NIHCM Newsletter / October 2022
Long Covid and the Importance of Boosters
Released: October 6, 2022
August 17th Article: Taquet, et al. Neurological and psychiatric risk trajectories after SARS-CoV-2 infection: an analysis of 2-year retrospective cohort studies including 1 284 437 patients. The Lancet Psychiatry. (2022).
- September 22nd Article: Xu, E., Xie, Y. & Al-Aly, Z. Long-term neurologic outcomes of COVID-19. Nat Med (2022). https://doi.org/10.1038/s41591-022-02001-z
Long Covid and the Importance of Boosters
The Centers for Disease Control and Prevention (CDC) recommends the new COVID boosters to everyone over twelve. However, less than 4% of eligible people have gotten the shot. A survey by Kaiser Family Foundation found that about half of adults have heard little or nothing about the booster that targets newer omicron variants and the original strain of the virus. While experts say that COVID is under control in the US, new variants might emerge this fall, leading to a new infection. More information about what we’re learning about COVID is below:
- Brain Fog: Nearly 15% of American adults who have had COVID have long COVID and may experience brain fog, one of many long COVID symptoms. Brain fog is most often a disorder that makes concentrating, multi-tasking, and planning difficult. There are no tools to measure or cure brain fog. Current treatment is limited to helping people manage their symptoms.
- Demographics: Research on COVID-related deaths in California shows a decline among the Latino population compared to a proportional increase among White people. Experts link this to White people being more likely to work remotely during the first two years of the pandemic while large numbers of essential, frontline workers were Latino. In terms of long COVID, CDC data from the Household Pulse survey show that rates of long COVID are higher for female adults (18%) compared to males (11%).
- COVID & Children: Pfizer is seeking Food and Drug Administration (FDA) authorization for an Omicron-tailored COVID-19 vaccine booster authorization for children 5 to 11 and Moderna is seeking authorization for boosters for adolescents 11 to 17 and children six to 11. A study found that long COVID is uncommon among children.
Resources & Initiatives:
- Resting a lot can help manage and potentially prevent long COVID.
- A new study found that regular exercise can substantially lower your risk of getting COVID-19 or developing severe illness.
- Learn more about Paxlovid, the latest COVID medication, and concerns such as rebound infections.
- See the federally funded services and supports for people with long COVID.
- The Conversation examines the ways that COVID-19 can cause lasting lung damage.
- The Public Health Communications Collaborative shares communication resources for booster doses and supporting local vaccination outreach.
- Horizon Blue Cross and Blue Shield of New Jersey share information on the updated COVID-19 booster and the annual flu shot.
- Independence Blue Cross shares back-to-school advice on how to protect children from COVID-19.
Hurricanes and the Environment’s Impact on Health
During the last week of September, Hurricane Ian hit Florida as a Category 4 storm, killing at least 100 people, and leaving many communities uninhabitable for weeks or months. Beyond disrupting human life, health experts warn that extreme weather events, such as hurricanes, can cause a rise in infectious diseases, water contamination, respiratory conditions, and air pollutants. Many people may also experience anxiety, depression, and an exacerbation of ongoing mental health issues. Climate change related extreme weather events also threaten health care services, medically vulnerable patients, and damage facilities.
- Impact of Recent Hurricane: More than 250,000 Floridians are still without electricity in the wake of Hurricane Ian. Boil water notices remain in effect for many counties across the state. As a result of Hurricane Ian and losing access to clean water and power, at least nine hospitals and numerous nursing homes had to evacuate patients during the storm, risking already medically vulnerable patients.
- Update: More than 100,000 people in Puerto Rico were still without power two weeks after Hurricane Fiona.
- Water Pollution: Lack of access to safe, uncontaminated drinking water can cause dehydration, malnutrition, lead poisoning, and bacteria exposure. In Jackson, Mississippi, President Biden declared a state of emergency over the water crisis, where flooding and water treatment facility problems shut down the city’s water supply.
- The Impact of Wildfires on Water: In the western US, wildfires have been burning at higher elevation, threatening water supplies. This summer, New Mexico endured a record-breaking wildfire; now, residents face a drinking water crisis as heavy rain has released contaminants into the drinking water.
- Climate Change and Respiratory Conditions: As climate change continues to raise temperatures, asthma and other breathing conditions are expected to worsen. Compared to White children, Black and Hispanic children disproportionately suffer from asthma and are more likely to die from such conditions.
Resources & Initiatives:
- Many of the Blue Cross Blue Shield plans have responded to Hurricane Ian, including Blue Cross Blue Shield of Massachusetts, Elevance Health, Florida Blue, and Blue Cross Blue Shield of North Carolina.
- Weather events can negatively impact mental health; learn how to protect your mental health during a hurricane.
- Blue Cross and Blue Shield of Louisiana shared emergency preparedness tips for residents with disabilities and for those impacted by hurricanes.
- Learn about environmental health with these NIHCM resources, including webinars and infographics.
- Elevance Health is working to alleviate the impact of climate change on health as part of its whole-health approach.
- WIRED recently convened scientists, entrepreneurs, and more to discuss climate change and actionable-solutions.
The Latest on Viruses
As COVID-19 hospitalizations are declining, many hospitals are updating the traditional hospital design model to better accommodate the next pandemic. Some familiar viruses, such as influenza, have returned in unexpected ways while other viruses, including monkeypox and enterovirus, have become more prevalent.
- Influenza: With COVID-19 precautions continuing to weaken and fewer individuals immunized against influenza, health officials are warning that this fall and winter may be an exceptionally severe flu season and that cases may begin to rise earlier than usual. The projected rise in flu and COVID-19 cases this winter could result in the long-feared "twindemic."
- Poliovirus: The US was recently designated as a country where circulating vaccine-derived poliovirus has been reported, joining a list with 30 other outbreak countries.
- Monkeypox Cases: The US reported almost two-fifths of the world’s monkeypox cases. While new cases and serious complications are still occurring, transmission in the US appears to be slowing down. The CDC recommends that the monkeypox antiviral be reserved only for people at high risk for severe disease.
- Perception of Monkeypox: Awareness of monkeypox surged over the summer in the US and public health experts continue to warn about stigmatizing monkeypox messaging as was the case during the HIV/AIDS epidemic. Increased awareness of monkeypox has also been accompanied by increased scrutiny for many individuals with skin conditions. For those that have contracted the lesion-causing virus, it continues to impact both physical and mental health.
- EV-D68 in Children: In September, the CDC issued a health advisory about the nationwide increase in pediatric hospitalizations with severe respiratory illness who also tested positive for rhinovirus or enterovirus EV-D68. In rare cases, this virus can cause polio-like symptoms in children.
Resources & Initiatives:
- Blue Cross and Blue Shield of Texas is sponsoring a Care Van program to provide free vaccinations to schools and community centers around the state.
- Blue Cross and Blue Shield of Louisiana reminds adults to stay up-to-date on vaccines, including flu shots, COVID-19 boosters, and tetanus boosters.
- Learn more about poliovirus, monkeypox, and rhinovirus and enterovirus with these resources.
- The New York Times released resources on how to prepare for this year’s flu season. Learn more about influenza with this resource.
- The CDC launched a pilot program to set aside doses of the monkeypox vaccine for communities that have faced barriers accessing the shots and have been disproportionately impacted by the outbreak.
- NIHCM Grantee, the Alliance for Health Policy is hosting a webinar on October 12th discussing the state of HIV/AIDS progress and applying lessons learned to current public health problems. NIHCM also recently released an infographic on HIV in the US.
Cancer in America
Cancer death rates have been declining by 2% every year since 2016, according to a report from the American Association for Cancer Research. The report credits declines in smoking and developments in detection and treatment for driving the change. President Biden recently spoke on progress in his cancer moonshot program and acknowledged the stark inequities in cancer diagnosis and treatment. The US spends more on cancer care than most countries but without better outcomes.
- Access to Care: Rural cancer patients struggle to access treatment due to cost and distance. Another barrier to accessing care is the price of cancer drugs. A recent report found that hospitals marked up cancer drugs as much as 11 times under a program that was created to ensure access to low-income patients.
- Disparities in Cancer: Racial and ethnic minorities have a disproportionately higher burden of cancer. In 2019, overall cancer death rates among Black men and women were higher than all other racial and ethnic groups in the US. Research shows that screening for cancer is lower among Black, Hispanic, American Indian and Alaskan Native populations compared to their White counterparts.
- Breast Cancer: October is Breast Cancer Awareness Month and one in eight women are diagnosed with breast cancer in their lifetime. This article, under a NIHCM grant, describes how while genetic tests can create opportunities to guide the treatment of breast cancer, there is confusion among providers about how best to deploy them.
Resources & Initiatives:
- See the American Cancer Society’s information on cancer and services for patients as well as their roundtables that are a model for partnerships across diverse sectors.
- The CDC supports routine cancer screenings for breast, cervical, colorectal, and lung cancers.
- The Department of Health and Human Services awarded over $5 million to 11 HRSA-funded community health centers to facilitate access to cancer screenings and early detection services for underserved populations.
- Florida Blue collaborated with Florida Cancer Specialists & Research Institute to improve patient care.
- September was colorectal cancer awareness month. Blue Cross and Blue Shield of Louisiana shared the importance of screening. Independence Blue Cross and the Colorectal Cancer Alliance launched a program to address health equity. Blue Cross Blue Shield of Massachusetts launched a Nudge Unit, which drove a 3% increase in uptake of colorectal cancer screening tests.
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