About the public’s health
Cocoa Increases Mental Agility And Cognitive Ability, Finds Study: Start off the week with some good news.
”Researchers at the University of Birmingham have found in a new study that increased consumption of flavanols can increase your mental agility.The study revealed that people given a cocoa drink containing high levels of flavanols were able to complete certain cognitive tasks more efficiently than when drinking a non-flavanol enriched-drink. Flavanols, a sub-group of plant flavonoids, are present in cocoa, grapes, apples, tea, berries and other foods. They give fruits and vegetables their bright colors and are known to have a beneficial effect on cardiovascular health, but their effects on brain health are not well understood.”
New ‘Green’ Mediterranean Diet May Be Even Healthier for You: “Researchers say a new ‘green’ Mediterranean diet is healthier for you than even the traditional Mediterranean diet.
The green version replaces the minimal amount of red meat allowed in the traditional Mediterranean diet with plant-based protein.
Experts say plant proteins have additional health benefits that include anti-inflammatory characteristics.”
'A natural disaster ... in all 50 states' is unfolding just as travelers disperse nationwide after Thanksgiving: Now back to reality…an update on COVID-19 statistics.
Moderna to file for FDA emergency use authorization for COVID-19 vaccine: “Moderna announced that it plans to file with the FDA Monday for an emergency use authorization for its coronavirus vaccine, which the company said has an efficacy rate of 94.1%.”
Biden’s other health crisis: A resurgent drug epidemic: “Biden, who has stocked his team with addiction experts with extensive backgrounds in public health, will emphasize new funding for substance abuse treatment and prevention, while calling to eliminate jail time for drug use. It’s a departure from his tough-on-crime approach as a senator — and from President Donald Trump’s frequent focus on a law enforcement response to the drug crisis, which experts said undercut necessary public health measures.”
Estimated incidence of COVID-19 illness and hospitalization — United States, February–September, 2020: This research indicates the number of reported COVID-19 cases may have underestimated the true incidence.
”We estimated that through the end of September, 1 of every 2.5 (95% Uncertainty Interval (UI): 2.0–3.1) hospitalized infections and 1 of every 7.1 (95% UI: 5.8–9.0) non-hospitalized illnesses may have been nationally reported. Applying these multipliers to reported SARS-CoV-2 cases along with data on the prevalence of asymptomatic infection from published systematic reviews, we estimate that 2.4 million hospitalizations, 44.8 million symptomatic illnesses, and 52.9 million total infections may have occurred in the U.S. population from February 27–September 30, 2020.”
Democrat Schumer says $30 bln in federal funds needed to distribute COVID vaccine: The headline speaks for itself.
Biden adds new members to COVID-19 task force: “The new members are Jane Hopkins, RNMH; Jill Jim, PhD; and David Michaels, PhD.
Ms. Hopkins, who immigrated to the U.S. from Sierra Leone, worked for more than two decades as a bedside nurse, most recently in the Seattle area, and is executive vice president of SEIU Healthcare 1199NW.
Dr. Jim is a Navajo Nation member and executive director of Window Rock, Ariz.-based Navajo Nation Department of Health.
Dr. Michaels, a former Occupational Safety and Health Administration administrator, is an epidemiologist and professor at the George Washington University School of Public Health in Washington, D.C.”
The task force is wonderfully diverse with respect to race and gender, but lacks logistics and social marketing expertise.
United Begins Flying Pfizer’s Covid-19 Vaccine: Speaking of logistics… “United Airlines Holdings Inc. on Friday began operating charter flights to position doses of Pfizer Inc.’s Covid-19 vaccine for quick distribution if the shots are approved by regulators, according to people familiar with the matter.
The initial flights are one link in a global supply chain being assembled to tackle the logistical challenge of distributing Covid-19 vaccines. Pfizer has been laying the groundwork to move quickly if it gets approval from the Food and Drug Administration and other regulators world-wide.”
About health insurance
CMS proposed rule reduces user fee in ACA exchanges: “In the proposed annual Notice of Benefit and Payment Parameters for the 2022 Proposed Rule released late Wednesday afternoon, CMS is proposing to reduce the user fee for federally facilitated exchange issuers from 3% to 2.25% of premium for the 2022 benefit year. This will add to the 0.5% reduction in the user fee rate included in the 2020 payment notice, for a total reduction of 1.25% over the past four years.
CMS proposes to reduce the user fee for issuers offering plans through state-based exchanges that use the federal platform to 1.75% of premium…
CMS is continuing to allow states to implement Section 1332 waivers to waive certain ACA statutory requirements. This proposal allows states to decentralized enrollment through insurers and web brokers rather than using HealthCare.gov.”
CMS announces new flexibilities for care outside of a hospital setting amid COVID-19 surge: “The Centers for Medicare and Medicaid Services has approved waivers for six health systems to provide acute care at home.
The hospitals include Brigham and Women's Hospital in Massachusetts; Huntsman Cancer Institute in Utah; Massachusetts General Hospital in Massachusetts; Mount Sinai Health System in New York City; Presbyterian Healthcare Services of New Mexico; and UnityPoint Health of Iowa.“
About pharma
Canada blocks bulk exports of some prescription drugs in response to Trump import plan: It was inevitable… “‘Certain drugs intended for the Canadian market are prohibited from being distributed for consumption outside of Canada if that sale would cause or worsen a drug shortage,’ Health Minister Patty Hajdu said in a statement.
‘Companies will now also be required to provide information to assess existing or potential shortages, when requested, and within 24 hours if there is a serious or imminent health risk,’ the statement said.”
The Colchicine Debacle Revisited: This article is a great case study of what happens when “unapproved” drugs that have been used for decades get FDA approval and attendant market exclusivity. The result is, for example, that “Medicaid spending for colchicine increased almost 3000%, from $1.1 million in 2008 to $32.2 million in 2017…
[T]he manufacturer increased the price of colchicine from what had previously been only a few cents to $5 a tablet…”
About healthcare IT
Universal Patient Identifier and Interoperability for Detection of Serious Drug Interactions: Retrospective Study: “Among a population of 49.7 million patients, 242,646 serious drug-drug interaction alerts occurred in 3 years. Of these, 2388 (1.0%) crossed insurance and were discovered because the pharmacy benefit manager used a unique patient identifier. We estimate that up to 10% of serious drug-drug alerts in the United States go undetected by pharmacy benefit managers because of unexchanged information or pharmacy benefit managers that do not use a unique patient identifier. These information gaps may contribute, annually, to up to 6000 patients in the United States receiving a contraindicated medication.”
Is the solution a pharmacy issue or should we (finally) assign unique patient identifiers, like other countries do?
California medical center server issue exposed patient data for 4.5 years: “FMC determined that the misconfiguration existed from around Dec. 16, 2015, to July 31, 2020. The medical center said it cannot rule out unauthorized access to patient records that were present on the server during the time period. Patient data contained on the server includes names, medical images, dates of birth, identification numbers and ordering providers.” While data compromises are, unfortunately, commonplace, this one was unusually long.
About hospitals and health systems
Cleveland Clinic's net income triples in Q3: “The 18-hospital system's revenue climbed to $2.72 billion in the third quarter of this year, up from $2.65 billion in the same period of 2019, according to recently released unaudited financial documents. The increase in revenue was driven by $77 million in grants received through the Coronavirus Aid, Relief and Economic Security Act and employee retention credits.
The system's net patient service revenue decreased $4.5 million in the third quarter of 2020 compared to the same period of 2019. Inpatient admissions declined 5.3 percent year over year in the third quarter of this year and were down 7.4 percent in the first nine months of 2020.”
These trends have been typical, especially declining patient revenue and admissions as well as reliance on the federal relief funds.