Matthew Mayich Collapse at ASU: Review Finds Coaches Failed to Submit Trainer-Approved Plan Before Heat Workout

Table of Contents

1. Key Highlights
2. Introduction
3. What happened at the Aug. 20 workout
4. The official review and ASU’s proposed reforms
5. Family response and calls for an outside investigation
6. Why heat and strenuous exercise can become lethal
7. Best-practice standards and oversight expectations
8. Where ASU’s findings intersect with established protocols
9. How previous cases reshaped institutional practices
10. Athlete culture, pressure to perform and reporting barriers
11. Practical steps programs must implement now
12. Legal exposure and potential avenues for accountability
13. The missing pieces in public reporting so far
14. How immediate medical actions influence outcomes
15. The role of outside consultants and guest speakers
16. The PHPA statement and athlete advocacy
17. What other universities and leagues do differently
18. How this incident could reshape policy and practice
19. The balance between tough training and athlete safety
20. What to watch next in the Mayich case
21. Broader implications for organized sport
22. The human dimension: Matt Mayich’s community and support
23. Final considerations
24. FAQ

Key Highlights

• Arizona State University review found coaches did not submit a training plan to strength and conditioning staff before an outdoor workout on Aug. 20 during which Hamilton-born NHL prospect Matthew Mayich collapsed and remains in critical but stable condition.
• The review calls for a blue-ribbon advisory panel and new protocols for planning, staffing, monitoring and emergency response for outdoor athletic activities; the player's family and lawyer are pressing for a county attorney investigation and accountability.
• The incident highlights systemic risks in high-intensity conditioning, the importance of acclimatization and emergency-action preparedness, and the fragile line between tough training and life-threatening exertional illness.

Introduction

Before dawn on Aug. 20 at Sun Angel Stadium in Tempe, a group of student athletes began a coach-led outdoor workout. The temperature was near 30 C. Exercises included calisthenics, pushups, planks and running. Less than an hour into the session, 21-year-old Matthew Mayich — an NHL draftee from Hamilton, Ont. — staggered, dropped a medicine ball and collapsed. He attempted to get up, fell to his knees and was taken to hospital in critical condition. An internal review by Arizona State University concluded coaches had not submitted a plan for the session to the university’s strength and conditioning staff for review. The finding has reopened difficult questions about duty of care, heat-related illnesses, emergency medical readiness and the culture of elite athlete conditioning.

This account reconstructs the workout and the institutional response, explains how exertional heat illnesses develop and are treated, compares the episode to prior high-profile cases, and lays out the policy and legal considerations likely to shape the aftermath. The university’s review, the family’s demands, professional standards and the broader conversation about athlete safety converge here. The stakes are clear: proper planning and an immediate, appropriate response can be the difference between full recovery and permanent harm.

What happened at the Aug. 20 workout

ASU’s senior vice-president of educational outreach and student services, James Rund, wrote that the incident occurred just before 8:30 a.m. at Sun Angel Stadium on the Tempe campus. The day’s recorded temperature was about 30 C. Activities described in the review included bodyweight exercises — pushups and planks — basic running drills and other calisthenics. The hockey coaches had invited a speaker, Timothy Zeisel, who had worked with the team on leadership and teamwork topics during the 2025–26 season.

Crucially, Rund’s report states the coaches did not submit a written plan of the training activities for review by ASU’s strength and conditioning coaches prior to the workout. Near the end of the session, Rund wrote, Matthew “appeared to struggle, and then in rapid succession stumbled, dropped the medicine ball and fell to the ground. He attempted to get up and resume running but fell to his knees.”

The timeline in the university memo and public summaries leaves room for detail, but two elements stand out immediately: an early-morning, high-intensity session on a hot day; and a failure to route the workout through the unit charged with supervising conditioning safety. Those facts frame both the medical questions about what happened physiologically and the institutional questions about whether proper safeguards were in place and used.

The official review and ASU’s proposed reforms

ASU’s review stops short of assigning individual blame in the public summary, but it identifies process failures and recommends significant structural changes. Rund indicated the university will “undertake a comprehensive review” of planning, conduct and monitoring of athletic activities and of emergency response protocols. The review explicitly calls for assembling a blue-ribbon advisory panel of experts to recommend best practices for:

• Planning and approving outdoor athletic activities, including strength and conditioning sessions, practices and competitions.
• Staffing, monitoring and conduct of outdoor activities, with guidance on adjustments for changing conditions and for responding when athletes show adverse reactions.
• Preparation for and response to adverse events during athletic activities.
• Use of outside consultants for planning and delivery of strength and conditioning or practice activities.

ASU’s police department also confirmed it is investigating the incident — described as a “standard procedure” for events of this severity. The combination of an internal operational review, a proposed expert panel, and a police inquiry indicates the university is responding on several fronts: operational reform, fact-finding and legal risk management.

Family response and calls for an outside investigation

The family’s lawyer, Rob Carey, described Mayich as “in stable but critical condition” and said the family is “praying for a miracle.” Carey has publicly criticized how Mayich was treated at the scene, saying there was “no plan and no preparation,” and alleging the response “hurt his chances rather than helped them.” He also asserted that, despite ASU’s newly published policies, “a month later, nobody’s been named, nobody’s been suspended, nobody’s been fired for violating the very policies ASU published today,” and said the family will request that the county attorney investigate.

Carey’s account also characterizes the session as a “military-style, brutal, gruelling workout” with no breaks and no water for over an hour. That allegation, if substantiated, would be central to assessing negligence. It underscores the difference between sanctioned, trainer-supervised conditioning — with built-in adjustments for temperature, hydration and fitness levels — and ad hoc, high-pressure drills that can overwhelm thermoregulatory systems.

The St. Louis Blues — the NHL club that drafted Mayich in 2023 — issued a statement expressing support for Matthew and his family and confirming the organization is monitoring his medical treatment in Arizona.

Why heat and strenuous exercise can become lethal

Exertional heat illness is a spectrum. It ranges from mild heat cramps and syncope to exertional heat exhaustion and the most serious form, exertional heat stroke (EHS). EHS is characterized by a core body temperature typically above 40 C and central nervous system dysfunction (confusion, collapse, seizures). It is a medical emergency that requires immediate cooling and advanced care.

Two physiologic realities explain the danger. First, intense muscular work generates heat rapidly; second, environmental heat reduces the body’s ability to dissipate that heat. Sweat, evaporation and circulatory adjustments usually keep temperature in check, but when heat production outstrips loss — because of high exertion, high humidity, inadequate acclimatization or insufficient hydration — core temperature can rise to dangerous levels.

The critical immediate intervention for exertional heat stroke is rapid cooling. Clinical and sports medicine consensus identifies cold-water immersion as the gold standard: immerse the athlete in 1 to 10 degrees Celsius water as soon as possible and continue until core temperature drops to a safe level (around 38.3–39.4 C). Other measures — like misting fans, wetting clothing or transporting an athlete to a hospital without prior on-field cooling — are substantially less effective and can worsen outcomes if they delay rapid cooling.

The natural history of EHS can be unforgiving. Brain injury, multi-organ dysfunction and death are possible when cooling is delayed. That clinical reality is why athletic programs are expected to have clear emergency-action plans (EAPs), trained personnel and equipment on site, and decision-making protocols that empower trainers to modify or cancel sessions when risks are elevated.

Best-practice standards and oversight expectations

National and international sports medicine organizations provide detailed guidance on preventing and managing heat illnesses. Key elements commonly recommended include:

• Environmental monitoring: Use Wet Bulb Globe Temperature (WBGT) or similar indices to gauge heat stress, and modify activity intensity and duration based on thresholds.
• Acclimatization: Introduce athletes gradually to hot conditions over 7–14 days, progressively increasing duration and intensity.
• Hydration and scheduled rests: Provide water access and enforce work-to-rest ratios, especially during high heat stress.
• Staffing: Ensure certified athletic trainers and medical personnel are present for organized team activities, and that strength and conditioning staff coordinate closely with medical staff.
• Emergency Action Plans: Maintain written, practiced EAPs for heat illness and other medical emergencies. EAPs should specify roles, equipment (including immersion tubs), communication channels, transport plans and documentation procedures.
• Authority structure: Grant medical staff the authority to curtail or stop workouts based on health and safety concerns without needing approval from coaching staff.

Collegiate programs typically fold these elements into institutional policies. Where breakdowns occur — failure to involve the strength and conditioning staff, unclear authority, reliance on outside consultants without enough oversight — risk increases.

Where ASU’s findings intersect with established protocols

The ASU review’s short summary identifies a single procedural gap with outsized consequences: coaches did not submit the workout plan for review by the university’s strength and conditioning coaches. That control point exists precisely to ensure workouts are appropriate for the environment, that staffing is sufficient, and that equipment and emergency preparations are in place.

Missing that step may have allowed a training session to proceed without formal assessment of heat exposure, acclimatization status, hydration plans, rest intervals, or immediate medical readiness on site (such as an immersion tub or medically trained personnel). If emergency response then deviated from best-practice treatment, the combined effect would compound risk.

ASU’s plan to convene an expert panel to recommend practices on planning, staffing, monitoring and emergency response mirrors reforms that followed earlier high-profile tragedies in American sports. The university’s move signals recognition that procedural fixes and culture change must be part of the remediation.

How previous cases reshaped institutional practices

High-profile exertional heat illness cases in organized sports have driven policy changes in the past. Two widely cited cases illustrate how outcomes catalyze reform.

• Korey Stringer (NFL, 2001): The Minnesota Vikings’ offensive lineman died during training camp in 2001 from exertional heat stroke. The case prompted the NFL to intensify its focus on heat illness prevention, including adjusting practice policies and emphasizing acclimatization and emergency response.
• Jordan McNair (University of Maryland, 2018): McNair, a college football player, collapsed after a conditioning workout and later died. The incident generated multiple investigations, a widely publicized independent review and legal settlements. It also led universities and athletic conferences to reassess conditioning oversight, trainer authority and emergency procedures.

Those episodes show a pattern: when institutions discover gaps — whether in planning, monitoring, response or culture — public pressure and legal scrutiny follow. The reforms that follow range from simple equipment purchases (immersion tubs, WBGT monitors) to structural changes (staffing requirements, mandatory plan reviews and legal agreements with outside trainers). They also reveal a crucial cultural issue: whether athletes feel safe reporting symptoms without fear of roster or status consequences.

Athlete culture, pressure to perform and reporting barriers

The Professional Hockey Players’ Association (PHPA) issued a statement emphasizing the systemic nature of the problem: when athletes fear speaking up about injury, illness or exhaustion, the system fails them. That warning hits a central point. Athletes at every level face incentives to minimize or hide symptoms. Elite prospects, in particular, confront intense pressure in tryouts, early-season assessments and coach-led workouts. The result can be delay in reporting or acceptance of conditions that medical staff would otherwise modify.

Institutional safeguards must therefore do more than provide equipment and checklists. They must change incentive structures and empower independent medical staff to make safety calls that override competitive pressures. Formal lines of authority, whistleblower protections, and routine audits of practice plans and medical responses are part of an effective cultural reset.

Practical steps programs must implement now

The ASU review’s proposed advisory panel should produce recommendations aligned with consensus standards. For athletic programs facing similar risks, the checklist is straightforward and actionable:

• Require pre-approval of all coach-led workouts by certified strength and conditioning and medical staff. No exceptions for “first-day” or ad hoc sessions.
• Mandate environmental monitoring with WBGT or comparable indices and set clear activity modification thresholds.
• Enforce acclimatization schedules for athletes arriving from cooler climates or returning from off-season.
• Ensure hydration protocols, scheduled breaks and shade are built into every session.
• Require on-site certified athletic trainers for all high-intensity activities and guarantee the presence of rapid cooling equipment, including full immersion tubs or portable cold-water options.
• Practice EAPs regularly, document drills and maintain role clarity so that any staff member can trigger emergency protocols immediately.
• Document attendance, conditions, and the workout plan for post-session review and legal defensibility.
• Limit use of outside consultants to those vetted and integrated into the program’s medical oversight structure, with explicit accountability and documented coordination.
• Establish reporting channels and protections so athletes can report symptoms without fear of exclusion or retribution.

These measures are not novel. Where they are enforced, morbidity and mortality from exertional heat illnesses fall. The challenge for many programs is not a lack of guidance but inconsistent application and, at times, an unspoken tolerance for grueling sessions that push boundaries in dangerous weather.

Legal exposure and potential avenues for accountability

When an athlete collapses during an organized activity, several legal pathways often emerge. Civil negligence lawsuits typically examine duty of care, breach of that duty, causation and damages. In a case where coaches fail to follow established university policy or national standards, plaintiffs can argue breach. Operational documentation — or the absence of it — is crucial evidence.

Criminal investigations are less common but not unprecedented, particularly where conduct is alleged to be reckless or where a death occurs. The family’s plan to ask the county attorney for an investigation follows that path. A criminal inquiry would need to establish a higher level of culpability than a civil claim.

Institutional liability also extends to accreditation issues, NCAA or conference sanctions, insurance claims and reputational damage. Athletic departments typically respond to these risks by cooperating with investigations, conducting internal reviews, and making policy changes to demonstrate remediation.

At the same time, legal outcomes are not predetermined. They depend on detailed facts: what medical care was rendered on site, how quickly cooling was initiated, whether medical staff had authority and whether clear protocols were ignored. Public statements and timelines, properly documented, will influence how accountability is assigned.

The missing pieces in public reporting so far

Public summaries of ASU’s review and family statements provide essential contours but leave important operational details unreported. Key open questions include:

• Who was medically supervising the session and where were they positioned relative to the field?
• Were athletic trainers on site with cold-water immersion capability, and if not, why?
• Was environmental monitoring in place (WBGT readings) and were thresholds exceeded?
• Did the workout deviate from a pre-existing plan, or was water and rest intentionally withheld?
• When and how was cooling initiated, and what specific medical interventions were used before hospital transport?
• Who documented the incident in real time and what do those records show?

Answers to those questions will shape both medical and legal assessments. If the university’s internal review and the police inquiry produce detailed timelines and documentation, they will form the basis for more definitive conclusions and potential policy remedies.

How immediate medical actions influence outcomes

Medical science on exertional heat stroke emphasizes a narrow window of opportunity. Rapid cooling within the first 30 minutes after collapse correlates strongly with better neurologic and survival outcomes. Delay in cooling increases the risk of brain injury and organ dysfunction.

Cold-water immersion achieves the fastest core temperature reduction. Other methods — fanning, misting, removing clothing, transporting the athlete to a hospital before reducing temperature — are significantly slower. Therefore, protocols give priority to on-site cooling when EHS is suspected, followed by rapid transport when stabilization permits.

The family’s lawyer contends that Mayich was treated “in a way that hurt his chances.” That allegation suggests either a delay in initiating appropriate cooling or an incorrect sequence of interventions. Confirming or disproving that claim requires access to detailed medical records and witness statements. The police investigation and the family’s request for outside review indicate those records will be scrutinized.

The role of outside consultants and guest speakers

The coaches allowed Timothy Zeisel to speak to the team that morning. The review notes Zeisel had spoken to the ASU hockey team previously about leadership and teamwork. Outside consultants and speakers are common in collegiate athletics. They can provide valuable mentorship and expertise, but their participation should be integrated into the program’s safety framework.

When outside consultants lead or significantly influence conditioning logistics, the program must ensure they work under the authority and oversight of certified medical and strength personnel. That oversight includes pre-approval of session structure, clarity about hydration and rest policies, and confirmation that medical readiness is in place. Unvetted or loosely supervised sessions increase liability and risk for participants.

The PHPA statement and athlete advocacy

The PHPA’s comment that athletes “should never have to choose between their health and their careers” underscores an ethical and structural issue. Athlete advocacy groups argue for independent medical staff, transparent reporting mechanisms and safeguards against retaliation. Those measures aim to remove the perceived conflict of interest when a coach’s desire to push performance collides with a trainer’s duty to prioritize health.

Building such protections requires institutions to separate medical decision authority from competitive decision-making. Where that separation exists in practice, athletes report higher rates of symptom reporting and better overall safety profiles.

What other universities and leagues do differently

Institutions and professional leagues have adopted a range of measures to mitigate heat risks. Examples include:

• Mandatory WBGT monitoring at all outdoor practices, with color-coded action plans that restrict activity at specific thresholds.
• Strict acclimatization calendars, especially for athletes arriving from cooler climates or returning from injury.
• Required presence of certified athletic trainers for all high-intensity sessions and explicit authority for trainers to pause or stop activities.
• Investment in portable immersion tubs, ice and temperature-monitoring devices to allow immediate treatment in the field.
• Routine audits of practice plans and EAPs by independent safety officers or external consultants.

Some leagues and universities also require annual training for coaches on heat illness recognition and treatment, and they collect post-session reports to identify patterns of excessive intensity or inadequate medical supervision.

How this incident could reshape policy and practice

ASU’s decision to convene an expert panel, combined with the public scrutiny and the family’s legal posture, makes policy change likely. Possible outcomes include:

• Mandatory pre-approval of all workouts for NCAA teams by certified strength and conditioning and medical staff.
• New staffing mandates: trainers on site for all conditioning sessions, with explicit authority to stop activities.
• Installation of WBGT monitors and immersion-capable cooling systems at practice sites across campus.
• Formalized integration and vetting of outside consultants.
• Revision of student-athlete education programs to emphasize symptom reporting, hydration and acclimatization.
• Transparent disciplinary protocols for policy violations.

If implemented and enforced, those measures would address many of the procedural gaps identified in the review summary. The degree to which they change culture depends on consistent enforcement and the willingness of leadership to prioritize safety over competitive expediency.

The balance between tough training and athlete safety

High-performance sports have always demanded rigorous conditioning. Coaches view hard work as necessary to develop elite competitors. The question is where to draw the line between pushing athletes to their limits to build performance and subjecting them to conditions that create unacceptable health risks.

Best practices do not eliminate challenging training. They simply manage risk: adjusting intensities for environmental conditions, allowing for adequate recovery and ensuring immediate medical capability. The most effective programs marry intensity with safety, because the long-term viability of an athlete’s career depends on both performance gains and preserved health.

For a player like Mayich — an NHL draft pick pursuing an elite pathway — the pressure to perform and integrate quickly into a new environment is intense. That reality heightens the duty of programs to protect athletes from conditions that exploit perceived vulnerabilities rather than train them safely.

What to watch next in the Mayich case

Several developments will shape the public understanding and potential consequences of what occurred on Aug. 20:

• Completion and release of ASU’s full review or the blue-ribbon panel’s recommendations. A thorough report should include timelines, witness statements, medical interventions, equipment inventories and policy assessments.
• Results of the ASU Police Department’s investigation. The scope and findings of any criminal inquiry will be determinative for questions of culpability.
• Any action by the county attorney in response to the family’s request for an external probe or criminal referral.
• Potential civil litigation by the family, which would involve discovery of medical records, personnel files, emails and internal workflows.
• ASU’s implementation of immediate operational changes (if any) such as mandatory pre-approval of workouts, improved medical staffing or equipment purchases.
• Statements or actions from the NHL and the St. Louis Blues regarding protocols for drafted players training with collegiate programs.

The family, the university and the broader hockey community will watch these steps closely. The choices ASU makes about transparency, accountability and reform will influence not only this case’s legal trajectory but also how other programs treat similar risks.

Broader implications for organized sport

This incident should prompt administrators across collegiate and youth sports to reassess their practices. Four lessons are especially salient:

1. Procedures matter. Requiring written, pre-approved workout plans with medical sign-off is a low-cost, high-impact control.
2. Time-sensitive medical care saves lives. Rapid recognition and immediate cold-water immersion for suspected exertional heat stroke must be standard.
3. Culture and incentives matter. Athletes must be able to report symptoms without fear, and medical staff must have clear decision-making authority.
4. Documentation protects athletes and institutions. Accurate records of plans, attendance, environmental conditions and medical response are essential for quality control and, when needed, legal defense.

Programs that adopt and enforce these lessons reduce both harm to athletes and exposure to legal and reputational risk.

The human dimension: Matt Mayich’s community and support

Beyond protocols and policy discussions, this episode centers on a young athlete and his family. Mayich grew up in Hamilton and played with the Hamilton Huskies and the Hamilton Jr. Bulldogs. Those who coached and played with him remember not only his skill on the ice but also his commitment to mentoring younger players and his positive impact off it. The Hamilton Steel Hockey Club described him as “a tremendous hockey player and, more importantly, an outstanding person both on and off the ice.”

The personal and communal responses — from teammates, from the Blues organization, and from local hockey programs — reflect the human stakes behind the policy debates. Families and teams look for accountability, clarity and swift action to prevent similar tragedies. For the Mayich family, the stakes are immediate and personal; their calls for answers and for an external investigation aim to ensure that the system changes to protect others.

Final considerations

Athletic excellence and athlete safety must not be competing objectives. When safety protocols are robust and enforced, athletes can train hard with much lower risk. The outbreak of scrutiny following Mayich’s collapse puts that principle to the test. How ASU answers will influence not only one program but the expectations colleges set for preparing athletes to train in heat and other adverse conditions.

Expect the coming weeks to produce more detail. The university’s blue-ribbon panel, the police inquiry, and any external investigations will determine whether failures were systemic or individual, whether corrective measures are sufficient, and whether accountability extends beyond policy changes to personnel decisions. The broader sports community will watch closely. The lessons learned here could alter routines on practice fields, in weight rooms and at stadiums across the country.

FAQ

Q: What exactly did ASU’s review say about the workout? A: The review, summarized by James Rund, said coaches did not submit a written plan of the training activities to ASU’s strength and conditioning coaches before the outdoor workout on Aug. 20. The session occurred near 30 C, included calisthenics and running, and Matthew Mayich collapsed just before 8:30 a.m. The university announced it will convene a blue-ribbon advisory panel to recommend best practices on planning, staffing, monitoring and emergency response, and confirmed the ASU Police Department is investigating.

Q: What is the medical condition cited in descriptions of Mayich’s collapse? A: Public reports indicate he collapsed during intense physical activity in heat and was hospitalized in critical but stable condition. While the university and family statements do not use a specific clinical diagnosis in their public summaries, the circumstances are consistent with exertional heat illness, which can range from heat exhaustion to exertional heat stroke. A precise diagnosis would require clinical records from the treating physicians.

Q: What did the family’s lawyer allege? A: Family lawyer Rob Carey said there was “no plan and no preparation” for the workout and that the way Mayich was treated “hurt his chances rather than helped them.” He also alleged, based on his investigation, that the session resembled a “military-style, brutal, gruelling workout” with no breaks and no water for over an hour. Carey said the family would ask the county attorney to investigate.

Q: What are the accepted best practices for preventing and treating exertional heat stroke? A: Prevention includes environmental monitoring (WBGT), graded acclimatization, enforced hydration and scheduled rest periods, proper staffing and medical readiness, and mandatory pre-approval of high-intensity workouts by certified strength and conditioning and medical staff. For suspected exertional heat stroke, immediate cold-water immersion on site is the gold-standard treatment; rapid cooling within minutes is associated with better outcomes.

Q: Could ASU or individual staff face legal consequences? A: Legal consequences depend on the outcomes of investigations and the evidence. Civil suits for negligence are common after such incidents if procedures are shown to have been breached. Criminal investigations are possible if conduct is alleged to be reckless and resulted in severe harm. The family’s request for a county attorney investigation opens the possibility of a criminal inquiry, but any charges would depend on findings of the probe and applicable state law.

Q: How common are incidents like this? A: Serious exertional heat illnesses that result in hospitalization or death are rare but not unheard of. Historical cases, including deaths of high-profile athletes, have led to strengthened policies and equipment standards. The rarity does not reduce the need for rigorous prevention because the outcomes can be catastrophic.

Q: What should other athletic programs take away from this incident? A: Programs should require pre-approved workout plans with medical sign-off, ensure WBGT monitoring and acclimatization policies, staff practices with certified athletic trainers empowered to stop activity, maintain immersion cooling capability on site, regularly practice EAPs, document all sessions and responses, and protect athletes who report symptoms from retaliation.

Q: Where can coaches and athletic departments find guidance? A: Consensus statements and guidelines from organizations such as the National Athletic Trainers’ Association (NATA), the American College of Sports Medicine (ACSM), and specific collegiate athletic conferences provide practical, evidence-based recommendations on heat illness prevention and treatment. Institutions should align policies with those guidelines and ensure routine training and audits.

Q: What are the next steps in the Mayich case? A: Watch for the release of ASU’s detailed internal review or the blue-ribbon panel’s recommendations, updates from the ASU Police Department’s investigation, any decision by the county attorney to open an external probe, and potential civil litigation by the family. The university may also announce immediate operational changes around practice approvals and medical staffing.

Q: How can athletes protect themselves during high-heat conditions? A: Athletes should report symptoms early, follow acclimatization schedules, stay hydrated, understand the signs of heat-related illness (dizziness, confusion, muscle cramps, collapse), and expect that medical staff have the authority to pause or stop activities. Awareness and early reporting, combined with strong institutional protections, reduce the chance of severe outcomes.