Respiratory Illnesses are Elevated

COVID & Respiratory Illnesses

With the conclusion of the holiday season, respiratory illnesses (such as flu and COVID) are on the rise. Compared to last year’s seasonal peaks, there are fewer severe COVID cases. Researchers from the Centers for Disease Control and Prevention (CDC) report a high level of COVID in community wastewater in every region. In the United States, the COVID JN.1 variant has become the most prevalent variant. Despite its resurgence, scientists state the latest wave is not as severe. The CDC also estimates there have been more than 7 million illnesses, 73,000 hospitalizations and 4,500 flu-related deaths this season.

• Children’s Health: In the Southeast and West, flu cases are growing exponentially and impacting young children more than older adults. Pediatric respiratory cases, including RSV, are overwhelming hospital systems. A JAMA Pediatrics study found maternal flu vaccine uptake provided important protection for infants, though uptake is low.
• Long-COVID: A recent study in Nature found that the cause of extreme fatigue, which is a symptom of long-COVID, may be tied to cellular-level malfunction within the mitochondria. Another study associated chronic pulmonary disease and chronic neurologic disorder with long-COVID.
• Vaccines: Recent studies reveal the risk of obtaining long-COVID is lowered drastically by COVID-19 vaccination. A BMJ study reported that one shot of the COVID vaccine lowered the risk of long-COVID by 21%, two doses lowered it by 59%, and three or more reduced it by 73%.
• Hospitals: Due to elevated levels of respiratory illnesses, New York City public hospitals are reinstating mask mandates in facilities operated by NYC Health + Hospitals. A new JAMA study reports the cost of hospital care rose by 26% during the pandemic, with costs continuing to rise after the release of the COVID-19 vaccine.

Resources & Initiatives

• The CDC has information on staying up to date on COVID-19 vaccines.
• The Department of Health and Human Services (HHS) lists common frequently asked questions regarding the flu.
• The TODAY show lists symptoms parents should know during this flu season, where 20 US children have died.
• For people with long-COVID, the American Academy of Physical Medicine and Rehabilitation lists resources.

Drug Pricing & Shortages

Efforts are underway to mitigate the escalating costs associated with prescription drugs. The $35 price cap on insulin went into effect January 1st, marking a notable step in this direction. However, this coincides with a projected increase in prices for at least 500 drugs in January. Additionally, there remain concerns about drug shortages and accessibility.

• Pricing Strategies: Medicare will be able to negotiate prices with drug manufacturers beginning this year. A recent report found the prices for the first ten prescription drugs under negotiation were three to eight times higher than those in comparison countries. The Food and Drug Administration (FDA) issued Florida the first approval for mass drug imports from Canada, with an estimated savings of $150 million. The low prices of generic drugs address costs, but manufacturing issues and other factors may contribute to drug shortages.
• Shortages: The scarcity of chemotherapy drugs has made it difficult for some patients with aggressive cancers to receive treatment. Stakeholders, including lawmakers, U.S. officials, and industry experts, have proposed ways to ease drug shortages, such as price floors, considering government manufacturing, and improving transparency.
• Patents & Development: The White House is considering measures to override patents on high-priced drugs. Concurrently, drug development continues with a rebound in FDA approvals, including a groundbreaking treatment for sickle cell disease. The CRISPR-based treatment shows promise for treating additional diseases, including heart disease, cancer, and rare genetic disorders.

Resources & Initiatives

• The FDA shares resources on drug shortages and availability.
• See these strategies to reduce your drug spending such as by shopping around.
• Learn about different countries' approaches to drug price negotiation.
• Blue Cross Blue Shield companies are partnering with Civica Rx in an effort to ensure the accessibility of essential medicines.

Health Care Updates

Current challenges to health care include the high costs of essential services, concerns about quality, and accessibility. During the pandemic health disparities were exacerbated. A recent analysis reveals that half of Black Washington, D.C. residents lack easy access to health care. Delve into the latest developments in the health care landscape below.

• Medical Errors: A recent article highlights the association between adverse medical events and private equity acquisition. Another study on medical errors identifies strategies to address patient safety with missteps in laboratory diagnostic tests, which are a leading cause of death.
• Older Adult Health: The Institute for Nonprofit News, a NIHCM grantee, has released a series on the challenges facing rural nursing homes. Insufficient staffing is a primary concern at many of these facilities and new federal staffing standards could go into effect within two years. There are concerns about how the nursing homes will be able to meet these standards.
• Home Health: Many families struggle to find affordable home health care and have to rely on family and friends. The New York Times provides a helpful guide for those seeking aides for home care services.

Resources & Initiatives

• Stay informed with recent episodes from the Tradeoffs podcast, which covers topics such as the closure of rural hospitals and the need for hospitals to confront medical errors.
• Blue Cross Blue Shield of Michigan’s Blueprint for Affordability program aligns provider incentives, financial accountability, and data to improve health outcomes.
• Explore the concept of value-based care further through this comprehensive resource from the Centers for Medicare & Medicaid Services.
• Mass General Brigham, the largest health care system in Massachusetts, offers hospital level treatment at home and finds that it's still cheaper than inpatient care.

In Other Public Health News…

Reproductive Health

For women undergoing fertility treatment, a new study from Mass General Brigham suggests stress before pregnancy may affect blood sugar levels, a marker of cardiovascular health. Additionally, due to high rates of maternal mortality in Black women, the risks of pregnancy casts fear into some Black women who report they are unable to joyously celebrate their pregnancy. Learn more about issues in reproductive health below.

• Ward Closures: Rural hospitals are closing maternity wards. Compared to urban residents, rural residents have a 9% greater probability of facing pregnancy-related death or complications. Maternity ward closures are exacerbating health disparities and forcing patients to travel to receive care. Between 2011 and 2023, 217 hospital obstetric units have closed. These closures occurred primarily in hospitals that are dependent on Medicaid, which has historically provided lower reimbursement rates.
• Federal Initiatives: To create safer births and reduce high rates of maternal mortality, the Centers for Medicare and Medicaid (CMS) released the Transforming Maternal Health (TMaH) Model for women with Medicaid and Children's Health Insurance Program (CHIP) coverage.

Resources & Initiatives:

• Scientists at Northwestern University were awarded $5 million from the National Institutes of Health (NIH) to study the effects of pregnancy on children with disabilities.
• Arkansas’ Blue Cross Blue Shield provides resources on the signs of postpartum depression.
• NIHCM released an infographic on Women’s Reproductive Health and Fibroids.
• To learn more, NIHCM has produced webinars and research insights on Maternal Health.

Social Determinants of Health

The White House and the United States Department of Health and Human Services (HHS) have released a playbook, a call to action, and a framework that aim to improve the social determinants of health that impact people and their environments. To improve health equity for more than 170 million individuals supported by the Centers for Medicare and Medicaid Services (CMS), CMS has also released a framework to reduce health disparities. At an American Heart Association Conference, preliminary findings demonstrated SDOHs were linked to faster genetic aging.

Resources and Initiatives:

• Arkansas Blue Cross Blue Shield is offering up to $200,000 in grants to eligible organizations that are addressing SDOH disparities in Arkansas. Letters of Intent close on January 12th, 2024.
• The U.S. Department of Agriculture has released the Summer Electronic Benefits Transfer for Children Program, or Summer EBT. It is a new child nutrition program to mitigate child hunger while schools are on summer break.
• In 2023, Highmark BCBS provided $8.2 million to area nonprofits to advance health equity.