Policy Updates 9/16/2022

1. Influenza

The Hill: Nation Warned To Brace For A Difficult Flu Season
Health experts are warning the nation to brace for what could be an exceptionally severe flu season this fall and winter, as more people who have not built up immunity over the last few years mix and mingle. There are two big reasons why more people could be vulnerable to the flu this year. The first is that with coronavirus restrictions such as the wearing of masks all but forgotten, people are more likely to come into contact with the flu virus this year than over the last two years. (Choi, 9/15)

KQED: When Should You Get Your 2022 Flu Shot?
The Centers for Disease Control and Prevention estimates that, annually, the flu caused 140,000-710,000 hospitalizations and 12,000-52,000 deaths between 2010 and 2020. But the organization says that in the 2020-2021 flu season, only around half of adults got a flu shot. Getting a flu vaccine can prevent you from getting sick with the flu, which is a draining, unpleasant experience even if your symptoms are not severe. And if you do get the flu, having a flu shot can also stop you from getting sick enough to have to go to the hospital (and be exposed to all the COVID risks hospital settings can bring). (Severn, 9/15)

1. Mental Health

Los Angeles Times: How California’s CARE Court Will Address Mental Illness
California has a new statewide approach to treatment for people struggling with serious mental illness: the CARE Court. The program connects people in crisis with a court-ordered treatment plan for up to two years, while diverting them from possible incarceration, homelessness or restrictive court-ordered conservatorship. (Garcia, 9/15)

Axios: America's Fentanyl Problem A Growing Threat For Teens
Fentanyl is posing a growing health threat for teenagers across the nation, and as kids return to schools and colleges, officials warn there's a higher chance they may encounter the drug disguised in forms they might not expect. (Reed, 9/16)

San Francisco Chronicle: What Is Rainbow Fentanyl? The New Opioid Found In The Bay Area
“Rainbow fentanyl,” a brightly color version of the super powerful opioid largely driving the overdose epidemic, has hit the Bay Area, worrying public health and law enforcement experts. While the drug is just as powerful and deadly as other fentanyl on the streets, the so-called rainbow version is marketing ploy to make the drugs look appealing, sometimes resembling the popular cereal Fruit Loops or Skittles candy, experts say. (Ravani, 9/15)

Bloomberg: ADHD Drug Adderall Runs Low At CVS, Walgreens As Demand Soars
Bloomberg spoke to half a dozen patients in states including California, Indiana and Michigan who said that they called or went into CVS Health Corp. or Walgreens Boots Alliance Inc. pharmacies in August or September and were told the medicines were out of stock. In some cases, patients were told they might have to wait more than a week to get their medication, which is supposed to be taken every day. (Swetlitz, 9/15)

The Wall Street Journal: DEA Investigating ADHD Telehealth Provider Done
U.S. Drug Enforcement Administration agents have questioned people about telehealth company Done Global Inc.’s practices for prescribing controlled substances, according to documents reviewed by The Wall Street Journal and people familiar with the inquiries. The inquiries in recent weeks suggest ongoing and potentially widening interest from federal authorities in online mental-health companies such as Done that during the Covid-19 pandemic have been prescribing stimulants like Adderall for treatment of attention-deficit hyperactivity disorder—drugs the U.S. government classifies as controlled substances in the same category as OxyContin. (Winkler, 9/15)

AP: California Governor OKs Mental Health Courts For Homeless
With more than 100,000 people living on California’s streets, Gov. Gavin Newsom signed a first-of-its kind law on Wednesday that could force some of them into treatment as part of a program he describes as “care” but opponents argue is cruel. Newsom signed the Community Assistance, Recovery and Empowerment Act on Wednesday. It would let family members, first responders and others ask a judge to draw up a treatment plan for someone diagnosed with certain disorders, including schizophrenia. Those who refuse could be placed under a conservatorship and ordered to comply. (Har and Beam, 9/14)

NPR: New 988 Mental Health Crisis Line Sees Rising Use Since Launch
New data released Friday by the U.S. Department of Health and Human Services show that in August – the first full month that 988 was operational — the Lifeline saw a 45% increase in overall volume of calls, texts and chats compared to August 2021. (Chatterjee, 9/10)

Atlanta Journal-Constitution: Morehouse School Of Medicine Report Highlights Cost Of Mental Health Inequities
A lack of investment in mental health has taken nearly 117,000 lives and cost $278 billion from 2016-2020, with underserved and underrepresented communities across the country experiencing the brunt of the effects, according to a report released Wednesday by the Satcher Health Leadership Institute at Morehouse School of Medicine. (Thomas, 9/12)

1. Health Care

Bloomberg: US Hospital Losses: 53% Expect To Lose Money This Year, AHA Study Finds
An eight-hour emergency room wait. The closing of a local clinic in a high-poverty area of rural Arkansas. Dwindling maternity wards. These are some of the outcomes of the financial pain US hospitals are feeling as spiking costs dictate sometimes-dire decisions. And it’s not getting any better, according to a report Thursday. (Coleman-Lochner, 9/15)

Modern Healthcare: Healthcare Industry On Defense In Climate Crisis: Report
Greenhouse gases released from the healthcare sector make up 10% of total U.S. emissions, and they continue to grow. According to the report, carbon dioxide, methane, nitrous oxide, and fluorinated gas emissions rose 6% between 2010 and 2018, resulting in the loss of 388,000 disability-adjusted life-years. The House Ways and Means Committee published these findings in conjunction with a hearing on the subject Thursday. (Hartnett, 9/15)

1. Polio

KHN: With Polio’s Return, Here’s What Back-To-Schoolers Need To Know
Before polio vaccines became available in the 1950s, people wary of the disabling disease were afraid to allow their children outside, let alone go to school. As polio appears again decades after it was considered eliminated in the U.S., Americans unfamiliar with the dreaded disease need a primer on protecting themselves and their young children — many of whom are emerging from the trauma of the covid-19 pandemic. (Gounder, 9/16)

NBC News: New York Declares A State Of Emergency Over Polio
"On polio, we simply cannot roll the dice,” New York State Health Commissioner Dr. Mary Bassett said in a statement. “If you or your child are unvaccinated or not up to date with vaccinations, the risk of paralytic disease is real. I urge New Yorkers to not accept any risk at all." (Bendix, 9/9)

AP: Poliovirus Detected In More Wastewater Near New York City
The sample is genetically linked to the polio case from Rockland and provides further evidence of expanding community spread, state health officials said. ... Hochul declared a state disaster emergency that allows EMS workers, midwives and pharmacists to administer polio vaccines and allows doctors to issue standing orders for the vaccine. Data on immunizations will be used to focus vaccination efforts where they’re needed the most. (Hill, 9/9)

1. Women’s Health

KHN: New Abortion Laws Jeopardize Cancer Treatment For Pregnant Patients
As abortion bans go into effect across a contiguous swath of the South, cancer physicians are wrestling with how new state laws will influence their discussions with pregnant patients about what treatment options they can offer. Cancer coincides with roughly 1 in 1,000 pregnancies, most frequently breast cancer, melanoma, cervical cancer, lymphomas, and leukemias. But medications and other treatments can be toxic to the developing fetus or cause birth defects. In some cases, hormones that are supercharged during pregnancy fuel the cancer’s growth, putting the patient at greater risk. (Huff, 9/16)

KVPR: Kern County's Mothers And Babies Are Dying And No One Seems Certain Why
Childbirth is safer in California than in most of the country. But some parts of the state—namely the San Joaquin Valley—lag behind. In 2019, Kern County’s infant mortality rate was 57% higher than the state average, according to data from the research and advocacy organization March of Dimes. It’s one of the highest rates in California. (Klein, 9/12)

The Hill: FDA Schedules Meeting On OTC Birth Control Pill Application
The Food and Drug Administration (FDA) has scheduled a joint meeting to discuss pharmaceutical company Perrigo’s application for what could be the first over-the-counter (OTC) daily birth control pill available in the U.S., the company announced Monday. The joint meeting will be held on Nov. 18 with the FDA’s Nonprescription Drugs Advisory Committee and the Obstetrics, Reproductive, and Urologic Drugs Advisory Committee, according to Perrigo. (Choi, 9/12)

Axios: Affordability Questions Linger Around Over-The-Counter Birth Control
The FDA's decision to consider the first birth control pill that could be sold without a prescription may solve some contraception access problems. But gaps in insurance coverage rules could make it unaffordable for some. (Gonzalez and Owens, 9/13)

1. Shootings

Mass Shootings In The United States: Population Health Impacts And Policy Levers

Aparna Soni and Erdal Tekin

1. Monkeypox

CalMatters: With Monkeypox, California Colleges Face Dual Threat
After a couple years of living with COVID-19, UC Santa Barbara student Alex Niles heard about the monkeypox outbreak. “Here we go again,” he thought. Niles, who is president of the UC Student Association, knew monkeypox was transmitted very differently than COVID-19 and generally posed less risk. But he began to notice concern percolating within UC Santa Barbara’s student body. (Seshadri, 9/15)

CIDRAP: CDC Head Says Monkeypox Slowing In US
Today the Senate Health, Education, Labor and Pensions (HELP) Committee met for the first time to address the federal response to the US monkeypox outbreak, and Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky, MD, MPH, addressed the rocky federal start of outbreak response but noted that cases are now declining. She also highlighted CDC outreach at a time when the disease was brand new to most frontline clinicians. (Soucheray, 9/14)

CIDRAP: CDC Head Says Monkeypox Slowing In US
Today the Senate Health, Education, Labor and Pensions (HELP) Committee met for the first time to address the federal response to the US monkeypox outbreak, and Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky, MD, MPH, addressed the rocky federal start of outbreak response but noted that cases are now declining. She also highlighted CDC outreach at a time when the disease was brand new to most frontline clinicians. (Soucheray, 9/14)

Los Angeles Times: L.A. County Reports Nation's First MPX Case In Exposed Healthcare Worker
“We have identified a healthcare worker with monkeypox who appears to have been exposed to the virus at their worksite,” Dr. Rita Singhal, chief medical officer for the L.A. County Department of Public Health, said in a presentation to the Board of Supervisors. “This is the first case of monkeypox in a healthcare worker in the United States that has been linked to a worksite exposure.” (Toohey, 9/13)

1. LGBTQ Health

The 19th: LGBTQ+ Americans Report More Discrimination At The Doctor, Poll Finds
When LGBTQ+ people go to the doctor, they are more likely to be refused medical services, blamed for their health problems and discriminated against than cisgender and heterosexual people, a new 19th News/SurveyMonkey poll has found. (Rummler and Mithani, 9/15)

1. Health Coverage

KHN: Court Ruling May Spur Competitive Health Plans To Bring Back Copays For Preventive Services
Tom and Mary Jo York are a health-conscious couple, going in for annual physicals and periodic colorectal cancer screening tests. Mary Jo, whose mother and aunts had breast cancer, also gets regular mammography tests. The Yorks, who live in New Berlin, Wisconsin, are enrolled in Chorus Community Health Plans, which, like most of the nation’s health plans, is required by the Affordable Care Act to pay for those preventive services, and more than 100 others, without charging deductibles or copays. (Meyer, 9/15)

Axios: The Uninsured Rate Of Americans Remains Relatively Steady
The number of Americans without health insurance fell by a million people in 2021, according to U.S. Census Bureau data published yesterday. (Knight, 9/14)

1. COVID

AP: WHO: COVID End 'in Sight,' Deaths At Lowest Since March 2020
The head of the World Health Organization said Wednesday that the number of coronavirus deaths worldwide last week was the lowest reported in the pandemic since March 2020, marking what could be a turning point in the years-long global outbreak. At a press briefing in Geneva, WHO Director-General Tedros Adhanom Ghebreyesus said the world has never been in a better position to stop COVID-19. “We are not there yet, but the end is in sight,” he said, comparing the effort to that made by a marathon runner nearing the finish line. “Now is the worst time to stop running,” he said. (9/14)

1. Health Care Providers

Press Association: Burned-Out Doctors Pose Risks To Patient Safety, BMJ Study Finds
Patients being treated by burned-out doctors may face additional risks when they receive care, a new study suggests. A new review concluded that doctors experiencing burnout are twice as likely to be involved in patient safety incidents such as medication errors and "suboptimal care". (Pickover, 9/14)

1. Children’s Health Care

KHN: Newborns Get Routine Heel Blood Tests, But Should States Keep Those Samples?
Close to 4 million babies are born in the United States every year, and within their first 48 hours nearly all are pricked in the heel so their blood can be tested for dozens of life-threatening genetic and metabolic problems. The heel-stick test is considered such a crucial public health measure that states typically require it and parents aren’t asked for their permission before it’s done. But the lab tests for newborn screenings generally don’t use all of the half-dozen or so drops of blood collected on filter paper cards. So states hold on to the leftover “dried blood spots,” as they’re called, often without parents’ knowledge or consent. In recent years, privacy-related concerns have grown about the sometimes decades-long storage and use of the material. (Andrews, 9/14)

Stat: Providers Urged To Be Alert For Rare Polio-Like Syndrome In Kids
Pediatricians and top health officials are warning about an uptick in activity of a common virus that in rare cases can cause a polio-like syndrome in young children. (Joseph and Branswell, 9/12)

1. Poverty

Bloomberg: Poverty Rate Rises For Second Year While Incomes Are Little Changed
The U.S. poverty rate climbed for a second straight year in 2021 and household income slipped slightly as the economy slowly started a recovery from the COVID-19 pandemic. (Tanzi and Saraiva, 9/13)

The New York Times: Expanded Safety Net Drives Sharp Drop In Child Poverty
For a generation or more, America’s high levels of child poverty set it apart from other rich nations, leaving millions of young people lacking support as basic as food and shelter amid mounting evidence that early hardship leaves children poorer, sicker and less educated as adults. But with little public notice and accelerating speed, America’s children have become much less poor. A comprehensive new analysis shows that child poverty has fallen 59 percent since 1993, with need receding on nearly every front. (DeParle, 9/11)

1. Climate Change

Los Angeles Times: Despite Heat, Few People Go To L.A. Cooling Centers. Why?
Anthony Willis has been living at a homeless encampment on Vermont Avenue and West 3rd Street near Koreatown for years. During the blistering heat wave last week that brought triple-digit temperatures to portions of Southern California, Willis used a hand fan, a big umbrella and drenched himself with ice to stay cool. “It’s so hot,” said Willis, 35, on Friday. “I go to the Starbucks and grab ice water every day to keep from dying out here. I’m surprised we have a breeze coming through today — the wind is actually blowing.” (Lin, 9/13)