Be wary of bad hand sanitizers

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By NCL Executive Assistant Adrienne Archer

Hand sanitizers help protect and prevent the spread of COVID-19 when soap and water are not readily available. When the coronavirus first emerged, demand for hand sanitizers soared. Stores were unable to maintain ample inventory, resulting in rampant hoarding and price gouging. Essential workers that desperately needed hand sanitizer couldn’t get them, prompting some companies to start making sanitizers that originally did not produce them (i.e. distilleries, cosmetic companies, etc.)

Guidelines from the Centers for Disease Control and Prevention (CDC) require hand sanitizer to have at least 60 percent ethanol (ethyl alcohol) in order for it to be effective. The CDC does not encourage members of the public to make hand sanitizer for individual use.

The Food and Drug Administration (FDA) has observed a sharp increase in those that, in addition to ethanol, also contain methanol—an ingredient that can be toxic when absorbed through the skin and can be fatal when ingested. Children and adults ingesting certain sanitizers led to blindness, hospitalizations, and even death.

Extended exposure to methanol can cause nausea, vomiting, seizures, permanent blindness, or death. The FDA has also found sanitizers with 1-propanol are also harmful. Accidental ingestions can cause central nervous system depression or death. Consumers that may have been exposed to hand sanitizers containing methanol or 1-propanol should seek medical attention immediately.

The FDA recently updated its guidelines on temporary policies about testing hand sanitizers to determine methanol levels. As companies produce hand sanitizers, they should frequently test to ensure that methanol is not created as a byproduct of either ethanol or isopropyl alcohol. The testing should be performed by an FDA inspected lab to ensure that it has met current good manufacturing practice (CGMP) standards. CGMP ensures the proper design, monitoring, and control of manufacturing processes and facilities. If alcohol (ethanol) has been found to contain more than 630 parts per million of methanol, it is contaminated and should be disposed of in hazardous waste containers. This guidance serves to help state-licensed pharmacies and outsourcing facilities report any incidents. The FDA has guidelines for an additional deterrent formula of alcohol to prevent children from ingesting them.

Consumers should also be cautious of false claims that hand sanitizers provide prolonged protection against COVID-19. Carefully inspect any purchased hand sanitizers to see if methanol or 1-propanol is listed.

FDA maintains a current list of hand sanitizers that are not recommended. As consumers review the list, they should compare the manufacturer name, product name, and National Drug Code (NDC) # on the hand sanitizer. If you find a product on the list, dispose of it immediately in a hazardous waste container and NOT down the drain.

The FDA encourages health professionals, consumers, and patients to report adverse effects and problems to the FDA’s MedWatch Adverse Event Reporting Program. Questions can be emailed to COVID-19-HandSanitizers@FHA.nns.gov. The FDA has also created a quiz to test consumer’s knowledge about hand sanitizers and a Q&A section on hand sanitizers and COVID-19 to keep consumers informed.

‘Should I stay or should I go?’ How the pandemic has affected higher education

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By NCL Health Policy intern Talia Zitner

Every morning, I wake up with a new decision to make. Am I going back to campus? Or am I spending the Fall semester taking online classes from the comfort of my childhood bedroom? I’m a rising sophomore at Wesleyan University, and to add insult to injury, I’m also an incoming transfer student. My internal debate about going back to school is near-constant, and despite weighing the pros and cons of each, I still can’t seem to come to a comfortable conclusion.

Around the country, colleges and students are faced with this same, nearly impossible challenge. If schools can’t or won’t open in the fall, they risk closing forever without tuition money. If they do allow students to come back to campus, and an outbreak occurs, they put students, professors, faculty, staff, their families, and the greater community at risk. Students rely on colleges to be their home away from home, a place where they can work and learn in a structured, safe, and healthy environment, not to mention the social benefits.

Consequently, coming back to campus poses a serious financial and ethical question. Like anything else, college and higher education is a business. Consumers want to get the most for their money, and the colleges and universities need consumers to engage to have a sustainable business model. The pandemic has shifted the conversation in many areas of life, higher education included.

This issue is especially complicated because it can be broken down from multiple perspectives. For example, an economic point of view argues that colleges are only re-opening because they need the money. Like many other businesses, they stay open because they have no other choice. Without the money generated through tuition and other forms of revenue like donation and state funding, it would take years for schools to recover from the impact of COVID. But college is a substantial investment for families. Why should consumers be expected to pay full (or reduced) tuition for an experience that is more like a monastery than college? Will the investment really be worth it if schools are simply shut down again because of an outbreak at a campus party?

On the other hand, if students aren’t in school come fall semester, what else would they be doing? Most students are hard-pressed to find a job or internship that’s worth taking a semester off for in this environment. And time off may push back a student’s graduation time, putting them behind the rest of their peers. For very legitimate reasons, students want to come to campus and keep their college experience intact.

This seems to be where my own expectations fall. I have no idea if the situation will improve between now and the spring semester. To me, the only course of action is to enjoy the experience that I will have, even if it means wearing a mask.

Talia is a Washington, DC native and a rising sophomore at Wesleyan University, where she is studying English. Beyond health policy, Talia’s interests are in journalism, law, and social justice.

Understand the opioid epidemic and protect yourselves and loved ones

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Knowing the rights, risks and responsibilities of prescription opioid use is an important first step to addressing the opioid epidemic. Whether you are taking medication to treat pain, or have friends or family members who have been prescribed opioids, knowing the facts can help prevent misuse before it occurs.

NCL recently partnered with the Allied Against Opioid Abuse (AAOA) to create a new batch of resources to help educate consumers about prescription opioid safety. The new Consumer Toolkit includes educational materials to help reinforce the need for patients, caregivers, parents, and others to understand their rights, risks, and responsibilities associated with prescription opioid use.

Prescription opioids are medications prescribed by healthcare providers to treat moderate to severe pain for health conditions that cause ongoing discomfort as well as for pain following surgery or injury. Common prescription opioids include:

  • Oxycodone
  • Morphine
  • Hydrocodone
  • Oxymorphone
  • Codeine
  • Fentanyl

If you are not sure if your medicine is an opioid, check your prescription labels to look for generic names. The National Safety Council also provides a helpful chart of medicines that contain opioids. You should always ask your healthcare provider or pharmacist if you are not able to find the name or have questions.

Watch for risk factors associated with prescription opioids, including:

  • Mixing opioids with other medications, drugs, nutritional supplements or alcohol
  • Taking more than prescribed
  • Taking a high daily dose of opioids
  • Certain conditions such as depression, anxiety, post-traumatic stress disorder, HIV, sleep apnea, or liver or lung disease
  • Pregnancy
  • Older age
  • Family history of substance abuse

Let your doctor know if you or your loved ones have any of these risk factors before filling any opioid prescription.

“Opioid misuse often starts in the home, so safe storage and disposal are key to prevention,” said Sally Greenberg, executive director of NCL. “Make sure that prescription opioids are stored securely and remember to properly dispose of all unused prescription opioids as soon as possible.”

AAOA offers a safe disposal locator for you to find a place to safety get rid of your unused medications. Find details on safe disposal options here.

Consumers for Safe CBD is working to protect, educate Americans

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As America’s premier consumer advocacy organization, with a rich history of fighting to make the marketplace fair, safe, and healthy for consumers, NCL is hard at work on the most important issues in food and drug safety and to collaborate on improving consumer education.

In recent years, NCL has been observing the CBD, or cannabidiol, marketplace exploding, with products lining shelves of grocery stores, specialty shops—even gas stations. Products were appearing to make many claims or hint at miracle cures, and most consumers had no idea how or whether the products were being regulated. Who is making sure these tinctures, oils, gummies, and lotions are safe, and do they do what they claim?

This is why last year, NCL joined forces with the Consumer Federation of America and the Community Anti-Drug Coalitions of America, to create a national campaign called Consumers for Safe CBD.

NCL had identified a serious need for greater education among consumers about CBD, and that’s why Consumers for Safe CBD was created. Consumers for Safe CBD aims to help educate the public about the risks related to untested, unapproved CBD products on the market, champion the rights of consumers, and call on the U.S. Food and Drug Administration (FDA) and industry to do better to ensure safety and promote a pathway for new products through clinically tested scientific research.

“Cannabidiol, commonly referred to as CBD, is being used in a growing number of consumer products and is illegally sold in stores and on the Internet,” said NCL Executive Director Sally Greenberg. “We’re working to educate consumers and ensure accurate labeling, clear guidelines, and further research to protect against unknown and known risks of CBD products.”

NCL and its partners continue to raise awareness among consumers, policymakers, and regulators about the health risks associated with the unregulated CBD marketplace, in particular with the unproven health claims and often inaccurate labeling of products on the market today. Beyond the known health risks associated with unregulated CBD, there are a number of unscrupulous marketing tactics that prey on unsuspecting consumers. This includes false and dangerous claims that CBD has medical benefits that can prevent and stop the spread of the COVID-19.

By warning consumers about these false claims, participating in media interviews and publishing op-eds across the country, highlighting important research and reports, and sending letters to several retailers, state Attorneys General and Members of Congress, the campaign is working to protect consumers across the country from unapproved and potentially dangerous CBD products.

“We need to better understand the potential health benefits of CBD, but this can only be accomplished through clinical testing and scientifically validated methodologies,” said Greenberg. “We need the FDA to step up for consumers and for the public health.”

The time for action is now. CLICK HERE for more information about the Consumers for Safe CBD effort.

Reopening the economy prematurely has dire consequences for states

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By NCL Health Policy intern Talia Zitner

The past month has seen a serious surge in reported coronavirus cases in the United States. It seems the virus is going to be with us for a while. Of states where COVID is spiking, the majority are in the South, many of which had ambitious reopening plans that are now being reconsidered.

Three of these states—Texas, Florida, and Arizona—have current surges. All three pushed to reopen their economies early in an attempt to “return to normal.” The current deluge in cases that resulted was due to a lack of continuing stay-at-home order and a failure to require masks.

Texas officially started Phase 1 of its reopening plan on May 1, but—as of June 26—had to retract much of the opening that it had started. In total, Texas was only able to reopen the state for 55 days. As of July 27, Texas has seen an average of 8,089 new cases of the coronavirus over a seven-day period. Compared to cases in April, when there were 814, this is astounding. Texas Governor Greg Abbott (R) has since ordered everyone to start wearing face masks and has limited the size of public gatherings.

It does not appear that Texas will shut down again, however. As the governor said, “we need to refocus on slowing the spread, but this time we want to do it without closing down Texas again.” Although it is an issue of public health, the issuance of a statewide masking policy and the staggered re-opening of the economy has become a matter of contention across party lines. Some residents find the Governor’s actions to be inadequate, and others feel as if the newly implemented precautions impede their personal liberties.

Florida and Arizona are not faring much better. As of April, Florida had 1,027 cases reported. In July, it was 6,563. Florida started its reopening plan on May 4 and entered into Phase 2 on June 5. Clearly, cases have surged.

Earlier this week, Florida reported 8,892 new COVID-19 cases. Like Texas, there seems to be a mixed reaction among Florida representatives to slow the spread of the virus. Senator Rick Scott (R) has been vocal about his intentions for Florida, and it appears the state will not roll back any of its reopening course. As Senator Scott put it a couple of months ago, “wearing a mask is a choice you get to make.”

Like Texas and Florida, Arizona is hurting badly, with only 115 in April surging to 4,753 cases in July. Arizona’s stay-at-home order lasted until May 15, and was replaced by the new Stay Healthy, Return Smarter, Return Stronger Executive Order, on May 16. When Arizona first reopened, Governor Doug Ducey did not require residents to wear face masks, but as the case numbers increased, he allowed local governments to set their own masking policies. As of July 1, officials said that Arizona saw the highest rate of new cases in the entire country.

Many public officials are starting to realize opening too soon was foolhardy and has spread the virus. New revelations by scientists show the virus can actually be airborne, urging those to take indoor transmission more seriously. The virus is also proving to be more of a blood vessel disease than solely a respiratory one, which may lead to long-term impacts that doctors are still learning about.

There’s one takeaway here: following the example of states like Texas, Florida, and Arizona is not recommended. The more seriously states take this crisis the better, and the sooner the entire country will be able to move towards a newer, safer “normal”.

Talia is a Washington, DC native and a rising sophomore at Wesleyan University, where she is studying English. Beyond health policy, Talia’s interests are in journalism, law, and social justice.

Farmworkers and COVID: ‘A ticking time bomb’

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It’s been referred to as a “ticking time bomb,” the coronavirus and its potential impact on farmworkers—the incredibly hard-working men, women, and children who pick our fruits and vegetables and provide other essential agricultural work. Farmworkers are notoriously underpaid for dirty, back-breaking work and now face great risk from COVID-19.

Farmworker advocacy groups that National Consumers League (NCL) works with or supports—such as Farmworker Justice, the Coalition of Immokalee Workers, the United Farmworkers of America (UFW), the Farm Labor Organizing Committee, and a national cadre of legal aid attorneys—have spent recent months strategizing about ways to protect this community that is especially vulnerable to the virus.

Farmworkers are poor, with extremely limited access to health care and, due to their poverty, often report to work despite illness. The risks of an outbreak are especially great because workers often toil in close physical proximity to one another as they harvest, ride to the fields in crowded buses and cars, have limited access to sanitary facilities, including hand-washing, and often live in overcrowded, dilapidated housing.

Despite their essential contributions to the economy, farmworkers have been cut out of the emergency relief packages. The Trump Administration has even revealed plans to lower pay for agricultural guest workers who sacrifice home and family to come to the United States to perform arduous farm labor. Advocates fear that decreasing guest worker wages would drive down wages for farmworkers already living and working in the United States.

The majority of farmworkers are immigrants from Mexico or are the children of Mexican immigrants, often socially isolated from mainstream America. Poverty forced many farmworkers to leave school at an early age. It also causes them to bring their children to work in the fields so that child labor can supplement their meager incomes. Language and cultural barriers further their isolation. NCL, through the Child Labor Coalition (CLC), which it founded and co-chairs, continues to work to close the loopholes in labor laws that allow children in agriculture to work at early ages—often 12—and to begin performing hazardous work at age 16.

“When the virus began to move into America’s rural areas, many socially- and culturally-isolated farmworkers hadn’t heard about the virus,” said Reid Maki, director of child labor issues and coordinator of the CLC. “Some were confused that the grocery store shelves were empty and that the bottled water they usually buy suddenly cost much more. In some cases, farmworkers are not being told about the virus or the need to take special precautions while working.”

Farmworkers face an alarming dearth of protective equipment. Many farmworkers groups, are urgently racing to provide masks and other protective gear.

A farmworker with COVID-19 is unlikely to know he or she has it and, therefore, very likely to keep working and infect their family and coworkers. Recently, a growers group tested 71 tree fruit workers in Wenatchee, WA. Although none of the workers were showing symptoms of COVID-19, more than half tested positive!

Concerned about these developments, the CLC wrote letters in May to several appropriators and the Committee on Agriculture, asking for additional nutritional and childcare resources for farmworker families.

Box: How to get involved

  • Sign the Food Chain Workers Alliance to urge Congress to include resources for food chain workers.
  • Sign UFW’s petition urging Congress to stop Trump Administration efforts to lower wages for agricultural guest workers.
  • Make masks and send them to farmworker groups in your state.
  • Urge congressional representatives to fund farmworker relief efforts.

Meet the winners of this year’s Script Your Future Medication Adherence Team Challenge

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The 2020 Medication Adherence Team Challenge is part of the national Script Your Future public awareness campaign coordinated by NCL with support from its partners and the Challenge sponsors—the American Association of Colleges of Pharmacy (AACP), the National Association of Chain Drug Stores (NACDS) Foundation, the National Community Pharmacists Association (NCPA) and the American Pharmacists Association (APhA).

Medication non-adherence can lead to devastating health outcomes. Research shows that nearly one in five prescriptions go unfilled and half of all patients with chronic illnesses do not take their medication as prescribed. Improved medication adherence leads to better health outcomes and reduced total healthcare costs, and it was for these reasons that NCL launched the Script Your Future awareness campaign in 2011.

The Team Challenge was established to extend campaign messages into medical and other schools of health professions, and to nurture adherence-minded values in future generations of professionals entering the workplace. Each year, top performing teams are honored with a National Award for overall outstanding team achievement, or a Focused Award, which recognizes outstanding team achievement in the specific areas of health disparity/under-represented community outreach, media/communications outreach, or creative interprofessional team event. This year, we introduced a new focused award category, with the inclusion of a Technology Innovation Focused Award – a category that evaluates creative outreach with a focus on technology-based interventions.

In 2020, our Team Challenge student health professionals were met with unique challenges as they navigated the historic COVID-19 pandemic, which resulted in school closures, event cancelations, and a host of other obstacles. To adhere to social distancing guidelines, our dedicated teams pivoted their campaigns and made an impact in other ways. This year, the Team Challenge observed engagement from nearly 2,900 future healthcare professionals and volunteers, who all together hosted over 250 events in 14 states. Collectively, the teams directly counseled close to 12,000 patients and introduced Script Your Future messaging to over 430,000 consumers, nationwide.  Since the Team Challenge began in 2011, more than 21, 000 future healthcare professionals have directly counseled nearly 87,000 patients and nearly 26 million consumers.

The recognized schools, selected from dozens of applications and 82 participating educational institutions, are listed below.

National Award | University of the Sciences: Philadelphia College of Pharmacy, PA

University of the Sciences (USciences) interdisciplinary medication adherence outreach centered around individuals across all ages, from children to older adults. USciences’ team structure included students of pharmacy, occupational and physical therapies, medicine, and social work. Throughout the Team Challenge, USciences directly counseled 455 patients, reaching a total of 805 people. During their outreach, USciences introduced a new campaign theme – “A future of ______ begins with me”, to personalize medication adherence through each patient interaction. USciences’ campaign also placed a great emphasis on addressing racial disparities, reducing stigma surrounding mental health, and tangential issues like vaccine confidence and proper nutrition.

National Award Finalists

The following schools were named Finalists under the National Award category:
Pacific University School of Pharmacy, West Virginia University School of Pharmacy, Western University College of Pharmacy, Northeast Ohio Medical University (NEOMED), University of Charleston School of Pharmacy, Touro University College of Pharmacy, St. Louis College of Pharmacy.

Rookie Award | Howard University College of Pharmacy – Washington, DC

NCL is thrilled to announce that DC HBCU, Howard University College of Pharmacy, was the recipient of the 2020 Rookie Award. Howard University’s team included students of pharmacy, medicine, social work, and dentistry. Howard University’s target population included homeless or displaced minorities, children and parents, and adults with behavioral issues. The team tailored its disease focus to diabetes and heart disease, as they are chronic conditions that plague the region. Throughout the Challenge, Howard University directly counseled close to 400 patients and reached over 1,000 people with the help of 169 students and volunteers and distributed nearly 1,000 Script Your Future medication adherence resources.

Rookie Award Finalist: University of Arizona College of Pharmacy– AZ

The University of Arizona College of Pharmacy in Tucson, AZ also made a strong showing in the Team Challenge as a first-time competitor.

Focused Awards

Health Disparities Community Outreach Award | St. Louis College of Pharmacy – MO

Pharmacy students from St. Louis College of Pharmacy and nursing students from St. Louis University, joined forces to strategically and intentionally identify their target population – residents of a region of St. Louis known as the “Delmar Divide.” St. Louis College of Pharmacy chose this target population due to the stark disparities observed in the residents directly north and south of the Delmar Divide. For their outreach, St. Louis College of Pharmacy focused their interventions on communities north of the Delmar Divide, which predominantly consists of people of color of lower socioeconomic means. The team chose to focus on chronic conditions like diabetes and hypertension. Together, 60 students and volunteers directly counseled 350 patients and reached nearly 400 people. Through numerous events and newly fostered community partnerships, St. Louis College of Pharmacy disseminated nearly 400 Script Your Future medication adherence resources within the community.

Communication and Media Outreach Award | Lake Erie College of Osteopathic Medicine School of Pharmacy (LECOM) – PA & FL

To illustrate the diversity of their team, LECOM pharmacy and medical students from campuses based in PA and FL produced a public service announcement (PSA) spoken in eight languages, to help amplify the value of medication adherence to numerous populations. The PSA garnered over 2,800 views. LECOM employed social media platforms like Facebook, Instagram, Twitter, and LECOM’s Pulse Newsletter, to help disseminate Script Your Future medication adherence messaging. LECOM students also wrote an original book to present heart health information to the children entitled “Mr. Pumper and the Heart Valves”, which was read to third grade elementary students. Throughout the Challenge, 293 students and volunteers directly counseled over 500 patients, reaching over 1,200 patients, and disseminated over 730 Script Your Future resources in their community.

Creative Inter-Professional Team Event Award | University of Pittsburgh School of Pharmacy – PA

The University of Pittsburgh School of Pharmacy partnered with the Schools of medicine, dentistry, social work, nursing, dietetics, and rehabilitation sciences, to organize a team of over 300 students and volunteers to execute their medication adherence outreach. University of Pittsburgh harnessed the interdisciplinary nature of their team to build a campaign serving older adults in their community, from a holistic treatment perspective. The team addressed issues like hypertension, social isolation, and food insecurity. Throughout the Challenge, University of Pittsburgh directly counseled over 130 patients and reached over 2,200 patients.

Technology Innovation Award| Western University College of Pharmacy – CA

Western University College of Pharmacy made an impressive debut for the inaugural inclusion of the Technology Innovation Award. To foster medication adherence, the team created a dedicated website that directed patients to resources relating to disease areas like COPD, pneumonia, heart failure, and diabetes. The website was geared towards patients recently discharged following a hospital stay and contained features like medication and post-discharge appointment reminders and medication adherence-related infographics in multiple languages.

Advocating for emergency air transport coverage

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This spring, NCL sent a letter to the CEOs of Cigna, Aetna, and UnitedHealth Group, urging them to enter into productive negotiations with air medical service providers to ensure coverage of emergency air medical transportation. The ask came as the COVID-19 pandemic spread across the country, making air medical services even more essential, particularly in rural America.

“We are increasingly concerned about emergency air medical access during this crisis, and believe this life-saving care should be covered by every insurance plan,” said NCL Associate Director of Health Policy Nissa Shaffi.

“We are asking that insurers review the robustness of their coverage policies and immediately enter into network negotiations with air medical providers so that this critical service is covered, and patients are never left with a bill they cannot pay.”

At-home vision assessments no replacement for in-office visits

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With COVID-19 keeping many of us at home, companies claiming to offer at-home vision tests are ramping up their marketing, despite the fact that there is no U.S. Food and Drug Administration-approved at-home device that people can use to self-conduct a vision assessment, let alone a full eye examination. These devices aren’t even proven to provide an accurate vision prescription. NCL has long recommended an annual, in-person eye exam as part of consumers’ annual health and wellness routines.

“Consumers need to be wary of products that mistakenly claim that their at-home devices can provide an eye exam or a vision prescription and should instead consult their eye doctors who are available to help provide safe solutions,” said NCL Associate Director of Health Policy Nissa Shaffi.

Sorting through bogus health claims

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Across the United States, people are rising to the historic health needs and challenges posed by coronavirus, with healthcare workers on the frontlines risking their lives, and businesses pivoting to manufacture much-needed medical and protective supplies.

But deep concerns about the health implications—what happens to people who contract the disease from a health and financial perspective—are top of mind for many of us. And a cynical minority has seized on the crisis to employ unscrupulous, and frankly dangerous, marketing tactics to promote bogus products claiming to protect users against the coronavirus or provide relief for those infected—as well as peddling downright phony coronavirus testing products.

“These false claims touting unproven medical benefits are nothing more than craven attempts to take advantage of fearful consumers,” said NCL Executive Director Sally Greenberg.

“Moreover, they spread misinformation among consumers anxiously seeking ways to stay safe and healthy amidst the coronavirus crisis.”

In an op-ed in The Hill published in May, Greenberg noted that a number of CBD manufacturers and stores are falsely promoting unproven medical benefits of CBD products.

A CBD store in Portland, OR, for example, was recently ordered by the office of the state’s attorney general to take down signs claiming that its products could boost immunity against COVID-19.

“False claims such as this are particularly dangerous as consumers anxiously attempt to stay safe and healthy amidst the coronavirus crisis,” said Greenberg. “The need for science-backed treatments is significant and we must ensure products are tested and regulated for safety.”

Contrary to claims being made by CBD marketers that products containing cannabidiol can help those suffering from coronavirus, recent studies have actually found potential harmful side effects of cannabis products on infected coronavirus patients. Aurelius Data cautions the public against the potential harmful side effects that can come from consuming cannabis products with Tetrahydrocannabinol (THC) if a patient is infected with COVID-19. And studies have shown that many unregulated CBD products have been found to contain THC, though the labels may not disclose this.

“In these uncertain times, we urge consumers to continue to take precautions,” said Greenberg. “We urge everyone to follow CDC guidelines for COVID-19, practice safe social distancing, and at the same time avoid THC products and all untested, unregulated CBD products to help keep your family, friends, and communities safe.”