Tag Archives: public-health

Let’s set the record straight on Montana’s Medicaid Daily Montanan – Daily Montanan

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Plain and simple people get sick.

Right now, more than 250,000 predominantly low-income Montanans get help with healthcare through Medicaida state-federal partnership. Montana has overall and primary responsibility, while the Feds pick up most of the costs, averaging 80% (of total Medicaid spending). In 2022, the Federal government provided $1.8 billion to cover health care for Medicaid-eligible Montanans who live in every county across the Big Sky. Remarkably, two-thirds of Medicaid recipients live in our rural communities.

So, what is Medicaid, and who does it serve?

Not only does Medicaid fund health care services for our lower-income neighbors including children, families, and pregnant moms, but it also covers those with serious disabilities. By reducing the number of uninsured, Medicaid has also helped keep healthcare insurance costs down for everyone while pumping money into Montanas economy. The Medicaid reimbursements for rural and urban healthcare providers keep the doors of healthcare facilities open and help retain healthcare providers. Small businesses also benefit from Medicaid, as they often cannot afford to provide health insurance for their employeeswhether they work full or part-time.

Medicaid Expansion is a critical program for our Native American Montanans. The Indian Health Service continues to be woefully underfunded; a recent series of newspaper articles illustrates the healthcare challenges facing those who reside on reservations. Medicaid has greatly boosted services to Native Americans, allowing them to access a broader range of healthcare providers. The federal government reimburses the care provided to Native Americans on Medicaid at 100%.

Despite the benefits of Medicaid, we now have more than 120,000 Montanans18% of kiddoswho have lost Medicaid coverage due to DPHHSs procedural snafus. The end of the COVID public health emergency necessitated each state to review eligibility for Medicaid. Thats reasonable; however, Montana launched a process that is difficult, confusing, and sometimes impossible for people to reapply or maintain eligibility. The result: Almost one-in-every-three Medicaid recipients has been denied not because of eligibility, but 64% for technical or procedural issues. Montana now has among the highest and worst records in the nation for terminating health insurance for children. Disgraceful.

Reports indicate 4- to 6-hour telephone waits and multiple tries for Medicaid recipients to provide documentation to keep their insurance. Unbelievably, some folks did not know their coverage had been terminated until they arrived at the doctors office. What happened to Gov. Greg Gianfortes political promises of less bureaucracy?

Alarmed by Montanas record, federal healthcare authorities have twice requested changes to this processechoing a chorus of local healthcare providers (such as the Montana Chapter of the American Academy of Pediatricians) asking for a 30-day pause to stop children from losing their coverage. Meanwhile, state officials seem hell-bent on purging the Medicaid rolls, to the detriment of peoples health as well as our economy.

Is this purging a signal of things to come? Medicaid Expansion must be renewedduring the 2025 legislative session. Montanas Medicaid program is not plagued by fraud and abuseexactly the opposite. Its bewildering to think about the consequences of this purge. Ironically there is an ongoing major mental health reform initiative, aimed at expanding access. Yet, many of those losing Medicaid need mental or behavioral health servicesbut will no longer be eligible.

The governor is taking Montana backward, not forward Is this the Montana we want for our children, those less fortunate, or folks in rural areas?

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Let's set the record straight on Montana's Medicaid Daily Montanan - Daily Montanan

Water Quality Advisory Issued for Picnic Island Beach | Florida Department of Health in Hillsborough – Florida Department of Health

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Tampa, Fla. The Florida Department of Health in Hillsborough County (DOH-Hillsborough) has issued a water quality advisory for the following location:

Picnic Island Beach7409 Picnic Island BlvdTampa, FL 33616

Tests completed on Wednesday, January 24, 2024, indicate that the water quality at Picnic Island Beach does not meet the recreational water quality criteria for Enterococcus bacteria recommended by the Florida Department of Health.

DOH- Hillsborough advises against any water-related activities at this location due to the potential for high bacteria levels. Bacteriological sampling conducted during regular water quality monitoring showed that the level of bacteria exceeds the level established by state guidelines.

This advisory will continue until bacteria levels are below the accepted health level. New test results should be available for Picnic Island Beach on Thursday, February 1, 2024.

For more information call 813-559-4065 or visit Florida's Healthy Beaches Program.

About the Florida Department of Health

The department, nationally accredited by the Public Health Accreditation Board, works to protect, promote, and improve the health of all people in Florida through integrated state, county and community efforts.

Follow us on Twitter at @HealthyFla and on Facebook. For more information about the Florida Department of Health, please visit http://www.FloridaHealth.gov.

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Water Quality Advisory Issued for Picnic Island Beach | Florida Department of Health in Hillsborough - Florida Department of Health

Covid Has Resurged, but Scientists See a Diminished Threat – The New York Times

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The holidays have come and gone, and once again Americans are riding a tide of respiratory ailments, including Covid. But so far, this winters Covid uptick seems less deadly than last years, and much less so than in 2022, when the Omicron surge ground the nation to a halt.

Were not seeing the signs that would make me think that were heading into another severe wave, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. So far, were in relatively good shape.

Still, there are few masks in sight, and just a fraction of the most vulnerable people have received the latest Covid shots, she noted.

Its not too late, Dr. Rivers added. We have not even reached peak yet for Covid, and once you reach peak, you still have to get down the other side. That leaves plenty of time for the vaccine to provide some protection.

Federal officials are relying on limited data to measure this years spread. After the end of the public health emergency in May, the Centers for Disease Control and Prevention stopped tracking the number of Covid infections. The agency now has only partial access to information from states about vaccination rates.

But trends in wastewater data, positive tests, emergency department visits, hospitalization rates and deaths point to a rise in infections in all regions of the nation, according to the C.D.C. These patterns have prompted many hospitals to reinstate mask policies, after initially resisting a return to them this fall.

As in previous years, the numbers have steadily been rising all winter, and are expected to increase further after holiday travel and get-togethers.

Many of the infections are caused by a new variant, JN.1, which has rapidly spread across the world in recent weeks. I think that theres no doubt its helping drive, pretty substantially, this winter wave, said Katelyn Jetelina, a public health expert and author of a widely read newsletter, Your Local Epidemiologist.

Unfortunately, its coming at the same exact time as us opening up our social networks due to the holidays, she said, so theres kind of a perfect storm going on right now.

Some scientists have pointed to rising levels of the virus in sewage samples as an indicator that infections are at least as high this year as they were at this time last year. But Dr. Rivers urged caution in interpreting wastewater data as a proxy for infections and said hospitalizations were a more reliable metric.

In the week that ended on Dec. 23, hospitalizations rose by nearly 17 percent from the previous week. There were about 29,000 new hospital admissions, compared with 39,000 the same week last year and 61,000 in 2021.

And weekly hospitalizations are increasing more slowly than in previous years, Dr. Rivers said.

Covid is still claiming at least 1,200 lives per week. But that number is about one-third the toll this time last year and one-eighth that in 2021.

We are in this pretty big infection surge right now, but whats really interesting is how hugely hospitalizations have and continue to decouple from infections, Dr. Jetelina said.

She said she worried most about hospitals buckling under the weight of multiple epidemics at once. Even in years before the pandemic, outbreaks of just influenza and respiratory syncytial virus could strain hospitals; rising Covid rates now overlap both illnesses, adding to the burden.

The C.D.C. estimates that so far this season, there have been at least 7.1 million illnesses, 73,000 hospitalizations and 4,500 deaths from the flu.

While Covid tends to be mild in children and young adults, influenza and R.S.V. are most risky for young children and older adults. All three diseases are particularly dangerous for infants.

Emergency department visits for Covid are highest among infants and older adults. While R.S.V. has leveled off in some parts of the country, hospitalization rates remain high among young children and older adults.

The JN.1 variant accounts for nearly half of all Covid cases in the United States, nearly six times the prevalence just a month ago. The variant has one mutation that gives it a greater ability to sidestep immunity than its parent, BA.2.86, which was limited in its spread.

JN.1 may in fact be less transmissible than previous variants. But its immune evasiveness, coupled with the disappearance of preventive measures like masks, may explain its exponential growth worldwide, said Dr. Abraar Karan, an infectious disease physician and postdoctoral researcher at Stanford University.

Still, JN.1 does not appear to cause more severe illness than previous variants, and the current vaccines, tests and treatments work well against all of the current variants.

Experts urged all Americans including those not at high risk of severe illness to opt for vaccines against both Covid and flu, to use masks and air purifiers to prevent infections, to be tested and treated and to stay home if they become ill.

Even those who do not become severely sick run the risk of long-term complications with every new viral infection, researchers noted.

Im not at high risk, to be honest Im young and vaccinated, Dr. Rivers said. But I continue to take precautions in my own life because I do not want to deal with that disruption, and the risk that I could develop a longer-term illness.

But few Americans are following that advice. As of Dec. 23, only 19 percent of adults had received the latest Covid vaccine, and about 44 percent had opted for the annual flu shot. Just over 17 percent of adults aged 60 and older had received the vaccine for R.S.V.

Even among those 75 and older, who are at highest risk from Covid, only about one in three have received the latest shot, according to the C.D.C.

Many people dont realize that shots that protect against the newest variants are available, or that they should be vaccinated even if they are not at high risk, said Gigi Gronvall, a biosecurity expert at the Johns Hopkins Center for Health Security.

Even if the Covid vaccine does not prevent infection, it can shorten the duration and severity of illness, and minimize the risk of long-term symptoms, including brain fog, fatigue, movement problems and dizziness collectively known as long Covid.

Im sure also there are plenty of people who are actively hostile to the idea, but most of the people I encounter, they just dont even know about it, Dr. Gronvall said.

Poor availability of the shots, particularly for children and older adults, has also limited the vaccination rates.

Dr. Gronvall struggled to find a Covid vaccine for her teenage son. Dr. Jetelina has yet to find any for her young children. She said her grandparents, who are both in their mid-90s, also had an incredibly challenging time.

One of them is in a nursing home and still hasnt been immunized because she happened to be sick the one day the vaccines were offered.

Many nursing home residents and staff members remain unvaccinated, because the staff doesnt understand the benefits, said Dr. Karan, who worked with nursing facilities in Los Angeles County.

Financial incentives can improve vaccine coverage, but the lack of awareness about the benefits is a major problem, he said.

Experts also urged people who develop symptoms to take a test and ask for antiviral drugs Tamiflu for influenza, Paxlovid for Covid especially if they are at high risk of complications.

Paxlovid is still available free of charge to most people, but many patients and even doctors avoid it out of a mistaken belief that it causes Covid symptoms to rebound, experts said. Recent studies did not find a relationship between antiviral drugs and symptom rebound.

For many viruses, including the flu, we know that earlier use of antivirals is going to be beneficial, Dr. Karan said. You stop viral replication quickly, you have less of an immune dysregulation thereafter.

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Covid Has Resurged, but Scientists See a Diminished Threat - The New York Times

A new COVID variant is dominant in the US: Know these symptoms – Yahoo News

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A heavily mutated, fast-spreading new COVID-19 variant called JN.1 is on the rise in the United States. Last month, JN.1 swept the country and quickly overtook other variants of the coronavirus to become the dominant strain nationwide.

The highly contagious omicron subvariant now accounts for over 60% of all infections in the U.S., and it's expected to continue driving an increasing number of cases as the country approaches peak respiratory virus season. In fact, data show and some experts say the country is currently in its second-largest COVID wave, smaller than only the omicron surge in late 2021 and early 2022.

JN.1 is also gaining speed in other parts of the world. On Dec. 18, the World Health Organization classified JN.1 as a variant of interest due to its rapidly increasing spread globally.

In the U.S., the share of cases caused by the JN.1 variant has nearly doubled in recent weeks. JN.1 is currently considered the fastest-growing variant in the country, according to the U.S. Centers for Disease Control and Prevention.

During a two-week period ending on Dec. 23, JN.1 accounted for about 44% of cases in the U.S., per the CDCs latest data. This was a steep increase from the previous two-week period ending on Dec. 9, when JN.1 made up 21% of cases.

After JN.1, the next most common strain in the U.S. right now is the HV.1 subvariant, which comprised about 22% of cases as of Dec. 23.

Scientists around the world have been closely monitoring JN.1, which has sparked some concern due to its rapid growth and large number of mutations. However, the new variant is closely related to a strain we've seen before: BA.2.86, aka "Pirola," which has been spreading in the U.S. since the summer.

JN.1 has one additional mutation compared to BA.2.86, which has more than 30 mutations that set it apart from the omicron XBB.1.5 variant. XBB.1.5 was the dominant strain for most of 2023 and it's the variant targeted in the updated COVID-19 vaccines, TODAY.com previously reported.

All of the COVID-19 variants that have gained dominance in the U.S. in the last year are descendants of omicron, which began circulating in late 2021. Since emerging, JN.1 has overtaken its parental strain BA.2.86, as well as HV.1, EG.5 or Eris and XBB.1.16, aka Arcturus.

JN.1's growth comes as COVID hospitalizations rise, influenza continues to spread and RSV activity remains high in many places, according to a Dec. 14 update from the CDC. The agency warned that at the end of the month, emergency rooms and hospitals could become strained, similarly to last year, especially in the South.

Will JN.1 cause a COVID-19 surge? Does JN.1 have different symptoms and is it still detected by COVID tests? Does it respond to vaccines and treatments? Here's what experts know about JN.1 so far.

JN.1 was first reported in August 2023 and it has spread to at least 41 countries so far, according to the WHO. It was first detected in the U.S. in September, the CDC said.

Just like the other newer variants, JN.1 is part of the omicron family.

"Think of (the variants) as children and grandchildren of omicron. They're part of the same extended family, but they each have their own distinctive personalities," Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, tells TODAY.com.

JN.1 descended from BA.2.86, which is a sublineage of the omicron BA.2 variant, TODAY.com previously reported that's what sets JN.1 and BA.2.86 apart from the other prevailing variants like HV.1 and EG.5, which descended from omicron XBB.

When its parent BA.2.86 emerged, everybody was worried because it had a lot of mutations and looked like it was going to evade a lot of the immunity from vaccines and infection in the population, Andrew Pekosz, Ph.D., professor and vice chair in the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health, tells TODAY.com. But (BA.2.86) sort of fizzled out, he adds.

Laboratory data suggest that Pirola is less contagious and immune-evasive than scientists once feared, NBC News reported.

JN.1, however, picked up an additional mutation in its spike protein called L455S, says Pekosz. Spike proteins help the virus latch onto human cells and play a crucial role in helping SARS-CoV-2 infect people, per the CDC. This mutation may affect JN.1's immune escape properties, says Pekosz.

"Now it's circulating and growing at a really fast rate compared to other variants, as well as the parent its derived from (BA.2.86), says Pekosz.

In early November, JN.1 accounted for fewer than 1% of COVID-19 cases in the U.S. Several weeks later, it was driving over 20% of cases, Dr. Michael Phillips, chief epidemiologist at NYU Langone Health, tells TODAY.com. Now, it's the dominant strain in the U.S.

Its not known whether JN.1 causes different symptoms from other variants, according the CDC.

Right now, theres nothing that says that JN.1 infection is any different from previous COVID variants in terms of disease severity or symptoms, but were paying close attention, says Pekosz.

The symptoms of JN.1 appear to be similar to those caused by other strains, which include:

According to the CDC, the type and severity of symptoms a person experiences usually depends more on a persons underlying health and immunity rather than the variant which caused infection.

While severe infections do still occur, overall (COVID-19) is causing a lot of milder illness, says Schaffner.

Some doctors have reported that upper respiratory symptoms seem to follow a pattern of starting with a sore throat, followed by congestion and a cough, NBC News previously reported.

The virus is adapting. ... I think its getting better at infecting humans and evading pre-existing immunity in the population ... but its not changing symptomology too much, says Pekosz.

At this time, theres no evidence that JN.1 causes more severe infection, the experts note.

One of the things these (omicron variants) have in common is that they are highly contagious, and as new variants crop up, they seem to be as contagious or even more contagious than the previous variants, says Schaffner.

According to the CDC, the continued growth of JN.1 suggests that the variant is either more transmissible or better at evading our immune systems.

Its probably a little bit more transmissible than its parental virus because weve seen an increase in case numbers that we didnt with (BA.2.86), says Pekosz. However, it is too early to tell how exactly JN.1's transmissibility or immune escape properties compare to other variants, such as HV.1, the experts note.

Many of the newer strains, including JN.1, have another mutation that affects how strongly the spike protein binds to cells in the respiratory tract, says Pekosz. We know that its probably helping the virus become better at replicating and helping the virus evade more of that pre-existing immune response, he adds.

JN.1 does not pose an increased public health risk compared to other variants currently in circulation, the CDC and WHO said.

The genetic changes in JN.1 could give it an advantage over other variants, but its unclear how that will affect cases in the coming months. So far, there doesnt seem to be a massive increase in transmission. ... We would be concerned if there was a huge surge in cases, says Pekosz.

Right now, JN.1 is increasing in terms of the percentage of COVID-19 cases its causing, and theres also been a slight increase in total cases," says Pekosz.

Test positivity, an early indicator of case levels, is also on the rise, says Phillips the rate was 12.7% during the week ending on Dec. 23, up from about 12% the week prior, per the CDC. (The CDC no longer tracks the total number of cases in the U.S.).

Hospitalizations have also risen by 17% and ICU admissions by 16.4% in the last two weeks, according to an NBC News analysis.

"The good news is that as of yet we're not seeing severe disease or hospitalizations going up significantly, and ICU admissions are still very low, but we're going to watch these carefully," says Phillips.

COVID-19 activity was expected to rise around this time as the U.S. enters winter and respiratory virus season, the experts note. In recent years, the virus has followed a pattern of increasing and peaking around new year, according to the CDC.

"Right now, we do not know to what extent JN.1 may be contributing to these increases or possible increases through the rest of December," the CDC said. Only time will tell whether JN.1 or another variant will cause a surge in infections this winter.

All COVID-19 diagnostic tests including rapid antigen tests and PCR tests are expected to be effective at detecting JN.1, as well as other variants, according to the CDC.

Testing is an important tool to protect yourself and others from COVID-19, especially ahead of indoor gatherings, says Schaffner.

The symptoms of COVID-19 are often indistinguishable from those caused by other viruses spreading right now, the experts note. These include respiratory syncytial virus (RSV), influenza and rhinovirus, which causes the common cold.

The experts urge anyone who becomes ill or is exposed to COVID-19 to take a test, especially people at higher risk of severe disease, such as people over the age of 65, who are immunocompromised and who have underlying health conditions.

Every American can order four free at-home COVID-19 tests from the government, which will be delivered by mail via the U.S. Postal Service. To order your free tests, go to COVIDTests.gov.

"Get tested because, whether it's COVID or flu, we have treatment available," says Schaffner. Current treatments are also expected to be effective against JN.1, the CDC said.

"JN.1 should be just as sensitive to the antivirals available as any other variants," says Pekosz, adding that antivirals like Paxlovid are most effective when taken within the first few days after infection.

The new, updated COVID-19 vaccines, recommended for everyone 6 months and older, are expected to increase protection against JN.1, as well as other variants, the CDC said.

Although the shots target omicron XBB.1.5, which has since been overtaken by HV.1, JN.1, EG.5 and others, there is still evidence that it will protect against new strains circulating this winter, TODAY.com previously reported.

Data from laboratory studies show that the vaccine appears to generate a strong immune response against JN.1's parent strain, BA.2.86, Schaffner notes.

The new vaccines also protect against severe disease, hospitalization and death, the experts emphasize. So even if you get COVID-19 after vaccination, the infection will likely be milder and it can keep you out of the hospital, Phillips adds.

However, uptake of the updated booster among the U.S. population has been low so far, the experts say. As of Dec. 22, only about 18% of adults and 7% of children have gotten the updated vaccine, according to the latest CDC data on vaccination trends.

On Dec. 14, CDC officials issued an alert to warn about low vaccination rates against COVID-19, flu and RSV in the U.S.

Now is the best time to get vaccinated if you haven't already, the experts say. "The sooner you get vaccinated, the sooner you'll be protected and it does take seven to 10 days for protection to build up to the maximum," says Schaffner.

Phillips recommends everyone, especially high-risk individuals, to get the seasonal influenza shot, as well. Hospitalizations for flu increased 200% over the past month, according to the CDC's Dec. 14 warning.

"Getting vaccinated is the best present you can give yourself and your family this holiday season," Schaffner adds.

Every day, but especially during respiratory virus season, people can take steps to protect themselves and others from COVID-19.

The experts encourage everyone to:

Stay up to date with COVID-19 vaccines.

Test if you have symptoms.

Isolate if you have COVID-19.

Avoid contact with sick people.

Improve ventilation.

Wear a mask in crowded, indoor spaces.

Wash your hands with soap and water.

This article was originally published on TODAY.com

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A new COVID variant is dominant in the US: Know these symptoms - Yahoo News

Transhumanism: Integrating Cochlear Implants With Artificial Intelligence and the Brain-Machine Interface – Cureus

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Transhumanism: Integrating Cochlear Implants With Artificial Intelligence and the Brain-Machine Interface - Cureus

Prostate Cancer in the Caribbean | Article – Cureus

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Please choose I'm not a medical professional. Allergy and Immunology Anatomy Anesthesiology Cardiac/Thoracic/Vascular Surgery Cardiology Critical Care Dentistry Dermatology Diabetes and Endocrinology Emergency Medicine Epidemiology and Public Health Family Medicine Forensic Medicine Gastroenterology General Practice Genetics Geriatrics Health Policy Hematology HIV/AIDS Hospital-based Medicine I'm not a medical professional. Infectious Disease Integrative/Complementary Medicine Internal Medicine Internal Medicine-Pediatrics Medical Education and Simulation Medical Physics Medical Student Nephrology Neurological Surgery Neurology Nuclear Medicine Nutrition Obstetrics and Gynecology Occupational Health Oncology Ophthalmology Optometry Oral Medicine Orthopaedics Osteopathic Medicine Otolaryngology Pain Management Palliative Care Pathology Pediatrics Pediatric Surgery Physical Medicine and Rehabilitation Plastic Surgery Podiatry Preventive Medicine Psychiatry Psychology Pulmonology Radiation Oncology Radiology Rheumatology Substance Use and Addiction Surgery Therapeutics Trauma Urology Miscellaneous

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Prostate Cancer in the Caribbean | Article - Cureus

The GAO Calls on the FAA to Improve its Mishap Investigation Process – Payload

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The US Government Accountability Office (GAO) says the FAA should improve its procedures when things go awry in spaceflight. The federal agency watchdog published a report yesterday that called on the FAA to develop tools to 1) define criteria for when a mishap report is operator-led, and 2) better evaluate the effectiveness of the process as a whole.

Without a comprehensive evaluation of its mishap investigation process, FAA cannot be assured its process is effective, especially given the expansion of commercial space operations in recent years, the GAO report said.

The FAAs Office of Commercial Space Transportation is responsible for issuing launch licenses and investigating flight mishaps.

12% mishap rate: Mishap investigations kick in when a flight is not completed as planned, like in the case of Starships two big kabooms this year. Out of 433 launches between 2000 and mid-January 2023, 50 were mishaps, according to the report.

In-house? Since all launch vehicles are specializedand literally rocket sciencethe FAA believes operators are best suited to sniff out root causes and identify corrective actions. The agency estimates that in-house investigations could take the agency 10-20 times longer.

After a September anomaly with Rocket Labs Electron, it took the FAA just 36 days to approve a Rocket Lab-led mishap investigation and Electron was cleared to fly again. According to the agencys estimates mentioned above, an FAA-led investigation could have taken north of a year.

GAO does not necessarily disagree with that logic; instead, they are requesting that the FAA better track effectiveness, share data, and develop a defined criteria for when the investigations should be operator-led.

The FAA concurs with the GAOs recommendations to evaluate and further improve the FAA commercial space mishap program, the FAA said in an email to Payload. Protecting public health and safety are at the core of the program.

Learning period: As for human spaceflight/tourism, the industry has been operating under an eight-year learning period, where the FAA is restricted from enacting regulations. The learning period is set to expire on Jan. 1.

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The GAO Calls on the FAA to Improve its Mishap Investigation Process - Payload