Mandy Oaklander | October 28, 2026

What should you say when someone confides in you that they’ve been having intrusive thoughts? It can be a tricky situation to navigate, but my colleague Angela Haupt shares what experts advise, below.

Also in today’s edition: the CDC now considers Candida auris one of the nation’s most urgent drug-resistant threats, and researchers publish some encouraging evidence about vaping for smoking-cessation.

TODAY’S TOPICS

A drug-resistant threat
Can vaping help you quit smoking?
When your insurer just says no to drugs
How to talk about intrusive thoughts
Changing organ-donor rules

QUICK CHAT

The CDC recognizes a growing fungal threat

In my new story published yesterday on the rise of dangerous fungal diseases, I write about Candida auris—a nasty yeast with mysterious origins that has been spreading rapidly in the U.S. and around the world. And yesterday, coincidentally, the U.S. Centers for Disease Control and Prevention (CDC) listed Candida auris as one of four top-priority drug-resistant pathogens that require "urgent and aggressive action.”

Dr. Andrej Spec, a fungal-disease specialist at Washington University in St. Louis, says we should be very worried about Candida auris. He spoke with me recently about why. —Dominique Mosbergen

This interview has been condensed and edited for clarity.

Candida auris fungus, illustration Science Photo Library—Reuters

Why are you so concerned about this fungus?

It spreads easily from person to person. It’s gone from being an emerging threat in a few places to being pretty much everywhere. We just haven’t found a way to limit its spread.

What kinds of diseases can it cause?

It can cause devastating bloodstream infections, and that’s mostly limited to people who are already very sick—people in hospitals, nursing homes, and people who are immunocompromised. But we are also seeing more cases of people who have more superficial diseases, like vaginal yeast infections and skin infections. These don’t carry the same mortality risk, but they’re still bad. They’re hard to treat. It can be awful for people who suffer from them.

What are you doing to address the threat of Candida auris and other dangerous fungal diseases?

Some of my research focuses on how we get more physicians to test for more fungal infections, because a lot of these infections get misdiagnosed. The other thing that we have started to try to develop is a pan-fungal test—a tool that can help busy doctors who aren’t mycology specialists determine whether an infection is fungal in the first place.

A few years ago, I also cofounded MyCARE, a patient-advocacy organization that focuses on fungal diseases. Every field of medicine does better when patients have a bigger voice. MyCARE recently created a cooperative agreement with the CDC to strengthen education and readiness efforts for serious fungal diseases.

Read the full story here.

INSIGHT OF THE DAY

Vaping might help smokers quit cigarettes

SolStock—Getty Images

Vaping isn’t harmless, but e-cigarette advocates have long argued that the devices can help people quit smoking traditional cigarettes, which are more dangerous. Now, a new study published in NEJM Evidence adds to that evidence. Cigarette smokers who were given a starter pack of e-cigs significantly improved their chance of quitting even without ongoing smoking-cessation counseling.

For the study, conducted in the U.K., researchers gave smokers e-cigarettes and found that 11% of them successfully quit smoking for at least six months. This was almost twice as effective as another strategy: sending smokers e-mails about how to quit cigarettes.

The takeaway: If you neither smoke nor vape, don’t start. But if you do smoke cigarettes, switching to vaping instead may at least be a good step. —Jeffrey Kluger

CAN THEY DO THAT?

Can your insurer refuse to cover a doctor’s prescription?

Yes, they can. Most insurers have something called a formulary, which is a list of drugs they cover and what the patient’s responsibility is. But those formularies can be limiting, especially for GLP-1s and other expensive brand-name drugs. One recent paper analyzed more than 1 million people attempting to fill prescriptions for brand-name drugs and found that 32% were rejected or required prior authorization.

Patients can appeal those denials, and the paper found that 39% of people whose drugs were rejected did eventually get their prescriptions filled. But many others didn’t; they either paid cash, switched to a different drug, or went without.

“It’s not the case that private insurers are legally bound to provide coverage for every single drug,” says Joe Levy, an assistant professor of health policy and management at Johns Hopkins Bloomberg School of Public Health and lead author of the study. The study also found that rejections increased by 67% from 2018 to 2024. —Alana Semuels

TIME TO TALK

How to respond when someone opens up about intrusive thoughts

Photo-Illustration by TIME (Source Image: Deagreez/Getty Images)

Sharing a disturbing intrusive thought can feel like confessing something terrible—even though the thought is unwanted. If you’re on the receiving end of this kind of confession, a calm response can keep shame from shutting down an important conversation.

Start with gratitude

Try: “I’m so glad you shared this with me. This doesn’t change how I think about you.” Then ask: “Do you want me to listen, or help you figure out what to do next?”

Don’t feed a reassurance loop

If they repeatedly ask what the thought means, say: “I’m not going to help you go down the rabbit hole, but I’ll sit with you while this feels hard.” If you’re unsure whether it’s an unwanted thought or an intention, ask calmly and directly.

Read the full story here.

TIME100 Most Influential Companies is expanding

TIME100 Most Influential Companies 2027 entries are now open.

With new Exceptional Workplaces categories, the TIME100 Companies publication is expanding to recognize businesses pioneering new approaches to how people work, from flexible and hybrid work to technology integration and career development.

Because it’s no longer just what you do, but how you do it.

Submit your company.

WHAT WE’RE READING

New Mexico is training more bilingual health care apprentices in an effort to combat a workforce shortage, Cecilia Nowell reports for the Guardian.
The rules around organ donation are changing—and not everyone is happy about it. Rob Stein at NPR explains what to know.
Would you break your ribs for an hourglass figure? Emma Russell at the Guardian investigates the rise of rib-remodeling surgery.