Tag: health

Tuberculosis cases on the rise globally and in Washington state

Washington’s tuberculosis (TB) cases are on the rise, putting state and local public health officials on heightened alert. Widespread disruptions in public health and healthcare services and missed TB diagnoses due to similarities in symptoms between COVID-19 and TB are thought to have contributed to TB cases rising both locally and globally.

TB reporting decreased in 2020 during the first year of the pandemic. Though efforts to prevent COVID-19 may also reduce the spread of TB, the decrease could also have been due to delayed or missed TB diagnoses because of strains in the health care system. Some people with TB may also have been misdiagnosed as having COVID-19.

Cases then rose notably beginning in 2021, when 199 cases of TB disease were reported, a 22% increase from 2020. Thus far in 2022, 70 cases have been reported and officials continue to monitor the situation closely. Seventeen new cases of TB disease all have connections with each other and several Washington state prisons, making it the state’s largest outbreak in the last 20 years.

“It’s been 20 years since we saw a cluster of TB cases like this,” says Tao Sheng Kwan-Gett, MD, MPH, Washington State Chief Science Officer. “The pandemic has likely contributed to the rise in cases and the outbreak in at least one correctional facility,” added Kwan-Gett. “Increased access to TB testing and treatment in the community is going to be key to getting TB under control.”

“Washington State Department of Corrections (DOC) identified a rise in cases in one of our facilities and immediately began working closely with the Department of Health and the Centers for Disease Control on testing, as well as ways to decrease the spread in the facility and out in the community,” said DOC Chief Medical Officer MaryAnn Curl, MD. “Testing of staff, and our incarcerated population at Stafford Creek Correction Center continues, which is how these cases were found. We’ll continue to communicate with staff, their incarcerated population and their families as appropriate.”

Knowing the facts helps to understand TB, which is preventable, treatable, and curable. Like COVID-19, TB is spread through the air when an infected person coughs or sneezes and the organism is breathed in by others. But unlike COVID-19, more prolonged exposure to someone with TB disease is typically necessary for infection to occur. Symptoms of TB disease can include coughing, with or without blood, and chest pain. General symptoms also include fever, night sweats, weight loss and tiredness.

If infection does occur the person exposed will most likely develop inactive TB or (also called latent TB infection), which does not have any symptoms and is not contagious. But if people with inactive TB do not receive timely diagnosis and treatment, the infection could develop into active TB disease which can then cause symptoms and be spread to others. An estimated 200,000 people in Washington have inactive TB.

Treatment for TB disease takes six months at a minimum. If treatment isn’t diligently followed, symptoms are likely to become more severe and patients risk continuing to be contagious, increasing the likelihood of TB further spreading within the community. Incomplete treatment can also contribute to the spread of antibiotic resistant strains of TB.

TB can infect anyone, but some people may be at increased risk for exposure including:

  • Those in close contact with someone who has TB disease.
  • People who are from, or frequently travel to, areas of the world where TB is more common.
  • People who live or work in a setting where there is more possible exposure to TB, such as homeless shelters, correctional facilities, and nursing homes.

DOH encourages people at risk for TB to get tested and, if the outcome is positive, to get treatment. More information about TB can be found at Facts About TB | Washington State Department of Health.

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Medicare Coverage of Telemental Health and the End of the PHE

The end of the COVID-19 public health emergency (PHE), currently scheduled for April 19, will affect the continuation — or expiration — of temporary Medicare flexibilities, including the  expansion of telehealth. During the pandemic, Medicare beneficiaries have had access to a wide range of telehealth services, including telemental health, and uptake has increased substantially. Unfortunately, once the PHE ends, the authority for these flexibilities will no longer be in effect, meaning that many beneficiaries will lose access to services. Federal action to temporarily extend the current telehealth waivers would allow policymakers time to study whether they should make permanent changes regarding telemental health care coverage.

Medicare Coverage of Telemental Health

At the beginning of the pandemic, Congress temporarily authorized the Centers for Medicare and Medicaid Services (CMS) to waive all statutory requirements governing Medicare coverage of telehealth, including telemental health care, as a means of rapidly responding to the pandemic. CMS then implemented several telehealth flexibilities, including:

  • allowing beneficiaries to receive telehealth services in all settings, including their homes
  • increasing provider reimbursement for telehealth
  • providing coverage for audio-only telehealth services
  • increasing the range of services eligible for telehealth coverage
  • expanding the type of providers who can furnish telehealth (including clinical psychologists, licensed clinical social workers, physical therapists, occupational therapists, and speech language pathologists)

Read the full article from the Commonwealth Fund.

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Determining the Safety of a Hospital or Medical Provider

Choosing a new hospital or provider is difficult, and safety is often a main concern. While there are several ways to look at safety information surrounding providers and clinics, there is no consensus as to the best approach. Here are some ways to evaluate the safety of your health care.

Medicare penalizes hospitals that have high rates of infections and patient injuries.  The information which hospitals the federal government has penalized (764 hospitals last year) is publicly available and can be viewed on KFN. However, the hospital industry has issues with penalties, saying that it creates an arbitrary cutoff for which institutions get punished and which don’t.

The Leapfrog Group has collected, analyzed, and published hospital data, and their 2021 Leapfrog Hospital Safety Grades include 49 Washington Hospitals.  U.S. News & World Report publishes a “Best Hospitals in Washington” ranking.  However, it does not rate the safety of the hospital, but the health outcomes and specialists that it employs.

Evaluating doctors is more difficult, as negative reviews given by patients cannot be commented upon by the care provider, due to HIPAA regulations. The Washington Department of Health regularly reports on any disciplinary actions against a health care provider on their newsroom page.  On their website, it is also possible to look up a health care provider license to view a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents.

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Nationwide recall on Similac formulas, all affecting WA WIC families

Abbott initiated a proactive, voluntary recall of powder formulas manufactured in Sturgis, Michigan due to contaminants related to Cronobacter sakazakii or Salmonella Newport.

A temporary list of Gerber and Mead Johnson non-contract standard formulas are ready to issue to WIC families beginning Monday, February 28. Please reach out to your local WIC clinic for direction on formula replacement if a therapeutic one is currently being used such as Alimentum.

  • Please do not feed your baby the recalled formula, dilute it or create a homemade formula.
  • Please do not discard the formula and instead return recalled formula to the store.

As store policy allows, this may include an identical exchange of non-recalled formula, a gift card, store credit, or a store refund in cash.  During the recall, WIC families can accept a gift card, store credit, or a store refund in cash.  Caregivers should go to the Customer Service desk to return the formula. If further questions arise, do not hesitate to reach out to your local WIC clinic staff for direction.”

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EPA unveils strategy to regulate toxic ‘forever chemicals’

The Biden administration said Monday it is launching a broad strategy to regulate toxic industrial compounds associated with serious health conditions that are used in products ranging from cookware to carpets and firefighting foams.

Michael Regan, the head of the Environmental Protection Agency, said his agency is taking a series of actions to limit pollution from a cluster of long-lasting chemicals known as PFAS that are increasingly turning up in public drinking water systems, private wells and even food.

The Defense Department said it is moving to assess and clean up PFAS-contaminated sites throughout the country, while the Food and Drug Administration will expand testing of the food supply to estimate Americans’ exposure to PFAS from food. And the Agriculture Department will boost efforts to prevent and address PFAS contamination in food.

Read the full article from AP.

Four Things You Can do to Support Your Teen’s Mental Health

Whether you and your teen are getting along well or having challenges, it is important to show that you love and support them, that you can help them navigate tough times and that you are always there for them.

Here are four things to keep in mind when having that ‘how-are-you-doing?’ conversation with your teen and to show that you are always there for them.

1. Encourage them to share their feelings

  • Look for ways to check in with your teen. Ask them how their day has been and what they have been doing. It could be by inviting them to join you in a task, such as preparing dinner, so you can use the time to chat about their day.
  • Remind them that you are there for them, no matter what, and that you want to hear how they are feeling and what they are thinking. A few simple words of encouragement can help them feel comfortable sharing their feelings with you.
  • It is important to acknowledge and understand emotions they might be experiencing, even if it feels uncomfortable. When they open up to you, you can respond with “I understand”, “it sounds like a difficult situation” or “that makes sense”.
  • It can be easy to notice the things your teen is doing that you do not like. But also try to notice and praise them for something they are doing well — even something simple like cleaning up after themselves.

Read the full article from UNICEF.

A Hospital Charged $722.50 to Push Medicine Through an IV. Twice.

Claire Lang-Ree was in a lab coat taking a college chemistry class remotely in the kitchen of her Colorado Springs, Colorado, home when a profound pain twisted into her lower abdomen. She called her mom, Jen Lang-Ree, a nurse practitioner who worried it was appendicitis and found a nearby hospital in the family’s health insurance network.

After a long wait in the emergency room of Penrose Hospital, Claire received morphine and an anti-nausea medication delivered through an IV. She also underwent a CT scan of the abdomen and a series of tests.

Hospital staffers ruled out appendicitis and surmised Claire was suffering from a ruptured ovarian cyst, which can be a harmless part of the menstrual cycle but can also be problematic and painful. After a few days — and a chemistry exam taken through gritted teeth — the pain went away.

Then the bill came.

Patient: Claire Lang-Ree, a 21-year-old Stanford University student who was living in Colorado for a few months while taking classes remotely. She’s insured by Anthem Blue Cross through her mom’s work as a pediatric nurse practitioner in Northern California.

Total Bill: $18,735.93, including two $722.50 fees for a nurse to “push” drugs into her IV, a process that takes seconds. Anthem’s negotiated charges were $6,999 for the total treatment. Anthem paid $5,578.30, and the Lang-Rees owed $1,270 to the hospital, plus additional bills for radiologists and other care. (Claire also anted up a $150 copay at the ER.)

Read the full article from Kaiser Health News.

Remember Summer Safety Precautions Ahead of Expected Weekend Heatwave

The Washington State Department of Health (DOH) is urging people to take precautions, stay cool, and protect themselves ahead of a record-breaking heatwave expected this weekend.

Stay indoors and in an air-conditioned environment as much as possible. Visit friends, family or neighbors with air conditioning or spend time in air-conditioned public places. If you are not fully vaccinated against COVID-19, make sure to wear a mask whenever you’re indoors with people who don’t live with you.

If air conditioning is not available to you, pulling window shades closed throughout the day when the sun is on the windows will help keep the inside cooler. Do not rely on a fan as your only cooling source. While fans might provide some comfort, they won’t prevent heat-related illness when temperatures are very hot. Use your stove and oven less to maintain a cooler temperature in your home.

Stay hydrated. Drink plenty of fluids but avoid beverages that contain alcohol, caffeine or a lot of sugar. Carry water with you and don’t wait until you’re thirsty to drink.

Help those who are vulnerable or at higher risk. Check in frequently with family, friends and neighbors who are elderly, ill or may need help. Avoid dressing babies and children in heavy clothing or wrapping them in warm blankets. Keep outdoor pets safe in the heat, make sure they have protection from heat and sun and access to cold, fresh water. Asphalt gets very hot and can burn your pet’s paws, walk on grass if possible. Never leave any person or pet in a parked vehicle.

If you do go outside, protect yourself from heat and sun. Sunburn slows the skin’s ability to cool itself, so make sure to use sunscreen with a high SPF rating. Wear a wide-brimmed hat and light-colored, loose-fitting clothes. Seek shade in parks and greenspaces where it will be cooler than in paved areas.

If you are working outside, try to plan strenuous activities for early or late in the day when temperatures are cooler. Take frequent breaks and hydrate regularly. Employers should take steps to protect people who work outdoors, including adjusting work schedules and activities, providing access to water and monitoring workers for illness.

If you notice symptoms of heat illness (dizziness, nausea, headaches, muscle cramps), act immediately. Move to a cooler location to rest for a few minutes and seek medical attention immediately if you do not feel better.  

Avoid extreme temperature changes. Taking a cold shower right after coming in from the heat or jumping into cold water when swimming outside can cause rapid changes in your breathing, heart rate and blood pressure and even cause hypothermia.

Follow water safety tips if you go swimming or boating. Remember that swimming in open water is very different from swimming in a pool and make sure to wear a life jacket that fits you.

Before lighting any outdoor fires, check for restrictions or warnings in your area. High temperatures and dry conditions increase wildfire risk.

“Hot weather and high temperatures can quickly go from uncomfortable to life-threatening,” said Umair A. Shah, MD, MPH, Secretary of Health. “We can all take steps to reduce our risk of heat exhaustion or heat stroke and help others stay safe.”