“Some portion of this steep rise in cases is related to the fact that more people are being tested for the flu than in previous years. Over the month of November, about twice as many flu tests were done at clinical labs nationwide as during the same period last year (about 540,000 versus 265,000). More testing means more cases will get picked up.
However, there are corroborating warning signs that this is truly a bad season. Flu hospitalizations have been off the charts and are rising quickly. In a press conference Monday, CDC director Rochelle Walensky said there have already been 78,000 flu hospitalizations this season, or nearly 17 out of every 100,000 Americans. That’s “the highest we’ve seen at this time of year in a decade,” she said. In keeping with past trends, the highest hospitalization rates are among adults 65 and older.
What’s making these high hospitalization rates particularly concerning is their overlap with surges in other viruses causing many people to get sick enough to require admission. One of those is RSV, which has been packing pediatric hospitals for more than six weeks. And while Walensky noted there were signals RSV transmission was slowing in parts of the country, Covid-19 hospitalizations recently began to tick upward.”
“According to a 2022 report from the National Academies of Sciences, Engineering, and Medicine, “on average, the number of ongoing drug shortages has been increasing and are lasting longer.” The root cause of that problem, per a report from the Food and Drug Administration, is the economics of the pharmaceutical market itself.
The reasons for shortages are generally consistent no matter the drug: either a shortage of raw materials or a problem at the plant where the drug is manufactured. Shortages for medicines that a patient can pick up at the pharmacy often draw the most headlines, but most of the medications that end up in short supply are generic, injectable drugs that are used in hospitals: usually, these drugs have only one or two suppliers. So if there is a problem at the factory of one company, there is not an easy way to scale up production to make up for a shortfall. And they are usually cheap, which means the companies that manufacture them do not have a strong economic incentive to produce any excess supply.”
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““It makes a lot of sense when you think about it from their perspective. But when you think about it from the hospital perspective, it’s very frustrating.”
Some of these shortages have led directly to patient deaths. An Associated Press report in 2011 linked at least 15 deaths over the prior 15 months to drug shortages. A more recent study, following the year-long shortage of a drug used to treat septic shock, found higher mortality rates for patients who relied on a substitute. Even short of death, drug shortages can meaningfully change the care patients get — if, for example, a pregnant person undergoes a cesarean delivery, with its higher risk of complications and longer recovery time, because the drug that could have induced labor earlier is out of stock.
Experts do have ideas about how to make the pharmaceutical supply chain more resilient. But they require action by the federal government. Until that happens, there is little reason to think the pace and duration of America’s drug shortages will slow down.”
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“These companies rely on razor-thin margins and massive scale to make their business work. They have a “just in time” production schedule, which means almost as soon as the product rolls out of the factory, it is delivered to health care providers. There aren’t warehouses with emergency stockpiles, because it wouldn’t really make financial sense for manufacturers to produce and store the excess supply.”
“Over the last five years, syphilis transmission has increased explosively all over the US. The spread of this infection, which starts as a rash but can progress to severe disease in adults, is particularly alarming because syphilis infections during pregnancy can lead to death or disability in newborns.
Although syphilis trends are bad on a national scale, South Dakota’s numbers are particularly concerning. Since 2020, cases in the state have increased tenfold. Furthermore, infections are not evenly spread across the population: American Indians make up more than two-thirds of the state’s cases.”
“about 900 Americans died in 2020 from complications related to childbirth. Another 50,000 or more women experienced severe pregnancy-related complications. Four of five of those deaths were from preventable causes. In terms of scale and rate, America’s maternal mortality dwarfs the issues of other wealthy countries, and these gaps in maternity care shoulder much of the blame.”
“The lesson here should not be that assisted suicide is bad, but heavy government involvement in health care decisions has an inescapable distorting influence. At the very least, how Canada manages health care access is a massive contributing factor. A survey from 2016 found that Canadians wait longer to access health care services than citizens in 11 other countries. The United States is one of the countries of comparison, but the survey also looks at other countries with government-managed health care systems like the United Kingdom and France. A 2020 study from the Canadian Family Physician journal notes that the country simply provides less freedom and opportunity for people seeking medical care than other countries, even when healthcare is centrally planned: ” What these countries do differently than Canada is they allow the private sector to provide core health care insurance and services, require patients to share in the cost of treatment, and fund hospitals based on activity (rather than the global budgets that are the norm in Canada).””
“the US was one of only two among 21 selected similar wealthy countries — along with Israel — in which life expectancy continued to decline last year. While most countries suffered hundreds of thousands of untimely deaths during the first year of Covid-19, once people began to get vaccinated, life expectancies for almost all the 21 countries either stayed the same or began to rise again, many up to their pre-pandemic levels.
The US started off with lower pre-Covid life expectancies than other rich countries like South Korea, France, and Australia. It has been the case for decades that the United States spends exorbitant amounts on health care, yet has worse health outcomes than comparable countries. Even before the pandemic, people in the US faced the opioid epidemic, gun violence, and higher chronic disease rates than people in other rich countries.”
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“Lack of health access and a robust public health care system exacerbated Covid-19’s effects, said Noreen Goldman, a professor of demography and public affairs at Princeton University. The lack of national coordination to address the pandemic, and lower vaccination rates, said Goldman, have also been a factor in outcomes being worse in the US than other comparable countries.
Young people were dying more from Covid-19 in 2021 than 2020, said Theresa Andrasfay, a demography researcher at the University of Southern California. While age remains the biggest risk factor, more middle-aged adults who are not vaccinated are dying. Additionally, she said, high rates of chronic disease, obesity, and diabetes had not yet affected mortality statistics, but when a disease — Covid-19 — came along that had these as risk factors, “it was like lighting a match.””
“Hospitals across the country are grappling with widespread staffing shortages, complicating preparations for a potential Covid-19 surge as the BA.5 subvariant drives up cases, hospital admissions and deaths.
Long-standing problems, worker burnout and staff turnover have grown worse as Covid-19 waves have hit health care workers again and again — and as more employees fall sick with Covid-19 themselves.”
“if we’re not very careful now, humanity may backslide into a world where our antibiotics become useless — and the common infections they used to treat cut our lives short.
The Covid-19 pandemic has made that danger worse. According to a new report from the Centers for Disease Control and Prevention (CDC), during the first year of the pandemic, the problem of drug resistance only intensified.
Drug resistance is what happens when we overuse antibiotics in the treatment of humans, animals, or crops. When a new antibiotic is introduced, it can have great, lifesaving results — for a while. But then the bacteria adapt. Gradually, the antibiotic becomes less effective, and we’re left with diseases we’re less able to treat.
Even before Covid-19, experts had been warning that we’re approaching a post-antibiotic era — a time when our antibiotics would become largely useless against health problems ranging from tuberculosis to STIs to urinary tract infections. They noted that routine hospital procedures like C-sections and joint replacements could become more dangerous, too, as the risk associated with infection — especially infections acquired in hospitals — increases.
Some professionals, especially in hospitals, had heeded the experts’ warnings, and we’d seen some progress as a result. Take staph infections, for example. A 2019 CDC report noted that rates of methicillin-resistant Staphylococcus aureus (MRSA) had dropped. And overall, deaths caused by drug resistance had decreased by 18 percent since 2013.
But the Covid-19 pandemic has reversed years of hard-won progress. Drug-resistant hospital-related deaths and infections from seven pathogens grew 15 percent from 2019 to 2020, including a 13 percent increase for MRSA infections, which can be deadly.
One reason for that is that hospitals overprescribed antibiotics, according to the CDC. From March through October 2020, almost 80 percent of Covid-19 patients who were hospitalized were given antibiotics. As a viral illness, Covid-19 isn’t affected by antibiotics, but doctors may have been keen to prescribe them to cure or protect against secondary infections, especially given that hospital stays for Covid-19 can be long and intensive.
“This setback can and must be temporary,” Michael Craig, the director of the CDC’s Antibiotic Resistance Coordination and Strategy Unit, said in a statement. “The best way to avert a pandemic caused by an antimicrobial-resistant pathogen is to identify gaps and invest in prevention to keep our nation safe.”
Obviously, the last thing we want is for the Covid-19 pandemic to pave the way for a new pandemic caused by some drug-resistant pathogen.”
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“The good news is that we can absolutely address the problem of drug resistance. In its new report, the CDC calls for doubling down on strategies we know work, like preventing hospital-acquired infections in the first place and training medical professionals on when it is and isn’t appropriate to dole out antibiotics.”
“The whole sorry affair should remind us of one key reason why Roe was decided in the first place: to protect doctors.
It is a sad fact that some doctors will avoid providing essential medical care if the treatment in question is politically controversial. These doctors understandably fear that an overzealous prosecutor might use a vague law against them, just as Indiana’s attorney general threatened to do here.
Doctors who deal in certain types of pharmaceuticals run the same risks. In fact, just three days after Dobbs, the Supreme Court actually enhanced the legal protections for doctors who prescribe opioids. In an ironic twist, the Court did so while effectively reviving a pre-Roe case that protected the medical privacy rights of abortion providers.”
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“The Dobbs decision obliterated those medical privacy protections by a narrow 5–4 vote. Yet by a 6–3 vote just three days later, the Supreme Court embraced the logic of Roe’s most important predecessor (Vuitch) when it strengthened the medical privacy rights of doctors who prescribe opioids (Ruan).
This contradictory and confusing state of affairs is bad both for medicine and for the law, and it ought to be fixed as soon as possible. Whenever a poorly drafted statute is open to abuse by an overreaching prosecutor, the Supreme Court has the option of using the void-for-vagueness doctrine to strike down the offending law. The Court could also require that all abortion regulations conform to the doctor-friendly rules spelled out in Ruan and Vuitch. Particularly egregious laws, meanwhile, can be invalided by the courts for lacking a rational basis.
The Constitution provides firm procedural safeguards whenever the government interferes with life, liberty, property, or privacy. The Supreme Court needs to ensure that doctors still enjoy those safeguards’ benefits.”