Category: Morbidity

Covid National Emergency Ends

Mary Pat Campbell

Link: https://kelleyk.substack.com/p/covid-national-emergency-ends

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Biden signed H.J.Res. 7, which ended the national emergency for Covid. Both the text of the bill, and the corresponding press release from the White House are short and sweet. The White House recently said Biden “strongly opposes HJ Res 7,” but that he would sign the bill if it passed. It passed with bipartisan support in both the House.

One thing that is tied to the national emergency is an extension of COBRA deadlines for people who are out of work. These deadlines are extended during the “outbreak period” which ends 60 days after the end of the national emergency.

The DHS rules for vaccine mandates for foreign travelers at land border crossings from Canada and Mexico rely on the national emergency as their legal basis, so theoretically they will end with the national emergency. But there has been no official actions to lift those rules, and I suspect the White House expects this vaccine mandate to continue for at least another month. (See section on travel vaccine mandates further down for more details.)

Author(s): Kelly K

Publication Date: 11 April 2023

Publication Site: Check Your Work

I Gave Myself Severe Diarrhea for Science. Don’t Tax Me for It.

Mary Pat Campbell

Link: https://reason.com/2023/04/05/i-gave-myself-severe-diarrhea-for-science-dont-tax-me-for-it/

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I drank the bespoke pathogenic cocktail as part of what’s known as a “human challenge study” run by the Center for Vaccine Development at the University of Maryland, Baltimore. In a human challenge study, adult volunteers are exposed to a pathogen. The study I was involved in was intended to test an experimental vaccine. The process may sound somewhat medieval, but these studies are critical scientific tools that prioritize participant safety. From 1980 to 2021, over 15,000 volunteers have been exposed to one of dozens of diseases in such studies, and not one has died. 

Dysentery can be fatal. While Shigella is treatable with antibiotics, resistance is evolving at a worrying pace, and tens of thousands of children still succumb to it every year in the developing world. Those it does not kill are often left with stunted growth.

….

For my assistance in the development of a potentially lifesaving vaccine, I was paid $7,350. My motivations were altruistic to a degree: I wanted to pay my privilege forward. As I told Business Insider, however, I am not a complete saint and would not have done it for free.

As far as the Internal Revenue Service (IRS) is concerned, the compensation for my bout of dysentery has zero charitable component; it’s just regular old income, indistinguishable from, say, freelance writing or mowing lawns. If, God forbid, I am ever audited, I hope the IRS agent believes me when I say that’s just my diarrhea money.

I maintain, though, that I should not be taxed on that $7,350 at all: Treating clinical trial compensation as taxable income is just bad policy. 

Author(s): JAke Eberts

Publication Date: 5 April 2023

Publication Site: Reason

Flesh-rotting drug ‘Tranq’ linked to dozens of NY deaths: Schumer

Mary Pat Campbell

Link: https://nypost.com/2023/03/26/new-york-seeing-tranq-drug-related-deaths-schumer/

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Tranq – the deadly “zombie” drug formally known as xylazine – is circulating across New York and has been tied to dozens of deaths in the state, Senate Majority Leader Chuck Schumer warned Sunday.

Use of the flesh-rotting substance is “spreading” in Syracuse, Albany, Rochester and the Greater New York City area, Schumer said, as he called on increased federal funding for the state to help fight the disturbing trend.

….

Tranq, a veterinary drug, is Narcan-resistant, meaning its effects cannot be reversed in the event of an overdose.

It is said to cause skin and bone to deteriorate or rot over time. 

The US Drug Enforcement Administration recently issued a public safety alert, announcing that the agency had seized mixtures of xylazine and fentanyl in 48 of the 50 states. 

Author(s):Haley Brown and Stephanie Pagones

Publication Date: 26 Mar 2023

Publication Site: NY Post

ChatGPT: A conversation about underwriting and life insurance

Mary Pat Campbell

Link: https://www.dig-in.com/opinion/chatgpt-a-conversation-about-underwriting-life-insurance

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RGA decided to put ChatGPT to the test by posing three questions related to underwriting and the future of life insurance. The answers from ChatGPT that follow are entirely AI-generated. Following those responses is a brief FAQ that further explores this emerging topic.

How will COVID-19 affect U.S. long-term mortality?

It is difficult to predict the long-term effects of COVID-19 on mortality in the United States. The pandemic has already had a significant impact on mortality, with over 1.1 million COVID-attributed deaths reported in the country. However, it is possible that the mortality rate from COVID-19 could decline over time as more people become immune to the virus and as effective vaccines are developed and distributed.

There are also other factors that could affect the long-term mortality rate from COVID-19. For example, the effectiveness of public health measures, such as mask-wearing and social distancing, in controlling the spread of the virus could have a significant impact on the number of deaths. In addition, the availability of effective treatments for COVID-19 could also play a role in reducing the mortality rate from the virus.

It is important to continue monitoring the situation and taking steps to control the spread of the virus to minimize the impact on mortality.

Author(s): ChatGPT, Jeff Heaton, Dave Rengachary

Publication Date: 14 Feb 2023

Publication Site: Digital Insurance

Association of Cardiovascular Health With Life Expectancy Free of Cardiovascular Disease, Diabetes, Cancer, and Dementia in UK Adults

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2801750?guestAccessKey=9c49772f-a1bb-4a29-9a46-445f585b3781&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=olf&utm_term=022723

Cite: JAMA Intern Med. Published online February 27, 2023. doi:10.1001/jamainternmed.2023.0015

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Question  What is the association of cardiovascular health (CVH) levels, estimated by the American Heart Association’s Life’s Essential 8 score, with life expectancy free of major chronic diseases?

Findings  In this cohort study of 135 199 adults from the UK Biobank study, high CVH level was associated with substantially longer life expectancy free of 4 major chronic diseases (cardiovascular disease, diabetes, cancer, and dementia) in both men and women. Furthermore, the disease-free life expectancy was similar between low and other socioeconomic groups among participants with high CVH.

Meaning  These findings support improvement in population health by promoting a high CVH level, which may also narrow health disparities associated with socioeconomic status.

Author(s): Xuan Wang, MD, PhD1; Hao Ma, MD, PhD1; Xiang Li, MD, PhD1; et al

Publication Date: 27 Feb 2023

Publication Site: JAMA Internal Medicine

One-Year Adverse Outcomes Among US Adults With Post–COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2802095

JAMA Health Forum. 2023;4(3):e230010. doi:10.1001/jamahealthforum.2023.0010

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Key Points

Question  Do postacute sequelae of SARS-CoV-2 increase risks of 1-year adverse outcomes?

Findings  In this case-control study of 13 435 US adults with post–COVID-19 condition (PCC) and 26 870 matched adults without COVID-19, the adults with PCC experienced increased risks for a number of cardiovascular outcomes, such as ischemic stroke. During the 12-month follow-up period, 2.8% of the individuals with PCC vs 1.2% of the individuals without COVID-19 died, implying an excess death rate of 16.4 per 1000 individuals.

Meaning  Individuals with PCC may be at increased risk for adverse outcomes in the year following initial infection.

Author(s): Andrea DeVries, PhD1; Sonali Shambhu, BDS, MPH1; Sue Sloop, PhD1; et al

Publication Date:

Publication Site: JAMA Health Forum

Long COVID Correlates With High Mortality: Health Insurer

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2023/03/03/long-covid-correlates-with-high-mortality-health-insurer/

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A giant health insurer says health plan enrollees who suffered from long COVID-19 symptoms were more than twice as likely as other enrollees to die during a 12-month follow-up period.

Andrea DeVries, a researcher at Elevance Health, and three colleagues found that, during the year studied, 2.8% of the 13,435 enrollees classified as having “post-COVID-19 condition” died, according to a study published in the JAMA Health Forum, which is affiliated with the Journal of the American Medical Association.

That compares with a death rate of just 1.2% for similar enrollees without COVID-19 during the same period.

….

Elevance Health is the company formerly known as Anthem. The company provides or administers major medical coverage for about 48 million people.

The DeVries looked at claim records for 249,013 Elevance plan enrollees ages and older who were diagnosed with COVID-19 from April 1, 2020, through July 31, 2020 — before regulators had adopted a long COVID diagnosis code.

The team began by identifying enrollees with COVID-19 who had been enrolled in an Elevance plan for at least five months before being diagnosed with COVID-19 and who had survived for at least two months after the diagnosis date.

Because of the lack of a long COVID-19 diagnosis code, the team used claims for other conditions, such as loss of the sense of smell, brain fog, anxiety and heart rate problems, to come up with a list of enrollees with long COVID.

Author(s): Allison Bell

Publication Date: 3 March 2023

Publication Site: Think Advisor

CalPERS’ Refusal to Put Clearly Insolvent Long-Term Care Insurance Plan in Bankruptcy Increases Harm to Policyholders and Makes Board and Responsible Executives Liable

Mary Pat Campbell

Link: https://www.nakedcapitalism.com/2023/02/calpers-refusal-to-put-clearly-insolvent-long-term-care-insurance-plan-in-bankruptcy-increases-harm-to-policyholders-and-makes-board-and-responsible-executives-liable.html

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The CalPERS long-term care fiasco continues, with the board and staff taking a course of action that increases harm to policyholders by continuing to bleed them rather than put the program in bankruptcy.

For those new to this train wreck, the public comment at the February 14 CalPERS board meeting by policy-holder and certified financial planner Lawrence Grossman provides an introduction. A key bit of background is that state legislation allowed CalPERS to jump on the long-term care insurance bandwagon in the 1990s. Most of these insurance plans have gotten into a world of hurt by underestimating the degree to which proper elder care would extend lifepsans of policy-holders and overestimating the lapse rate (lapsed policies mean the premiums paid by dropouts benefit the remaining policyholders). But CalPERS’ recklessness and incompetence were in a league of its own.

CalPERS not only considerably underpriced its policies compared to commercial competitors, but it made matters worse via giving CalPERS policyholders the options of lifetime benefits (as opposed to fixed dollar benefits) and inflation protection. Inflation protection would seem like an incredible promise for any long-term insurance scheme. Yet the policies were advertised as CalPERS policies, not those of a free-standing “CalPERS Long-Term Care Fund,” as in not backed by CalPERS or the state of California.

….

Four years later and things are going according to CalPERS’ abusive plan. Even though Judge Highberger clearly rejected CalPERS’ position that it can violate policy terms and raise premiums, CalPERS has continued to increase premiums because the court so far has issued only preliminary decisions. Note these increases are vastly in excess of those implemented by commercial carriers.

Author(s): Yves Smith

Publication Date: 15 Feb 2023

Publication Site: naked capitalism

Masks Make ‘Little or No Difference’ on COVID-19, Flu Rates: New Study

Mary Pat Campbell

Link: https://reason.com/2023/02/07/masks-covid-dont-work-cochrane-library-review-mandate/

Excerpt:

The wearing of masks to prevent the spread of COVID-19 and other respiratory illnesses had almost no effect at the societal level, according to a rigorous new review of the available research.

“Interestingly, 12 trials in the review, ten in the community and two among healthcare workers, found that wearing masks in the community probably makes little or no difference to influenza-like or COVID-19-like illness transmission,” writes Tom Jefferson, a British epidemiologist and co-author of the Cochrane Library’s new report on masking trials. “Equally, the review found that masks had no effect on laboratory-confirmed influenza or SARS-CoV-2 outcomes. Five other trials showed no difference between one type of mask over another.”

That finding is significant, given how comprehensive Cochrane’s review was. The randomized control trials had hundreds of thousands of participants, and made useful comparisons: people who received masks—and, according to self-reporting, actually wore them—versus people who did not. Other studies that have tried to uncover the efficacy of mask requirements have tended to compare one municipality with another, without taking into account relevant differences between the groups. This was true of an infamous study of masking in Arizona schools conducted at the county level; the findings were cited by the Centers for Disease Control and Prevention (CDC) as reason to keep mask mandates in place.

Author(s): Robby Soave

Publication Date: 7 Feb 2023

Publication Site: Reason

Long COVID Is Keeping Significant Numbers of People Out of Work, Study Finds

Mary Pat Campbell

Link: https://www.yahoo.com/news/long-covid-keeping-significant-numbers-125618654.html

Source of study: https://ww3.nysif.com/

Link to study (will download): https://ww3.nysif.com/~/media/Files/NYSIF_Publications/PDF/NYSIFLongCOVIDStudy2023.ashx

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Long COVID is having a significant effect on America’s workforce, preventing substantial numbers of people from going back to work while others continue needing medical care long after returning to their jobs, according to a new analysis of workers’ compensation claims in New York state.

The study, published Tuesday by New York’s largest workers’ compensation insurer, found that during the first two years of the pandemic, about 71% of people the fund classified as experiencing long COVID either required continuing medical treatment or were unable to work for six months or more. More than a year after contracting the coronavirus, 18% of long COVID patients had still not returned to work, more than three-fourths of them younger than 60, the analysis found.

“Long Covid has harmed the work force,” said the report, by the New York State Insurance Fund, a state agency financed by employer-paid premiums. The findings, it added, “highlight long Covid as an underappreciated yet important reason for the many unfilled jobs and declining labor participation rate in the economy, and they presage a possible reduction in productivity as employers feel the strains of an increasingly sick work force.”

Author(s): Pam Belluck

Publication Date: 24 Jan 2023

Publication Site: Yahoo (originally published at NYT)

Incidence of COVID-19 Among Persons Experiencing Homelessness in the US From January 2020 to November 2021

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2795298

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JAMA Netw Open. 2022;5(8):e2227248. doi:10.1001/jamanetworkopen.2022.27248

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Question  How many cases of COVID-19 in the US have occurred among people experiencing homelessness?

Findings  In this cross-sectional study of 64 US jurisdictional health departments, 26 349 cases of COVID-19 among people experiencing homelessness were reported at the state level and 20 487 at the local level. The annual incidence rate of COVID-19 was lower among people experiencing homelessness than in the general population at state and local levels.

Meaning  The findings suggest that incorporating housing and homelessness status in infectious disease surveillance may improve understanding of the burden of infectious diseases among disproportionately affected groups and aid public health decision-making.

Author(s): Ashley A. Meehan, MPH1; Isabel Thomas, MPH1,2; Libby Horter, MPH1,3; et al

Publication Date: August 18, 2022

Publication Site: JAMA Open Network

Public Health Agencies Try to Restore Trust as They Fight Misinformation

Mary Pat Campbell

Link: https://khn.org/news/article/public-health-agencies-try-to-restore-trust-as-they-fight-misinformation/

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Across the country, health officials have been trying to combat misinformation and restore trust within their communities these past few years, a period when many people haven’t put full faith in their state and local health departments. Agencies are using Twitter, for example, to appeal to niche audiences, such as NFL fans in Kansas City and Star Wars enthusiasts in Alabama. They’re collaborating with influencers and celebrities such as Stephen Colbert and Akbar Gbajabiamila to extend their reach.

Some of these efforts have paid off. By now, more than 80% of U.S. residents have received at least one shot of a covid vaccine.

But data suggests that the skepticism and misinformation surrounding covid vaccines now threatens other public health priorities. Flu vaccine coverage among children in mid-December was about the same as December 2021, but it was 3.7 percentage points lower compared with late 2020, according to the Centers for Disease Control and Prevention. The decrease in flu vaccination coverage among pregnant women was even more dramatic over the last two years: 18 percentage points lower.

Other common childhood vaccination rates are down, too, compared with pre-pandemic levels. Nationally, 35% of all American parents oppose requiring children to be vaccinated for measles, mumps, and rubella before entering school, up from 23% in 2019, according to a KFF survey released Dec. 16. Suspicion swirling around once-trusted vaccines, as well as fatigue from so many shots, is likely to blame.

Author(s): Laurie Sausser

Publication Date: 3 Jan 2023

Publication Site: Kaiser Health News