Category: Covid-19

Asystematic review posted in Clinical Infectious Diseases reveals that, amid the COVID-19 pandemic, many physicians felt less ethically obligated to provide care to infectious-disease patients if they fear contracting the disease.

A Duke Universityled team reviewed 155 published studies exploring treatment obligation and refusal, HIV/AIDS, COVID-19, and pandemics up to October 25, 2022.

"During pandemics, healthcare providers struggle with balancing obligations to self, family, and patients," the study authors wrote. "While HIV/AIDS seemed to settle this issue, coronavirus disease 2019 (COVID-19) rekindled debates regarding treatment refusal."

The included studies examined ethical treatment obligations for patients with HIV/AIDS (72.2%), severe acute respiratory syndrome (SARS; 10.2%), COVID-19 (10.2%), Ebola (7.0%), and flu (7.0%).

Most articles (81.9%) argued for an obligation to treat these patients, while most papers (60.0%) that endorsed withholding treatment were on COVID-19, and HIV had the fewest papers advocating for treatment refusal (13.3%).

The most common reasons given for an obligation to treat were professionalism (55.5%), the social contract (45.3%), and the law (20.3%).The most common reason for advocating for withholding COVID-19 treatment was labor rights and worker protection (40%); labor rights were cited in only 17% to 19% for other infections.

For HIV care, labor rights was the least cited reason for treatment refusal (6.2%). A total of 26.7% of articles published during COVID-19 cited the risk of infection to physicians and their families, compared with 8.3% for flu and 6.3% for SARS.

"All the papers throughout history have shown that physicians broadly believed they should treat infectious disease patients," lead author Braylee Grisel, a fourth-year student at Duke University School of Medicine, said in a Dukepress release."We figured our study would show the same thing, so we were really surprised when we found that COVID-19 was so different than all these other outbreaks."

The researchers said the COVID-19 pandemic may have altered the perceived social contract between physicians and patients, because it had several unique characteristics, including a shortage of resources (eg, personal protective equipment, hospital rooms, respirators, vaccines, treatments), broadly disseminated misinformation about the disease (eg, how the virus spreads, effective treatments, vaccine efficacy and safety), its highly contagious nature, and escalating abuse of staff by patients and their families.

Arguments were made based on reciprocity, medical triage, and personal responsibility to exclude patients who refused vaccines from consideration when ventilators and other resources were limited.

Senior author Krista Haines, DO, of Duke University, said, "Some of these results may be because we had the unique opportunity to evaluate changing ethics while the pandemic was actively ongoing, as COVID-19 was the first modern outbreak to put a significant number of frontline providers at personal risk in the United States due to its respiratory transmission."

Some papers discussed the consideration of COVID-19 vaccination status in treatment decisions. "Patients who refused vaccination were at a higher risk of complications while also putting other patients and providers at risk," the researchers wrote. "Arguments were made based on reciprocity, medical triage, and personal responsibility to exclude patients who refused vaccines from consideration when ventilators and other resources were limited."

The findings show how physicians are not immune from sociopolitical influences, Grisel said. "In future pandemics, we may need to become more aware of how the risks and outside pressures of an active pandemic influence willingness to provide care," she said. "Health care systems can learn how to mitigate these influences to ensure that hospitals are adequately staffed to meet patient needs."

The authors noted that the obligation to provide care was supported throughout the 20th and early 21st centuries. "Striking a balance between providing care, limiting patient discrimination, respecting provider autonomy, and protecting the healthcare workforce is crucial to adequately meet public needs during a global health crisis," they concluded.

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COVID may have eroded doctors' belief that they are obligated to treat infectious patients - University of Minnesota Twin Cities

LOS ANGELES (AP) On a recent afternoon, Grant Oh zigzagged across the University of Southern California campus as if he was conquering an obstacle course, coming up against police blockade after police blockade on his way to his apartment while officers arrested demonstrators protesting the Israel-Hamas war.

In many ways, the chaotic moment was the culmination of a college life that started amid the coronavirus pandemic and has been marked by continual upheaval in what has become a constant battle for normalcy. Oh already missed his prom and his high school graduation as COVID-19 surged in 2020. He started college with online classes. Now the 20-year-old will add another missed milestone to his life: USC has canceled its main commencement ceremony that was expected to be attended by 65,000 people.

His only graduation ceremony was in middle school and there were no caps and gowns.

Its crazy because I remember starting freshman year with the start of the Russian invasion of Ukraine, which came after senior year of high school when the Black Lives Matter protests were happening and COVID, and xenophobia, he said It feels definitely surreal. It still shocks me that we live in a world that is so fired up and so willing to tear itself apart.

Oh, who is getting a degree in health promotion and disease prevention, added that his loss of a memorable moment pales in comparison to what is happening: At the end of the day, people are dying.

College campuses have always been a hotbed for protests from the civil rights era to the Vietnam war to demonstrations over apartheid in South Africa. But students today also carry additional stresses from having lived through the isolation and fear from the pandemic, and the daily influence of social media that amplifies the worlds wrongs like never before, experts say.

Its not just about missed milestones. Study after study shows Generation Z suffers from much higher rates of anxiety and depression than Millennials, said Jean Twenge, a psychologist and professor at San Diego State University, who wrote a book called Generations. She attributes much of that to the fact that negativity spreads faster and wider on social media than positive posts.

Gen Z, they tend to be much more pessimistic than Millennials, she said. The question going forward is do they take this pessimism and turn it into concrete action and change, or do they turn it into annihilation and chaos?

Protesters have pitched tents on campuses from Harvard and MIT to Stanford and the University of Texas, Austin, raising tensions as many schools prepare for spring commencements. Hundreds of students have been arrested across the country. Inspired by demonstrations at Columbia University, students at more than a dozen U.S. colleges have formed pro-Palestinian encampments and pledged to stay put until their demands are met.

The campus will be closed for the semester at California State Polytechnic University, Humboldt, which has been negotiating with students who have been barricaded inside a campus building since Monday, rebuffing an attempt by the police to clear them out.

USC announced Thursday that it would be calling off its main graduation ceremony after protests erupted over not only the Israel-Hamas war but the schools decision earlier this month to call off the commencement speech by its valedictorian Asna Tabassum, who expressed support for Palestinians. Officials cited security concerns.

By trying to silence Asna, it made everything way worse, Oh said, adding that he hopes there will be no violence on graduation day May 10 when smaller ceremonies will be held by different departments.

Maurielle McGarvey graduated from high school in 2019 so was able to have a ceremony but then she took a gap year when many universities held classes only online. McGarvey, who is getting a degree in screenwriting with a minor in gender and social justice studies at USC, called the cancellations heartbreaking, and said the situation has been grossly mishandled by the university. She said police with batons came at her yelling as she held a banner while she and fellow demonstrators said a Jewish prayer.

Its definitely been like an overall diminished experience and to take away like the last sort of like typical thing that this class was allowed after having so many weird restrictions, so many customs and traditions changed, she said. Its such a bummer.

She said the email by the university announcing the cancellation particularly stung with its link to photos of past graduates in gowns tossing up their caps and cheering. Thats just insult to injury, she said.

Students at other universities were equally glum.

Our grade is cursed, said Abbie Barkan of Atlanta, 21, who is graduating from the University of Texas in two weeks with a journalism degree and who was among a group of Jewish students waving flags and chanting at a counter-protest Thursday near a pro-Palestinian demonstration on campus.

University of Minnesota senior Sarah Dawley, who participated in pro-Palestinian protests, is grateful graduation plans have not changed at her school. But she said the past weeks have left her with a mix of emotions. Shes been dismayed to watch colleges call in police.

But she said she also feels hope after having gone through the pandemic and become part of a community that stands up for what they believe in.

I think a lot of people are going to go on to do cool things because after all this, we care a lot, she said.

____

Watson reported from San Diego. AP journalists Stefanie Dazio and Eugene Garcia in Los Angeles, Mark Vancleave in Minneapolis, Jim Vertuno and Acacia Coronado in Austin, Texas, and Rodrique Ngowi in Boston contributed to this report.

Link:

Class of 2024 reflects on college years marked by COVID-19, protests and life's lost milestones - ABC4.com

Most travel insurers have retained the cover they began offering for Covid-related issues during the pandemic (although many now refer in more general terms to pandemics rather than specifically to Covid).

A comprehensive travel policy is likely to cover you for some or all of the following Covid scenarios:

However, terms and conditions around the cancellation element relating to Covid can vary between insurers so, as with any insurance, check the policy wording carefully to find out what is both included and excluded from cover.

Anna-Marie Duthie, travel insurance expert at financial data company Defaqto, explained: Medical costs will be covered in relation to Covid, as they would be in any other circumstance or illness.

However, when it comes to cover for cancellation that is specifically due to Covid, rules will vary by insurer. For example, cancellation may be covered only with a medical note from a medical practitioner advising you not to travel, for example, rather than just a positive Covid test being enough evidence for an insurance claim.

This is because Covid tests are no longer mandatory and while there may be a moral argument there are no legal restrictions regarding travelling with Covid.

Defaqto data shows that 99% of annual travel insurance policies cover medical expenses in relation to Covid-19, and 95% cover cancellation due to a positive Covid test.

If you are concerned about the cover you may have in relation to Covid, check with your insurer before you travel.

Read more from the original source:

Travel insurance with Covid Cover (2024) Forbes Advisor UK - Forbes

Wang H, Paulson KR, Pease SA, Watson S, Comfort H, Zheng P, et al. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 202021. Lancet. 2022;399(10334):151336.

Article CAS Google Scholar

Mostafa-Hedeab G. ACE2 as drug target of COVID-19 virus treatment, simplified updated review. Rep Biochem Mol Biology. 2020;9(1):97.

Article CAS Google Scholar

Yu W-L, Toh HS, Liao C-T, Chang W-T. Cardiovascular complications of COVID-19 and associated concerns: a review. Acta Cardiol Sinica. 2021;37(1):9.

Google Scholar

Page EM, Arins RA. Mechanisms of thrombosis and cardiovascular complications in COVID-19. Thromb Res. 2021;200:18.

Article CAS PubMed PubMed Central Google Scholar

Liu L, Jing H, Wu X, Xiang M, Novakovic VA, Wang S et al. The cross-talk of lung and heart complications in COVID-19: endothelial cells dysfunction, thrombosis, and treatment. Front Cardiovasc Med. 2022;9.

Shehata GA, Lord KC, Grudzinski MC, Elsayed M, Abdelnaby R, Elshabrawy HA. Neurological complications of COVID-19: underlying mechanisms and management. Int J Mol Sci. 2021;22(8):4081.

Article CAS PubMed PubMed Central Google Scholar

Al-Karmalawy AA, Soltane R, Abo Elmaaty A, Tantawy MA, Antar SA, Yahya G, et al. Coronavirus disease (COVID-19) control between drug repurposing and vaccination: a comprehensive overview. Vaccines. 2021;9(11):1317.

Article CAS PubMed PubMed Central Google Scholar

Ashour NA, Abo Elmaaty A, Sarhan AA, Elkaeed EB, Moussa AM, Erfan IA et al. A systematic review of the global intervention for SARS-CoV-2 combating: from drugs repurposing to molnupiravir approval. Drug design, development and therapy. 2022:685715.

Ritonavir-Boosted Nirmatrelvir. (Paxlovid) [ https://www.covid19treatmentguidelines.nih.gov/therapies/antivirals-including-antibody-products/ritonavir-boosted-nirmatrelvir--paxlovid-/.

Ghasemiyeh P, Mohammadi-Samani S. COVID-19 outbreak: challenges in pharmacotherapy based on pharmacokinetic and pharmacodynamic aspects of drug therapy in patients with moderate to severe infection. Heart Lung. 2020;49(6):76373.

Article PubMed PubMed Central Google Scholar

Ghasemiyeh P, Borhani-Haghighi A, Karimzadeh I, Mohammadi-Samani S, Vazin A, Safari A, et al. Major neurologic adverse drug reactions, potential drugdrug interactions and pharmacokinetic aspects of drugs used in covid-19 patients with stroke: a narrative review. Ther Clin Risk Manag. 2020;16:595.

Article CAS PubMed PubMed Central Google Scholar

Ghasemiyeh P, Mortazavi N, Karimzadeh I, Vazin A, Mahmoudi L, Moghimi-Sarani E, et al. Psychiatric adverse drug reactions and potential Anti-COVID-19 drug interactions with psychotropic medications. Iran J Pharm Research: IJPR. 2021;20(3):66.

CAS PubMed PubMed Central Google Scholar

Ghasemiyeh P, Mohammadi-Samani S. Iron chelating agents: promising supportive therapies in severe cases of COVID-19? Trends Pharm Sci. 2020;6(2):656.

CAS Google Scholar

Ghasemiyeh P, Mohammadi-Samani S, Vazin A. Micronutrients supplementation in pregnant women during COVID-19 pandemy: pros and cons. Trends Pharm Sci. 2021;7(3):15360.

CAS Google Scholar

Zarkesh K, Entezar-Almahdi E, Ghasemiyeh P, Akbarian M, Bahmani M, Roudaki S, et al. Drug-based therapeutic strategies for COVID-19-infected patients and their challenges. Future Microbiol. 2021;16(18):141551.

Article CAS PubMed Google Scholar

Ghasemiyeh P, Mohammadi-Samani S. The necessity of early anti-inflammatory therapy initiation in cases with mild-to-moderate COVID-19: a personal experience from an attending pharmacist and his resident. Acta Bio-medica: Atenei Parmensis. 2021;92(3):e2021250e.

PubMed Google Scholar

Vetter P, Vu DL, LHuillier AG, Schibler M, Kaiser L, Jacquerioz F. Clinical features of covid-19. British Medical Journal Publishing Group; 2020.

Pelaia C, Tinello C, Vatrella A, De Sarro G, Pelaia G. Lung under attack by COVID-19-induced cytokine storm: pathogenic mechanisms and therapeutic implications. Ther Adv Respir Dis. 2020;14:1753466620933508.

Article CAS PubMed PubMed Central Google Scholar

Bazdyrev E, Rusina P, Panova M, Novikov F, Grishagin I, Nebolsin V. Lung fibrosis after COVID-19: treatment prospects. Pharmaceuticals. 2021;14(8):807.

Article CAS PubMed PubMed Central Google Scholar

Villapol S. Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome. Translational Res. 2020;226:5769.

Article CAS Google Scholar

Shih AR, Misdraji J. COVID-19: gastrointestinal and hepatobiliary manifestations. Hum Pathol. 2023;132:3955.

Article CAS PubMed Google Scholar

Kunutsor SK, Laukkanen JA. Renal complications in COVID-19: a systematic review and meta-analysis. Ann Med. 2020;52(7):34553.

Article CAS PubMed PubMed Central Google Scholar

Gjonbalaj N, Uka S, Olluri E, Sulovari A, Vishaj M, Kamberi L, et al. Renal artery thrombosis as a long-term complication of COVID-19. Radiol Case Rep. 2023;18(1):2605.

Article PubMed Google Scholar

Fried JA, Ramasubbu K, Bhatt R, Topkara VK, Clerkin KJ, Horn E, et al. The variety of cardiovascular presentations of COVID-19. Circulation. 2020;141(23):19306.

Article CAS PubMed PubMed Central Google Scholar

Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020;38(7):15047.

Article PubMed PubMed Central Google Scholar

Sheraton M, Deo N, Kashyap R, Surani S. A review of neurological complications of COVID-19. Cureus. 2020;12(5).

Nagu P, Parashar A, Behl T, Mehta V. CNS implications of COVID-19: a comprehensive review. Rev Neurosci. 2021;32(2):21934.

Article CAS PubMed Google Scholar

Guck AJ, Buck K, Lehockey K. Psychological complications of COVID-19 following hospitalization and ICU discharge: recommendations for treatment. Professional Psychology: Research and Practice; 2021.

Google Scholar

Alahyari S, Moradi M, Rajaeinejad M, Jalaeikhoo H. Post-COVID-19 hematologic complications: a systematic review. Expert Rev Hematol. 2022(just-accepted).

Fanaroff AC, Lopes RD. COVID-19 thrombotic complications and therapeutic strategies. Annu Rev Med. 2023;74:1530.

Article CAS PubMed Google Scholar

Bouzid D, Visseaux B, Kassasseya C, Daoud A, Fmy F, Hermand C, et al. Comparison of patients infected with Delta versus Omicron COVID-19 variants presenting to Paris emergency departments: a retrospective cohort study. Ann Intern Med. 2022;175(6):8317.

Article PubMed Google Scholar

Therapeutic Management of Nonhospitalized Adults With COVID. -19 [ https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-adults/nonhospitalized-adults--therapeutic-management/#:~:text=The%20Panel%20recommends%20using%20nirmatrelvir,of%20symptom%20onset%20(%20AIIa%20).

Therapeutic Management of Hospitalized Adults With COVID. -19 [ https://www.covid19treatmentguidelines.nih.gov/tables/therapeutic-management-of-hospitalized-adults/.

Coronavirus Disease. 2019 (COVID-19) Treatment Guidelines [ https://www.covid19treatmentguidelines.nih.gov/.

Spyropoulos AC, Goldin M, Giannis D, Diab W, Wang J, Khanijo S, et al. Efficacy and safety of therapeutic-dose heparin vs standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19: the HEP-COVID randomized clinical trial. JAMA Intern Med. 2021;181(12):161220.

Article CAS PubMed PubMed Central Google Scholar

Thiruchelvam K, Kow CS, Hadi MA, Hasan SS. The use of remdesivir for the management of patients with moderate-to-severe COVID-19: a systematic review. Expert Rev anti-infective Therapy. 2022;20(2):21129.

Article CAS PubMed Google Scholar

Gupte V, Hegde R, Sawant S, Kalathingal K, Jadhav S, Malabade R, et al. Safety and clinical outcomes of remdesivir in hospitalised COVID-19 patients: a retrospective analysis of active surveillance database. BMC Infect Dis. 2022;22(1):18.

Article CAS PubMed PubMed Central Google Scholar

Remdesivir [Available from. https://www.covid19treatmentguidelines.nih.gov/therapies/antivirals-including-antibody-products/remdesivir/.

Wen W, Chen C, Tang J, Wang C, Zhou M, Cheng Y, et al. Efficacy and safety of three new oral antiviral treatment (molnupiravir, fluvoxamine and paxlovid) for COVID-19: a meta-analysis. Ann Med. 2022;54(1):51623.

Article CAS PubMed PubMed Central Google Scholar

Tanne JH. Covid-19: FDA authorises pharmacists to prescribe Paxlovid. British Medical Journal Publishing Group; 2022.

Jayk Bernal A, Gomes da Silva MM, Musungaie DB, Kovalchuk E, Gonzalez A, Delos Reyes V, et al. Molnupiravir for oral treatment of Covid-19 in nonhospitalized patients. N Engl J Med. 2022;386(6):50920.

Article PubMed Google Scholar

McCreary EK, Kip KE, Collins K, Minnier TE, Snyder GM, Steiner A, et al. editors. Evaluation of Bebtelovimab for treatment of COVID-19 during the SARS-CoV-2 Omicron variant era. Open Forum Infectious Diseases; 2022.

Kozani PS, Sheikhi M, Baharifar N, Shokoohi SD, Sheikhi S, Mirarefin SMJ et al. Bebtelovimab: the FDA-approved monoclonal antibody for treating patients with mild-to-moderate COVID-19. Trends Med Sci. 2022;2(3).

Vilobelimab [Available from. https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/.

Kuritzkes DR. Bamlanivimab for Prevention of COVID-19. JAMA. 2021;326(1):312.

Article CAS PubMed Google Scholar

Herman GA, OBrien MP, Forleo-Neto E, Sarkar N, Isa F, Hou P, et al. Efficacy and safety of a single dose of casirivimab and imdevimab for the prevention of COVID-19 over an 8-month period: a randomised, double-blind, placebo-controlled trial. Lancet Infect Dis. 2022;22(10):144454.

Article CAS PubMed PubMed Central Google Scholar

Ao G, Li A, Wang Y, Tran C, Qi X. Lack of efficacy for sotrovimab use in patients with COVID-19: a meta-analysis. J Infect. 2022.

Jorda A, Kussmann M, Kolenchery N, Siller-Matula JM, Zeitlinger M, Jilma B, et al. Convalescent plasma treatment in patients with Covid-19: a systematic review and Meta-analysis. Front Immunol. 2022;13:817829.

Article CAS PubMed PubMed Central Google Scholar

Troxel AB, Petkova E, Goldfeld K, Liu M, Tarpey T, Wu Y, et al. Association of convalescent plasma treatment with clinical status in patients hospitalized with COVID-19: a meta-analysis. JAMA Netw open. 2022;5(1):e2147331e.

Article PubMed PubMed Central Google Scholar

Kirkham AM, Bailey AJ, Monaghan M, Shorr R, Lalu MM, Fergusson DA, et al. Updated Living Systematic Review and Meta-analysis of controlled trials of mesenchymal stromal cells to treat COVID-19: a Framework for Accelerated Synthesis of Trial evidence for Rapid ApprovalFASTER approval. Stem Cells Translational Med. 2022;11(7):67587.

Article Google Scholar

Dorward J, Yu L-M, Hayward G, Saville BR, Gbinigie O, Van Hecke O, et al. Colchicine for COVID-19 in the community (PRINCIPLE): a randomised, controlled, adaptive platform trial. Br J Gen Pract. 2022;72(720):e44655.

Article PubMed PubMed Central Google Scholar

Ghaith HS, Gabra MD, Nafady MH, Elshawah HE, Negida A, Mushtaq G et al. A review of the rational and current evidence on colchicine for COVID-19. Curr Pharm Design. 2022.

Griesel M, Wagner C, Mikolajewska A, Stegemann M, Fichtner F, Metzendorf M-I et al. Inhaled corticosteroids for the treatment of COVID-19. Cochrane Database Syst Reviews. 2022(3).

Clemency BM, Varughese R, Gonzalez-Rojas Y, Morse CG, Phipatanakul W, Koster DJ, et al. Efficacy of inhaled ciclesonide for outpatient treatment of adolescents and adults with symptomatic COVID-19: a randomized clinical trial. JAMA Intern Med. 2022;182(1):429.

Article CAS PubMed Google Scholar

Nyirenda JL, Sofroniou M, Toews I, Mikolajewska A, Lehane C, Monsef I et al. Fluvoxamine for the treatment of COVID-19. Cochrane Database Syst Reviews. 2022(9).

Mehta P, Chambers RC, Dagna L. Granulocyte-macrophage colony stimulating factor in COVID-19: friend or foe? Lancet Rheumatol. 2021;3(6):e3945.

Article CAS PubMed PubMed Central Google Scholar

Lee TC, McDonald EG, Butler-Laporte G, Harrison LB, Cheng MP, Brophy JM. Remdesivir and systemic corticosteroids for the treatment of COVID-19: a bayesian re-analysis. Int J Infect Dis. 2021;104:6716.

Article CAS PubMed PubMed Central Google Scholar

Noreen S, Maqbool I, Madni A, Dexamethasone. Therapeutic potential, risks, and future projection during COVID-19 pandemic. Eur J Pharmacol. 2021;894:173854.

Article CAS PubMed PubMed Central Google Scholar

Martinez-Guerra BA, Gonzalez-Lara MF, Roman-Montes CM, Tamez-Torres KM, Dardn-Fierro FE, Rajme-Lopez S, et al. Outcomes of patients with severe and critical COVID-19 treated with dexamethasone: a prospective cohort study. Emerg Microbes Infections. 2022;11(1):509.

Article CAS Google Scholar

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Lessons we learned during the past four challenging years in the COVID-19 era: pharmacotherapy, long COVID ... - Virology Journal

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Effectiveness of Vitamin D and Alpha-Lipoic Acid in COVID-19 Infection: A Literature Review - Cureus

More than 1 million people keep Oregon Health Plan benefits due to efforts to expand coverage options

SALEM, Ore. (KTVZ) With more than 90 percent of the states 1.5 million renewals complete, more than 4 out of 5 Oregonians are keeping their Oregon Health Plan or other Medicaid benefits.

During the COVID-19 Public Health Emergency (PHE), which ended one year ago in April 2023, the federal government allowed states to keep people on Medicaid benefits. This ended when the pandemic emergency ended, so over the last year Oregon has been making sure everyone on OHP is still eligible.

At this point in the PHE unwinding process:

Oregons 81.8 percent renewal rate continues to be thethird highest in a national comparison of state renewal rates by KFF, a nonpartisan health policy organization. Oregons high renewal rates are due to proactive efforts by the state to keep people covered, including extended response timelines, and adding theupcoming OHP Bridge programfor adults with higher incomes.

Members who have not received a renewal yet should:

Although most people are keeping coverage, approximately 240,000 people will lose or have reduced medical benefits and need to consider other coverage options.

On Feb. 13, 2024, the federal government approved a revised plan for Oregons remaining 126,000 post-pandemic renewals.

Many of these renewals were affected by a federal request for more than 30 states to review automated renewal processes or restorations of someOregon Supplemental Income Program Medical (OSIPM)benefits. A May 2024 technical update to Oregons ONE Eligibility systemwill enable Oregon to use the new automatedprocess for the remaining renewals.

Renewal letters will be sent to members in four waves between June and September. Members will still have 90 days to respond, and 60 days advance notice before any termination or reduction in benefits. This means the final responses would be due in December 2024, and the final closures will happen in February 2025.

Data about pandemic unwinding renewals appears in theMedical Redeterminations Dashboard. The dashboard data and these press releases will not include renewals for OHP members who have already renewed early in the unwinding process, who are coming up for renewal again. Over time, Oregon is switching to renewing most OHP members every two years instead of annually.

As of March 19, 2024, 1,317,810 people have completed the renewal process. This represents 90.6 percent of all OHP and Medicaid members.

If you need to sign up for Medicare for the first time, contact the Social Security Administration (SSA) at 800-772-1213 to enroll by phone or find a local office. You can also enroll in Medicare online atssa.gov/medicare/sign-up.

The Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS) are committed to transparency and will continue to send monthly information about medical coverage among Oregonians as the agencies continue to track theprograms. Check ourONE Eligibility Operations Dashboardsfor more frequent updates on medical renewal data and wait times for callers to the ONE Customer Service Center.

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One year after the end of COVID-19 pandemic emergency, Oregon is among top states keeping people covered - KTVZ

LEIPZIG, GERMANY - NOVEMBER 18: Doctors and nurses work in the Covid-19 intensive care unit at ... [+] University Hospital Leipzig on November 18, 2021 in Leipzig, Germany. Hospitals are coping with a high influx of patients as the fourth wave of the coronavirus pandemic is sending infection rates to new record highs in Germany. Saxony is especially hard hit, with an average of over 750 new cases per 100,000 over a seven-day period, the highest for any state nationwide. Germany's vaccination rate, currently at about 67% of the population, is low compared to many other EU countries. The vast majority of people currently being admitted to hospital with Covid are unvaccinated. (Photo by Jens Schlueter/Getty Images)

While most researchers, policymakers, lawyers, and journalists have always advocated that doctors are obligated to treat patients with infectious diseases, the Covid-19 pandemic might have changed that long-held view. According to a new study that analyzed peoples tolerance for doctors withholding treatment to Covid-19 patients, researchers observed a steadily growing acceptance of the view that it could be ethically acceptable for doctors to refuse care.

All the papers throughout history have shown that physicians broadly believed they should treat infectious disease patients, lead author, Braylee Grisel, a student at Duke University School of Medicine, said in a press release.

We figured our study would show the same thing, so we were really surprised when we found that COVID-19 was so different than all these other outbreaks, Grisel added.

Grisel and colleagues assessed 187 published articles, which included legal briefings, news stories, academic papers, opinion pieces, and policy statements. The researchers selected those articles because they addressed the ethical dilemma that doctors have been facing over the last four decades while treating outbreaks of infectious diseases like HIV, influenza, SARS, and more recently the novel coronavirus.

Around 75% of the articles staunchly advocated for every doctors obligation to treat patients. However, Covid-19 had the highest number of articles (60%) stating that it is ethically acceptable for doctors to refuse treatment. Meanwhile, only 13.3% of the 187 articles said doctors refusing to treat patients with HIV was acceptable.

Until the Covid-19 pandemic started wreaking havoc globally five years ago, only 9% to 16% of published views from the 1980s to 2019 argued that it was okay for doctors to withhold treatment from patients.

Some of these results may be because we had the unique opportunity to evaluate changing ethics while the pandemic was actively ongoing, as COVID-19 was the first modern outbreak to put a significant number of frontline providers at personal risk in the United States due to its respiratory transmission, said senior author of the study, Krista Haines, an assistant professor at Duke University School of Medicine, in a press release.

The researchers found that the main reason views shifted so significantly was due to labor rights and worker protections, which were key issues that authors had highlighted in 40% of articles published after the Covid-19 pandemic began. Compared to that, labor rights were brought up in only 17% to 19% of articles for influenza and SARS and only 6.2% of the articles cited that issue for HIV.

The study, in the journal Clinical Infectious Diseases, brought out various factors that altered views on doctor's obligation to care for all Covid-19 patients. First, healthcare workers struggled through severe shortages of resources like hospital beds, ventilators, oxygen cylinders, and personal protective gear while being overwhelmed during multiple Covid-19 waves with different variants of the virus. Secondly, a growing number of health care workers faced mistreatment and aggression from patients and relatives and had to deal with patients refusing vaccinations and other forms of misinformation.

There was a great deal of discussion among frontline providers and ethicists on how best to allocate scarce resources, the authors wrote. Patients who refused vaccination were at a higher risk of complications while also putting other patients and providers at risk. Arguments were made based on reciprocity, medical triage, and personal responsibility to exclude patients who refused vaccines from consideration when ventilators and other resources were limited.

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Covid-19 Pandemic Led To Growing Acceptance Of Doctors Withholding Treatment - Forbes

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Thursday, April 25, 2024

Deidentified data from thousands of adults with long COVID are now available to researchers.

Secure data from more than 14,000 adults who participate in National Institutes of Health observational research on long COVID are now available to authorized researchers through BioData Catalyst (BDC). BDC is a cloud-based ecosystem developed by the National Heart, Lung, and Blood Institute (NHLBI), part of NIH, to accelerate research on heart, lung, blood, and sleep disorders. The research on long COVID broadly defined as signs, symptoms, or conditions that persist or develop for at least four weeks after an infection from the virus that causes COVID-19 is provided through the NIH Researching COVID to Enhance Recovery (NIH RECOVER) Initiative.

By giving researchers access to secure data, analysis tools, and resources, the BDC ecosystem aims to spur scientific innovation, collaboration, and discovery, while providing a platform for sharing data and validating results. The addition of RECOVER data to BDC can help investigators identify and explore long COVID connections that may benefit from or inform future studies.

Authorized researchers can now request access to a subset of data from adults in the observational RECOVER cohort. These data include information from more than 92,000 study visits collected between Oct. 29, 2021-Sept. 15, 2023 at 79 locations throughout the United States. New RECOVER data, including data from other studies, will be added to BDC at regular intervals.

As investigators seek to better understand, diagnose, and treat long COVID, many critical questions remain. By making RECOVER data more accessible by adding it to a central ecosystem, experts aim to find answers sooner.

David C. Goff, M.D., Ph.D., a senior scientific program director for the RECOVER Observational Consortium Steering Committee and director of the Division of Cardiovascular Sciences at NHLBI, is available to discuss BDC and new directions in long COVID research.

About RECOVER: The National Institutes of Health Researching COVID to Enhance Recovery (NIH RECOVER) Initiative is a $1.15 billion effort, which is supported in part through the American Rescue Plan Act of 2021. It seeks to identify how people recuperate from COVID-19 and who is at risk for developing post-acute sequelae of SARS-CoV-2 (PASC). Researchers are also working with patients, clinicians, and communities across the United States to identify strategies to prevent and treat the long-term effects of COVID, including long COVID. For more information, please visit recovercovid.org.

About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is the global leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit https://www.nhlbi.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

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NIH RECOVER makes long COVID data easier to access - National Institutes of Health (NIH) (.gov)

A comparative analysis yesterday inBMJ Global Health shows that national clinical guidelines for treating COVID-19 vary significantly around the world, and nearly every national guideline (NG) recommends at least one COVID-19 treatment proven not to work.

The authors considered the gold standard for clinical guidelines to be the World Health Organization's (WHO's) 2022 updated guidelinesthe 11th version of the WHO guideline.

They looked at NGs for 109 of the 194 WHO member states after the summer of 2022. Of the 85 countries not included in the final analysis, 9 did not have any NGs.

Regionally, Europe had the most countries with easily identifiable guidelines (69.8%), followed by Africa (53.2%). A country's ministry of health published 73.4% of guidelines, while 12.8% of the guidelines were published by a national disease organization.

The 11th WHO guidelines recommend that clinicians categorize disease severity as non-severe, severe, and critical. However, 84.4% of reviewed NGs defined COVID-19 severity differently from the WHO, and 6.4% of the guidelines did not define severity at all.

Just 10 countries (9.2%) had NGs that published severity definitions comparable to the WHO.

The WHO guidelines recommend 10 therapeutics or medications, but NGs recommended 1 to 22 therapeutics. The therapies recommended in NGs were graded in 25 (23.8%) of the guidelines assessed. Most (77%; 84) guidelines did not include an assessment of the strength of the therapeutic recommendation.

"The most commonly recommended drugs were corticosteroids; 92% (100/109) of the NGs featured corticosteroids, and 80% (88/109) recommended corticosteroids for the same disease severity as did the WHO," the authors wrote.

Corticosteroids were not recommended in severe disease in nearly 10% of guidelines, however, despite strong evidence of their benefit.

Several countries, especially those in poorer regions, in 2022 continued to recommend treatments that had been disproven and were not recommended by the WHO, including chloroquine, lopinavirritonavir, azithromycin, vitamins, and zinc.

Why do NGs differ so much in their treatment guidance for such a widespread and potentially serious infection when all have access to the same information?

"Why do NGs differ so much in their treatment guidance for such a widespread and potentially serious infection when all have access to the same information?" the authors wrote. "Apart from the prohibitive cost of some medications for low-resource settings, we do not have a satisfactory explanation."

More here:

National COVID-19 guidelines vary widely, often promote ineffective treatments - University of Minnesota Twin Cities

Astudy in JAMA Network Open finds that while US adults with long COVID have a higher rate of psychiatric conditions such as depression and anxiety and are just as likely to receive treatment, many cite cost as a reason for not seeking care.

A team led by University of British Columbia researchers parsed data on 25,122 US adults with and without long COVID (or post-COVID condition [PCC]) from the2022 National Health Interview Survey, a nationally representative interview-based survey, from October 2023 to February 2024.

The researchers used the Patient Health Questionnaire-8 to gauge depression symptoms and the General Anxiety Disorder-7 instrument to assess anxiety. Participants were considered treated if they received counseling or psychiatric medications for their symptoms. The median participant age was 46 years, half were women, and 3.4% were experiencing long COVID.

"The experiences of individuals who were unable to access care due to costs, stigma, or other reasons are important to consider when developing PCC-focused mental health supports," the researchers wrote. "Adults with mental illness frequently experience barriers to care and may be underserveda problem that was exacerbated during the COVID-19 pandemic."

Relative to participants without long COVID, those who had the condition were about twice as likely to experience depression (weighted prevalence [wPr], 16.8% vs 7.1%; adjusted odds ratio [aOR], 1.96), anxiety (wPr, 16.7% vs 6.3%; aOR, 2.21), sleep difficulties (wPr, 41.5% vs 22.7%; aOR 1.95), cognitive problems (wPr, 35.0% vs 19.5%; aOR, 2.04), and disabling fatigue (wPr, 4.0% vs 1.6%; aOR, 1.85).

People with PCC may have more difficulty paying for counseling or therapy due to lost employment wages and greater costs of managing complications from COVID-19, or they may experience challenges obtaining health plan authorization for these supports.

Having current long COVID was tied to female sex, White race, having multiple chronic conditions, and not having received a COVID-19 vaccine.

Of adults with depression or anxiety, those with long COVID (wPr, 28.2% vs 34.9%; aOR, 1.02) were similarly likely as those without the condition to not receive treatment in the previous year(wPr, 37.2% vs 23.3%; AOR, 2.05). But participants currently experiencing long COVID were twice as likely to report cost as a barrier to getting counseling (aOR, 2.12).

"People with PCC may have more difficulty paying for counseling or therapy due to lost employment wages and greater costs of managing complications from COVID-19, or they may experience challenges obtaining health plan authorization for these supports," the researchers wrote.

The authors said that theUS Department of Health and Human Services is helping healthcare systems create care pathways specific tolong COVID.

"These pathways can integrate mental health services by, for example, incorporating routine mental health screening in follow-up for individuals recovering from COVID-19 and including mental health professionals in multidisciplinary PCC clinics," they wrote. "In contexts in which mental health services are sparse, telehealth and group-based programs could be leveraged."

But these programs should recognize that long-COVID patients with or without psychiatric conditions may hesitate to seek care.

"These individuals have described experiencing stigma and medical gaslighting from clinicians, sometimes being told that their physical symptoms are psychosomatic," they wrote. "Standardized screening strategies for psychiatric symptoms in PCC clinics may help normalize mental health assessments for this population."

Original post:

Long-COVID patients more likely to report psychiatric symptoms, cost barriers to therapy - University of Minnesota Twin Cities