Ellen Stromdahl was at a garden party in coastal Virginia in June 2023 when her friend Albert Duncan stood up from where he was sitting and abruptly fainted. Duncan is an outdoorsman in his mid-80s — still active and healthy for his age. Stromdahl, an entomologist who works for the United States Army Public Health Center, the Army’s public health arm, rushed to his side. As Duncan came to, she noticed that his tanned skin was tinged with yellow. “This man looks jaundiced,” she thought to herself.

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Duncan spent the next several days in and out of the emergency room. His doctors administered countless blood tests and ruled out the usual suspects for an octogenarian — heart disease, diabetes, pneumonia. Finally, on Stromdahl’s recommendation, Duncan’s wife, Nancy, asked his doctors to test him for babesiosis, a rare malaria-like disease caused by microscopic parasites carried by black-legged ticks. The test came back positive not just for babesiosis but also for Lyme disease, another far more common illness caused by the same type of tick.

If Duncan’s doctors had caught the infections sooner, they could have eradicated them with a combination of oral antibiotics and antiparasitic medications. But Duncan, weeks into his illness, needed a procedure called an exchange transfusion. Doctors pumped all of the infected blood out of his body and replaced it with donor blood. About two weeks after the garden party, he was well again.

Babesiosis is rare — the Centers for Disease Control and Prevention reports around 2,000 cases in the United States every year. But what made Duncan’s case even more unusual is that he contracted babesiosis in Virginia, a state that registered just 17 locally acquired cases of the disease between 2016 and 2023.

It got Stromdahl wondering if babesiosis could be becoming more common in Virginia and neighboring states. She spent the following two years working with a team of 21 tick researchers from across the eastern U.S. and South Africa to assess the prevalence of Babesia microti, the parasite that causes babesiosis, in ticks and humans in those states from 2009 to 2024.

The results of the study, published in April in the Journal of Medical Entomology, reveal that the Babesia parasite is rapidly expanding through the mid-Atlantic. This shift, which has coincided with changing weather patterns, could pose a serious threat to people in communities where the disease has long been considered rare.

“Wherever we found positive ticks, there were cases,” Stromdahl said. “They’re small numbers, but that’s why we want to give the early warning before more people get sick.”

One in four cases of babesiosis is asymptomatic. People who do develop symptoms, especially older adults and immunocompromised people, can get quite sick with fever, chills, anemia, fatigue, and jaundice. Untreated, the parasites, which infect and destroy red blood cells, can lead to organ failure and death.

Babesiosis is typically found in the Northeast and the Upper Midwest. Between 2015 and 2022, case counts in the states that regularly report the disease — Connecticut, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, and Wisconsin — rose by 9 percent every year, a development researchers attribute in large part to warmer temperatures caused by climate change, which afford black-legged ticks more opportunities to bite people in a given year and more habitat to spread into.

Climatic conditions in the southern mid-Atlantic have always been welcoming for ticks, but warmer-than-average winters that have been occurring with grim regularity in recent years are turning some states in the region into year-round breeding sites for ticks and small rodents like mice, chipmunks, and shrews — the critters that carry Lyme bacteria and the Babesia parasite in their blood. Above-normal annual rainfall, which saturates the soil and adds to overall humidity in the region, also encourages the proliferation of ticks. The 2023 to 2024 winter season across much of the mid-Atlantic was 4 to 6 degrees Fahrenheit warmer than normal, and many states had some of their wettest Decembers and Januaries on record.

Stromdahl has been studying the movement of ticks and the diseases they carry for decades. She’s seen it all — including the northward spread of the Lone Star tick, which can impart a lifelong, sometimes deadly reaction to red meat. But even she was shocked to discover how far the Babesia parasite had spread.

She and her co-authors collected 1,310 ticks in Virginia, Maryland, and Delaware and found the B. microti parasite in all three states, indicating that there is potential for more human cases across the southern mid-Atlantic. None of those states had ever found the parasite in ticks before.

Many of the ticks the authors looked at were also infected with the bacteria that causes Lyme disease. The Lyme-babesiosis connection is an active area of research. Experts suspect ticks infected with one of the diseases are more predisposed to be infected with the other, but they still don’t know why exactly. What they do know is that Lyme is a harbinger of babesiosis. Previous studies on tick-borne illness found that areas that saw rising cases of Lyme disease from the 1980s to the early 2000s reported more babesiosis cases one to two decades later.

“The findings in the Stromdahl paper are consistent with what we’ve seen in the Northeast: Babesia infection seems to spread where Lyme infection is already present,” said Shannon LaDeau, a disease ecologist at the Cary Institute of Ecosystem Studies who was not involved in the study.

The authors also examined where human cases of babesiosis were clustered. Of particular concern were two hot spots: the five counties surrounding and encompassing the city of Baltimore and the Delmarva Peninsula — an 180-mile-long coastal landmass comprising parts of Delaware, Maryland, and Virginia. Fifty-five percent of Maryland’s cases were from the Baltimore area, and some 38 percent of cases from Virginia, Maryland, West Virginia, and the District of Columbia combined were from the Delmarva Peninsula.

Experts believe babesiosis cases are severely underreported due to a lack of physician awareness. Stromdahl and her colleagues hope their findings will inspire health departments in the mid-Atlantic to recognize that babesiosis is a growing concern, conduct surveillance for infected ticks, and put out public health warnings. If doctors in the region know to test for babesiosis, severe cases like Duncan’s can be avoided.

“Jurisdictions in the southern mid-Atlantic region should expect babesiosis cases,” the authors warn. “Tick range expansion is occurring at such a precipitous rate that public health guidance regarding tick-borne disease prevention and treatment can be rapidly rendered obsolete.”

Climate change isn’t the only environmental factor driving the rising density and expansion of tick populations. Efforts over the past few decades to reforest barren areas have encouraged herds of white-tailed deer, animals that pick up ticks and carry them miles before the arachnids drop off into the leaf litter, to proliferate. Declining rates of recreational and subsistence hunting are adding to deer overpopulations. At the same time, an ongoing expansion of suburban development into forested zones is putting more people in contact with ticks and the diseases they carry.

“The most important take-home is that tick-borne disease is a growing risk,” LaDeau said. The big question as tick populations increase, she added, is to figure out where and when infected ticks overlap with people. “There is still a huge need for data to understand how often these infected ticks come into contact with humans.”

This article originally appeared in Grist at https://grist.org/health/babesiosis-mid-atlantic-delaware-maryland-virginia-tick-borne-disease-lyme-research/.

Grist is a nonprofit, independent media organization dedicated to telling stories of climate solutions and a just future. Learn more at Grist.org

“I know nothing about Project 2025,” President Donald Trump said in a social media post last summer, four months before he defeated former vice president Kamala Harris and made a triumphant return to power.

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He was referring to a 900-page document written by the Heritage Foundation, a think tank that has been influencing Republican presidential policy since the 1980s, and other conservative groups. At least 140 members of Trump’s own former administration worked on the roadmap, which laid out the ways a second Trump term could fundamentally transform the federal government’s role in society.

As the public learned about radical proposals like replacing thousands of federal workers with conservative loyalists and commercializing government weather forecasts, Project 2025 became a political inconvenience for Republicans on the campaign trail. Last fall, only 13 percent of Americans said they supported the plan.

“I have no idea who is behind it,” Trump said in July as he tried to distance himself from the controversy.

If the notion that Trump was completely unaware of the origins or the contents of Project 2025 didn’t pass the straight-face test then, it’s ludicrous now.

Fewer than four months in, the Trump administration has accomplished policies that mirror about a third of the more than 300 policy objectives outlined in the blueprint, according to a crowdsourced website called Project 2025 Tracker. They include scrubbing mentions of diversity, equity, and inclusion from government documents and agencies; dismantling the Department of Education; and freezing federal science grants across the government. More than 60 measures recommended by the document are currently in progress.

“It’s actually way beyond my wildest dreams,” Paul Dans, the former director of Project 2025, told Politico last month.

About a fifth of the climate and environment measures proposed by the architects of Project 2025 have been implemented, according to another Project 2025 tracker run jointly by the policy think tanks Governing for Impact and the Center for Progressive Reform. Those measures include boosting fossil fuel drilling on public lands, rolling back grants for green programs, and reforming climate statutes.

All of these actions have something in common: they’ve flowed directly from the executive branch of government. Most of them have been decreed by Trump himself or have come from his cabinet secretaries.

James Goodwin, who runs the Project 2025 tracker at the Center for Progressive Reform, calls these executive measures “the stuff that doesn’t require much process” — in contrast to legislation, which requires negotiation with both houses of Congress. Trump has signed just five laws so far, the lowest count since Dwight D. Eisenhower was elected in 1953. He’s barreled ahead with an agenda that effectively ignores Congress, with little apparent concern for whether his actions are even legal. That means that, even as the Trump administration makes rapid headway on the Project 2025 agenda, the methods the administration has used to achieve those goals are being challenged in court — especially when they seek to unravel prior legislation.

“In Trump 1.0 they compiled a miserable, long loss record in court because they were so procedurally sloppy,” said Michael Gerrard, faculty director of Columbia University’s Sabin Center for Climate Change Law. “So far they may be doing even worse.”

On his first day in office, Trump signed an executive order called “Unleashing American Energy” that bundled multiple recommendations that echo Project 2025 objectives. Among these was a suggestion to update an Environmental Protection Agency rule called the endangerment finding. The policy requires the EPA to curb greenhouse gas emissions from power plants, vehicles, and other sources of pollution under the Clean Air Act. In March, EPA administrator Lee Zeldin said he aims to formally reconsider the rule and all regulations that rely on it — including most major U.S. climate regulations. Legal experts say weakening the rule or reversing it won’t be a cakewalk by any means — the finding is rooted in laws passed by Congress and has already withstood a barrage of legal challenges.

Project 2025 suggested freezing grants for green initiatives such as recycling education programs and eliminating the EPA Office of Environmental Justice and External Civil Rights. Trump is in the process of accomplishing those goals, which fall under the purview of the EPA. Some of these changes, such as eliminating funding to a “green bank” program established by Congress, are already being litigated, and judges ordered agencies to unfreeze a portion of the funds last week.

At the Department of the Interior, or DOI, similar Project 2025-inspired attacks on climate and environmental regulations are underway. Trump’s “Unleashing American Energy” order directed the DOI to assess and expand drilling and mining opportunities on public lands and expand energy extraction in Alaska under the guise of an “energy emergency” independent analysts say does not exist.

Last week, the DOI made good on that directive by announcing it would shrink down the time it takes to review the environmental and social impact of oil and gas projects on public lands — a process required by federal law — from one to two years to as little as 14 days. Truncated environmental review processes are sure to be challenged in court, and the administration’s efforts to boost drilling on public lands could also run into a 2024 rule that balances conservation with other public lands uses such as energy development and herd grazing.

At the Department of Energy, Secretary Chris Wright is overseeing Trump directives to quickly approve new liquefied natural gas exports and freeze funding from the largest climate-spending bill in American history, the 2022 Inflation Reduction Act. The natural gas exports will be litigated, Gerrard said, on the basis of whether emissions from those exports violate the National Environmental Policy Act, the same law the administration is trying to sidestep in order to expedite reviews of oil and gas drilling on public lands. Efforts to claw back Inflation Reduction Act funding have already been the subject of many legal challenges.

The text of Project 2025 encourages a future conservative president to use every executive power at their disposal, but it doesn’t recommend blatantly breaking the law. “One might imagine that the policy experts that worked on the Project 2025 plan assumed that the Trump administration would do things legally,” said David Willett, senior vice president of communications for the environmental advocacy group the League of Conservation Voters.

The blueprint’s authors write that White House lawyers should do as much as they can to promote the president’s agenda “within the bounds of the law.” It’s one of many places where the document references legal limits established by Congress and the Supreme Court and encourages a future administration to “look to the legislative branch for decisive action.”

“Their assumption was that actors on their side would be rational,” Willett said. “That has not been the case.”

Since taking office, Trump has ignored judicial orders, staging a constitutional showdown between the executive and judicial branches — a matchup that exceedingly few presidents in American history have sought to force.

After a federal judge ordered the Trump administration to restore federal funding, he soon found that the administration was not fully complying with his order. This month, a federal judge ruled that the administration violated a court order in its rush to halt Federal Emergency Management Administration grant funding to states. There’s also a high-profile clash playing out between the chief judge for the U.S. District Court for the District of Columbia, the Supreme Court, and the Trump administration over the deportation of a Maryland man to El Salvador.

These battles, the rapid firing and, in some cases, rehiring of federal workers, and a wider agenda that appears to hinge on the ever-changing whims of the president, have the makings of what Rachel Cleetus, a senior policy director at the nonprofit science advocacy group the Union of Concerned Scientists, calls an “authoritarian regime.”

“They’re just breaking things and then they’re going to have to put it back together again,” said Elaine Karmack, who served as senior policy adviser to former vice president Al Gore beginning in 1993. President Bill Clinton, who was inaugurated that year, sought to modernize the federal government in service of a government that “works better and costs less.” The Clinton administration did this legally — abiding by congressional statues and legal precedent as it sought to trim fat and balance the federal budget. In the end, Karmack helped Gore cut 426,000 federal jobs, slash 16,000 pages of federal regulation, reengineer the Internal Revenue Service and other government agencies, and otherwise accomplish a version of the kind of downsizing Project 2025 calls for.

“Everything they’ve done is basically illegal,” Kamarck added. “There will be consequences to the chaos.”

This article originally appeared in Grist at https://grist.org/accountability/project-2025-tracker-trump-environmental-policy-legal-constitutional-crisis/.

Grist is a nonprofit, independent media organization dedicated to telling stories of climate solutions and a just future. Learn more at Grist.org