For lots of gals, a heart illness diagnosis or recent cardiac event may well depart them feeling alone and frightened, but talking with somebody with a very similar working experience who can provide assistance and empathy can make all the variation.
To develop that possibility, Hartford HealthCare’s Heart & Vascular Institute has partnered with WomenHeart – a countrywide coalition for ladies with coronary heart illness – to offer a peer-to-peer help network for woman clients dwelling with heart disorder. The monthly just one hour meetings concentrate on giving emotional support and schooling to females who could be having difficulties with a new diagnosis, recovering from a the latest cardiac event or treatment, or just want to talk to another person who understands what they are suffering from.
“Our WomenHeart help network is an amazing local community useful resource for gals dwelling with heart illness,” reported Heather Swales, MD, a cardiovascular expert in Hartford HealthCare’s Coronary heart & Vascular Institute. “I have so numerous individuals who come to feel like they are dealing with heart disorder by itself. When they take part in the team, they recognize there are numerous girls out there battling with very similar complications. It is a awesome outlet for them to master how to advocate for by themselves and get assistance from other ladies in the neighborhood.”
Meetings have been founded in Southington and Stratford, and are led by specially-skilled Guidance Community Coordinators who are also living with heart disorder. Their schooling is delivered by WomenHeart, and features assistance to establish and direct affected person assist teams, understanding about coronary heart condition and educating women of all ages, and telling their personal tale to help empower other folks.
In addition to members sharing their exceptional activities and wellness standing updates, the conferences cover a range of matters including heart condition avoidance, nutrition, cardiac methods and drugs, physical exercise, psychological wellness wellness and much more.
“I joined the team for assist and to listen to and share with others,” explains a WomenHeart Assistance Community member. “The group has aided present me a way to stay with heart condition as I research to obtain a new typical.”
Conferences in the Fairfield Region are held at the HHC Urgent Care Building in Stratford (3272 Major St.) on the very first Wednesday of every month. In Southington, conferences are held at the Bradley Memorial Campus (81 Meriden St.) on the third Wednesday of every thirty day period.
To sign-up for conferences at both area, patients can phone 1.855.442.4373.
Today’s early morning highlights from the major news organizations. Note to readers: KHN’s First Edition will not be published Monday, May 30, in honor of Memorial Day. Look for it again in your inbox on Tuesday.
KHN:
Burned Out By Covid And 80-Hour Workweeks, Resident Physicians Unionize
In the early weeks of the pandemic, Dr. Lorenzo González, then a second-year resident of family medicine at Harbor-UCLA Medical Center, ran on fumes, working as many as 80 hours a week in the ICU. He was constantly petrified that he would catch the covid-19 virus and guilt-ridden for not having enough time to help his ailing father. In April 2020, his father, a retired landscaper, died of heart and lung failure. González mourned alone. His job as a doctor-in-training put him at high risk of catching the virus, and he didn’t want to inadvertently spread it to his family. Financial stress also set in as he confronted steep burial costs. (Kwon, 5/27)
KHN:
Betting On ‘Golden Age’ Of Colonoscopies, Private Equity Invests In Gastro Docs
Mariel needed a new gastroenterologist. Having just moved back to San Antonio, the 30-something searched for a doctor to manage her Crohn’s disease, an inflammatory bowel condition that is successfully managed with medications and lifelong monitoring — including regular colonoscopies. Mariel booked an appointment and learned she would be on the hook for a $1,100 colonoscopy — about three times what she had paid for the same test in a different state. Almost three-quarters of the bill would be a “facility fee” for the in-office procedure at a colonoscopy clinic. (KHN agreed not to disclose Mariel’s last name because she is concerned speaking out might affect her doctor’s willingness to manage her medical condition.) (Pisacreta and Huetteman, 5/27)
KHN:
‘An Arm And A Leg’: Private Equity Is Everywhere In Health Care. Really
When a listener wrote to us about a pricey colonoscopy quote, we got curious. It turns out, a few years back, investors identified gastroenterology as their next hot-ticket item. Private equity companies are the house-flippers of the investment world, and they’ve found their way into many areas of our lives. Now, they’re at gastroenterologists’ offices, too, hoping to change the way these doctors do business and make a quick buck selling the practice down the road. (Weissmann, 5/27)
KHN:
KHN’s ‘What The Health?’: A(Nother) Very Sad Week
This week’s mass shooting of elementary schoolers in Texas (just 10 days after a racially motivated mass shooting at a Buffalo, New York, grocery store) has reignited the gun debate in Washington, D.C., and around the country. But the political disagreements over guns and their appropriate role in American society are as insoluble as ever. Meanwhile, Oklahoma becomes the first state to try to ban all abortions, as the nation awaits the Supreme Court’s ruling in a case it is expected to use to overturn the landmark Roe v. Wade decision. (5/26)
The Centers for Disease Control and Prevention has identified nine cases of monkeypox across seven U.S. states, officials said Thursday: in California, Florida, Massachusetts, New York, Utah, Virginia and Washington. “The U.S. has the resources we need to help us respond to monkeypox in this country right now. We’ve been preparing for this type of outbreak for decades,” CDC Director Dr. Rochelle Walensky said in a briefing. (Bendix, 5/26)
The monkeypox outbreak in the US has expanded to include nine cases in seven states, senior health officials said Thursday, adding that the outbreak is expanding in countries where the virus does not normally circulate. Officials from the Centers for Disease Control and Prevention said the new monkeypox infections were found in Virginia, California and Washington state. Earlier this week, the agency said four cases had been identified in Massachusetts, Florida, Utah and New York. Some but not all of the US patients had recently traveled abroad. (Muller and Stein, 5/26)
Virginia public health officials on Thursday reported the state’s first presumed case of monkeypox, in a Northern Virginia woman who had recently traveled to an African country. The case is among nine recently identified in seven states, officials at the Centers for Disease Control and Prevention told reporters Thursday morning. The state lab identified the case, and as of Thursday afternoon, the Virginia Department of Health was awaiting CDC confirmation. (Portnoy, 5/26)
A presumptive case of monkeypox has been identified in Colorado, the state Department of Public Health and Environment announced Thursday. The infection occurred in a Denver-area man who had recently traveled from Canada, where there is an ongoing outbreak of the virus. Health officials are working to identify and monitor close contacts of the man’s, but Dr. Rachel Herlihy, the state epidemiologist, said there is not believed to be a high risk of community transmission. “Risk to Coloradans is low,” Herlihy said. (Ingold, 5/26)
Massachusetts General Hospital this week began vaccinating a small group of workers against monkeypox — the first time the new medicine has been used in this country outside of clinical trials. The workers were in close contact with a man diagnosed with the virus and hospitalized at Mass General from May 12 to May 20. The patient was the first person in the United States to be tied to an ongoing outbreak of the rare virus in Europe and North America. Monkeypox has now been identified in nine people across seven states, including Massachusetts, Florida, Utah, Washington, California, Virginia, and New York, the Centers for Disease Control and Prevention said Thursday. Among the latest cases, reported Thursday by health officials in Virginia, is a woman who recently traveled to an area in Africa where the disease is known to occur. They said she was not infectious during travel and did not require hospitalization. (Lazar, 5/26)
Public health authorities are scrambling to raise awareness of the growing monkeypox outbreak in advance of this weekend’s start of Pride Month celebrations. In doing so, they are trying to strike a delicate balance — getting out the message that monkeypox may currently be a risk to men who have sex with men, without stigmatizing the community by linking them to a scary-sounding virus that can infect anyone in certain circumstances. (Branswell, 5/27)
As mysterious cases of a rare and ominously named virus began surfacing in Europe, Germany’s disease-control center quickly told people to be on the lookout. In a May 19 alert, the agency listed telltale symptoms of monkeypox: fever, aches, a rash. Then, in a further comment that set different alarm bells ringing, the bulletin pointedly warned men who have sex with men to “seek immediate medical attention” if they detect signs of the disease. (Kirschbaum and Chu, 5/26)
The nation’s infant formula shortage likely won’t be fully resolved until late July, the head of the Food and Drug Administration (FDA) told senators Thursday. During a Senate Health Committee hearing, FDA Commissioner Robert Califf said it will take time to get to the point when store shelves are fully stocked but that eventually there will be a surplus. (Weixel, 5/26)
Food and Drug Administration Commissioner Robert Califf proposed a national stockpile of baby formula that authorities could tap to ease future shortages. Dr. Califf said in a hearing Thursday before the Senate Health, Education, Labor and Pensions Committee that he expects recent government and private sector moves will produce a surplus of formula in about two months. (Whyte, 5/26)
The U.S. Food and Drug Administration said on Thursday it has expanded its collaboration with Danone’s Nutricia business to boost supplies of specialized medical baby formula bottles to address its shortage among infants with certain allergies or critical health conditions. The health regulator said about 500,000 additional cans manufactured by Danone would be sent to the United States. (5/26)
Behind the refrigerator’s glass door Mark Bucher saw a single 8-ounce bottle of Similac baby formula. It was 9:30 a.m. at the Glassmanor Community Center in Prince George’s County. The fridge had been filled once this morning with formula, Bucher said, and this was all that was left a few hours later. “These bottles individually are like $4,” Bucher said as he propped open the fridge door and began placing bottles inside from a new Similac 24-pack. “It’s expensive. And if you don’t have SNAP benefits, that’s $16 a day to feed your kid, roughly speaking. That’s stressful.” The Supplemental Nutrition Assistance Program provides benefits to needy families to purchase food. (Swenson, 5/26)
As parents across the United States struggle to find formula to feed their children, the pain is particularly acute among Black and Hispanic women. Black women have historically faced obstacles to breastfeeding, including a lack of lactation support in the hospital, more pressure to formula feed and cultural roadblocks. It’s one of many inequalities for Black mothers : They are far more likely to die from pregnancy complications, and less likely to have their concerns about pain taken seriously by doctors. (Martin, Licon and Tang, 5/27)
Sitting in a quiet conference room, away from the chaos of the trauma unit at University Hospital [in San Antonio], Dr. Ronald Stewart paused and closed his eyes several times Thursday before choking back tears. “I feel so bad for those families,” he said, “and guilty, to some degree, that they don’t have their children and I do.” Stewart, senior trauma surgeon at University Hospital and the father of three adult children, was one of the doctors who treated the victims of Tuesday’s mass shooting at Robb Elementary School in Uvalde, where a gunman opened fire with a weapon of war, killing 19 children and two teachers. (Lozano, 5/26)
Dr. Bindi Naik-Mathuria, a pediatric surgeon at Baylor College of Medicine in Houston, knows what assault rifles can do to a child’s body. The damage, she said, is often insurmountable. “It’s not just the hole you see on the outside. It’s a huge blast effect,” Naik-Mathuria said. “You see completely shredded organs. Vessels are completely disrupted. There’s no way to salvage them. ”That’s why Naik-Mathuria is full-throatedly proclaiming that the issue of gun violence is “very much our lane.” “We have our hands inside these people, these children, trying to save them,” she said. “How can anyone tell us that it’s not our problem?” (Edwards, 5/26)
Sitting in his office on the third floor of the courthouse here, Judge Eulalio Diaz first saw a post around noon Tuesday from the city’s police. Not a first responder, he went about his day, watching ambulances and buses out two windows behind his desk, hearing and reading reports. About two hours later, he got a call requesting he “make a location,” indicating that at least one person is dead in a Texas county without a medical examiner. As the county’s justice of the peace, his duties usually include court cases and officiating weddings, but his role also includes serving as the coroner. “We were under impression that it was two or three people,” Diaz, 49, recounted Thursday. (Serrano, 5/26)
After a teenage gunman killed two of her high school students and wounded four others in her Florida classroom in 2018, Ivy Schamis found the strength to carry on teaching for two more years. Missy Dodds, who watched five of her pupils gunned down by a former student who shot his way into her classroom in Minnesota in 2005, returned for six weeks before abandoning the career she loved. (Reid, 5/26)
As negotiations on possible gun reform got underway in the U.S. Senate on Thursday, Majority Leader Chuck Schumer blasted Gov. Greg Abbott as an “absolute fraud.” Schumer accused Abbott of offering nothing but “empty platitudes about healing and hope” after he was confronted by Beto O’Rourke during a press conference in Uvalde on Wednesday. “He asked the people to put their agendas aside and think about someone other than themselves,” Schumer said. “How dare he. What an absolute fraud the governor of Texas is.” (Wermund, 5/26)
As news traveled around the country Tuesday of a mass shooting at a Texas elementary school that left at least 22 dead — including 19 children, two teachers and the 18-year-old gunman — California lawmakers were advancing a package of gun control bills, including one sponsored by Gov. Gavin Newsom that co-opts the structure of Texas’ abortion ban to crack down on illegal firearms. The striking timing highlighted a shared challenge facing California, Texas and other states: reducing gun deaths, which have ticked up dramatically nationwide amid the pandemic. (Hoeven, 5/25)
A grocery store. A church. An elementary school. Again. Within 10 days this month, mass shootings in Buffalo, N.Y., Laguna Woods, and Uvalde, Texas, have claimed dozens of lives, shattered families and communities, and put people around the U.S. on edge. (Amato, 5/25)
It’s important to stay informed, engaged and even outraged. But it’s also important to pay attention to our own limits and mental health by taking breaks, looking for signs of burnout, connecting with our families and consuming news in the smartest way possible. That means setting some ground rules for the main portal connecting us to nonstop tragedy: our phones. (Kelly, 5/25)
The White House on Thursday announced more steps to make the antiviral treatment Paxlovid more accessible across the U.S. as it projects COVID-19 infections will continue to spread over the summer travel season. The nation’s first federally backed test-to-treat site is opening Thursday in Rhode Island, providing patients with immediate access to the drug once they test positive. More federally supported sites are set to open in the coming weeks in Massachusetts and New York City, both hit by a marked rise in infections. (Miller, 5/26)
When the patient came back 10 days later, coughing repeatedly and complaining of headache, Davey Smith feared the worst. Smith had prescribed the patient Pfizer’s new antiviral pill, Paxlovid, on the previous visit, after a Covid-19 test came back positive. A resurgence of symptoms probably meant one thing, especially after Smith tested the patient and got another positive. “I was pretty sure it was resistance,” said Smith, an infectious disease physician at the University of California, San Diego. “I’m a virologist, I combat resistance all the time.” (Mast, 5/27)
The Centers for Disease Control and Prevention plans to simplify the Covid-19 hospital data it collects as the demands of the pandemic evolve and some assembled information has become outdated or redundant. The agency is likely to stop collecting data from hospitals on suspected Covid cases that haven’t been confirmed by tests, for example, and may also wind down federal reporting from rehabilitation and mental health facilities that aren’t major intake points for virus cases, according to a draft of the plan that was viewed by Bloomberg News. (Griffin and Armstrong, 5/26)
Cases of COVID-19 are – yet again – on the rise. The U.S. is seeing an average of more than 100,000 reported new cases across the country every day. That’s nearly double the rate a month ago and four times higher than this time last year. And the real number of cases is likely much higher than that, according to health officials. Because many people now rely on at-home tests, “we’re clearly undercounting infections,” White House COVID-19 Response Coordinator Dr. Ashish Jha told reporters at the most recent COVID press briefing. Hospitalizations are trending upwards too, though only gradually in most places. (Simmons-Duffin, 5/27)
This week Utah reported more than 5,000 new coronavirus cases, more than 100 new hospitalizations and a dozen more deaths — including one girl between the ages of 1 and 14. The Department of Health said it had no additional information about her death. Last week, state health officials and doctors told reporters Utah was in the midst of a coronavirus surge and would likely see rising case counts and other metrics for several more weeks. Intermountain’s Dr. Brandon Webb said high positivity rates suggested case counts showed a “significant undercount.” (Harkins, 5/27)
The Centers for Medicare and Medicaid Services is probing hospitals where a high rate of patients have gotten Covid-19 infections after cases spiked to record highs this year. Jon Blum, the agency’s principal deputy administrator and chief operating officer, told POLITICO on Wednesday that the regulator is focusing on facilities with Covid outbreaks, taking into account patient and health workers’ safety complaints, a change from the agency’s “less rigorous” process early in the pandemic. (Levy, 5/26)
UCLA has ordered a mask mandate in indoor settings on campus, effective Friday, as coronavirus cases continue to climb in Los Angeles County. Officials said the mask order was needed to avoid disrupting in-person learning and campus activities, including graduation. “An important strategy to curb the spread of COVID-19, in addition to ongoing testing and daily symptom monitoring, is the consistent use of well-fitting masks indoors,” the campus said in a letter Thursday. (Lin II and Money, 5/26)
The coronavirus mutant that is now dominant in the United States is a member of the omicron family but scientists say it spreads faster than its omicron predecessors, is adept at escaping immunity and might possibly cause more serious disease. Why? Because it combines properties of both omicron and delta, the nation’s dominant variant in the middle of last year. A genetic trait that harkens back to the pandemic’s past, known as a “delta mutation,” appears to allow the virus “to escape pre-existing immunity from vaccination and prior infection, especially if you were infected in the omicron wave,” said Dr. Wesley Long, a pathologist at Houston Methodist in Texas. That’s because the original omicron strain that swept the world didn’t have the mutation. (Ungar, 5/26)
Many gyms and health clubs seem to be filling up again with people eager to return to their old routines and communities or get in shape for summer, at the same time that new Omicron variants are pushing Covid infections up. So, how safe is it to go back to the gym? Put another way, how many microscopic aerosol particles are the other cyclists in your spin class breathing out into the room? How many is the runner on the nearby treadmill spewing forth? A small study about respiration and exercise published Monday in the Proceedings of the National Academy of Sciences provides some rather startling answers. (Reynolds, 5/24)
Doctors cannot seem to pinpoint what is wrong with Michael Quintos. Mr. Quintos, 53, a Chicago resident, has constant stomach pain. He has been hospitalized, and his doctors have tried everything including antibiotics, antacids, even removing his appendix. “I still don’t feel good,” Mr. Quintos said. His doctors recommend using a CT scan with contrast, imaging that relies on a special dye often injected into patients to better visualize their blood vessels, intestines and organs like the kidney and liver. But a nationwide shortage of the imaging agents needed for the procedure — the result of the recent lockdown in Shanghai to quell a Covid outbreak — has prompted hospitals to ration these tests except in emergencies. Like thousands of others in recent weeks, Mr. Quintos cannot get an exam using the contrast dye. (Abelson, 5/26)
The Health and Human Services Department has withdrawn a policy initiated under President Donald Trump that would have required extensive reviews of its regulations. Under the SUNSET rule, nearly all HHS regulations would be scrutinized for economic impact and other factors after 10 years, and automatically eliminated if they were not reviewed within that time frame. President Joe Biden’s administration formally canceled this policy in a rule issued Thursday. The SUNSET rule would have substantially altered HHS operations and had negative consequences for people affected by departmental regulations, HHS announced in a Federal Register notice. (Goldman, 5/26)
Pharmacists and drug wholesalers can import prescription medicines from Canada for up to two years as part of state programs aimed at bringing down drug costs, according to final FDA guidance released Thursday. With President Biden’s drug pricing agenda still stalled, the FDA is further clarifying how states could take advantage of lower drug costs abroad without the need to limit prices in the U.S. Both the Biden and Trump administrations embraced limited importation to bring down health costs, though experts view the policy as having limited impact. (Bettelheim, 5/26)
A bipartisan group of Senate Finance Committee leaders on Thursday proposed expanding telehealth access for mental health services. The committee issued a discussion draft that pushes to eliminate Medicare’s in-person visit requirement prior to patients seeking online mental health services. This requirement has not gone into effect due to the COVID-19 public health emergency. But when the emergency ends, it would limit older adults’ ability to access virtual care. Committee Chair Ron Wyden (D-Ore.), ranking member Mike Crapo (R-Idaho), Sens. Ben Cardin (D-Md.) and John Thune (R-S.D.) released the draft urging stronger legislative action.Telehealth services proved to be a “game-changer” during the pandemic, Wyden said in a news release. (Berryman, 5/26)
CVS Health’s new digital platform intends to give consumers access to health services on demand, whether they are at home or in a retail or community-based setting. Eligible Aetna and CVS Caremark members will be able to use CVS Health Virtual Primary Care to request remote primary care, chronic condition management and mental health services, in addition to being seen at an in-network provider in person, the company said Thursday. The platform will roll out to Aetna memberson Jan. 1, 2023, and CVS Caremark during the second quarter of 2023. (Devereaux, 5/26)
A perfect storm looms for federally qualified health centers whenever the federal government decides the COVID-19 public health emergency is over. When that declaration ends, which isn’t likely to happen until at least October, many community health center patients are expected to lose Medicaid coverage, which will leave clinics without reimbursement for services they provide. Planning for the future is further complicated by a pending funding cliff in fiscal 2023 and numerous other policy challenges. “It’s very stressful looking for money rather than taking care of people,” said Mary Elizabeth Marr, CEO of community health center chain Thrive Alabama. “We are the ones that take care of people that nobody else wants to take care of, and yet we’re having to do all kinds of heroic things to try to raise funds.” (Goldman and Hartnett, 5/26)
About 400 workers at Planned Parenthood offices in five states said Thursday they plan to unionize as their employer deals with the potential loss of business in states where abortions may become illegal if the U.S. Supreme Court overturns the landmark 1973 Roe v. Wade ruling. Workers for Planned Parenthood North Central States in Iowa, Minnesota, Nebraska, North Dakota and South Dakota said they have signed cards showing majority support for unionization, and on Thursday they formally filed for a union election with the National Labor Relations Board, said Ashley Schmidt, a training and development specialist for Nebraska and western Iowa. (Pitt, 5/26)
Citing understaffing and a “sense of urgency” amid reports that the U.S. Supreme Court will overturn abortion protections, Planned Parenthood employees in Iowa have announced their intention to unionize. Workers at the nonprofit, which provides abortions and other reproductive services, have filed an election petition with the National Labor Relations Board, forming a potential bargaining unit with Planned Parenthood North Central States employees. In addition to employees in Iowa, the unit would cover those in Minnesota, Nebraska, North Dakota and South Dakota. (Jett, 5/26)
Calling it unlawful, the Democratic lawmakers on an interim health and human services legislative committee are asking the state health department to rescind an emergency rule it recently issued that stops transgender Montanans from being able to update gender markers on their birth certificates. The state health department issued the emergency rule earlier this week. It blocks people from changing their birth certificates in all cases except if there was a data entry error. In 2021 state lawmakers passed a law requiring a person to have gender-affirming surgery and petition a court to update their birth certificate, but a Billings judge temporarily blocked that law earlier this year. (Bichels, 5/26)
An Oklahoma bill limiting access to public-school bathrooms by a person’s birth sex is now law. School districts and charter schools that don’t comply face a 5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} deduction in their state funding. That could subtract thousands to millions of dollars, depending on the school system. Gov. Kevin Stitt signed Senate Bill 615 into law Wednesday. An emergency provision in the bill caused it to take effect as soon as the governor wrote his signature. (Martinez-Keel, 5/25)
Most Dallas firefighters don’t trust their top leaders, around a quarter of almost 900 workers say they’ve experienced symptoms of depression, and nearly 1 in 10 say they’ve thought of harming themselves, according to the results of an internal city survey released Thursday. The survey accessing the mental health of Dallas Fire-Rescue workers also found that 37{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of respondents reported drinking more alcohol since starting their job, 34{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} say they have increased anxiety, and most are aware of several programs offered through the city to decrease stress, but 83{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} say they don’t use any of them. (Bailey Jr., 5/26)
Marshfield is the latest city to find elevated levels of “forever chemicals” in its water supply. The city found levels of PFAS above the state’s current recommended health standard of 20 parts per trillion in one entry point to its water system, according to a news release from the city Thursday. The system consists of three entry points fed by 15 wells throughout the area. The city shut down the entry point upon learning its results on Tuesday, the release said, as well as the four wells that contribute to it. Residents in the meantime can continue to use their water as normal, as all of the other wells are below the recommended health guidance of 20 parts per trillion. (Schulte, 5/26)
The Jif peanut butter recall has rapidly expanded in the past week and it now affects at least 69 other products. The cascading effect is due to the many companies who use the peanut butter in their own chocolates, peanut butter sandwiches and more. J.M. Smucker Co., Jif’s parent company, issued the initial voluntary recall last week, after the Food and Drug Administration traced a salmonella outbreak to a manufacturing facility in Lexington, Ky. Almost every day since, other companies have issued their own recall notices, after confirming that their products also were affected. They range from fruit or veggie snack packs that include individually wrapped Jif cups to confections made with Jif peanut butter, including fudge and store-brand pies. (Chappell, 5/26)
A painting project is to blame for an odor that affected some cruise ship passengers in Virginia and prompted the U.S. Coast Guard to send a crew to investigate Thursday, Carnival Cruise Line said. The Coast Guard first received reports on Wednesday of an odor and people feeling ill on the Carnival Magic ship, Petty Officer Stephen Lehmann said. He said a crew went to the vessel on Thursday morning but no one needed to be evacuated for medical treatment. The vessel is docked in Norfolk. (5/26)
Women from the remote U.S. territories of Guam and the Northern Mariana Islands will likely have to travel farther than other Americans to terminate a pregnancy if the Supreme Court overturns a precedent that established a national right to abortion in the United States. Hawaii is the closest U.S. state where abortion is legal under local law. Even so, Honolulu is 3,800 miles (6,100 kilometers) away — about 50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} farther than Boston is from Los Angeles. (McAvoy, 5/27)
The World Health Assembly on Thursday voted in favor of a resolution that condemned Russian attacks on the health-care system in Ukraine before rejecting a parallel proposal presented by Moscow that Kyiv’s representative to the United Nations in Geneva had called a “subterfuge” that presented a “twisted alternative reality” of the conflict. (Taylor, 5/26)
According to North Korea, its fight against COVID-19 has been impressive: About 3.3 million people have been reported sick with fevers, but only 69 have died. If all are coronavirus cases, that’s a fatality rate of 0.002{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, something no other country, including the world’s richest, has achieved against a disease that has killed more than 6 million people. (Kim, 5/27)
Chile’s president publicly apologized to a woman who was sterilized without her consent at a public hospital two decades ago because she was HIV-positive, ending a years-long legal process that included taking her case to the Inter American Commission on Human Rights in Washington. (Politi, 5/26)
A Tokyo court began hearings Thursday in a lawsuit seeking nearly $5 million in damages for six people who were children in Fukushima at the time of its 2011 nuclear power plant disaster and later developed thyroid cancer. The plaintiffs are suing the operator of the nuclear plant, saying radiation released in the accident caused their illnesses. It is the first group lawsuit filed by Fukushima residents over health problems allegedly linked to the disaster, their lawyers say. (Yamaguchi, 5/26)
The Hunan Provincial Center for Disease Control and Prevention reported last week that a retrospective H3N8 avian flu case was confirmed in Changsha City in a 5-year-old boy, according to a report translated and posted today on Avian Flu Diary (AFD), an infectious disease news blog. This case marks the world’s second known infection from this particular avian flu strain, with the first case confirmed 1 month ago. (5/26)
This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
In a move that many health care advocates have been pushing for years, the state Senate introduced a bill on Wednesday that would expand the state’s Medicaid program to some half million-plus low-income North Carolinians.
Until this point, Medicaid has been reserved mostly for children from low-income families along with a small number of parents in those families, poor seniors and people with disabilities. Since 2012, the possibility to sweep in many low-income workers has been on the table as a result of the Affordable Care Act, but Republican leaders in the state senate have been staunch opponents.
Now, after years of saying no, powerful Republicans in the state Senate are saying yes.
“Why now? Why this? First, we need coverage in North Carolina for the working poor,” said state Senate leader Phil Berger (R-Eden), who admitted during a press conference Wednesday that he has likely been the most outspoken person in the state about his opposition to Medicaid expansion.
“Second, there is no fiscal risk to the state budget moving forward with this proposal,” Berger added, noting that the bill includes pay-fors that would have hospitals largely on the hook to pay the 10 percent of the costs for the expansion population not covered by an enhanced federal payment. There’s also a federal incentive that would total some $1.5 billion in extra funds that would flow to North Carolina over a two-year period.
Finally, he argued that since the state has moved Medicaid from being a state-run fee-for-service program to one managed by commercial insurance companies, the program has been “reformed and transformed.”
“Medicaid expansion has now evolved to a point that it is good state fiscal policy,” Berger continued. “But again, I cannot emphasize this enough: Expanding Medicaid needs to happen with additional reforms.”
Those reforms could make the bill to be titled Expanding Access to Healthcare in North Carolina a hard pill for many to swallow. One aspect of the bill would set up a work requirement for the new beneficiaries, something that’s been repeatedly struck down in other states by federal judges.
What really might jeopardize passage of the bill is that it contains provisions that already are raising hackles in some powerful health care lobbies, including those that advocate for the state’s physicians and hospitals.
Resistance from doctors
One reform proposed in the 33-page bill would make it possible for advanced practice nurses such as nurse practitioners, nurse midwives and certified registered nurse anesthetists (CRNAs) to practice without having a contract with a physician for their supervision.
Physician and nursing groups have been divided over the so-called SAVE Act for years, with medical providers — led by the North Carolina Medical Society — usually being able to stop the nurses from having more leeway in their practices. At a Senate Health Care Committee hearing held after the press conference, several Democratic lawmakers also expressed reservations over this part of the bill.
Chip Baggett, head of the North Carolina Medical Society, also spoke out about the nursing practice language in the bill at the committee. He had a number of problems with the changes.
“The first is the foundational education that is received by APRNs, many of which are receiving online education right now, and we do not think that provides the foundation necessary for independent decision making,” Baggett added after the meeting.
Joyce Krawiec, a Republican state senator from Kernersville, noted that 137 health care facilities across North Carolina only have CRNAs to deliver anesthesia services and that 34 other states have already loosened the rules around nursing practice.
“My husband had a colonoscopy recently, and they can do it with the supervision of a physician,” Krawiec said. She recounted how she asked the physician leading the procedure if he was overseeing the anesthesia. He responded, “Heavens, no, I don’t supervise her. He said I haven’t looked at anesthesiology since I was in medical school. I wouldn’t know what to do. She does it all on her own.”
Sen. Ralph Hise (R-Spruce Pine) argued that making it easier for nurses to practice, particularly in rural burgs, needed to be included in any bill that would make it easier for more people to see those providers.
“Finding nurses in this state is becoming more and more impossible,” Hise said. “And so this bill, allowing the nursing profession to expand its scope, to have more upward mobility in the nursing program is what ultimately I think will allow us to provide a lot of health care that we currently just don’t do.”
Rep. Gale Adcock (D-Cary), who is also a nurse practitioner, said that increasing access to health insurance would require adding providers.
“The majority of folks clearly understand these things all need to happen at the same time, and I’m excited to see that it might happen soon,” she said.
Hospitals, House objecting?
One of the big obstacles to Medicaid expansion that Republican lawmakers have raised for years has been where the 10 percent of the expansion cost not covered by the federal government would come from. For years, lawmakers have argued that hospitals would be the main beneficiaries of more federal dollars for Medicaid flowing to the state, so hospitals could foot much of the bill in the form of an additional assessment.
Hospitals have said they lose so much on uninsured patients that they were willing to pay for some of the cost, but not the whole tab. In Medicaid expansion bills in other years, this cost was also borne by a new tax on commercial managed care companies providing coverage under the “transformed” Medicaid program.
Rep. Tim Moore (R-Kings Mountain), speaker of the North Carolina House of Representatives, told reporters on Wednesday afternoon that he didn’t think members of his caucus had an appetite for Medicaid expansion this year. Photo credit: Rachel Crumpler
Hise contended the proposal will definitely help hospitals’ bottom lines, with more federal money flowing into the health care systems than they’ll have to put out to cover the rest of the Medicaid expansion population.
A spokesman from the NC Healthcare Association, which represents the state’s hospitals, told NC Health News that his organization was reviewing the new bill and would wait to offer comment on its potential impact.
The other big obstacle to passage of the bill may come from the other side of the General Assembly building in Raleigh, in the House of Representatives. Leaders there have expressed hesitation about making such a big policy change during this year’s short legislative session.
“The position of the House is we have no plans to take up expansion in the short session,” Rep. Donny Lambeth (R-Winston-Salem) said in a text to NC Health News.
Lambeth has been leading a committee with members from the House and Senate since January that has been examining what it would mean for the state to expand Medicaid.
“The work of the committee has not been finished and the committee has made no recommendations,” Lambeth continued.
The line from Lambeth and others on the House side has been that they’d rather come back for a special session on health care access in the fall. That, however, has drawn misgivings from state health leaders.
“I mean, September sounds nice,” Health and Human Services Sec. Kody Kinsley said last week. “But here’s why I’m worried. First and foremost, this $1.5 billion dollar signing bonus that’s on the table right now. Right now, the money that is earmarked for North Carolina is nothing more than, you know, some print on a piece of paper. And it would not be hard for Congress to take that off the table, so they can invest it in other things they need to invest in. We cannot wait.”
On Wednesday afternoon, Rep. Tim Moore (R-Kings Mountain), the speaker of the House of Representatives, said he believed that money would be available next year.
“All indications are it would,” he said. “If that is going to go away, then that’s a problem with the premise of even doing this.”
Medicaid already expanded
Since the beginning of the pandemic, Medicaid rolls have ballooned to close to 2.7 million beneficiaries, up from 2.1 million enrollees since March 2020. That’s because in one of their early COVID-19 relief bills, the U.S. Congress ordered all the new enrollees who qualified for the program to stay on the program for the duration of the federal state of emergency created by the pandemic.
Advocates have pointed out that many of those folks were people who would have qualified had North Carolina already expanded the program.
North Carolina likely paid billions more to cover those additional 600,000 people than the state would have if they had already expanded Medicaid, as the Affordable Care Act allowed. Instead of getting the 90 percent match that the federal government would have provided, the state had to make up the difference, paying 27 percent of the cost.
“We’re actually looking at a situation where a lot of the expansion population are already enrolled on Medicaid,” Hise admitted.
Hise also talked about the anxiety that county social service leaders have around the requirement to “recertify” all of these new Medicaid enrollees once the federal emergency ends. If the state doesn’t expand, at least half of those new enrollees would be purged from the rolls in a time-intensive process that would take up to a year.
The process of recertifying these peoples’ eligibility would be much less cumbersome if they end up rolled onto the program via Medicaid expansion, Hise noted.
Political process
After years of waiting for such a bill to come out of the Senate, there was a palpable upbeat energy in the Senate committee room.
“Sen. Krawiec, I hate to say I told you so,” quipped Sen. Gladys Robinson (D-Greensboro), an advocate of expanding Medicaid for years. Laughter erupted.
That giddy feeling might not last long. Getting the bill across the finish line seems like a stretch, given the resistance from the House and from powerful groups.
Catawba College political science professor Michael Bitzer said that many details could be hashed out once the House rejects the bill and it goes to a conference committee with people from both chambers.
“You know, conference committees are typically called the third chamber of the legislature because that is where the true dealmaking has to occur within the legislative dynamic,” Bitzer said. “With the way the two chambers are, that could become the real power base of any type of legislation that’s gonna get moved from either chamber.”
That bargaining will come down to who is willing to give up what from their wish lists during negotiation, Bitzer added.
“I think oftentimes with this type of significant legislation, people are probably more willing to say, ‘I can live without this,’ rather than, you know, ‘this is what my final demands are going to be,’” Bitzer said.
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by Rose Hoban and Rachel Crumpler, North Carolina Health News May 26, 2022
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It’s been two and a half years since Tracey Edwards went through a pregnancy, labor and birth while incarcerated at the North Carolina Correctional Institution for Women.
The suffering she experienced during her birth process still keeps her up at night.
That experience is behind the lawsuit she filed last year against state prison officials for “vindication” for “unlawful treatment during the most vulnerable time in her life.” Her lawyers say her case could be reflective of the way pregnant people are treated in prisons in North Carolina and beyond.
Edwards claims in the suit that during her pregnancy, she was shackled whenever she received medical care outside of the prison. She also claims she was shackled while she was in active labor at the hospital, something that has since been outlawed. Edwards also said prison staff denied her access to her mental health medications and that she was forced off treatment for her opioid use disorder once she gave birth.
“It was horrible,” Edwards said. “I don’t wish that on my worst enemy. I mean, it was just like an animal.”
Edwards labored for twelve hours with cuffs around her ankles and one leg and arm chained to her hospital bed before officers removed her shackles, according to the complaint. Less than an hour after she gave birth, she was in handcuffs again.
North Carolina Health News reached out to the North Carolina Department of Public Safety for comment, but spokesman John Bull said that the department “does not comment on pending lawsuits.”
Shackled during pregnancy
Edwards’ case involves events from 2019, but by then the use of restraints during labor and birth violated the state prison system’s own policy, which was established in 2018.
In 2021, Gov. Roy Cooper signed a bipartisan bill limiting the use of restraints on pregnant people incarcerated in North Carolina’s jails and prisons. But Edwards’ lawyer, Lauren Kuhlik, said she is “not sure” that even if the 2021 law were in effect it would have prevented her client from being shackled.
“At the time that she was shackled this way, there was a departmental policy prohibiting the use of shackling,” Kuhlik said. “I don’t think we can assume that just because there’s a law passed, that’s automatically going to trickle down to the prison.”
Shackling during pregnancy is also potentially dangerous. If someone stumbles or trips with their ankles or wrists chained together, they may be unable to break their fall, causing possible harm to them and their baby. Restraints during labor and delivery make it more difficult for patients to change positions if needed, NPR has previously reported.
Edwards noted this in her complaint as well. She “could not move or adjust her position to alleviate the pain and discomfort of labor. The skin around her ankles became red
and raw as the shackles constricted her circulation, leading to excruciating pain and suffering. Any attempt to move or struggle against her ankle shackles caused her even greater discomfort and pain,” the complaint reads.
In order to avoid a similar experience, Kristie Puckett-Williams, with the American Civil Liberties Union of North Carolina, said she took a plea deal 10 years ago when she was incarcerated and pregnant. She didn’t want to give birth in restraints.
“I made the decision to enter into second-class citizenship permanently,” Puckett-Williams said. “So that my children could be born free. That’s not a decision that anybody should have.”
Still, one 2018 study found that 82 percent of hospital nurses who cared for incarcerated pregnant patients said they were shackled “sometimes” to “all of the time.”
State prison policy states that pregnant people should not be shackled or restrained unless “there are reasonable grounds to believe the offender presents an immediate, serious threat of hurting herself, staff, or others, including her fetus or child, or that she presents an immediate, credible risk of escape that cannot be reasonably contained through other methods.”
Edwards said she didn’t pose a flight risk.
“I was excited,” she said. “I was going to have a baby.”
Painful withdrawal symptoms
Edwards’ pain and discomfort did not stop after she gave birth, she argues in her suit.
Throughout her pregnancy, Edwards was prescribed Subutex, a form of buprenorphine which is a medication to treat opioid use disorder. It’s considered best practice to prescribe medications to prevent withdrawal for pregnant women with substance use disorders so as to not harm their fetuses.
Medications for opioid use disorder are approved by the U.S. Food and Drug Administration and are considered the gold standard of care for people with opioid addiction. It is the Department of Public Safety’s policy to provide these medications to pregnant prisoners with opioid use disorder. However, there is still no statewide program to make this addiction treatment accessible to the entire prison population.
Soon after giving birth, Edwards was tapered off opioid treatment over the course of nine days. She experienced severe opioid withdrawal symptoms including vomiting and diarrhea as postpartum changes were also taking place. She said she was in pain all over her body.
“You feel like your skin is crawling,” Edwards said. “You feel like there’s bugs, like, moving your skin.”
The report was co-authored by Elton Amos, the medical director of the NCCIW, the very institution that Edwards claims denied her the medications.
High risk?
Most people with an opioid use disorder end up being forced to go through withdrawal upon being incarcerated, even as experts have urged correctional officials to screen people for opioid use disorder and prescribe treatment while they are incarcerated to reduce the chance of fatal overdoses.
When prisoners exit incarceration and re-enter their home communities, their drug tolerance is usually reduced from not having access to drugs while they were incarcerated. That puts them at increased risk once they walk free, something that’s proven in the data finding that within two weeks of their release, former inmates are 40 times more likely than other North Carolinians to overdose.
Meanwhile, states such as Rhode Island saw a 60 percent decrease in overdose deaths among the formerly incarcerated after initiating a program providing medication for opioid use disorder.
And North Carolina jails that have addiction treatment programs have reported success, reducing both overdoses and recidivism.
However, consistent treatment is key to success. People who have suffered withdrawal symptoms from being abruptly taken off their medications might be less likely to try the treatment again, said Andrea Knittel, medical director for Incarcerated Women’s Health at UNC School of Medicine.
“Having an aversive association with one of the most effective and evidence-based options that we have for treatment is potentially a really significant downside,” Knittel said. “Our research shows that it’s a disruption in care that adds some logistical hurdles to folks who are trying to continue treatment when they are released, and I think, as a result, poses some real challenges to recovery for our patients.”
As for Edwards, she is now at home, with her little girl and her mother, waiting as her lawsuit starts the long process toward resolution.
She said she tries to block out her memories from her time in prison, but it’s difficult.
“I don’t really know if it’s ever gonna go away,” Edwards said. “Just because I committed a crime or allegedly committed a crime or whatever you want to call it, I don’t feel like I should have a lifelong problem mentally because of what they done to me.”
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by Elizabeth Thompson, North Carolina Health News May 25, 2022
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When hundreds of North Carolina public health leaders met in a Raleigh hotel recently for an annual conference, they could not help but look back at this most extraordinary time in health care and incorporate lessons learned from the pandemic as they planned for the future.
One theme that emerged from the gathering of the state’s county health directors, medical directors and state workers was an old one: How long will North Carolina continue to leave billions of federal dollars out of state coffers by refusing to expand Medicaid?
That money, the conference participants said, could help free up state dollars to shore up the public health infrastructure and bolster behavioral health programs that will become more important.
Now, a week after the Public Health Leaders’ Conference, Republicans in the state Senate are circulating a draft omnibus health care bill that would expand Medicaid to hundreds of thousands of low-income adults while also making changes to health care laws that their party has been pushing for years.
The bill would also give advanced practice registered nurses more independence to care for patients without being directly supervised by physicians, which is likely to be controversial among the powerful medical lobby.
It was unclear when such a bill would be introduced.
Sen. Phil Berger, the Republican from Eden who has warmed to the idea of Medicaid expansion after being a roadblock for years, has seen the proposal, according to Lauren Horsch, the Senate leader’s spokesperson.
“Senate Republicans continue to have discussions about how to address the rising costs of health care and how to increase access in the state,” Horsch said during a phone interview with NC Health News on Monday.
Horsch declined to comment on whether Berger supported the bill.
Last week during the Public Health Leaders’ Conference, the first time the participants had gathered in person since March 2019, a road map for a better public health system was being drawn.
“I know these last two and a half years have felt like 20 and a half,” Kody Kinsley, secretary of the Department of Health and Human Services, told the crowd of about several hundred. “I know that your teams are tired. I’m so glad that we’re having the occasion to gather and be together, I hope that you will invest in time with each other.
“You all have been on the frontlines in so many ways you have been battle worn and tried and tired.”
Big ticket promise
State epidemiologist Zack Moore shows off a special award given to him during the Public Health Leaders Conference last week for his work during the COVID-19 pandemic. “You really have been the intellectual and science hub of this response for us, you really kept us straight,” said State Health Director Elizabeth Cuervo Tilson who said she calls Moore, “all the time.” Photo credit: Rose Hoban
There was enthusiasm for new projects, but also recognition that even if a Medicaid expansion bill were introduced in the state Senate, there still could be some obstacles in the path of a possibility that’s been on the table since 2013.
“Over the last decade, we’ve been leaving about $4 billion on the table each year,” Kinsley said, citing the sum that would have flowed from federal to state coffers if the legislature had chosen to expand.
This put the state behind the curve at the start of the pandemic, he argued, with North Carolina having as many as 1.2 million people lacking health insurance and a usual source of care.
“You figure you have a million people who have no connection with a primary care provider, no experience in the health care system, the only place they know to go for care is the emergency department,” Kinsley said. “I always like to point out to people that when you tell someone who doesn’t have health insurance they should get tested, it’s free, you know, that’s not real, they don’t experience the healthcare system as free.”
Kinsley pointed out that expansion would do more than cover the costs of care for about 550,000 additional uninsured people. It also would help free up state dollars, the secretary added, particularly dollars that could be put toward behavioral health programs.
In addition, the Biden administration has dangled a one-time bonus to states that haven’t expanded as an inducement. North Carolina’s share of that money would be $1.5 billion.
“We could, essentially in one year, pull five and a half billion dollars down that would be so transformative to North Carolina for health care,” he said.
Renewing the workforce
Recent reports on the record numbers of people dying from opioid overdoses highlighted the enormous public health needs that continued to simmer below the surface, even as they’ve been eclipsed by the more than 24,627 deaths from the pandemic.
“We’ve got HIV up against us,” said Evelyn Foust, who leads the communicable disease branch of DHHS’s Division of Public Health. “I think just getting access to primary care is a huge challenge. And then, one more time we got into those real health equities we know are there.”
At the conference, where many of the attendees had heads full of gray hair, one of the biggest concerns was the driving need to recruit, train and retain the next generation of public health workers amid an exodus of older workers.
Even before the pandemic, more than half of public health workers nationwide were over the age of 45, according to statistics from the National Association of County and City Health Officials. That was before the stress of the pandemic.
In just the first year of the pandemic alone, more than half of public health leaders responding to a national survey said they experienced harassment and workplace violence, driving departures of experienced staff.
“Constrained by poor infrastructure, politics, and the backlash of the public they aimed to protect, public health officials described grappling with personal and professional disillusionment, torn between what they felt they should do and their limited ability to pursue it,” wrote researchers from the Johns Hopkins Bloomberg School of Public Health. “For some, the conflict was untenable.”
Part of North Carolina’s response to helping recruit and retain new workers includes providing flexibility for people who have had to juggle multiple demands over the past two years.
“We can accommodate brilliance in the workplace while recognizing that people have child care issues, and they have issues in taking care of their adult families,” Foust said. “We can accommodate that, and still get really outstanding stuff done.”
Gov. Roy Cooper’s recent proposed budget has $45 million in health care workforce enhancement, and a new pipeline of $10 million specifically to beef up local health departments.
Kinsley also talked about how public health workers need to take a rest.
“This is a time to take some time off to pivot,” he said. “I want folks to invest in themselves. You’ve got to put your oxygen mask on before assisting others and take a breath. But then, you know, let’s be intentional about transitioning.”
Unsexy infrastructure
Early in the pandemic, former DHHS secretary Mandy Cohen talked about how the state was collecting information on hospital admissions and completed COVID tests via faxes sent to Raleigh by hospitals, medical labs and testing centers. Even as the pandemic raged, public health officials started streamlining communications, installing updated software and creating databases.
It’s these types of needs that State Health Director Elizabeth Cuervo Tilson said the pandemic exposed, along with other, basic needs that have been neglected in public health.
“You gotta invest in your infrastructure, and that is people, that is IT, everything, all these foundational capabilities, you can’t do programs unless you have these foundational capabilities,” she said. “It’s kind of unsexy infrastructure, but that’s what we need.”
Kinsley said that some of the “unprecedented” federal dollars flowing to the state during this funding cycle could allow for this infrastructure development. His priorities include investments in behavioral health resources, child and family well-being, and recruiting the next generation of a workforce he wants to be more diverse.
“We’re investing in internship programs and public health credentialing programs,” he said, noting that Cooper’s budget includes investments in state staff, nursing home staff and public health workforce. “People are doing this because of passion, but at some point when you can go work in any other service sector job with a lot less stress and a lot more pay, it just doesn’t work.”
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by Rose Hoban, North Carolina Health News May 24, 2022
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Today’s early morning highlights from the major news organizations.
KHN:
The New MADD Movement: Parents Rise Up Against Drug Deaths
Life as he knew it ended for Matt Capelouto two days before Christmas in 2019, when he found his 20-year-old daughter, Alexandra, dead in her childhood bedroom in Temecula, California. Rage overtook grief when authorities ruled her death an accident. The college sophomore, home for the holidays, had taken half a pill she bought from a dealer on Snapchat. It turned out to be fentanyl, the powerful synthetic opioid that helped drive drug overdose deaths in the U.S. to more than 100,000 last year. “She was poisoned, and nothing was going to happen to the person who did it,” he said. “I couldn’t stand for that.” (Scheier, 5/23)
KHN:
Custom Caskets For Kids Look Like Something You ‘Would See In A Child’s Room’
Calyia Stringer had a smile on her face the day she posed for a photo with a yellow flower in her hand. The toddler beamed with pride as she showed off the bloom before handing it to her godmother, Jatoria Foster. “She was so happy,” Foster said. “That was one of the best memories I have of her.” No one thought the same image would end up on the lid of Calyia’s casket — until the unthinkable happened. The 3-year-old was killed last September when a stray bullet tore through her grandmother’s bedroom in East St. Louis, Illinois. For Calyia’s funeral, her family wanted to remember the happiest moments of her life, so the funeral home decorated her casket with three photos of the girl. (Anthony, 5/23)
KHN:
Journalists Explore Affordability Of Mental Health Care And Abortion Laws’ Effect On Miscarriages
KHN correspondent Aneri Pattani discussed why finding affordable mental health care is so difficult on NPR’s “A1” on May 18. … Freelancer Charlotte Huff discussed how Texas abortion laws complicate miscarriage treatment on “Texas Standard” on May 16. (5/21)
Health authorities said they may have found a third case of the monkeypox virus in the United States and are running tests on a patient in South Florida to confirm if the person has contracted the disease, which is staging a rare outbreak outside of Africa. The case in Broward County, Florida, is “related to international travel,” the U.S. Centers for Disease Control and the Florida Department of Health said in a statement on Sunday, “and the person remains isolated.” (Mckay, 5/23)
President Joe Biden sought to reassure Americans that the current monkeypox outbreak was unlikely to cause a pandemic on the scale of Covid-19. “I just don’t think it rises to the level of the kind of concern that existed with Covid-19,” he told reporters Monday in Tokyo at a joint press conference with Japanese Prime Minister Fumio Kishida. The US has enough small pox vaccine stockpiled to deal with the outbreak, Biden said. Still, he said people should be cautious. (Cook and Jacobs, 5/23)
President Biden said Monday that he did not believe a quarantine to prevent the spread of monkeypox in the United States would be necessary, saying there are sufficient vaccine doses available to combat any serious flare-up of the disease. Belgium became the first country to impose a quarantine on its residents because of monkeypox, requiring those infected to isolate for 21 days. (Kim, 5/23)
Biden administration health official Ashish Jha said Sunday he expects that monkeypox will not have widespread impact in the United States. “I feel like this is a virus we understand,” he said on ABC’s “This Week.” Speaking to host Martha Raddatz, the White House coronavirus response coordinator said monkeypox is far different than coronavirus, since it is not something new and treatments already exist for it. (Cohen, 5/22)
From past instances of human-to-human transmission, scientists have learned that the virus spreads through the exchange of large respiratory droplets or via direct contact with bodily fluids, lesions that form during infection, or contaminated items like clothing or bedding. Monkeypox isn’t considered a sexually transmitted infection, but it could be passed during sexual encounters, experts said. Many of the recent cases in Europe are among men who have sex with men, and a Friday alert from the Centers for Disease Control and Prevention suggested that some recent cases started out with lesions around the anus and genitals. “I’m guessing that sexual transmission will be high on the list of potential culprits,” said Dr. Grant McFadden, director of the Biodesign Center for Immunotherapy, Vaccines and Virotherapy at Arizona State University. (Bendix, 5/20)
The World Health Organization on Friday said it was stepping up efforts to understand and combat monkeypox as nearly a dozen countries are investigating “atypical” outbreaks. The organization said the ongoing situation is being discussed at several meetings. “There are about 80 confirmed cases so far, and 50 pending investigations. More cases are likely to be reported as surveillance expands,” the health agency said in a news release. The spike in monkeypox cases in Europe and North America has perplexed public health professionals because the rare disease is typically found in central and west Africa — and human-to-human transmission is usually considered uncommon. (Tebor, Shannon and Weise, 5/21)
Chinese social media users are speculating the US could be the source of monkeypox infections now reported in at least a dozen countries, including the UK, Spain and Australia. The viral infection has been highlighted as a trending topic on popular social media platform Weibo for the past three days with a hashtag on the US reporting two suspected monkeypox cases attracting more than 51 million views as of Monday. While Chinese state media has refrained from accusing the US of intentionally spreading monkeypox — an accusation it made about Covid-19 — many social media users haven’t held back. (Lew, 5/23)
Enough specialty infant formula for more than half a million baby bottles arrived Sunday in Indianapolis, the first of several flights carrying infant formula from Europe expected this weekend to relieve the deepening shortage in the U.S. The formula, weighing 78,000 pounds, or 39 tons, was being transported by military plane, White House press secretary Karine Jean-Pierre told reporters aboard Air Force One as President Biden flew from South Korea to Japan. Agriculture Secretary Tom Vilsack was in Indianapolis to greet the arrival of the first shipment. (5/22)
Another shipment of formula will be flying into Washington Dulles International Airport in Virginia on a FedEx plane this coming week, the White House announced Sunday afternoon. FedEx has secured a government contract to carry that critical cargo, bringing it from Ramstein Air Base in Germany. From there, the formula will be transported to a Nestlé facility in Pennsylvania via FedEx’s integrated air and ground network. The White House said the flight and trucking “will take place in the coming days.” (Hutzler, 5/22)
The Biden administration announced Sunday that it would use the Defense Production Act to give two companies priority on ingredients or equipment necessary to manufacture formula. Abbott Nutrition will be able to make priority orders for sugar and corn syrup. Reckitt will be able to place priority orders for filters that have been constrained during the pandemic. (Wang, Jeong and Johnson, 5/22)
Abbott Laboratories Chief Executive Robert Ford apologized Saturday for his company’s role in the nationwide shortage of baby formula and promised production will ramp up again in June. “We’re sorry to every family we’ve let down,” Mr. Ford wrote in a Washington Post op-ed. (Otis, 5/22)
Children’s Wisconsin has seen an increase in the number of babies being admitted due to inappropriate substitutions for baby formula, the hospital said Friday. The hospital frequently sees babies that are malnourished or show a failure to thrive, for reasons including a lack of access to formula, Heather Van Roo, a hospital spokeswoman, said in a statement to the Journal Sentinel. “But we are seeing more kids where inappropriate substitutions of formula is a factor in their hospitalization,” she said. (Shastri, 5/20)
Laurie Alexander, of West Price Hill, is researching how to get baby formula from outside the United States. She’s three months pregnant, and while she’s breastfed her three babies, she has always had to supplement with formula. The shortage of baby formula now is worrying her, even though her delivery date is six months out and federal officials say help is on the way. “It’s very scary,” Alexander said. “I’m looking at the U.K. and Canada. I’ve been trying to stock up on it early.” The nationwide shortage is alarming parents of babies who need it. In the Cincinnati area, nonprofits that help lower-income moms and women of color say the problem is exacerbated for their clients, who are suffering the most from ever-rising costs with inflation and often, a lack of transportation. (Demio, 5/23)
As a nationwide baby formula shortage sends parents into crisis mode, social media posts containing dangerous misinformation about homemade formula recipes have gone viral online, racking up views in the millions. Although major networks like Facebook, TikTok and YouTube have taken steps to label photos, videos and posts with contextual information pointing to the harms of such recipes, and in some cases removed them, they have done so inconsistently, allowing the advice to continue spreading and putting children at risk. (Alba, 5/21)
A spreading hepatitis outbreak that killed six children has infectious disease experts scrambling to find answers. The Centers for Disease Control and Prevention confirmed the sixth death last week. The CDC said the outbreak of the liver disease has expanded to 180 reported youth patients across 36 states and territories over the past seven months. The number of cases increased by 71 in two weeks, but the CDC said most of those were “retrospective” patients who may have been ill weeks or months earlier. “Not all are recent, and some may ultimately wind up not being linked to this current investigation,” the CDC said in a statement. The agency said testing ruled out some of the viruses that commonly cause hepatitis. (Bacon, 5/22)
Mexican authorities confirmed on Friday the first death of a child from a severe form of hepatitis with unknown origin in the country, marking the first death in Latin America as cases spread worldwide. The three-year-old child, originally from the central state of Hidalgo, was transferred to a hospital in Mexico City, but died this week, the Hidalgo Health Secretariat said. (5/20)
A new wave of abortion restrictions is expected in half of the U.S. if the Supreme Court overturns Roe v. Wade. Some local officials are pledging not to enforce them, potentially creating uneven legal landscapes within conservative states that are home to more liberal urban areas. District attorneys in metropolitan areas including Atlanta, New Orleans, Dallas and San Antonio have said they won’t prosecute abortion providers or others, including those who assist a woman in obtaining the procedure. Current state attorneys general who are up for re-election in Michigan and Wisconsin, as well as Democratic candidates for that office in Georgia and Arizona have likewise pledged not to enforce any laws banning abortion in their states. (Kusisto, 5/22)
Sen. John Cornyn on Friday said he would permit exceptions for cases of rape and incest in laws restricting abortion that will be triggered in Texas if Roe vs. Wade is abolished.
“I would permit those exceptions, but I understand others have strongly held feelings to the contrary,” Cornyn said during a recording of Lone Star Politics, a political show produced by KXAS (NBC 5) and The Dallas Morning News. Cornyn, who is against abortion, stressed that he respects the right of the Legislature to pass abortion-related laws. And he supports the view that Roe vs. Wade should be scrapped. Earlier this month a leaked draft opinion foreshadowed that the U.S. Supreme Court is poised to strike down the law, which in 1973 legalized abortions. (Jeffers Jr., 5/21)
Less than one-third of Oklahoma voters want a ban on all abortions and only Republicans are deeply divided on the question, according to a poll taken before the state Legislature approved bills this year aimed at shutting down most abortions. The poll, taken by Amber Integrated in December of 500 registered Oklahoma voters, shows 31{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} would support a total ban on abortion if the U.S. Supreme Court overturns Roe v. Wade; 55{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of the Oklahoma voters surveyed did not want a total ban and another 14{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} were unsure. (Casteel, 5/22)
As abortion access is thrown into uncertainty around the nation, Massachusetts lawmakers are pushing for legislation that would require health centers at public colleges and universities to offer medication abortions. Lawmakers and advocates who support the bills say medication abortion should be accessible on campus because college students may not know where to find abortion providers, often lack transportation to visit them and have class schedules that make traveling for care difficult. (Nittle, 5/20)
Florida’s Supreme Court, forged by Republican Gov. Ron DeSantis, could decide the fate of abortion rights in the state. That’s because Florida’s abortion rights are not just intertwined with federal court rulings but also rely on a decadesold Florida Supreme Court decision that extends privacy rights to abortion. Those rights are enshrined in the Florida Constitution, and the state Supreme Court has previously cited it to overturn restrictive abortion laws, including one requiring parental consent for minors seeking abortions. But the current Florida Supreme Court is dominated by conservatives, including three appointed by DeSantis, and some fear the state justices could interpret the privacy rights differently. (Fineout, 5/22)
Jacky Eubanks, a Trump-endorsed candidate for Michigan’s legislature, said she would vote to make contraception illegal. … Eubanks, who is running for Michigan’s 63rd House district, backed a ban on contraception during an interview with right-wing news outlet Church Militant. … Eubanks continued to blast contraception as leading people to believe in “the false sense of security that they can have consequence-free sex.” She said a ban on contraception would also convince people to wait until marriage to have sexual relations. (Stanton, 5/21)
Even now, laws in more than a dozen states that restrict abortion past 20 weeks are changing the use of the second-trimester anatomy scans. “People are moving those tests backward, doing them earlier than is optimal,” says Laura Hercher, a genetic counselor at Sarah Lawrence College who recently conducted a survey of genetic counselors in abortion-restrictive states. But the earlier the scan, the less doctors can see. Certain brain structures, such as the cavum septum pellucidum, might not develop until week 20, says Chloe Zera, an obstetrician in Massachusetts. Being unable to find this structure could indicate a brain anomaly, or just that the scan was done too early. Doctors might also pick up evidence of a heart defect but not know how severe or fixable it is. At 20 weeks, the heart is only the size of a dime. (Zhang, 5/20)
The number of Michigan counties where risk from COVID-19 is high has grown to 22 this week, according to the U.S. Centers for Disease Control and Prevention, as a new wave of cases and hospitalizations sweeps the state and the nation. “There’s a lot of infections across America,” Dr. Ashish Jha, White House coronavirus response coordinator, said earlier this week. “What’s driving that? What is primarily driving that is these incredibly contagious subvariants” of the omicron variant, BA.2 and BA.2.12.1. “They are more contagious with more immune escape, and they are driving a lot of the increases in infection that we’re seeing across the nation right now. And that is … a huge challenge.” (Jordan Shamus, 5/20)
School districts in the Washington region are contending with the national surge in covid cases that has resulted in the highest numbers since the winter omicron surge and left more students at home quarantining. But this latest spike in cases arrives after most districts have already lifted masking requirements and shortened quarantine protocols — and, following federal health guidelines, the region’s school leaders say they are not reconsidering a complete overhaul of covid policies in the final stretch of the academic year. Prince George’s County is the only school district — and one of the few big districts in the country — that still has a mask mandate. (Stein, Natanson and Asbury, 5/22)
A former high-level employee at the Rhode Island Department of Health says that COVID-19 cases have been on the rise for months in Rhode Island, but the information has been hidden in the official data and ignored by Governor Daniel McKee, whom he accuses of incompetence. Julian Drix, who was the acting co-director of the Health Department’s Health Equity Institute and in charge of the coordinated COVID response for Central Falls and Pawtucket, told the Globe on Friday that McKee’s administration dismantled the infrastructure that helped Rhode Island respond to and prevent the spread of COVID-19. Now, Drix says, Rhode Island is more vulnerable during this surge — and the problems exposed by the pandemic are straining the health care system. (Milkovits, 5/20)
The top watchdog for the Department of Homeland Security (DHS) revealed that the U.S. Immigration and Customs Enforcement’s (ICE) Enforcement and Removal Operations (ERO) failed to test migrants before transferring, transporting and releasing migrants from ICE detention facilities – a clear violation of the department’s COVID-19 policy. (Sganga, 5/20)
More adults died of COVID-19 in Massachusetts in the first 8 weeks of the SARS-CoV-2 Omicron variant surge than in the entire 23-week Delta period, suggests a modeling study published today in JAMA. (5/20)
A new study shows significantly less antibody waning 6 months after two doses of the Pfizer-BioNTech COVID-19 vaccine in people with low body weight, suggesting that those adults could wait longer than 6 months for a booster dose. The study appears in JAMA Network Open. The small study involved 50 South Korean young adult healthcare workers who received the standard series of Pfizer vaccine and had not had a previous infection with COVID-19. Eighty percent of participants were women. (5/20)
There is little consensus on the exact definition of long Covid, also known by the medical term PASC, or post-acute sequelae of Covid-19. While the World Health Organization says long Covid starts three months after the original bout of illness or positive test result, the Centers for Disease Control and Prevention sets the timeline at just after one month. (Sheikh and Belluck, 5/21)
The U.S. Army reports that it nears a 100{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} COVID-19 vaccination rate among troops, claiming the service has issued 3,411 general officer reprimands to soldiers who refused the order to be vaccinated. The active forces have recorded a 97{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} completion of vaccination regimen, with that number to hit 98{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} after additional troops complete their current booster regimen. The Pentagon in Aug. 2021 issued a vaccine mandate for the armed forces, with Secretary of Defense Lloyd Austin ordering each branch to fully vaccinate active duty, Guard and Reserve troops. Troops in various military branches had months to comply with the order, with each branch setting its own deadline to complete the regimen. (Aitken, 5/22)
Amid controversy over the use of patient coupons, Pfizer has agreed to refund $290,000 to settle charges of misleading roughly 5,000 people in Colorado, Kansas, Vermont, and Arizona who spent much more than expected when they used coupons supplied by the drug maker. The company will also pay a total of $120,000 to the states to cover legal costs, among other things. This is only the latest instance in which Pfizer has been cited over such allegations. Three years ago, the company paid $975,000 to settle charges of misleading consumers in Oregon and, in 2018, it reached a $700,000 settlement with New York State. In each episode, consumers were told they would “pay no more than” a small amount of money — typically, from $15 to $25 — for certain drugs, but were actually required to pay more due to limits on total savings that were not prominently disclosed. (Silverman, 5/22)
Oklahoma legislators on Friday approved plans to revamp the state’s Medicaid program into a value-based health care model that incentivizes providers to improve patient health. The plan includes some elements of the Medicaid managed care plan the Stitt administration tried to implement last year, but lawmakers were directly involved in crafting the details this time. The Oklahoma Supreme Court last year ruled the Oklahoma Health Care Authority, which oversees the state’s Medicaid program, exceeded its authority in trying to implement managed care. (Forman, 5/21)
Pennsylvania Lt. Gov. John Fetterman has been released from the hospital more than a week after he had a stroke, his wife Gisele Barreto Fetterman tweeted Sunday. Fetterman won the Democratic primary for Senate while he was in the hospital recovering. (Reardon, 5/22)
The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention are investigating an outbreak of salmonella infections that is possibly linked to Jif peanut butter products. The J.M. Smucker Company issued a voluntary recall for its creamy, crunchy, natural and reduced fat peanut butter products that were distributed nationwide, with lot code numbers 1274425 to 2140425, the FDA announced Friday. (Meltzer, 5/22)
An Iowa company has recalled about 185,610 pounds of ready-to-eat bacon topping products that might be contaminated with metal, according to a U.S. Department of Agriculture news release Friday. The USDA’s Food Safety and Inspection Service said it expects there to be additional products containing the bacon and urges consumers to check back frequently to view updated lists and labels. The product was produced on various dates between Feb. 21 and 23 and March 3 and 5. (Garcia, 5/20)
Global health leaders gathered in Geneva on Sunday to discuss the pandemic are facing another viral problem: a visceral, passionate online backlash that falsely accuses the World Health Organization of conspiring to take power from national governments. The World Health Assembly, the decision-making body of the WHO’s 194 member states, is holding its first fully in-person event in two years as some coronavirus-related restrictions are lifted. While the assembly, now in its 75th year, is usually considered a dry, technocratic event, this year it is being framed by conspiracy theorists as a key moment in the battle between democracy and tyranny. (Taylor, 5/22)
In the latest dust-up over the safety of medicines, the European Medicines Agency recommended suspending marketing authorization for dozens of generic drugs after finding problems with tests conducted by a contract research organization. Specifically, the regulator pointed to “serious concerns” about the quality and reliability of data in bioequivalence studies run by Synchron Research Services, which is based in Ahmedabad, India. Bioequivalence studies are conducted to show that a generic medicine releases the same amount of an active ingredient in the body as a brand-name medicine. (Silverman, 5/20)
English health officials have suggested the country should raise the legal smoking age from 18 to 21 as part of an initiative to discourage smoking and mostly eliminate it by 2030. The British government in 2019 set the new deadline after a green paper report indicated that the then-current timeline of ending smoking by 2025 seemed unlikely. The report found that 14{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of adults smoked. Health Secretary Sajid Javid said that the goal is to bring that number to below 5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} over the next eight years, and raising the legal age for smoking to 21 could prove a crucial part to that plan. (Aitken, 5/21)
This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.