Holding open the door on scholarship weekend in Spring 2024, alumnus Derryl Barnes kept looking over his shoulder wondering if more students were coming. Among the sea of new premier scholarship recipients invited to meet their peers, Barnes saw almost no students that looked like him. 

Something was off. 

At Horizons, a pre-orientation program known to bring together multicultural students, Student Government Diversity, Equity and Inclusion Council Chair Alexis Owens was confused after meeting just one Black student. 

Then came a wave of half-filled organization meetings. 

The first general body meeting for United Black Students, the first formally recognized Black student organization at the University of Miami, had only three first-year students in attendance. Historically, there have been lines out the door. 

The shockingly low presence of first-year Black students confirmed student leaders’ concerns – Black enrollment was down. 

In a statement to The Hurricane on Sept. 16, the data released by the University of Miami revealed that Black enrollment had been nearly cut in half, making up only 5% of the Class of 2028. 

Students and administrators attribute this drop mostly to the U.S. Supreme Court decision that ruled 6-3 against the use of race in college admissions, finding that it violated the Equal Protection Clause of the Constitution and Title VI of the Civil Rights Act of 1964 on June 29, 2023.

The class of 2028 is the first group experiencing the consequences of the post-affirmative action admissions process, and across the country universities have reported a decrease in select race groups, predominantly those identifying as Black. 

“Within the multicultural identity, sure, it’s more diverse, but with that diversity came a decline in the Black student representation,” Owens said.

This is a cause of concern for student leaders across campus who spend hours planning events and leading organizations to guarantee spaces on campus for Black students.

“That’s a whole class of students that don’t have as much community within themselves that can go on after I graduate,” Owens said. “Who’s carrying our legacy?”

The student leader’s concern

At UM, Black students fought for a voice on campus. The University did not desegregate until 1961, when the Board Of Trustees voted to “admit qualified students without regard to race or color.” Six years later, UBS was founded. 

In 1968, UBS students staged a sit-in in then-University President Henry King Stanford’s office demanding an increase in Black enrollment, faculty and minority scholarships. Their work continued for decades, despite frequently facing arrest or disciplinary action from the school.

For over 60 years Black students have worked to solidify their presence as advocates for belonging and cultivated spaces for students to connect with their culture and learn about others. From Black pre-health organizations to Black Creatives Collective, their large community has allowed for widespread impact.

In 2022, four Black students competed in the Homecoming pageant and won, representing their organizations and cultures on the Royalty Court. Before this year, the past three Student Government presidents – Landon Coles, Jamie Williams and Niles Niseem – were Black.

“Those are influential people. Pillars on the campus who wouldn’t have been there,” Barnes said

The Gravity Magazine and UMTV’s The Culture were started by Black students to provide opportunities for other Black students to showcase their experiences, talent and creativity.

Annual events like Taste of Africa and the Hairology hair show regularly gather crowds of over 300 students.

“I owe it to places like UBS, the Caribbean Students Association, Planet Kreyol, African Student Union, just providing a space where people of color can come together and not only be educated on cultures that are not their own, but also to have community with other other people of different backgrounds, even though we’re different from each other.” UBS President Zuri Greenlee said.

According to these student leaders, this is what the University of Miami stands to lose if Black enrollment rates continue to fall. 

“I definitely am concerned,” Greenlee said. “Just in terms of SAFAC, they go based off of your members. As the seniors graduate, and people leave, we’re going to start not having as much funding.”

Since the start of the semester the DEI Council has heard concerns from students who are in classes finding that they are the only Black student in the room. Student leaders have also expressed concern over low turnout at events, programs and outreach efforts that have had no problem succeeding in the past. 

“You feel underrepresented, or you don’t feel heard, or you don’t feel as valued in certain spaces, because then you feel like maybe I don’t deserve to be in that space,” Owens said. “That is another hindrance of just being proud of getting into this school, getting this education, being in this environment. It can be hard, because then you’re like, do I really belong here?”

Specific representation matters

As a whole, the University’s diversity numbers remained about the same at 44%, with Hispanic students increasing as much as Black students decreased in the Class of 2028. Barnes explained that despite the diversity numbers looking good on paper, it is important for students of color to see others that look like them.  

“Say UM is the number one football team in the nation, they’re going to turn that camera, point it in the stands and every single person in those stands is either white or white-passing Hispanic. It’s just going to give a certain illusion, right?” Barnes said.  

Seeing Black students succeeding across campus was one of the main factors that led Barnes to choose UM over other universities. In high school, Barnes was often the only Black student in his Advanced Placement and honors classes. UM offered him a new opportunity to immerse himself in a Black community that had his same ambitions and commitment to academic achievement.

“Right off the bat it [UM] already felt more like home than the other schools that I was going to,” he said. 

Where does UM go from here?

Understanding that these effects are largely outside the University’s control, Black student leaders are simply asking to be included in the conversation.

“What is the plan to make sure that we’re admitting black students in the school, because at the end of the day, our organizations cannot continue without those black students,” Greenlee said.

“Having that dialogue between us will go a long way to see even what we can do on our end to prevent this from happening in the future.”

At a routine physical, Marylin Spunar was shocked to hear that she had been diagnosed with atrial fibrillation at 51 years old, an irregular heart rhythm that if left untreated can lead to a stroke. At the appointment, her doctor told her about a feature on her Apple Watch that could monitor her heart rate.“I turned it on and sure enough, I get the alert like five or six times a day because with Afib it’s constant. It sort of gets annoying,” Spunar said.

Just 10 months after seeing a cardiologist and receiving treatment, an alert on her watch let her know that the irregular heart rate was back.

“If I did not have that watch. I wouldn’t know. I really wouldn’t,” she said. “Because of the watch, I feel and my doctors feel confident that I’m going to know when it happens.”

Symptoms for atrial fibrillation, commonly known as Afib, include fatigue, heart palpitations, trouble breathing and dizziness. Afib is one of the most common arrhythmias. Risk factors for Afib include high blood pressure, coronary artery disease and obesity.

Most people diagnosed with Afib are in their 50s or 60s, but according to Dr. Yasser Rodriguez, an electrophysiologist at Cleveland Clinic Weston, diagnoses for Afib are increasing — and the patients are getting younger.

“With the increasing obesity epidemic, we’re seeing a lot more sleep apnea and obesity in younger people, which is shifting the patients closer to their 50s,” Rodriguez said.

Dr. Pedro Martinez-Clark, medical director and CEO of Amvita Heart & Vascular Health, also attributes the younger age of diagnosis to better technology, like wearable devices, which have allowed for conditions to be detected, diagnosed and treated at an earlier stage.

More and more people are using wearable devices like smartwatches and fitness trackers to monitor their physical activity and well-being. However, others, like Spunar, are using them to help with early detection and management of medical conditions.

When it comes to wearable technology, many devices are available to consumers, but not all are FDA-approved. The most common devices, Apple Watch and Fitbit, have been cleared by the FDA to identify Afib.

“I think these technologies are definitely a significant move forward in our ability to detect patterns of risk,” Martinez-Clark said. “But just like anything else, there are positives and negatives.”

What wearable devices can do

Wearable devices offer a range of features, from tracking activity levels and sleep quality to monitoring vital signs, such as heart rate and blood pressure. This can be helpful to detect irregularities in heart rates for patients that are less symptomatic.

“Let’s say you’re having dinner and you’re relaxed, and then your heart rate is at 140-150; that’s abnormal,” Martinez-Clark said. “In the absence of symptoms, wearable technology can tell us that there is a fast rate in a situation where it shouldn’t be fast.”

According to Martinez-Clark, what may be even more important than detecting an arrhythmia is keeping track of the frequency and regularity of the arrhythmia. Because symptoms can vary, this is the critical information doctors will use when making a diagnosis — a task wearable devices have made easier for potential patients.

“Regardless of the age of the patient, irregular heart rhythms can have very serious implications,” Martinez-Clark said.

What wearable devices can’t do

On the flip side, obsessive tests and false alarms are just a few reasons why physicians advise the public to take the wearables’ advice with caution.

“Companies would rather over-call things than under-call them, and because they’d rather over-call, make sure they’re not missing anything than the other way around,” Rodriguez said. “A lot of times that patient will come and it’s not exactly atrial fibrillation, it’s something else that’s much more benign.”

For example, with younger people, an out-of-the-ordinary fast heartbeat could be normal, but would trigger false alarms. And for patients with significant anxiety, detection and alerts can trigger even more anxiety.

“We actually recommend to those patients not to wear those devices,” Martinez-Clark said.

Another problem with the readings done by a smartwatch or fitness tracker is the varying levels of interference. According to Dr. Andre Landau, interventional cardiologist at Broward Health North, in a test done by a physician, the skin is disinfected and sometimes shaved to create close contact. Not only that, for the entire test, the patient stays still.

“If the patient is moving at the time of the recording, it makes the recording more difficult to interpret,” Landau said.

Because of this, medical professionals strongly urge the public to visit a physician and get properly tested if they feel symptoms or receive alerts that an arrhythmia was detected.

For symptomatic patients or those who have experienced a stressful situation, like a stroke, Landau recommends a more sophisticated device, like KardiaMobile, an FDA-approved device to detect Afib, to monitor electrical signals in the heart.

“It’ll record an EKG, transmitted to your cell phone, that you can text or email to a doctor for more analysis,” Landau said.

New treatment for Afib launching at Cleveland Clinic 

On Monday, Cleveland Clinic Weston is launching a new treatment for Afib known as “Pulsed-Field Ablation.” PFA is a non-thermal treatment method that promises faster procedure times and less risk to adjacent structures.

“It’s just completely revolutionary. I don’t want to overuse that word, but I probably will not see another technology in my career that is as disruptive as this was overnight,” Rodriguez said.

The catheter ablation therapy uses electroporation, or the delivery of rapid, high-voltage pulsed electrical fields to tissue, causing cell membranes to become permeable, to treat cardiac arrhythmias.

“It’s almost instantaneous,” Rodriguez said. “Every treatment is 2.5 seconds. With the older technology it was 10 to 15 seconds. You’re getting the entire vein and you’re getting it in seconds.”

According to Rodriguez, there are at least 12 million people in this country that have been formally diagnosed with Afib, and projections are “going sky high.”

“I tell everybody, you have to go for that annual physical,” Spunar said. “Because even if you don’t have the watch, at least your physical can capture some of this.”

A survey published by the American Hospital Association found that 94% of hospitals have experienced financial disruptions from the Change Healthcare cyberattack. Jackson Health System in Miami was one of the hospitals affected.

UnitedHealth disclosed nearly a month ago that a cyber threat actor breached part of Change Healthcare's information technology network. Change Healthcare offers e-prescription software and tools for payment management, and the interruptions left many providers temporarily unable to fill medications or get reimbursed for their services by insurers.

“When hospitals don't get paid for the services they provide, that affects their ability to pay their doctors, nurses and their other staff, to sustain 24/7 operations and timely access to healthcare,” said Mary Mayhew, the Florida Hospital Association’s president and CEO.

The FHA represents over 200 hospitals in Florida, providing service and support focused on advancing healthcare policy at the state and federal level. The association also serves as a convener to support best practices, quality improvement and response to emergencies like this cyberattack.

Jackson Health System and its IT department were notified of the attack on Feb. 20 and immediately cut all access to any Change Healthcare team and disconnected the software that was purchased from the organization.

“We were not sure what was happening on their end, and whomever had done this to them could very easily get access through their system into ours,” said Myriam Torres, the Chief Revenue Officer for Jackson Health System. “IT has a whole set of protocols, and immediately the one thing they do is remove access.”

As of now, patients are not being affected. The current impact lies on the payer’s side with their inability to process the hospital’s claims. As time goes on, weeks of insurance claims are building up, and according to Mayhew, it is expected that hospitals will be owed billions of dollars because of this attack.

However, according to Torres, “we should all be concerned.”

“Even though this is an issue that has heavily impacted healthcare across the country, everyone should be concerned over the financial impact this could potentially have," she said. "A situation like this cannot linger on for an undefined period of time because hospitals cannot function without payment.”

According to Mayhew, the cyber criminal's ability to hack the Change Healthcare system reveals the vulnerable state of the country’s healthcare infrastructure.

“One of the biggest concerns is the fact that these cyber criminals were able to successfully attack the country's largest health insurance company that has undoubtedly dedicated tens of millions of dollars to cybersecurity. So, they were vulnerable,” Mayhew said. “It means it's not whether it's going to happen again, it's when it's going to happen again.”

Although the FHA has so far continued to maintain access to healthcare, Mayhew points out that “as a country, and as a state, we've got to come together and look at ways in which to strengthen our various systems.”

The Jackson Health System does not know when this will come to an end. According to Torres, Change Healthcare is restarting its systems slowly.

“They're not just bringing up their entire system up at once, they're going tool by tool,” Torres said. “There's billing tools, processing tools, payment tools, and not all of them are up yet.”

UnitedHealth, which provides care for 152 million people, hasn't disclosed what kind of data was compromised in the attack, or whether it cooperated with the cyber threat actor to restore systems. The company said it's been working closely with law enforcement and third parties like Palo Alto Networks and Google Cloud's Mandiant to assess the breach.

“We're waiting on a meeting between the executives from Change Healthcare IT and the executives from IT at Jackson to share more information,” Torres said.

UnitedHealth Group said Monday that it's paid out more than $2 billion to help healthcare providers who have been affected by the cyberattack on subsidiary Change Healthcare.

According to a survey by the AHA, more than 60% of the 1,000 hospitals surveyed estimated the revenue hit to be around $1 million per day. Responses were collected between March 9 and March 12.

"We continue to call on Congress and the Administration to take additional actions now to support providers as they deal with significant fallout from this historic attack," AHA CEO Rick Pollack said in the release.

The Biden administration announced Wednesday that it has launched an investigation into the company due to the "unprecedented magnitude of the cyberattack."

The U.S. Department of Health and Human Services' Office for Civil Rights is carrying out the inquiry. The OCR enforces the Health Insurance Portability and Accountability Act's security, privacy and breach notification rules, which most health plans, providers and clearinghouses are required to follow to protect health information.