About Covid-19
Unraveling the Mystery of Why Children Are Better Protected from COVID Than Adults: “The immune system uses a special mechanism to protect children from novel viruses—and it typically saves them from a severe course of COVID-19 in two different ways. In the mucous membranes of their airways, it is much more active than that of adults. In children, this system reacts much faster to viruses that it has never encountered, such as pandemic pathogens. At least, that is what a recent study by Irina Lehmann of the Berlin Institute of Health at Charité and her colleagues suggests.”
Read the article for more details.
CDC panel says more evidence needed for booster recommendation: “Members of the CDC's Advisory Committee on Immunization Practices (ACIP) said the evidence on boosters is not clear and indicated it would likely consider a risk-based approach that would prioritize residents of long-term care facilities and health workers rather than all eligible Americans at once.”
In related articles:
Immunity To COVID-19 Could Last Longer Than You'd Think: Very readable presentation of why we may have long-lasting immunity. Note: It might take 6 months to develop that protection.
New data confirm Covid vaccines provide strong protection against hospitalization: Om Monday, “Dr. Sara Oliver, a C.D.C. scientist, presented unpublished data from Covid-Net, a hospital surveillance system. All three vaccines used in the United States remained highly effective at preventing hospitalizations from April through July, when Delta became dominant, the data suggested.
For adults under the age of 75, the shots were at least 94 percent effective at preventing hospitalizations, a rate that has remained steady for months, Dr. Oliver said. Protection against hospitalization did decline in July for adults 75 or older, but still remained above 80 percent.”
Factors Associated With Household Transmission of SARS-CoV-2: “In this updated systematic review and meta-analysis of 87 studies representing 1 249 163 household contacts from 30 countries, the estimated household secondary attack rate was 19%. An increase in household transmission was observed over time, perhaps owing to improved diagnostic procedures and tools, longer follow-up, more contagious variants, and different study locations.”
FDA approval of Pfizer's COVID-19 vaccine spurs American confidence: Harris Poll: “A Harris Poll survey over the weekend found that 80% of Americans who were aware of the approval now have more confidence in it. Even more encouraging? Almost half (49%) of unvaccinated people who heard about the approval said they will “probably” or “definitely” get vaccinated.Overall awareness of the Pfizer approval was high—79% of those surveyed by The Harris Poll were aware of the FDA thumbs-up.”
About the public’s health
Acute Consumption of Alcohol and Discrete Atrial Fibrillation [AF] Events: “Individual AF episodes were associated with higher odds of recent alcohol consumption, providing objective evidence that a modifiable behavior may influence the probability that a discrete AF event will occur.”
U.S. mortality rates to remain elevated, childbearing to lag through 2023 because of pandemic, new government report predicts: “The federal government expects U.S. mortality rates to be elevated by 15 percent over pre-pandemic norms in 2021 and not return to normal levels until 2023, according to a report released Tuesday by the Trustees of the Social Security and Medicare programs.
The trustees concluded that these elevated mortality rates, along with lower immigration and depressed fertility rates, have had a significant effect on the trust funds supporting Medicare in the short term. But the report found that Medicare’s main trust fund will still be able to pay out full benefits until 2026, a timeline unchanged since last year.”
About hospitals and health systems
Fitch: COVID-19 resurgence threatens nonprofit hospitals' margins, credit ratings: “The group said smaller, lower-rated hospitals will be less capable of fending off the rising expenses and declining reimbursement that comes with ICUs full of labor-intensive COVID-19 patients.
Highly rated hospitals, on the other hand, ‘should have sufficient financial cushion to absorb an increase in operating costs and a shift in volume type without meaningfully affecting credit,’ Fitch wrote.”
Hospitals to face new emission goals, and potential penalties for noncompliance, under new HHS office: “The Department of Health and Human Services (HHS) aims to roll out new requirements for hospitals and health systems to cut greenhouse gas emissions and could potentially levy penalties to facilities for failing to do so.
HHS announced Monday the creation of the new Office of Climate Change and Health Equity tasked with taking on the health impacts of climate change and its effects such as extreme weather. The new office plans to roll out specific goals for emissions levels at hospitals at a later date.”
Federal judge grants final approval of $575M settlement against Sutter Health: “A federal judge has granted final approval for a $575 million settlement with Northern California-based hospital system Sutter Health that settles allegations of price gouging.
The settlement judgment, announced late Friday, requires Sutter to not only pay $575 million but also to adopt several reforms aimed at curbing anti-competitive practices.”
Cleveland Clinic posts $339M profit in Q2 after major patient revenue rebound: “The Cleveland Clinic generated $339 million in operating income for the second quarter of the year as its patient service revenue saw a massive 50% rebound compared to the same period in 2020 when the system faced major strain from the pandemic.
The hospital system generated $3.2 billion in operating revenue for the second quarter compared to $2.3 billion for the second quarter in 2020. A major reason was the boosted $2.7 billion in net patient service revenue, up from $1.8 billion over the same period last year.
The Cleveland Clinic used a series of measures to reduce costs including “restricting travel, reducing purchased/administrative service expenses and other controllable costs, suspending annual pay increases for caregivers in 2020 and postponing certain non-critical capital expenditures,” according to its earnings report.”
About healthcare IT
Electronic Health Record Interoperability—Why Electronically Discontinued Medications Are Still Dispensed: “Electronic prescriptions (e-prescriptions) are transmitted using the National Council for Prescription Drug Programs SCRIPT standard, which has been widely implemented by EHRs and pharmacy systems. Electronic medication discontinuation (e-discontinuation) is included in this standard. Therefore, the functionality exists to send a request from a prescriber to a pharmacy to discontinue a medication (a CancelRx message) via a health information network, most commonly the Surescripts network. Although most EHRs have this functionality, it is often not ‘turned on,’ as that would entail additional costs for health care professionals and networks, including costs for software licensing and integration, as well as ongoing network fees and maintenance costs.”
DuPage Medical Group reports data breach: “The largest independent physicians group in Illinois is notifying more than 600,000 patients whose information may have been compromised in a recent breach, DuPage Medical Group said in a statement today.
Through an investigation, the company determined that a July network outage was caused by unauthorized actors gaining access to its network, the statement says.
Patient information that may have been compromised includes names, addresses, dates of birth and diagnoses, according to the statement. Financial account numbers were not included, but social security numbers for a ‘small subset of individuals’ may have been affected.”
Where the US stands on telehealth coverage: 13 states that let orders expire or kept expansions: A good summary about this issue. Many states are extending or making telemedicine coverage permanent while others have let provisions expire.
About health insurance
Uber Health Expands Access to Transportation Options for Medicaid Recipients in Texas: “Uber Health today announced Texas Medicaid recipients will now have access to non-emergency medical transportation (NEMT) options to and from medical appointments through the Uber Health platform. Following legislation in 2019 to update the state’s Medicaid program to allow non-emergency ridesharing solutions to Medicaid recipients across the state, the Texas Health and Human Services Commission recently made changes to facilitate the seamless integration of transportation network companies. This decision will allow Uber Health to open up access to its NEMT solutions to Texas’ nearly 4.4 million Medicaid enrollees, directly addressing barriers to care, reducing costs for the state government, and streamlining population health management at scale.”
About 1.6 mln more Americans had health insurance in 2020 - CDC: “Estimates based on a household survey by the statistics division of the U.S. Centers for Disease Control and Prevention showed on Tuesday that a total of 31.6 million, or 9.7% of Americans of all ages, were uninsured last year, down from 33.2 million in 2019.
Among Americans of all age groups, the number of people with public health plan coverage grew by 2.1 million to 123.5 million in 2020, while those that had private health insurance grew by 1.9 million to 200.6 million.”
About pharma
Biogen Offers Free Alzheimer’s Drug as Medicare Coverage Remains Uncertain: “Biogen is offering its Alzheimer’s drug, Aduhelm (aducanumab), free to certain patients as uncertainty remains about how Medicare will reimburse the drug, which costs $56,000 a year.
The drugmaker is reportedly providing Aduhelm to a neurology center in Florida free of charge. Supplying free drugs to patient assistance programs is often used as part of a promotional strategy.”
The objection to the drug has been about its safety profile almost as much as its cost- so even if free, it may not show the growth the company expected.
Initial treatment with a single pill containing quadruple combination of quarter doses of blood pressure medicines versus standard dose monotherapy in patients with hypertension (QUARTET): a phase 3, randomised, double-blind, active-controlled trial: Standard blood pressure treatment usually starts with one drug that is titrated up in dose as needed. If that one medication does not work, it might be changed to a different class of drugs or a second class of medication is added to the first. In this study, a combination of 4 drugs was used to begin treatment.
”A strategy with early treatment of a fixed-dose quadruple quarter-dose combination achieved and maintained greater blood pressure lowering compared with the common strategy of starting monotherapy. This trial demonstrated the efficacy, tolerability, and simplicity of a quadpill-based strategy.”