities will wake up to some morning low clouds, even some patchy fog, followed by afternoon sunshine. Temperatures at L.A. County beaches will reach 67 to 72 degrees, but hover around the low 60s for Orange County beaches. Most of the region, including downtown L.A., should see highs in the low to mid 70s.

Valley communities and the Inland Empire will see highs mostly in the upper 70s, and up to 81 degrees in the western San Fernando Valley.

In Coachella Valley, the highs today are expected to reach up to 88 degrees.

As the cost of living continues to pinch Californians, state lawmakers have a new focus: bringing down the cost of housing construction to get more homes built quickly.

Their solution, so far, is to industrialize the building process by facilitating prefab, modular and manufactured housing. Earlier this year, a group of California lawmakers held a series of hearings as part of the Select Committee on Housing Construction Innovation to understand what barriers stand in the way of scaling up factory-built construction.

It comes after lawmakers last year passed a series of bills that streamlined environmental reviews for housing developments and transformed the way housing is built near transit.

“A key piece of making housing more affordable is bringing down the cost of construction,” Committee Chair and Assemblymember Buffy Wicks (D-Berkeley) said in a statement to KQED. “Factory-built housing is not a silver bullet, but it can be part of the solution to our housing crisis.”

A report, published Monday, from UC Berkeley’s Terner Center for Housing Innovation, found factory-built housing, also known as prefab and manufactured housing, could cut costs by up to 20% and slash building timelines in half — a key innovation needed to ramp up construction and meet the state’s goal of building 2.5 million homes by 2030.

A Factory OS employee work on the assembly process of modular homes at the Vallejo warehouse on August 6, 2020.

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Beth LaBerge

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KQED

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But, these projects face big hurdles in securing financing and overcoming a patchwork of regulatory approvals that can vary by jurisdiction. Following the committee’s Construction Innovation hearings, state lawmakers now plan to introduce their own package of bills aiming to streamline the process.

Those efforts will dovetail with legislation at the federal level, where lawmakers are also trying to solve the nation’s growing housing affordability crisis, caused in part by a construction slump. Federal legislators are currently working on two separate bill packages taking aim at red tape and outdated safety standards which lawmakers on both sides of the aisle argue have prevented factories from churning out housing for decades.

And while there has historically been resistance from unions to factory-built housing, there is a growing recognition of the benefits to workers. Jeremy Smith, deputy legislative director for the State Building and Construction Trades Council of California, said during a committee hearing that while the trades prefer on-site construction methods, modular-built housing “provides a solution to building — to actually building — more housing for people of all income levels.”

He pointed to Fullstack Modular, a construction company with a factory in Carson, Ca., which employs about 200 unionized workers to construct modular homes. He said working in a factory, as opposed to commuting long hours to job sites, benefits employees.

“Because of the consistent work hours and the factory location within the community, trades workers and more crafts people are able to consider the trades and still accommodate childcare and other life needs,” he said. “Workers who have not secured reliable transportation, for example, can more easily get to the stationary location of the Carson factory, making their transition into the building trades easier.”

Factory-built housing is not necessarily new in California. For years, a number of construction firms have offered modular housing or prefabricated units, which can be manufactured miles away and assembled on site. But many of those firms have failed to scale up and have shuttered their factories.

Michelle Boyd, chief strategy officer for Terner Labs, a nonprofit incubator program connected to the Terner Center, said the construction industry hasn’t changed in decades and neither have the laws or financing systems surrounding it.

“The construction industry has worked the way it’s worked for 100 years,” she said. “And there are many different silos. Every player has their own little piece of the puzzle on how you put a house together or an apartment together.”

But industrialized construction consolidates that system into one factory, and that, in turn, runs up against regulatory and financing norms, which makes it difficult for new types of construction to successfully enter — and stay — in the market.

When it comes to regulations, the Terner Center’s report details inconsistencies between local governments’ building codes as one barrier to be removed. Although the state has adopted a set of standards for housing built in factories, local governments still require certain plan reviews and inspections, which can change a standardized product into a bespoke project for each city.

On the finance side, banks and insurance agencies have funded traditional site-built housing for decades, so they understand the risks involved. But factory-built construction has yet to meet mainstream adoption, which means financial institutions have less data and experience to gauge risk. That makes it harder to access capital needed to get projects off the ground.

Boyd said that because developers sometimes have trouble finding financing, it means deals can fall through, resulting in holes in the factories’ production pipeline. When that happens, she said, “They can’t sustain that because they have to pay the wages, and so they close.”

But she argues, the state could work to assume some of the risk of the transaction and stabilize the pipeline so those holes don’t exist.

“One of the main policy areas that we uncovered is a role potentially for the state in helping hold some of that risk, so we’re not really asking these developers to risk losing a lot of money or having the deal go upside down halfway through,” she said.

Taken together, Boyd said, these proposed reforms, if implemented, could have the potential to jumpstart the industry, bringing down the cost of construction for builders, and hopefully, for homeowners too.