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HEALTH POLICIES, ANALYSIS, AND RESOURCES

The Health Policy Domain tracks and reports on policies that deal with women’s health, the Affordable Care Act, Head Start, child care and child support services, the Children’s Health Insurance Program, and federal food and drug policy. This domain tracks policies emanating from the White House, the department of Health and Human Services, the US Food and Drug Administration and the Centers for Disease Control (CDC).

Latest Health & Gender Posts

 

The Trump Administration Threatens Hospital Funding Over COVID-19 Reporting

Brief #82—Health
By Taylor J Smith
After the Trump Administration’s July announcement requiring all hospitals to submit COVID-19 data to private company, TeleTracking Technologies, exclusively sharing data with the Department of Health and Human Services, critics opposed the White House’s move to bypass the Centers for Disease Control, raising transparency concerns. However, the requirements have continued, and President Trump has become dissatisfied with the level of compliance amongst the nation’s hospitals.

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Biden and COVID-19: 100 Million Vaccine Doses in 100 Days

Biden and COVID-19: 100 Million Vaccine Doses in 100 Days

Brief # 87 Health and Gender Policy

Biden and COVID-19: 100 Million Vaccine Doses in 100 Days 

By Justin Lee

December 28, 2020

Policy

In early December, President-elect Joe Biden announced the new members of his public health team and objectives he plans to implement within in his first 100 days in office. These objectives include a federal requirement for Americans to wear masks where Biden is legally able to enforce compliance and seeking strategies to open the majority of schools across the country.

Another objective Biden specifically mentioned is his plan to distribute 100 million doses of COVID-19 vaccine within his first 100 days in office. The Food and Drug Administration (FDA) issued Emergency Use Authorizations (EUA) for the Pfizer-BioNTech vaccine on December 11th, 2020 and for the Moderna vaccine on December 18th, 2020. Since then, over 9.5 million doses have been distributed across the nation, yet only a little more than a million people have been vaccinated as of the end of December.

The Trump administration had a federal goal of inoculating 20 million Americans by the end of 2020; a goal that was missed by a laughable margin. Is Biden’s plan to vaccinate 50 million Americans before May 2021 another laugh for skeptics?

Analysis 

In short, Biden’s road to vaccinate 50 million Americans is possible but filled with many challenges. Here are some basics to consider:

Vaccine delivery timing: In late December, the Trump administration reached a second deal with Pfizer to secure an additional 100 million doses of the COVID-19 vaccine. This news follows a similar agreement with Moderna, with the government reaching a second agreement to double their initial order by 100 million doses. In total, the US has secured 400 million doses; enough to vaccinate 200 million Americans (over 65% of the US population) with additional options with both companies to purchase hundreds of millions of more doses.

The potential issue here is not necessarily “how much”, but of “when”. The government’s second agreements with Pfizer and Moderna for over 200 million doses indicate delivery completion well into Q2 and early Q3 of 2021. As the first 200 million doses of the Pfizer and Moderna vaccines are currently being distributed, Biden’s estimate of 100 million doses by mid Q2 does seem realistic. However, both vaccines have had slower-than-anticipated launches and distributions. As the supply seems to be readily available to hit Biden’s goal, administrating the vaccine into patients seem to have its own separate hurdles.

Manufacturing supply chain: Both vaccines are composed of the active ingredient messenger RNA, a series of lipids (fats), salts, and sugars. Each ingredient serves a different purpose as the vaccine is frozen/refrigerated, thawed, and administered. A shortage of one of these components, or a shortage of the laboratory equipment used to manufacture the vaccines, can lead to delays in dose delivery. As Pfizer, a global biopharmaceutical giant which generated over $50 billion in revenue in 2019, has experience in mass-scale global supply chains, Moderna is the opposite. Moderna has never had a marketed product, and their inexperience in global launches and the current unprecedented demand can lead to future supply chain bottlenecks.

Vaccine storage: As many are aware, both vaccines require storage under specific temperatures. Pfizer, in particular, require their vaccines to be stored in minus 70 Celsius, which in turn requires administering health clinics to have the specialized freezers for storage. Distributing vaccines requiring sub-arctic temperatures also require large amounts of dry ice and packaging compartments suitable for freeze delivery. A shortage or unavailability of either can also pose  critical risks to delays in vaccine distribution.

Learn More

Helpful links

https://www.cbsnews.com/news/biden-covid-vaccine-100-million-doses-first-100-days/

https://www.fda.gov/media/144412/download

https://www.fda.gov/media/144636/download

https://www.cnbc.com/2020/12/23/covid-vaccine-us-has-vaccinated-1-million-people-out-of-goal-of-20-million-for-december.html

https://www.npr.org/sections/coronavirus-live-updates/2020/12/23/949541001/u-s-reaches-deal-with-pfizer-for-100-million-more-vaccine-doses

https://www.washingtonpost.com/business/2020/12/05/operation-warp-speed-coronavirus-vaccine-shortfall/

https://www.usatoday.com/story/news/health/2020/12/12/pfizer-covid-vaccine-ingredient-list-nothing-too-surprising-there/6520511002/

https://www.npr.org/sections/health-shots/2020/11/17/935563377/why-does-pfizers-covid-19-vaccine-need-to-be-kept-colder-than-antarctica

Engagement Resources

The American Red Cross heavily relies on volunteers to assist during a health crisis; including the COVID-19 pandemic. Volunteers play active roles in clinical and non-clinical settings. The American Red Cross also operates one of the largest blood donation networks in the US. To volunteer in a clinical setting and/or to give blood, use the links below:

https://www.redcross.org/volunteer/become-a-volunteer.html#step1

https://www.redcrossblood.org/give.html/find-drive?scode=RSG00000E017&cid=nonbrand&med=cpc&source=google&gclid=CjwKCAiA25v_BRBNEiwAZb4-ZTVUgQWZI38TYhnwpjE6tlzT7vSAflWYudRcZuYuWVIpYpEhFHf1zBoCLc0QAvD_BwE&gclsrc=aw.ds

Trust for America’s Health is a public health policy and research organization that advocates for a nation that values the health and well-being of Americans. Their organization has valuable information regarding health policies and issues on a federal and state level, and also actively publishes reports regarding public health on their website. To find more information or to get involved, use the link below:

https://www.tfah.org/

The American Public Health Association is an organization aimed to Improve the health of the public and achieve equity in health status. As the main publishers for the American Journal of Public Health and The Nation’s Health newspapers, APHA educates the public on public health, policy statements, and advocacy for public health. To volunteer or become a member, use the link below:

https://www.apha.org/

Pfizer and BioNTech Vaccine Receives US Approval

Pfizer and BioNTech Vaccine Receives US Approval

Brief #86 – Health and Gender

Author Taylor J Smith

Brief Title: Pfizer and BioNTech Vaccine Receives US Approval

The Policy

The US saw a million new COVID-19 cases in the first five days of December and states have begun reimplementing restrictions; However, the US Food and Drug Administration approved the Pfizer & BioNTech vaccine last weekend and Moderna was approved this week. First doses of the Pfizer & BioN Tech vaccine have arrived in the US with health care workers and nursing home residents are at the top of distribution lists.

Moderna’s coronavirus vaccine’s data review confirmed that it is highly protective, with an efficacy rate of 94.1%. Side effects of the vaccine include a fever, a headache and fatigue, while all were found to be unpleasant, none were in fact dangerous. Once approved, the distribution of millions of doses could begin as early as next week.

Over the summer, the US government signed deals with both companies to acquire 200 million doses by early 2021, and last week, the White House announced they had purchased an additional 100 million doses from Moderna. With 300 million expected doses, 150 million Americans can be expected to be vaccinated with one of the two-dose vaccines developed through Operation Warp Speed. However, that number is less than half of the US population and it is unclear how long it will take to get everyone vaccinated.

COVID-19 Internationally

-Puerto Rico reports it has received only half of the doses of the 32,500 doses expected for the island. The mix up is said to be a result of logistical error, with the other half of doses expected to arrive in the next two days.

-The first doses of the Pfizer & BioNTech vaccine has been administered in the United Kingdom. Notably, a William Shakespeare was the second patient in the UK to receive a vaccination. For the first time in the organization’s history, humanitarian organization UNICEF will help feed people in Britain as children struggle with food insecurity amid the pandemic.

-Ecuador’s health ministry has approved the use of Pfizer & BioNTech’s vaccine, with doses arriving in January 2021.

-Russian President Vladimir Putin has announced that mass vaccination is necessary to end the pandemic, a shift from his previous stance on the pandemic. With this statement, he still has not been vaccinated with Russian-made Sputnik V, as it is not advised for people older than 60 and Putin is 68.

-French President Emmanuel Macron has tested positive for the virus on Thursday morning. Currently no Prime Ministers who recently met with the President have tested positive.

-European Union plans on vaccinating citizens on December 27, 28, and 29, according to European Commission President Ursula von der Leyen.

-Japan’s capital Tokyo reported the highest single-day rise in cases since the start of the pandemic on Thursday.

Analysis:

There have been over 300,000 American deaths due to the coronavirus. Multiple vaccines during what is expected to be one of America’s darkest winters is a feigned beacon of hope, as experts say the vaccine is too late to stop the impending wave of infections and deaths. New estimates put covid-19 related deaths over 500,000 by April, another 200,000+ deaths in the next three months.

The expected approval of Moderna’s vaccine reassures vaccine shortage fears, as both manufactures are capable of mass production, with hopes of having enough for the entire country by late 2021. Both vaccines are provided free of charge, quelling fears of accessibility. However, Pfizer & BioNTech’s vaccine requires much colder storage, making shipping, storage, and handling more complicated, especially for communities with limited or insufficient infrastructure. These potential issues are small in comparison to the very real possibility that a good portion of Americans will not want to get vaccinated. A new survey found that around a quarter of Americans simply don’t want the vaccine, most citing lack of government trust and possible side effects as top concerns.

Here’s how some of the vaccines compare:

Producers Type Doses Needed Efficacy Storage Cost Per Dose
Oxford / AstraZeneca Viral Vector Two 62-90% Regular fridge temp  

$4

Moderna RNA Two 95% -20C, up to 6 months $33
Pfizer / BioNTech RNA Two 95% -70C $20
Gamaleya (Sputnik V) Viral Vector Two 92% Regular fridge temp $10

 

Engagement Resources:

For concerns about COVID-19, please seek assistance with the Center for Disease Control, the World Health Organization, or local health officials.

Subscribe HERE to stay up to date with COVID-19

Number of COVID-19 cases and deaths as of December 17, 2020 – Consult the CDC or Johns Hopkins for an update in numbers.

Nation Confirmed Cases Deaths
Globally 74,467,555 1,654,461
United States 17,011,532 308,098
India 9,956,557 144,451
Brazil 7,040,608 183,735
Russia 2,736,727 48,568
France 2,465,246 59,472
Turkey 1,928,165 17,364
United Kingdom 1,918,786 65,618
Italy 1,906,377 67,220
Spain 1,773,290 48,596
Argentina 1,517,046 41,365

 

Supreme Court Sides with Religious Groups Over COVID-19 Mitigation Strategies

Supreme Court Sides with Religious Groups Over COVID-19 Mitigation Strategies

Policy

The US Supreme Court upheld challenges from New York Churches and synagogues to state pandemic restrictions on religious services just before Thanksgiving. This 5-4 ruling comes after New York Governor Andrew Cuomo enacted an executive order on pandemic safety measures that applied to houses of worship in early October. This rule created graded color zones, classifying COVID-19 risks, and applying restrictions to those zones. For example, houses of worship in red zones are limited to 10 people in attendance, and in orange zones, the cap is set at 25 people. The Catholic Diocese of Brooklyn, among others, asked the Supreme Court to block the restrictions on houses of worship, claiming the rules unfairly target religion, as other establishments had different or no caps for capacity.

Analysis

While this official ruling is a win for religious groups, Governor Cuomo had already lifted the restrictions amid criticisms. Supporters of Cuomo’s decision cite the growing COVID-19 cases, the multiple cases of mass infections because of large religious gatherings, and the traditional aspects of religious services (i.e., gathering inside, large gatherings of people, singing and shouting) as strong reasons to limit religious services. Opponents criticize the move as an infringement on religious freedom and an overreach of power. As forementioned, the executive action was already lifted, but the Supreme Court found this case worthy of hearing and ruling on to prevent future infringements on religious rights during the ongoing pandemic.

An important question that has come from this executive order is where do we place religious services, in essential or nonessential services? The order places restrictions on essential businesses and different restrictions on nonessential ones, while placing harsher restrictions on religious institutions. Such actions support the Diocese’s argument that religious institutions are not being treated fairly. Circling back to the initial question, it is imperative to establish where religious institutions fall. Once that is determined, it will be easier to implement fair restrictions to prevent the spread of COVID-19. Nevertheless, amid a global pandemic, restrictions are key to preserving public health.

Lawyers for the Church argued that spacious houses of worship are capable of social distancing and an hour-long mass is safer than a typical trip to the grocery store or working a 9-5 in the workplace; Therefore, these restrictions are aggressive, targeting, and unnecessary, and houses of worship should be given the opportunity to operate as other establishments.

Given the rising cases and hospitalizations, all restrictions should be considered to mitigate COVID-19. Without an order like the one enforced by Cuomo it is likely that gatherings for religious services will continue to contribute to the spread of COVID-19.

Engagement Resources:

For concerns about COVID-19, please seek assistance with the Center for Disease Control, the World Health Organization, or local health officials.

Subscribe HERE to stay up to date with COVID-19

Pfizer and BioNTech Vaccine Receives US Approval

Effective COVID-19 Vaccines Emerge as the Pandemic Rolls On

Brief #84 – Health and Gender

Author Taylor J Smith

Brief Title: Effective COVID-19 Vaccines Emerge as the Pandemic Rolls On

The Policy

As the globe inches towards month ten of the coronavirus pandemic, promising vaccine advancements were announced last week. Companies Pfizer & BioNTech and Moderna released trial results deeming their vaccines to be 90%* and 94% effective, respectively. Both Companies have requested emergency FDA authorization in the US, with the hopes of distributing by the new year. The United Kingdom approved the Pfizer / BioNTech vaccine earlier this week.

This news comes after the US reported record smashing 217,664 new cases, and over 100,000 of hospitalizations and 2,978 deaths on Thursday. With the continuous increase in cases and deaths, more than a quarter of a million people in the US have died from the disease, surpassing the White House’s projections. Experts like top infectious disease official, Dr. Anthony Fauci, conclude that the globe is reaching troubling waters and warned that January will be exceptionally terrible. To mitigate the current outlook, another lockdown in states is being considered. Just Thursday, Californian Governor Gavin Newsom announced a second round of regional stay-at-home orders for the state. This comes as intensive-care beds fill up across California, the lockdown will take effect in communities with intensive-care bed capacities below a 15% threshold. As cases rise from Thanksgiving holiday, it is expected that other states will follow suit.

This week, the Center for Disease Control issued new guidelines to curb the spread of the coronavirus. Most notably, specialists advise “universal” mask usage indoors, particularly for Americans, in addition to continued mask use in outdoor-public spaces. The CDC also recommended people avoid non-essential indoor spaces and postpone travel. 

*Pfizer later released data stating that their vaccine was in fact 94.5% effective, an increase from the initial 90%.

COVID-19 Internationally

Canada has extended the closure of its shared border with the US until at least December 21st. The border has been closed since March 18th and the closure has been renewed every month since.

UK Health Minister Matt Hancock announced on Wednesday that the Pfizer/BioNTech vaccine has been approved for use within the UK. Initial doses are already en route, with elderly people in care homes and care home staff placed at the top of the list for distribution. The UK government has already ordered 400 million doses of the vaccine, enough to vaccinate 20 million people, which is less than a third of the UK’s entire population of roughly 67 million.

Friday afternoon, Bahrain became the second country to approve the Pfizer vaccine for mass distribution. Officials granted emergency authorization for the vaccine, with little else known regarding roll-out or how many doses were purchased, but 800,000 doses are expected to be distributed next week.

Chinese officials have announced that China will have 600 million doses, produced by two Chinese manufacturers Sinopharm and Sinovac, by the end of 2020. These manufactures are also expected to create and distribute an additional 200 million doses for other nations.

Analysis:

Operation Warp Speed is seemingly meeting expectations, in creating a safe and effective vaccine in such a short period of time. However, as previously discussed, the haste of the operation, while necessary to save lives, has a very real potential of prompting hesitancy and uncertainty for widespread vaccinations.

With the Pfizer / BioNTech being approved for distribution in the United Kingdom, vaccinations are expected to start Tuesday. Some are asking why the UK was first to approve a vaccine and why the US is yet to approve any vaccine. According to UK officials, they simply have “the best medical regulators”, while American officials say the contrary, that the UK is not being as careful as the FDA is being. However, on Friday afternoon, US Vice President Pence announced he was very optimistic that a vaccine may be approved within two weeks’ time. It can be expected that there will be at least one vaccine approved for widespread distribution in multiple countries before the years end, creating some hope in a year of despair.

Here’s how some of the vaccines compare:

Producers Type Doses Needed Efficacy Storage Cost Per Dose
Oxford / AstraZeneca Viral Vector Two 62-90% Regular fridge temp  

$4

Moderna RNA Two 95% -20C, up to 6 months $33
Pfizer / BioNTech RNA Two 95% -70C $20
Gamaleya (Sputnik V) Viral Vector Two 92% Regular fridge temp $10

*note not yet peer reviewed, numbers are preliminary phase three results.

Engagement Resources:

For concerns about COVID-19, please seek assistance with the Center for Disease Control, the World Health Organization, or local health officials.

Subscribe HERE to stay up to date with COVID-19

Number of COVID-19 cases and deaths as of December 4, 2020 – Consult the CDC or Johns Hopkins for an update in numbers.

Nation Confirmed Cases Deaths
Globally 65,669,150 1,514,387
United States 14,282,494 277,958
India 9,571,559 139,188
Brazil 6,487,012 175,270
Russia 2,382,012 41,730
France 2,321,492 54,858
United Kingdom 1,694,790 60,714
Italy 1,688,939 58,852
Spain 1,684,647 46,252
Argentina 1,447,732 39,305
Colombia 1,343,322 37,305

 

OxyContin Maker, Purdue Pharma, Pleads Guilty to Federal Criminal Charges

OxyContin Maker, Purdue Pharma, Pleads Guilty to Federal Criminal Charges

Author Taylor J Smith

Brief Title: OxyContin Maker, Purdue Pharma, Pleads Guilty to Federal Criminal Charges

The Case
In late October, Purdue Pharma agreed to plead guilty to three federal criminal charges for its clear and impactful role in the nation’s deadly opioid crisis. In addition to pleading guilty, the Purdue will pay more than $8 billion and permanently close the company. The financial contributions will primarily go to opioid treatment and abatement programs, on top of $3.5 billion fine, $2 billion forfeiture of past revenue, and $2.8 billion in civil liability fees. Because the company does not have $8.3 billion in cash, the company will dissolve, and its assets will be used to create a “public benefit company” controlled by a trust.

Purdue has pled guilty to three counts, including conspiracy to defraud the United States, and violating anti-kickback laws from 2009 -2017.

Analysis

This is the highest-profile settlement, finally holding a major drug maker responsible for a twenty plus yearlong opioid crisis, resulting in over 400,000 overdose fatalities. Democratic attorneys general criticized the settlement, claiming the settlement is feigned justice and the company likely will not fulfill its promise of paying fines and penalties. However, those who have been impacted by the opioid crisis say this is a step in the right direction and hope that the next step in justice will have members of the Sackler family found criminally liable. A hope that is possible as the plea bargain notably does not absolve any of Purdue’s company executives or owners – the Sackler family- from criminal liability. Such charges are still under investigation.

As expected, the Sackler family will lose control of their company and it will become a public benefit company, governed by a trust that must balance the trust’s interests against the interests of the American public and public health. Currently, the new company is expected to continue manufacturing Oxycontin and other painkillers, as well as lifesaving overdose medication. The idea of dissolving Purdue and creating a new company to sell OxyContin has raised concerns and objections across the country. Twenty-five state attorneys general oppose the government taking control of the company, arguing the federal government should have no business in selling OxyContin and playing a role in the ongoing crisis.

Many argue the settlement is far too lenient and the settlement was rushed, wrapping up the case before election day. Having a giant like Purdue Pharma held responsible in the largest opioid case adds to Trump’s re-election portfolio. While his promises of combatting drug addiction and holding Big Pharma responsible was an early pledge, Trump has done little in this area. However, the outcome here may provide a much-needed boost to his approval ratings. Only time will tell if the recent court cases against Big Pharma will repair the decades long damage it has caused.

Lawsuit Timeline

2001 – CT Attorney General Richard Blumenthal urges Purdue to take action regarding OxyContin abuse.

2003 – Federal Drug Administration issues a warning letter to Purdue about OxyContin’s misleading advertisements.

2004 – West Virginia – Purdue sued for reimbursements of “excessive prescription costs” paid by the state. Result: $10 million settlement.

May 2007 – Purdue pleads guilty to misleading the public about OxyContin’s addiction risk, company ordered to pay $600 million.

Oct 2007 – Kentucky – Purdue sued for the state’s widespread Oxycontin abuse. Result: $24 million settlement 8 years later, Dec 2015.

Jan 2017 – Washington – Purdue sued for not upholding agreement in previous suit to track suspicious excessive ordering and potential black-market sales. Result: Case is ongoing, Washington has dismissed offers to settle.

March 2019Oklahoma – Purdue sued for its contribution in the death of thousands in the state. Result: $270 million settlement.

Sept 2019 – Purdue Pharma sued for deceptive marketing practices and their role in the opioid crisis by thousands of municipal governments and nearly two dozen states. Result: A $10-12 billion settlement and Sacklers are to pay 3 billion over 7 years.

Sept 2019 – New York – Purdue Pharma and the Sackler family file for bankruptcy. Result: $10 – 12 billion settlement for company dissolvement.

Oct 2020 – Purdue pleads guilty to 3 federal crimes. Result: $8 billion settlement.

Engagement Resources:

The Trump Administration Threatens Hospital Funding Over COVID-19 Reporting

The Trump Administration Threatens Hospital Funding Over COVID-19 Reporting

Brief #82 – Health and Gender

Author Taylor J Smith

The Policy

After the Trump Administration’s July announcement requiring all hospitals to submit COVID-19 data to private company, TeleTracking Technologies, exclusively sharing data with the Department of Health and Human Services, critics opposed the White House’s move to bypass the Centers for Disease Control, raising transparency concerns. However, the requirements have continued, and President Trump has become dissatisfied with the level of compliance amongst the nation’s hospitals. Such dissatisfaction has prompted an emergency rule threatening Medicare and Medicaid funding for hospitals’ non-compliance. Hospitals that fail to comply with federal requirements on COVID-19 and influenza data are at risk for losing U.S. funding. Hospitals will be given 14 weeks, from the late August announcement, to make adjustments and comply before enforcements take effect. Nursing homes and labs are also included under this rule and therefore subject to fines and punishments.

The information the White House wants completed is a general report on hospitals’ COVID-19 and influenza data. Among the data requested is the number of Covid-19 patients in each hospital and availability of medical equipment such as ventilators and protective gowns for employees. One of the most difficult requirements for hospitals, especially small ones, is that they are required to submit reported data every day, even on weekends. Should a hospital worker responsible for completing the form be sick or out of the hospital, partially fill out the form, or simply forget to complete the form, the hospital falls into noncompliance.

Previous to this crackdown, hospitals were participating in the voluntary reporting system, however, full compliance has been low, only 24% of hospitals reported all required elements every day. As mentioned, the Administration was not satisfied with the 86% reporting rate, by implementing this rule, Trump leaves hospitals no choice but to reach a 100% reporting rate.

Analysis:

Supporters of this rule emphasize how critical the data is in understanding the severity of the coronavirus and how central the data is for the national response to the pandemic. Seema Verma, the Center for Medicare and Medicaid Services Administrator, said the changes “represent a dramatic acceleration of our efforts to track and control the spread of COVID-19”.

However, withholding of Medicare and Medicaid funding would be a major blow to almost any hospital and would be too hard on the communities they serve, many experts say. For many hospitals, Medicare and Medicaid account for 40-60% of total funding and revenue. The American Hospital Association immediately denounced the rule, highlighting the risk of hospitals going out of business, and noting the penalty would be “too severe a penalty on a community”, a community that should not suffer because of subjective rules.

This rule is detrimental to the very institution serving as the American people’s first line of defense against the coronavirus. While the pursuit for COVID-19 and influenza data is just, the penalty is excessive and unnecessary. Such penalties jeopardize patient access to hospital care during a pandemic, likely resulting in widespread complications, suffering and/or deaths, which can only be exacerbated by the current pandemic.

Engagement Resources:

For concerns about COVID-19, please seek assistance with the Center for Disease Control, the World Health Organization, or local health officials.

Subscribe HERE to stay up to date with COVID-19

Number of COVID-19 cases and deaths as of October 17, 2020 – Consult the CDC or Johns Hopkins for an update in numbers.

Nation Confirmed Cases Deaths
Globally 39,415,643 1,105,621
United States 8,052,978 218,618
India 7,432,680 112,998
Brazil 5,200,300 153,214
Russia 1,376,020 23,857
Argentina 965,609 25,723
Colombia 945,354 28,616
Spain 936,560 33,775
France 876,342 33,325
Peru 859,740 33,577
Mexico 841,661 85,705

 

Welfare Demand Peaks During the Pandemic

Welfare Demand Peaks During the Pandemic

Out of work for a year, Gail Doffifild of California said that the pandemic has put her job search on life support. Doffifild, a former substance abuse counselor, relies on public assistance to meet basic needs for housing and food, a first in her lifetime.

Along with business closings and job programs on hold that delay employment, a nationwide surge in new welfare applicants is creating bureaucratic delays for all recipients at local welfare offices.

On a recent weekday at noon, Doffifild queued up outside her local welfare office to talk with a caseworker for a few minutes using a phone bank inside. “I’m having to wait like everyone else for the help I need, said Doffifild, who is in her 50s.

Across the U.S., welfare offices report that the record demand for public assistance by new and returning recipients has yet to subside since the pandemic started in early spring.

  • More than 12.5 million American adults were unemployed in September, according to the U.S. Bureau of Labor Statistics. Many are turning to local welfare offices for help
  • Likewise, a record number of Americans have applied for food stamps in 2020. From February-May, the number of Americans receiving food stamps increased by 17 percent to 43 million.

HEALTH SAFETY CONCERNS AT WELFARE OFFICES

The Families First Coronavirus Response Act — which expired Sept. 30, 2020 — allowed states to relax welfare and food stamp rules to meet the special need for assistance.  Food stamps are based on a USDA estimate on the costs to maintain an adequate and healthy diet. In 2019, the most recent statistics available, a family of three was eligible for up to $505 per month in food stamps. The Families First Coronavirus Response Act authorized states to provide emergency supplements to food stamps that raised limits on how much assistance could be provided. The Act:

  • Eased eligibility rules for food stamps;
  • Raised  the amount of food stamp benefits by 15 percent individuals can receive;
  • Increased emergency benefits from three to seven months;
  • Increased school meal benefits for income-eligible students.

STAYING FLEXIBLE TO THE NEEDS OF UNEMPLOYED AMERICANS

A newly released study by The Center on Budget and Policy Priorities, a nonpartisan research institute, describes as “unprecedented” the demand for food stamps, also known as SNAP, since special emergency legislation, in the form of disaster relief, was enacted by Congress in March 2020.

“The far-reaching health and economic effects of COVID-19 and widespread business closures to limit its spread have made it even more difficult for many low-income households to afford food, and data have shown a sharp increase in the number of families reporting difficulty in affording adequate food and other basic needs. SNAP is essential to helping these families put food on the table, according to the Center on Budget and Policy Priorities.

The center is urging the federal government to extend emergency welfare relief and remain flexible to the needs of Americans experiencing record  unemployment. Lawmakers are poised to do just that.

EMERGENCY WELFARE ASSISTANCE AWAITS FINAL PASSAGE

Lawmakers have included an extension to emergency food stamp benefits in new legislation known as the Heroes Act, which addresses a range of unemployment and job loss issues resulting from the pandemic.

The Heroes Act, which passed in the House in May, continues an emergency increase of 15 percent in food stamp amounts through September 2021, averaging about $25 per person more per month. The legislation has yet to advance to a final vote in the Senate. The bill puts a special focus on ensuring that income-eligible children continue to qualify for benefits, even during school closings and remote learning from home.

The influential Washington, D.C., political newspaper, The Hill, published an editorial this month urging the Senate to adopt the new legislation.

“In the few days left before senators head back to their states, they should immediately pass the updated HEROES Act, not only because families need it to survive, but also because it could spare children engaged in the juvenile justice system damage to their health, education and mental wellbeing,” The Hill stated in the Oct. 7, 2020, editorial.

Resistance Resources

  1. Understanding Food Stamps and How to Apply

Primer is a first step to learning about food stamps, including whether you and your family may be eligible.

https://www.usa.gov/food-help

  1. The Center on Budget and Policy Priorities

The Center on Budget and Policy Priorities has made recommendations on extending food stamp and special assistance during coronavirus pandemic. https://www.cbpp.org/research/food-assistance/states-are-using-much-needed-temporary-flexibility-in-snap-to-respond-to

  1. Families First Coronavirus Act

The Families First Coronavirus Response Act provided temporary new authority and broad flexibility for the Agriculture Department (USDA) and states to adapt the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) to address the current public health emergency. The act expired Sept. 30, 20220.

https://www.congress.gov/bill/116th-congress/house-bill/6201/text

  1. The Heroes Act

The $1 trillion Heroes Act addresses job loss and provides economic assistance including additional welfare funding. The act is close to final passage and in committee in Congress.

https://www.congress.gov/bill/116th-congress/house-bill/6800

  1. The Hill.com

The Hill is an influential digital political newspaper published in Washington, D.C. It is owned by News Communications, Inc. Here is an editorial published in October urging passage of the Heroes Act, which in part extends emergency welfare assistance due to the pandemic.

https://thehill.com/opinion/civil-rights/520044-the-senate-must-pass-the-updated-heroes-act-to-protect-justice-involved

Convalescent Plasma is FDA Approved, and Vaccine Trials are Underway as the US Death Toll Passes 200,000

Convalescent Plasma is FDA Approved, and Vaccine Trials are Underway as the US Death Toll Passes 200,000

COVID-19’s Status in the US

As the US struggles to manage the outbreak of coronavirus, the US Food and Drug Administration has issued an emergency use authorization for convalescent plasma to treat COVID-19. Reportedly, over 70,000 patients have been treated with the blood and plasma of those who previously recovered from the infection since the pandemic started and have responded positively to the new treatment.

While this authorization has been touted as a “historic breakthrough”, scientists say additional data is necessary, citing the misleading statements by Trump overstating the limited evidence behind the new therapy. Documented positive outcomes of individuals being treated with convalescent plasma is encouraging when developing therapies to treat COVID-19, but widespread emergency use is still uncertain

Operation Warp Speed (OWS), first introduced over the summer, is the Administration’s operational goal of creating a vaccine for the coronavirus at a considerably faster rate than traditional vaccines. Trump and his team are pushing for a vaccine to be effective and ready for mass distribution before the November 3rd election day. Such an accelerated timeline requires pharmaceuticals and manufactures to work faster and more funding to support their efforts, the Administration has already committed billions of dollars to the vaccine pursuit.

 

Manufacturers Country Type of Vaccine Current Phase Notes
Moderna and National Institutes of Health (NIH) USA Messenger RNA (mRNA) Phase III US Govt initially funded nearly $1 billion, was given an additional $1.5 billion in exchange for 100 million safe and effective doses.
University of Oxford & AstraZeneca UK & Sweden Viral Vector Phase III First vaccine to reach Phase III. The US awarded the two $1.2 billion in May and in Aug, the European Union ironed out a deal for 400 million vaccine doses.  On Sept 6 trials were halted after a participant experienced severe neurological symptoms, trials in the UK and Brazil resumed on Sept 12, others are still paused.
Johnson & Johnson, & Beth Israel Deaconess Medical Center USA Viral Vector Phase I/II – moving to phase III in late Sept. In March, the two received $456 million from the US government and a contract of $1 billion for 100 million doses if the vaccine is approved, back in August.
Pfizer, BioNTech, & Fosun Pharma USA, Germany, & China Messenger RNA (mRNA) Phase II/III – there are currently two versions of the vaccine. Trump Administration awarded a $1.9 billion contract for 100 million doses by December, Japan made a deal for 120 million doses and the European Union arranged 200 million doses. Company executives said they should know by October if the vaccine works.
Sinopharm & Beijing Institute of Biological Products China Inactivated Coronavirus Phase III Given emergency approval in the United Arab Emirates on Sept 15. The vaccine is authorized to only be used on healthcare workers.
Gamaleya Research Institute Russia Viral Vector Phase III The vaccine, renamed Sputnik V, is approved for early use. At first, little was known or shared about this vaccine. The globe was surprised by Putin’s announcement that a vaccine had been approved when few knew one was being developed, back in August.

 

Recently CNN reports that nine vaccine makers say they have signed a joint pledge to uphold “high ethical standards,” suggesting they won’t seek premature government approval for any Covid-19 vaccines they develop. The companies that signed the pledge include AstraZeneca, BioNTech, Moderna, Pfizer, Novavax, Sanofi, GlaxoSmithKline, Johnson & Johnson and Merck.

Analysis:

The emergency authorization announcement came on the eve of the Republican National Convention, where Trump is attempting to resurrect his struggling polling numbers and popularity. It can be assumed that if Trump is viewed as finding a solution to the current pandemic, his favorability will increase, and the chances of reelection are higher. However, pushing a treatment before it has been fully tested can have disastrous effects, can dissuade supporters, and negatively impact future trust in treatments and vaccines. Scientists should explore this treatment as a viable option in treatment, but until a thorough study is conducted, it should not be touted by the President as a golden ticket out of the pandemic.

As with the emergency authorization of convalescent plasma, many see the rush for a vaccine as risky. While many of the manufacturers are reputable, the idea of cutting down a vaccine development process by half promotes uncertainty. This is particularly dangerous when it comes time for mass vaccinations.

AstraZeneca has come into the forefront of this race for a vaccine, but their trial  hit a small bump in the road. After a participant began experiencing severe spinal cord inflammation, the trial was tentatively halted. Following protocol, researchers were tasked with determining if the symptoms were a result of the vaccine or if this was an unrelated occurrence. This suspension comes after another participant was dismissed from the trial after too experiencing neurological symptoms. However, it was concluded that the participant had  anundiagnosed case of multiple sclerosis, and the vaccine was not to blame. The trial continued September 17th in the United Kingdom and Brazil, other nations where testing is underway are still on pause. Currently, there are plenty of vaccines racing to bring this pandemic to an end, until one is deemed safe and effective, and gain approval, the race shall continue.

Engagement Resources:

Number of COVID-19 cases and deaths as of September 23, 2020 – Consult the CDC or Johns Hopkins for an update in numbers.

Nation Confirmed Cases Deaths
Globally 31,673,086 972,372
United States 6,902,930 201,120
India 5,646,010 90,020
Brazil 4,591,364 138,105
Russia 1,117,487 19,720
Colombia 777,537 24,570
Peru 776,546 31,568
Mexico 705,263 74,348
Spain 682,267 30,904
South Africa 663,282 16,118
Argentina 651,174 13,952

 

US and Global Coronavirus Update

US and Global Coronavirus Update

COVID-19’s Status in the US

As cases across the globe passes 27.6 million and over 6.5 million cases in the US, the death rate is not staying on pace, as many would expect. This phenomenon has yet to be fully understood by scientists and doctors. Some say this occurrence is because interventions are becoming more successful at treating complications; while others point to the clear trend that the COVID-19 is now becoming a “young person” disease. Where young adults are less likely to die or suffer from severe complications, more can be infected while keeping death rates relatively low. This comes after the disease ravaged nursing homes and the elderly population. Doctors are still adjusting to the seemingly changing affected demographic.

Schools across the nation are scrambling to manage how to keep students, faculty, and staff in the absence of a vaccine. Already, more than 37,000 cases of COVID-19 have been reported at colleges and universities. K-12 schools vary from in-person, virtual, and hybrid classrooms, a scattered approach that represents the lack of uniformity and varying opinions on the safest and best approach for education amid a global pandemic. Combatting a widespread misconception, researchers have stated that adolescents are equally capable of transmitting the virus as adult and age should not be considered an impervious shield to the virus. It is unclear how the rest of the school year will go as in-person learning communities experience massive outbreaks and parents are starting to go back to work.

COVID-19’s Status Internationally

Researchers in Hong Kong have documented the first case of virus reinfection. A 33-year-old patient was diagnosed with COVID-19 on Aug 15th, over four months after their first bout with the disease on March 26th. With this being the first case, there is an understanding that there could be more, researchers are now on high alert for more cases.

African nations have not gone untouched by the virus, but few nations are experiencing the peaks in both cases and deaths, that other nations have gone through. Some have attributed this to the relative youth of the continent, comparing it to Europe where more EU citizens are more likely to reach 80 years of age, and therefore more susceptible to COVID complications and deaths. Additionally, COVID-19 is known to have a higher mortality rate amongst those with health problems like obesity and type 2 diabetes, which are less common in the African nations. More populous nations like South Africa, Egypt and Nigeria COVID rates have slowed but increases have been present in Libya, Morocco, and Tunisia.

After the first week in September, UK officials tallied the highest daily number of cases, 2,988, since May, and have had four days with over 2,000 new cases. Prime Minister Boris Johnson announced new restrictions to curb the spread and prevent a second lockdown.

New cases send India sprinting to third in world ranking of cases. Even with the new increasing deaths, 72,775, researchers suggest that all cases are not being reported and the numbers could be much higher. All cases are not being reported to the World Health Organization, in addition to states attributing deaths to underlying conditions instead of COVID-19, and discrepancies are being found in deaths reported and counts from crematoria and burial grounds, thus prompting uncertainty in the accuracy of India’s reported numbers.

Mexico, fourth in line for most COVID deaths, reported nearly 3,500 new cases of COVID-19 on last Monday. President Nicolas Maduro has announced the mysterious and locally licensed Russia vaccine will be distributed to Venezuela in late September for clinical trials and “other vaccines” come October.

Analysis:

The emergence of a virus reinfection case prompts concern regarding immunity. While experts suggested previously infected individuals likely carried antibodies and therefore had some level of immunity against the coronavirus, new findings suggest that immunity may only last for a few months.

The previously mentioned phenomenon of an increase in cases, but not in deaths is contributing to the misconception that this disease and virus are not deadly. Such an idea is spreading throughout the US and as a result people are no longer taking the disease seriously, prompting anti-mask protests, young people gathering for parties, and other practices that are incompatible with CDC recommendations.

Engagement Resources:

For concerns about COVID-19, please seek assistance with the Center for Disease Control, the World Health Organization, or local health officials.

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Number of COVID-19 cases and deaths as of September 13, 2020 – Consult the CDC or Johns Hopkins for an update in numbers.

Nation Confirmed Cases Deaths
Globally 28,892,810 922,525
United States 6,519,249 194,069
India 4,754,356 78,586
Brazil 4,330,455 131,625
Russia 1,059,024 18,517
Peru 722,832 30,526
Colombia 708,964 22,734
Mexico 668,381 70,821
South Africa 649,793 15,447
Spain 566,326 29,747
Argentina 555,537 11,352

 

Medicaid Holdout States and the Covid-19 Crisis

Medicaid Holdout States and the Covid-19 Crisis

SUMMARY:

Medicaid is the primary government-funded health insurance for low-income Americans available in every state. An expansion of Medicaid  under the Affordable Care Act (ACA) allows more working Americans on low incomes to be eligible for coverage. Holdout states that have not increased Medicaid eligibility may be less prepared to diagnose, manage and treat patients during the Covid-19 crisis, according to recent studies by the government and nonprofit health advocacy organizations.

Before California, 34 other states and the District of Columbia expanded Medicaid under Obamacare, Oakland resident Jamal Ali, like many other low-wage workers in the U.S., put off medical care unless he had an emergency.

Ali, 34, was not offered health insurance in his sales job and could not afford coverage on his own. A lung infection that caused his asthma to flare up prompted Ali to seek urgent care after he had trouble breathing and was at risk of pneumonia.

Ali got the expert medical care he needed plus antibiotics. But it came at a high cost without insurance: $250 in out of pocket costs. Now with Medicaid expansion under the Affordable Care Act – formerly known as Obamacare – Ali says he does not worry about how he will afford treatment if he gets really sick again. “It’s all covered,” said Ali, who proudly showed his Medi-Cal benefits card, which he keeps handy in his wallet.

Ali is among more than 12 million Americans who have received coverage under Medicaid expansion since 2014, and those numbers continue to grow, according to the Center on Budget and Policy Priorities.

The Affordable Care Act , or ACA, was signed into law by former President Obama in 2010, after much debate and controversy in Congress. But it quickly gained popularity with uninsured and under-insured Americans as well as the business community. The new law signaled the biggest Medicaid eligibility expansion since its inception more than 50 years ago. The ACA required states to expand Medicaid to include more working, low-income Americans, but a subsequent U.S. Supreme Court ruling has left the decision to the states.  Not all have followed but pressure by voters is changing that.

Nebraska recently expanded Medicaid, after voters approved a ballot initiative. Maine, Utah and Idaho also approved expansion by vote.

ANALYSIS

The Center on Budget and Policy Priorities reports that the ACA Medicaid expansion has many benefits. It has helped to close the gap in both quality and access to health care for people of color like Ali, who is African American.Most important during the pandemic, California and other Medicaid expansion states are better poised to respond to the Covid-19 crisis with testing, diagnosis and treatment. Many of the Americans covered by Medicaid under ACA are front-line workers, known as “essential” employees, including hospital workers, grocery stores clerks and cashiers, and home-health aides.

Experts estimate that expanding Medicaid to the holdout states would cover an additional four million Americans, which include 650,000 frontline workers.

Because of his asthma condition, for example, Ali would be at a greater risk of complications if he were to contract Covid-19. But this time around, if he gets seriously ill, Ali said he would not hesitate to seek treatment like he did previously, when he did not have a regular physician and delayed care until it was an emergency.

With many companies shutting down since the pandemic, millions of additional workers have lost employment in 2020, according to the Kaiser Family Foundation. The foundation’s research found that if the remaining states expanded Medicaid eligibility under ACA, their economies would rebound faster as businesses begin to re-open, because of earlier diagnoses, better health outcomes and less financial hardship on individuals and families.

The Center on Budget and Policy Priorities has found that “the lifesaving effects” of Medicaid expansion include people getting regular checkups, improved access to prescription drugs, and more early stage screenings for cancer.

NET SAVINGS FOR STATES

In 2020, the federal government pays 90 percent of the costs, which decreases the financial burden of charity care for uninsured hospital patients, which is passed along through higher health-care costs as well as steeper premiums for all consumers with coverage. Patients not only benefit from better outcomes but health-care providers are assured that they can depend on payment.

In addition, Congress adopted the Families First Coronavirus Response Act, which increases Medicaid costs the federal government will cover during the pandemic, easing the burden on holdout states. It also requires certain employers to provide paid sick leave, through December 2020.

California and other states are reporting a net savings in health-care costs after increasing Medicaid eligibility to include more low-income workers. So-called Medi-Cal brought in up to $3.5 billion in federal dollars in 2014, which grew to $4.5 billion in 2019, according to the UCLA Center for Health Policy Research. In California, a study by the UCLA Center for Health Policy Research concluded that: “Medi-Cal expansion [makes] funding more stable for providers” who care for the uninsured, which improves access to care for low-income communities.

Resistance Resources: The following are nonprofit organizations and government agencies that provide information on Medicaid access and eligibility under ACA and on health coverage during the Covid 19 pandemic.

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