“This was after adjustment for cardiovascular and pulmonary diseases and care home residence, which our results suggest explained some but not all of the increased risk,” the researchers wrote.
Their analysis involved more than 8 million adults who were part of a coronavirus risk assessment project sponsored by the British government. Of the 8.26 million people in the tracking study, 4,053 had Down syndrome. Of those, 68 people with the disability died and 40% were killed by Covid-19. Seventeen died of pneumonia or pneumonitis and 35% died of other causes.
Those numbers compare with more than 41,000 people without Down syndrome who died, but just 20% died from the coronavirus, 14% from pneumonia or pneumonitis and 65% died of other causes.
Down syndrome is not included in any guidance from the US Centers for Disease Control and Prevention or the UK’s health ministry as a condition that would put people at increased risk for Covdi-19.
“However it is associated with immune dysfunction, congenital heart failure, and pulmonary pathology and, given its prevalence, may be a relevant albeit unconfirmed risk factor for severe COVID-19,” researchers concluded.
A community at risk
National Down Syndrome Society President and CEO Kandi Pickard said her group is grateful that the study has put a focus on the impact of Covid-19 on people with Down syndrome.
“From the beginning of the pandemic, we have been concerned about our community, especially given the complex medical histories of many of our loved ones,” Pickard said. “This recent study confirms our concerns.”
“People with Down syndrome may also have a hard time telling others when they don’t feel well,” according to the coalition. “They may have trouble knowing they have symptoms or how to describe them. For these reasons, they may not raise concerns or seek medical care quickly. Therefore, it is necessary to pay close attention and be watchful.”
In Mississippi, more White people now have gotten Covid-19 than African Americans. Attitudes about masks might help explain why, official says
Early on, Black Mississippians accounted for roughly 60% of the state’s cases and deaths, the state health department says.
But the tide has turned in the Magnolia State.
While several factors may be at play, the state health officer suggests one in particular: He thinks large segments of the White population aren’t social distancing and wearing masks as wholeheartedly as much of the Black community has been recently.
“And I just will say … I think big parts of the White community, especially in areas that maybe weren’t as hard-affected (previously), have not been as compliant or engaged actively with social distancing and masking. And I think that does make a difference.”
Asked about this Thursday, Dobbs told CNN he’s relying somewhat on anecdotal evidence, but also “looking at how schools are operating. We are seeing a lot more enthusiastic compliance with … masking in public” and social distancing “in the Black community.”
And, “we’ve seen a lot of stuff (with) parent-sponsored youth events — dances, parties, things of that nature, that have really undermined a lot of our efforts to keep the schools open,” he said.
Dobbs highlighted a case to reporters earlier this week: Sumrall High School outside Hattiesburg closed for two weeks starting October 15 because of a Covid-19 outbreak that “seems to be related to an extracurricular social event put on by families and parents,” he said.
Mississippi reissues mask mandates for some counties as cases rise
Dobbs’ words about mask-wearing and distancing come as Mississippi, like the country, is seeing rises in new daily cases after easing down from a summer surge.
On September 14, Mississippi reported its post-peak low for average daily cases: 412, Johns Hopkins University data show. That meshes with the country’s post-peak case low of September 12. Reeves allowed the statewide mask mandate to expire September 30.
Case averages are now on the rise, reaching the 750s this week. On Monday, Reeves put nine of Mississippi’s 82 counties back on a
Democratic presidential nominee Joe Biden has been hammering home the points that the Trump administration backs that suit, that a Supreme Court with Amy Coney Barrett on it might be sympathetic to the challenge and that the ACA is what stands between voters and the old days when preexisting conditions could disqualify you from coverage.
President Trump, however, continues to insist that although the ACA is bad and should go, “we’re always protecting people with preexisting conditions.”
“I can’t say that more strongly,” he said during his town hall last week.
Republican Senators up for reelection have been making the same claim. “You know, preexisting conditions is something we all agree should be covered,” Sen. John Cornyn (R-Tex.) said in a campaign ad this month.
There’s a danger that the two talking points will cancel each other out. (Both sides agree!) That’s why it’s important to understand the facts about why protections for preexisting conditions — the part of the ACA everyone seems to like — cannot be so easily saved if the rest of the law is overturned.
The ACA’s various taxes, subsidies and regulations make it possible for insurance companies to cover people with preexisting conditions (whose health care is generally more expensive). You can’t protect those people without the ACA or a substitute system — and the Republican opponents of the ACA have not offered a viable alternative.
Trump says that he has a competing plan, but what he’s done so far is the equivalent of waving a magic wand. Campaign-trail slogans aside, he issued an executive order saying it is the “policy of the United States” to “ensure that Americans with preexisting conditions can obtain the insurance of their choice at affordable rates.” But the president’s order carries no force of law.
Even if it did, you need a health insurance system, not a simple command from on high to achieve that goal. The details matter a lot here. First, truly protecting people with preexisting conditions requires a whole array of insurance regulations, not just one that generally prohibits discrimination against them. The ACA goes into significant detail to make sure there are no loopholes: It prohibits insurance companies from denying coverage, charging people higher premiums based on their health or gender, limiting benefits tied to preexisting conditions and capping insurance payouts for people who are very sick (either in one year or throughout their lifetimes).
Just as importantly, a plan to protect people with preexisting conditions has to contend with the economic forces that make doing so such a challenge. A key danger is what actuaries ominously call a “death spiral.”
If you guarantee comprehensive insurance to everyone, with no strings attached, people will tend to wait until they’re sick and need the insurance before buying it. With mostly sicker people in the insurance pool, premiums would go up, causing an even larger number of healthier people to drop their coverage. This process would continue and premiums would spiral out of control. The insurance market
The death of Supreme Court Justice Ruth Bader Ginsburg—and President Donald Trump’s controversial nomination of Amy Coney Barrett to fill her seat—have ignited concerns over how a court with a six-to-three conservative majority might rule on an upcoming case on the Affordable Care Act (ACA).
The Senate Judiciary Committee is scheduled to vote on Barrett’s confirmation this Thursday. On November 10 the court will hear Texas v. California. That case will decide whether to uphold a lower court’s ruling that the ACA’s individual mandate to purchase health insurance makes the entire act unconstitutional—or to declare that the mandate is “severable” from the rest of it. If the ACA as a whole is struck down, 20 million people in the U.S. would lose their insurance. Even if it is partially struck down, up to 129 million could lose protections for preexisting conditions—including the more than eight million who have had COVID-19. If she is confirmed before the case is heard, Barrett has given no assurances that she will vote to uphold the landmark health care law.
Many legal scholars say the case for nixing the entire ACA is very weak. But even if the court severs the mandate from most of the law—as Justice Brett Kavanaugh and others have hinted—and strikes down only parts of it, that decision could still do significant damage because the ACA is so intricately tied to the health care system, a number of experts say. Invalidating the law would “throw the nation into economic chaos, in addition to people not having health insurance,” says Georges Benjamin, executive director of the American Public Health Association, a professional organization that promotes public health. “The unintended consequences of even a small tinkering of the ACA could have enormous implications.”
In 2012 the Supreme Court ruled in National Federation of Independent Business v. Sebelius that the ACA’s individual mandate was constitutional because the penalty for not being insured could be considered a tax. But in 2017 Congress passed a tax bill that lowered the penalty to $0, beginning in January 2019. As a result, Texas and other states filed a civil suit claiming the mandate was unconstitutional in 2018. A federal judge in Texas ruled that the individual mandate was unconstitutional and nonseverable, making the entire law unconstitutional—but he did not overturn it. The decision was appealed and eventually made it to the Supreme Court, which is now preparing to hear the case.
A range of different outcomes is possible, according to Katie Keith, a part-time research faculty member at the Center on Health Insurance Reforms at Georgetown University and a principal at the consulting firm Keith Policy Solutions. First, the court will have to determine whether the plaintiffs have standing to challenge the mandate. “If the answer is no, the case kind of goes away,” she says. Second, it must decide whether the mandate is constitutional or not. “Reasonable minds could disagree,” she says, but the case also goes away if the mandate is found to be constitutional.
Credit – Getty Images—Jonnie Miles
On Oct. 20, researchers at the Imperial College of London announced plans for the first human challenge study of COVID-19, which involves deliberately infecting volunteers with the virus that causes the disease, in order to test the effectiveness of vaccines.
The strategy is controversial, as researchers have to weigh the risks of infection against the benefits of learning how well the various vaccine candidates can fight that infection. The strongest argument in favor of the studies has to do with time. If cases of COVID-19 are waning, then the likelihood that people who are vaccinated would get exposed to and potentially infected with the virus naturally declines as well, and it takes researchers longer to accumulate enough data to tell if a vaccine is effective or not. By intentionally exposing people to the virus after they have been vaccinated, researchers can shrink this timeline significantly.
Scientists have used the model to test vaccines against a number of different diseases, including the very first one against smallpox—Edward Jenner infected his son with cowpox, and then exposed his son to smallpox as a way to test his theory that exposure to the former would protect his son from infection by the latter. Scientists tested an H1N1 influenza vaccine by exposing people to the flu, and did the same with a cholera vaccine and the bacterium that causes it. But the strategy requires a solid base of information about both the disease and the vaccine in order to justify the risks. More recently, for example, scientists considered intentionally infecting volunteers with the Zika virus to test vaccines against that disease, but ultimately decided they didn’t have enough data to justify the risk.
Adair Richards, honorary associate professor at the University of Warwick who last May published guidelines on how to ethically conduct human challenge studies, notes that during a pandemic, the risk of delays in developing treatments should be considered alongside the risks to volunteers who are intentionally exposed to disease. “There is a moral weight to inaction as well as action,” he says. “There is an unseen risk if we don’t do [these studies]. We send a lot of doctors, nurses and care workers to work every day, and some will get really sick and die of COVID-19 in the next few weeks. [Those] few weeks count—that’s the unseen risk.”
More than 38,000 people in the U.S. agree, and have registered their intention to volunteer for challenge studies on 1DaySooner.org, an online recruiting group—despite the fact that no such studies have been planned in the country yet.
The London-based scientists still need to submit a detailed proposal to regulatory agencies on how they could conduct their study. If the proposal is approved, the team won’t start exposing any volunteers until January. Before that, they will first need to determine what dose of SARS-CoV-2, the virus that causes COVID-19, is safe to give to people but can still produce
Fitness classes for homeless people opens to public after charity founder bounces back from covid-19
Michelle Reilly, who set up Street Fit Scotland while working in a hostel in 2014, was floored by covid-19 then pleurisy for a month just after lockdown in March. The 37-year-old feared her health and fitness programme would go to the wall.But instead the charity, which runs free outdoor boot camps for rough sleepers and those living in bed-and-breakfast accommodation, is ramping up its programme and launching a new running group – open to anyone in the Capital.Ms Reilly, who shared the stage with Dame Kelly Homes MBE at a wellbeing festival this year as the athlete talked about her battles with depression, has now been awarded £40,000 by NHS and ECC for two years.Over forty people are put through their paces every week at outdoor boot camps and online sessions led by Michelle and a range of coaches. The cash will mean SFS can support more people, including those recovering from addictions.Ms Reilly, who experienced homelessness as a teenager, was terrified when she struggled to get out of bed after getting the virus and a severe chest infection. But when she found out that two people in her group had attempted suicide during lockdown, she pushed herself to get back on her feet.She said: “I was so scared about what could happen to everyone if I wasn’t there. Lockdown was hard for the group. I had my phone on 24/7 on high suicide alert. If you’re stuck in a B&B it’s not always a positive place, we help get them out. We can’t just leave people to rot. Some people in hostels or temp accommodation are terrified, it can be chaotic.””People in the group have problems but Street Fit gives them access to something fun that they can do at their own pace and they don’t feel judged. They can come in feeling rubbish and leave buzzing,”The 37-year-old lost her younger brother and cousin to suicide and addiction. She said it hit her after lockdown that physical activity and the peer-led, group support was going to be even more vital in covid-19 times, especially for those already struggling with their mental health.”Two of the group tried to take their life during lockdown. It’s heart-breaking. My cousin was always in crisis and never had consistent support. That was one of the catalysts for me, to recognise there is not enough support for mental health.””Some of the group really struggled and some still are. They will feel like that again. I think we are going to see a big wave of mental health problems. What we are doing with outdoor boot camps, the online sessions and the new walking groups gives them a coping strategy. I can see it helping to build their resilience. Behaviour does change over time, given a chance. They are helping each other through hard times.”Members now get access to phone counselling and the charity has delivered tablets for everyone to make sure
In an effort to slow cost growth and improve health care quality, Medicare has in recent years developed a number of new ways to pay for and provide health care, and has been testing them through pilot programs in facilities and communities across the country. These test programs give heath care providers both financial incentives and new flexibility to change how they deliver care, with the goal of improving coordination and quality, reducing unnecessary or duplicative services, and focusing on outcomes important to patients and their families.
This report highlights and describes in detail seven innovative programs that represent a variety of approaches and span a wide range of Medicare services. In selecting these promising innovations, the authors examined the evidence of their effects on cost and quality-of-care. They also considered other implications, including effects on individuals’ access to care, and on patients’ and family caregivers’ experiences. The innovations are sorted into three groups based on evidence for their potential benefits.
In addition to describing these seven innovations, the report includes a discussion of each program’s results: its scope and scale, and its effects so far on cost and quality. The discussions review available evidence from Medicare as well as other government agencies and outside experts, covering specific dollar amount cost savings as well as quality measures, (e.g., hospitalizations, readmissions, emergency department visits), and other findings from patients and clinicians when available. The discussions consider potential benefits to consumers and to Medicare were any of these programs to be scaled up; they also identify potential negative effects and areas for potential improvement.
Transformation in health care takes time. However, with careful evaluation, development, and expansion of successful models, innovative Medicare payment and delivery models, like those reviewed here, have the potential to help control Medicare spending while improving the quality of care.
The seven innovations sorted into three groups based on evidence for potential benefits are as follows:
Group One: Innovations with demonstrated evidence of success that could yield broad benefits to both consumers and the Medicare program if expanded.
Innovation #1 – Independence at Home: Comprehensive In-Home Primary Care for People with High Needs
Independence at Home is testing whether providing comprehensive primary care services at home for individuals with very high health care needs leads to better health outcomes, improved patient and caregiver satisfaction, and lower Medicare costs. In theory, home-based care allows clinicians to provide coordinated, comprehensive care that reduces the risk for costly preventable hospital stays, readmissions, or emergency department visits.
Innovation #2 – Community-based Care Transitions Program: Partnerships between Community-Based Organizations and Hospitals to Improve Post-Hospital Transitions
The Affordable Care Act (ACA) mandated this program with the goal of reducing hospital readmissions, which are often caused by factors beyond the walls of the hospital (e.g., medication errors or not receiving sufficient assistance with activities of daily living). This initiative, now completed, relied heavily on community-based organizations with experience connecting patients and family caregivers to community support services (e.g., Meals on Wheels, transportation). Most of the
MONTGOMERY, AL — After several weeks of decreasing numbers on new COVID-19 cases, Alabama has seen a gradual increase in the number of new cases per day in recent weeks. As well, the state surpassed 2,800 total deaths since the pandemic began, placing Alabama 20th in the U.S. in deaths per number of cases.
Alabama is still averaging more than 1,000 new cases of COVID-19 each day. By the end of September, the state was averaging fewer than 900 new cases per day.
In the last seven days, the average number of COVID-19 hospitalizations has been higher (838) than it was when the month began (751).
Of the 153,016 confirmed cases of COVID-19, the Alabama Department of Public Health estimates that 74,238 people are presumed to have recovered from the virus.
health officials point to several factors that could contribute to a spike in new cases in Alabama. Some say a relaxed attitude toward wearing masks and social distancing is one factor, as well as students returning to school and parents attending athletic events.
New cases of COVID-19 statewide in the last week:
October 13: 886 new cases
October 14: 1,235 new cases
October 15: 1,238 new cases
October 16: 1,331 new cases
October 17: 985 new cases
October 18: 874 new cases
October 19: 1,085 new cases
Sanitizing Stations Gifted To UAB To Help Prevent Coronavirus Spread
Hoover Schools To Bring Students On Campus Full Time Monday
This article originally appeared on the Birmingham Patch
A new report finds that more than 100,000 California residents have purchased a gun or firearm in response to the onset of the COVID-19 pandemic, a response attributed to a jump in concern of violence during the global health crisis.
Conducted by researchers at the University of California, Davis Firearm Violence Research Center and Violence Prevention Research Program, an online survey was administered to 2,870 adults across California from July 14 to 27 — a relatively short time span, but with a representative sample of Californian adults.
In response to questions about perceived increases in violence, 2.4 percent of respondents said that they purchased a firearm due to the pandemic. Within this group, 43 percent reported that they did not own a firearm prior to the onset of the coronavirus.
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When extrapolating this amount of people from the approximate 30.1 million residents in California, researchers estimate that roughly 110,000 Californians acquired firearms during the pandemic, amounting to 47,000 new gun owners.
The questions were aimed at gauging respondents’ feelings surrounding personal and general safety concerns regarding different incidences of violence before and during the pandemic, such as mass shootings, assault, robbery, homicide, violence and accidental shootings in response to a pandemic-related loss.
Questions were also asked about firearm acquisition practices during the pandemic.
Results found that the percentage of respondents who reported that they were either “somewhat” or “very worried” about instances of violence spiked sharply over the course of the pandemic, with most respondents reporting an increased fear of all types of violence, including robberies, police violence and unintentional shootings.
The only notable decrease were concerns over mass shootings, potentially due to restrictions on large gatherings to reduce virus transmission.
When asking respondents what their primary motivator was for purchasing firearms, 75.9 percent said it was due to a concern over lawlessness, followed by concerns about prisoner releases and governmental overreach.
“Violence is a significant public health problem which touches the lives of far more people than is typically recognized,” the report reads. “Our findings from this first-of-its-kind population-representative survey of California adults add support to a growing body of research suggesting that the coronavirus pandemic and efforts to lessen its spread have compounded the burden of violence-related harms.”
The authors conclude that the report’s respondents expressed increased levels of concern about violence during the pandemic when compared to pre-pandemic levels and that firearm acquisition during this period was mainly out of a concern for self-protection.
There is a larger concern over the longer term public health implications for the rise in gun acquisitions. Most frequently, women and children bear the brunt of the elevated risk that comes with a gun present in a household, but suicide is another danger that comes with firearm ownership.
LONDON (Reuters) – Most people would get a COVID-19 vaccine if their government or employer recommended it, results of a global poll showed on Tuesday, amid growing concerns about public distrust of the shots being developed at speed to end the pandemic.
Some 71.5% of participants said they would be very or somewhat likely to take a COVID-19 vaccine and 61.4% reported they would accept their employer’s recommendation to do so, according to the survey in June of more than 13,000 people in 19 countries.
The poll was overseen by the Vaccine Confidence Project (VCP), a global surveillance programme on vaccine trust funded by the European Commission and pharmaceutical companies among others, as well as Business Partners to CONVINCE, a U.S./British initiative that is partly government funded.
All respondents, regardless of nationality, said they would be less likely to accept a COVID-19 vaccine if it were mandated by employers.
There were regional differences in responses though, highlighting the polarisation in attitudes on the topic.
Almost 90% of participants in China said they accepted a vaccine, but the rate in Russia was less than 55%. In France, the positive response rate 58.89%, compared with 75.4% in the United States and 71.48% in Britain.
At least 60-70% of the population would need to have immunity to break the chain of transmission, according to the World Health Organization.
Respondents were aged 18 years or older from 19 countries from among the top 35 countries affected by the pandemic in terms of cases per million population.
The results will likely stir the debate about how to overcome public safety concerns, particularly in Western countries, about the frenetic speed of work to develop vaccines, potentially hampering efforts to control the pandemic and revive the global recovery.
There are about 200 COVID-19 vaccine candidates in development globally, including more than 40 in human clinical trials to test for safety and effectiveness. Many are being squeezed into a matter of months for a process that would typically take 10 years or longer.
Scott Ratzan, co-leader of Business Partners to CONVINCE and lecturer at CUNY Graduate School of Public Health and Health Policy, said the data demonstrated diminished public trust.
“It will be tragic if we develop safe and effective vaccines and people refuse to take them,” he said in an email.
“We need to develop a robust and sustained effort to address vaccine hesitancy and rebuild public confidence in the personal, family, and community benefits of immunisations.”
Reporting a willingness to get vaccinated might not be necessarily a good predictor of acceptance, as vaccine decisions can change over time.
Also the poll took place before Russia started the mass inoculation of its population with its Sputnik V shot before full studies had been completed and AstraZeneca
had to pause its late-stage study in September due to a participant’s illness.
Last month, nine leading U.S. and European vaccine developers issued a pledge to uphold scientific standards and testing rigour.
Last week, Facebook Inc
said it would start banning