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A Nebraska company on Friday expanded a recall of alfalfa sprouts after 15 cases of salmonella were linked to the food.
SunSprouts Enterprises doubled its recall that was first announced Thursday, Nebraska health officials said. The 1,406 pounds (638 kilograms) of raw sprouts was distributed in 4-ounce and 2.5-pound (113-gram and 1.13-kilogram) packages to food service and grocery customers in the Midwest between late November and mid-December.
The recalled sprouts have best-by dates between Dec. 10, 2022, and Jan. 7, 2023.
People who have the sprouts are advised to dispose of them.
Of the 15 confirmed cases in which people became ill, the Centers for Disease Control and Prevention said two were hospitalized. Eight cases were reported in Nebraska, six in South Dakota and one in Oklahoma.
The CDC said there likely are many more cases among people who didn’t seek medical care.
Nearly 1.4 million Americans are infected with salmonella bacteria each year, including 26,500 hospitalizations and 420 deaths, with food the major source of the illnesses, according to federal health data.
People who fall ill due to salmonella infection typically include diarrhea, fever, and stomach cramps, according to the Centers for Disease Control and Prevention. Symptoms can take anywhere between six hours and six days to manifest and usually last four to seven days.
Infections are detected via a laboratory test of a person’s stool, body tissue or fluids. Most people recover without clinical treatment, but those with a severe case may requirer antibiotics, according to the CDC.
Although salmonella illnesses are often linked to the consumption of chicken and other meat, bacteria can also be spread by other foods, including vegetables. In 2021, for example, fresh onions imported from Mexico were identified as the source of a salmonella outbreak across at least 37 states.
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The Centers for Disease Control and Prevention said Friday it is tracking a new variant of concern dubbed XBB.1.5. According to new figures published Friday, it estimates XBB.1.5 makes up 40.5% of new infections across the country.
XBB.1.5’s ascent is overtaking other Omicron variant cousins BQ.1 and BQ.1.1, which had dominated a wave of infections over the fall. Scientists believe its recent growth could be driven by key mutations on top of what was already one of the more immune evasive strains of Omicron to date.
“We’re projecting that it’s going to be the dominant variant in the Northeast region of the country and that it’s going to increase in all regions of the country,” said Dr. Barbara Mahon, director of the CDC’s proposed Coronavirus and Other Respiratory Viruses Division, in an interview with CBS News.
Mahon said the agency had not listed XBB.1.5 separately in its earlier projections because the strain had not cleared a minimum threshold in the underlying sequences collected by the agency.
The agency’s 40.5% figure is only a projection, Mahon stressed, with a probability interval ranging right now from 22.7% to 61.0%.
XBB.1.5’s prevalence is largest in the Northeast, the agency estimates. Most of the earliest cases from XBB.1.5 recorded in global databases through early November were sequenced around New York and Massachusetts.
More than 70% of infections in the regions spanning New Jersey through New England are now from XBB.1.5, the agency is projecting.
An increase in hospitalizations
The ascent of XBB.1.5 comes as COVID-19 hospitalizations have accelerated across the U.S. in recent weeks. The pace of new admissions is now worse than this past summer’s peak in several regions, but still lower than at this time last winter.
“There’s no suggestion at this point that XBB.1.5 is more severe. But I think it is a really good time for people to do the things that we have been saying for quite a while are the best ways to protect themselves,” said Mahon.
This month, the Northeast has recorded some of the worst COVID-19 hospital admission rates out of any region in the country. In New England, the CDC says new hospitalizations among Americans 70 and older have climbed to the highest levels seen since early February.
Around 13% of Americans are currently living in areas of “high” COVID-19 Community Levels, where the agency currently urges masking. Los Angeles, Miami, and New York City rank among the biggest counties now at these levels.
Mahon said XBB.1.5’s mutations could be part of driving the increase where XBB had failed to gain a foothold. But she added that other factors, like the higher risk posed by respiratory viruses during the winter holiday season, could also be playing a factor.
Mahon cited the agency’s recommendations to seek out updated COVID booster shots, as well as taking other precautions like improving ventilation, testing before gathering, or masking in high COVID areas.
“So that advice doesn’t change at all. And this time of year is a really good time to be following that advice,” said Mahon.
Ungrouping XBB.1.5 from XBB
The XBB.1.5 strain is a spinoff of the XBB variant, itself a “recombinant” blend of two prior Omicron strains, which drove a wave of infections overseas earlier this year.
Earlier this year, the Biden administration had voiced optimism that XBB was unlikely to dominate infections in the country. South Asian nations like Singapore reported that strain appeared to pose a lower risk of hospitalization relative to earlier Omicron variants.
After it was first spotted in the country, XBB had made up a small fraction of U.S. cases for several weeks despite appearing in a growing share of variants from arriving international travelers.
Then over the past month, XBB’s prevalence began to swell in the CDC’s estimates. These figures are released weekly in “Nowcast” projections based on the sequences that authorities have gathered so far.
Now, the CDC says that increase was driven largely by XBB.1.5. After ungrouping XBB.1.5, the agency estimates all other XBB infections currently make up just 3% of cases nationwide.
Beyond its parent, XBB.1.5 has an additional change called S486P. Chinese scientists have reported the mutation appears to offer a “greatly enhanced” ability to bind to cells, which could be helping drive its spread.
“We’ve been tracking XBB for weeks as I said, and it was XBB and XBB.1, and they really weren’t taking off. They weren’t increasing rapidly in proportion,” said Mahon.
Vaccines, treatments, and tests
Before evolving into XBB.1.5, XBB had already ranked among the strains with the largest immune-evasion relative to earlier major Omicron strains. Scientists in Japan reported this week that XBB appeared to be “the most profoundly resistant variant” to antibodies from breakthrough infections of any lineage they had tested.
Like BQ.1, XBB is resistant to a roster of monoclonal antibody drugs that doctors had relied on earlier in the pandemic before they were sidelined by new variants.
Data from a team of federally-backed researchers earlier this year found the current batch of updated bivalent boosters appear to offer better “neutralizing activity” Omicron variants, including XBB, when testing antibodies in the blood of people who got the updated booster compared to after only the original vaccines.
“We expect that the bivalent booster will provide protection against XBB.1.5 as it has against other Omicron subvariants. And if people haven’t gotten it yet, this is a great time to do it,” Mahon said.
However, antibody responses in that study were also worse for XBB compared to the other strains they studied.
“The XBB.1.5 variant would look similar to the XBB we tested in our study. The R346T/I mutation within the spike increases the ability of the virus to evade antibodies more efficiently,” Emory University’s Mehul Suthar told CBS News in an email.
For antiviral drugs like Pfizer’s Paxlovid, data from another team of scientists in Japan suggest they will retain efficacy against XBB.
“With what we know so far, XBB.1.5 has not acquired any new mutations in the viral protein targeted by Paxlovid. The susceptibility of XBB.1.5 against Paxlovid should not change given the current data,” the University of Wisconsin-Madison’s Peter Halfmann, one of that study’s authors, told CBS News in an email.
And for tests, the Food and Drug Administration warned Thursday on its website that one home collection kit — DxTerity’s saliva test for the virus — had been discovered to have “significantly reduced sensitivity” to variants with XBB’s mutations.
“We will update the page when significant new information becomes available, including when the FDA’s analyses identify tests for which performance may be impacted for known SARS-CoV-2 variants,” Jim McKinney, a spokesperson for the regulator, said in a statement.
Alexander Tin
CBS News reporter covering public health and the pandemic.
New study says some varieties of dark chocolate contain potentially hazardous heavy metals
New study says some varieties of dark chocolate contain potentially hazardous heavy metals
02:19
Hershey’s misled buyers of its dark chocolate by not disclosing the products contain lead and another potentially harmful chemical, according to a lawsuit filed against the candy maker.
Nassau County, New York, resident Christopher Lazazzaro said he would not have bought dark chocolate products sold by Hershey had it revealed the bars contains lead and cadmium, according to the suit filed Wednesday in federal court in Central Islip, New York.
Lazazzaro relied on the company’s presentation of its candy bars as containing only dark chocolate ingredients and as safe for consumption, according to the legal filing. Instead, he purchased and paid more than he would have had he known “the truth about the products,” the suit states.
The proposed class action comes two weeks after Consumer Reports published research showing potentially dangerous levels of heavy metals in multiple brands of dark chocolate, including Hershey’s, Godiva, Lindt, Trader Joe’s and Scharffen Berger.
Heavy metals in 28 popular brands
Scientists at the nonprofit advocacy organization recently measured the amount of heavy metals in 28 popular brands of dark chocolate bars and found cadmium and lead in all of them. For 23 of the bars, consuming just an ounce a day would put an adult over a level for at least one of the metals that could be harmful, CR said. Five of the bars were above those levels for both cadmium and lead.
Long-term exposure to even small amounts of heavy metals can lead to a slew of health issues, including developmental problems and brain development in young children, experts say.
Conversely, dark chocolate has long been viewed as a healthier option than milk chocolate and other treats, with studies finding it contains antioxidants that might help prevent heart disease.
Children’s clothes from popular retailers recalled over lead poisoning risk
00:19
In determining the risks for the chocolate it tested, CR used California’s maximum allowable dose level of 0.5 micrograms for lead and 4.1 micrograms for cadmium, as there are no federal limits.
CR found that an ounce of Hershey’s Special Dark Mildly Sweet Chocolate contained lead 265% above what California allows. The company’s Lily’s Extra Dark Chocolate 70% Cocoa product had lead 144% above the allowable level, and Lily’s Extreme Dark Chocolate 85% Cocoa product contained lead and cadmium that were 143% and 101%, respectively, above the state’s limit, the consumer group concluded.
A spokesperson for Hershey’s did not immediately respond to a request for comment to the suit. The company previously deferred to the National Confectioners Association (NCA) for comment about CR’s findings. In a statement earlier this month, the trade group objected to CR’s use of heavy metal levels set by California, noting that the state does not set federal food safety standards.
“The products cited in this study are in compliance with strict quality and safety requirements,” an NCA spokesperson said in an email to CBS MoneyWatch. “Food safety and product quality remain our highest priorities and we remain dedicated to being transparent and socially responsible.”
The Justice Department is suing AmerisourceBergen Corp., accusing the pharmaceutical giant of helping fuel the opioid epidemic by allegedly repeatedly failing to report suspicious orders of opioids for nearly a decade.
Federal law requires opioid makers to alert the Drug Enforcement Administration to any suspicious orders or “red flags” to help identify pharmacies that divert drugs to illegal avenues. The law also requires makers to refuse to ship orders it deems suspicious.
The civil complaint, filed in federal court in Philadelphia, alleged AmerisourceBergen and two of its subsidiaries failed to comply with these laws and could have failed to report hundreds of thousands of potentially suspicious orders.
The company is accused of ignoring alerts from its red flag system and continuing to sell to pharmacies, knowing they might be diverting some prescription drugs to illicit markets. The lawsuit also alleged AmerisourceBergen intentionally altered its own internal monitoring system to limit the alert system. In one year, the company spent more on taxis and office supplies than on the internal monitoring system, the Justice Department said.
“[T]he company’s repeated and systemic failure to fulfill this simple obligation helped ignite an opioid epidemic that has resulted in hundreds of thousands of deaths over the past decade,” DEA Administrator Anne Milgram said in a news release Thursday.
AmerisourceBergen’s alleged crimes could be billions of dollars in violations, according to a Justice Department official.
In a statement, the company said the Justice Department’s lawsuit focuses on five pharmacies that are “cherry picked” out of tens of thousands of pharmacies it works with and ignores the DEA’s “absence of action.”
“In fact, AmerisourceBergen terminated relationships with four of them before DEA ever took any enforcement action while two of the five pharmacies maintain their DEA controlled substance registration to this day,” the company said.
The report said the F.D.A.’s approval process for Aduhelm was “rife with irregularities” and criticized Biogen for setting an “unjustifiably high price.”
Ian Hamilton is an associate professor of addiction and mental health at the University of York and Sally Marlow is an addictions researcher at King’s College London.
It’s a new year and many people are in the mood for making a fresh start. And that often means giving something up (cigarettes, alcohol, junk food). Unfortunately, the odds of sticking with new year’s resolutions are not good. Come February, 80% of people will have given up giving up. So what can we learn from the 20% who make it?
Some might just be lucky, but most – whether they realize it or not – will be using techniques based on scientific evidence. While you might feel you have little in common with people who overcome drug dependency, you can benefit from the techniques that have been shown to help this group.
The two Ps
Perseverance underpins most stories of successful change, and it can take anywhere from six to 30 attempts to quit for those dependent on drugs to become abstinent. While these numbers might seem off-putting, it’s important to be realistic about the need to persevere. Incremental change is known to be superior to overly ambitious targets – appealing as they might be.
This leads to the second “p” — planning. Conventional wisdom suggests that planning improves the chances of success, but there is evidence that unplanned attempts to quit smoking can be just as successful. Good news for anyone embarking on an impromptu attempt to change.
So although spontaneous attempts can be successful for smokers, picking the right day to start changing other habits is likely to play a part. We know that motivation and energy fluctuate, so think about when you will have maximum levels of both. Starting well gives the initial encouragement needed to get to day two.
Learn from lapsing
Having a lapse shouldn’t be viewed as a failure or used as an excuse to give up. It can be tempting to view change in a binary way — success or failure. Instead, view a lapse as an opportunity to gain insight, reflecting as honestly as possible on why the lapse happened and how this could be avoided or counteracted on the next attempt at change. Research has repeatedly shown us that these processes are crucial for changing ingrained habits, so much so that in the world of addiction, treatment is often referred to as “relapse prevention“, to acknowledge that treatment is as much about preventing the negative as it is accentuating the positive.
High levels of self-efficacy (a belief and confidence in personal ability) when trying to change behavior predict ultimate success. Factors that increase self-efficacy include self-talk (“I can do this”), previous success at changing other behavior or habits, and affirmations from others.
Cultural differences can influence how comfortable and skilled an affirmation is. The way Americans routinely affirm each other is in contrast to those in the U.K. who tend to be suspicious of affirmations.
Believing change is possible can be undermined by “anticipatory anxiety” – when a person expects and fears withdrawal symptoms when changing a habit, such as smoking. The anticipated discomfort is usually greater than the actual experience but can paralyze any attempt to test reality. Rather than focusing on what you are losing by giving up smoking or alcohol, think of what you will gain (more money, better sleep). A useful exercise to help assess personal benefits is the decision balance sheet.
Decision balance sheet.
Agency for Healthcare Research and Quality
Tell someone what you plan to do, you won’t want to let them or yourself down. Weight Watchers employ this type of social contract in some ways to encourage but also as a deterrent to relapse. Shame and guilt are powerful emotions that most people will try to avoid.
So when it comes to adopting a scientific approach to change, the evidence provides some helpful tips. Be prepared for several change attempts, don’t be too ambitious, don’t keep your change a secret and allow yourself to be complimented and encouraged.
Finally, today might be the right day to start. If you’ve only just decided, with motivation and energy on your side, your chances of ditching that bad habit are just as good as those who’ve spent weeks preparing. Making a change is relatively easy for most of us; maintaining that change is evidently a lot tougher. So while some might be lucky enough to make a change and stick to it, most of us will have to keep trying. The science suggests we’ll get there in the end.
This article is republished fromThe Conversationunder a Creative Commons license and was originally published in 2020.
Travelers from China will need to test negative for COVID-19 before boarding flights to the U.S. starting next week, the Centers for Disease Control and Prevention announced Wednesday. The testing requirement will apply to travelers from mainland China, Hong Kong and Macau, and covers all passengers regardless of their nationality or vaccination status, the CDC said.
Americans should also “reconsider travel to China, Hong Kong, and Macau,” the CDC now urges. In a travel alert published Wednesday, the agency cited “reports that the healthcare system is overwhelmed,” along with the risk of new variants.
Beyond masking while traveling in places like airports or planes, the CDC also recommends that Americans visiting China wear masks while indoors in public.
The moves come amid a record wave of infections in China since it relaxed its “zero COVID” policy in early December. The Chinese government has also begun to ease travel restrictions that were imposed years ago, early in the COVID-19 pandemic.
“CDC is announcing this step to slow the spread of COVID-19 in the United States during the surge in COVID-19 cases in the [People’s Republic of China] given the lack of adequate and transparent epidemiological and viral genomic sequence data being reported from the PRC,” the CDC said in a statement.
Beginning Jan. 5, airlines will be required to collect proof of a negative COVID-19 test from all passengers ages 2 and older before they can board flights out of China into the U.S. Both lab-based PCR tests as well as antigen self-tests will be accepted, as long as they are overseen by a health care provider.
Travelers on connecting flights will also be required to provide proof of a negative test.
People traveling to the U.S. through South Korea’s Incheon International Airport, Canada’s Toronto Pearson International Airport, and Canada’s Vancouver International Airport will be required to test negative if they have been in China over the last 10 days.
“These three transit hubs cover the overwhelming majority of passengers with travel originating in the PRC and the Special Administrative Regions. We will continue to monitor travel patterns, adjust our approach as needed, and keep Americans informed in a timely manner,” the CDC said.
Federal health authorities have not required negative COVID-19 tests from any international visitors since the requirement was scrapped in June. The U.S. continues to require that all foreign travelers prove they are fully vaccinated with the primary series of a COVID-19 vaccine.
Officials said Wednesday that they were waiting until next week to impose the measure to allow for airlines to implement the revived requirements.
“It does take some effort by the airlines to update their data systems to put this all in place. And so we have to make this announcement today, but it will take time to implement the program,” a federal health official told reporters at a briefing.
Officials first acknowledged Tuesday that they were weighing the move, pointing to similar measures put in place on China by Japan and other countries. They also cited China’s own rules for arriving international travelers, which continue to require Americans and other foreign visitors to test negative.
“We’ve always believed that for all countries, COVID response measures need to be science-based and proportionate without affecting normal people-to-people exchange,” China’s foreign ministry spokesperson Wang Wenbin told reporters Wednesday ahead of the U.S. announcement.
Concern over COVID variants
In addition to the new requirement, the CDC said it is moving to expand its current variant surveillance efforts to two new international airports in Los Angeles and Seattle.
The agency has already been tracking variants over the past few months spotted in voluntary tests collected from arriving international travelers. Wastewater collected from some aircraft bathrooms are also now being tested for variants, the CDC says.
A total of some 290 weekly flights from China and nearby countries will be covered by the program once expanded, the CDC said.
“We have very limited information in public databases about variants that are circulating in China presently. In the past few months, only about a hundred sequences have been uploaded,” said the federal health official.
They cited the threat the virus could pose as it infects a vast swath of “immunologically naive” people in China.
“What we’re concerned about is a new variant that may emerge actually in China, with so many people in China being infected in a short period of time, there is a chance or probability that a new variant will emerge,” said the official.
Scientists have voiced frustration over sparse variant sequencing released from China amid the country’s current wave of infections, aside from a handful of travelers.
All of the current variants circulating in China are descendants of Omicron, Chinese state media have reported, quoting their country’s health officials, with BA.5.2 and BF.7 dominating infections in the country.
First spotted earlier this year, these two strains have made up a fraction of circulating virus in the U.S. to date. Instead, the CDC’s estimates rank the BQ.1, BQ.1.1, and XBB strains as far outpacing them around the country.
Infections linked to XBB has surged across the Northeast in recent weeks, climbing to more than half of new infections across the region. Ahead of Christmas, federal data shows hospitalizations reaching some of the highest rates since last February in the Northeast.
Scientists believe a descendant dubbed XBB.1.5 is behind the renewed surge, with immune evasive mutations that appear to bind well to human cells.
Alexander Tin
CBS News reporter covering public health and the pandemic.
Tokyo — Many hospitals and funeral homes say they’re being overwhelmed by a worsening COVID-19 outbreak in China, even as the government reports just a handful of new deaths from the virus. The surge in cases across China is drawing a response from other countries, including the U.S.
Japan, India, South Korea, Taiwan and Malaysia have already said they will require virus tests for visitors from China, and Japanese authorities have sharply restricted the number of flights to and from China.
U.S. officials are considering similar measures, with officials telling CBS News on Wednesday that concern is mounting over the rise in infections and the lack of transparent data from Beijing, which is making it increasingly difficult for public health officials to ensure that they’ll be able to identify any potential new variants and take prompt measures to reduce the spread.
Packed hospitals contradict China’s COVID-19 data
01:51
The U.S. officials told CBS News that, along with international partners, Washington was considering “potential steps” that could be taken to monitor the rising cases in China, identify any potential new variants of concern that emerge there, and “to protect the American people.”
Among the new restrictions imposed by Japan, travelers from China entering the country and found to have COVID-19 will have to quarantine at a designated facility for one week.
Japanese Prime Minister Fumio Kishida said the new restrictions were temporary — spurred by an information void about the true state of the pandemic in China.
Since dramatically reversing its years-old “zero-COVID” policy, which aimed to stamp out every case of the coronavirus, China has been lifting restrictions quickly. Authorities plan to remove all travel bans early next year — a move likely to trigger a flood of Chinese travelers abroad for the new year holiday after nearly three years of rolling lockdowns under the draconian zero-COVID approach.
News that international inbound travelers won’t have to go through quarantine, coupled with the lifting of a ban on passports being issued or renewed for Chinese nationals, have got people excited across the vast country.
Within 15 minutes of the policy change being announced, searches for popular international destinations had increased 10-fold, with popular Chinese travel booking site Qunar reporting a seven-fold increase in international flight searches.
But relief over the end of lockdowns in China has been tempered, and much of the nation is now in extreme distress. Some estimates suggest more than half of all residents in Beijing are currently infected with the virus.
New study estimates COVID deaths could reach 322,000 in China by April
05:05
Dr. Howard Bernstein said the hospital where he works in Beijing has run out of beds and “is just overwhelmed from top to bottom.
While Chinese officials say COVID has claimed only about 5,000 lives, recent scenes at funeral homes tell a grimmer story. The lines of coffins at one unidentified building in northern China this week seem endless.
By at least one estimate, the explosion of cases in China, where many people remain unvaccinated or under-vaccinated, could kill 1 million people by the end of 2023, and it is also threatening to unleash new, more dangerous mutations of the virus.
CBS News’ Tucker Reals, Gillian Morley and Shuai Zhang contributed to this report.
Millions of Americans gained Medicaid coverage during the pandemic. Starting next year, millions are likely to lose it.
The mammoth spending bill passed by Congress would allow states to kick some people off Medicaid starting in April. Millions would become uninsured, according to estimates from the administration and several health care nonprofits.
The Kaiser Family Foundation estimates that 15 million to 18 million people will lose Medicaid coverage — or about 1 in 5 people currently in the program. A December study by the centrist Urban Institute also estimated that 18 million people are set to lose Medicaid coverage next year and in 2024, leaving 3.8 million people without health insurance.
“The reality is that millions of people are going to lose Medicaid coverage,” said Jennifer Tolbert, the foundation’s associate director of the program on Medicaid and the uninsured.
Public health emergency
Since the coronavirus first struck in 2020, enrollment in Medicaid — the health insurance program for low-income people — has swelled by 20 million, to nearly 84 million people, according to KFF. That’s by design: When the administration first declared the public health emergency (PHE), it also barred states from kicking people off Medicaid.
In a normal year, many people enroll in Medicaid and many others leave as their income or circumstances change. States run routine checks on Medicaid members to make sure they’re still eligible for the program, and throw out anyone who isn’t. The public health emergency halted that process.
“There are lots of reasons people move on and off Medicaid, but what the PHE has done is, for the last few years, no one has moved off Medicaid,” Tolbert said.
New research says 100 million in U.S. saddled with debt from health care
05:24
The spending bill would allow states to start kicking people off starting April 1. The federal government will also wind down extra funds given to states for the added enrolees over the next year under the proposal.
“Unwinding the pandemic Medicaid continuous coverage provision is likely to be extremely challenging, and states have significant work to do to protect people from losing health coverage,” Allison Orris, senior fellow at the liberal-leaning Center on Budget and Policy Priorities, said in a recent blog post.
Before states remove Medicaid members, they are required to check patients’ eligibility and notify people if they’re losing coverage.
“What the state is required to do is use available electronic data sources to assess whether the person is still eligible for Medicaid. They will check things lke residency, do they still live in the state, what their current income and family situation is, and. based on that, do they still meet the eligibility requirements,” Tolbert said.
However, she added, it’s not unusual for people who are eligible for Medicaid to nonetheless get dropped from the program because of language barriers or administrative oversight. “Maybe at their annual renewal they missed a notice to provide documentation, or they didn’t know how to provide documentation,” she said.
Advocates have also raised concerns about how states will notify enrolees if they are being kicked off the program and what their options are. The effort will be particularly challenging for some of the country’s poorest people, who may not have a stable home address or access to internet or phone services to check their status.
Expanding postpartum Medicaid coverage in Michigan
04:40
When will people lose coverage?
The omnibus spending bill allows states to drop people from Medicaid starting April 1, but many will likely take longer. The Centers for Medicare and Medicaid has recommended that states take a full year to re-evaluate everyone in the program — although states are not required to follow that guidance.
“Moving these people off Medicaid isn’t going to happen on day one,” said Chris Meekins, an analyst with Raymond James who follows health care. “I expect red states have taken steps already to identify who they believe most likely to be ineligible, to target those people first,” he said.
Many people who lose Medicaid will be able to find other health insurance, such as through an employer, the Affordable Care Act marketplace or, in the case of kids, the Children’s Health Insurance Program. But about 5 million will remain uninsured — a potentially devastating situation.
“Those individuals don’t really have anywhere else to go to get coverage,” Tolbert said. “Because they remain eligible for Medicaid… they cannot go to the marketplace and get coverage.”
Even if those people eventually re-enroll in the program, experts fear that going without health insurance for months could be disruptive for anyone with ongoing health care issues.
“Maybe you go to your doctor’s office and find out you don’t have coverage, and you can’t get services that day because you need to reapply” for Medicaid, Tolbert said.
Health care advocates urge people who are on Medicaid to make sure their contact information is up to date on their accounts and that they check the mail frequently to keep an eye on their eligibility status as that April 1 date nears.
The spending bill also frees up additional funds to pay for more stable health insurance coverage for children in low-income households, by requiring states to keep those children on Medicaid for at least a year once they’ve enrolled.
The word “routine” can bring to mind words like mundane or ordinary. During the pandemic’s disruptions to daily life, routines may have felt boring and restrictive. However, as an occupational therapist and researcher of the impact of activity and participation on mental health, I know that routines can be powerful tools. They can support cognitive function, boost health and provide meaningful activities and social opportunities.
Early in the pandemic, researchers pointed to the value of daily routines to cope with change. As the two-year anniversary of the pandemic coincides with the relaxation of public health measures across the country, reflecting on routines and their value is useful when moving toward a “new normal.”
Routines support cognitive function
First, having a daily routine and regular habits supports cognitive function and may even free people up to be more creative. Research has found that having regular work processes allows workers to spend less cognitive energy on recurring tasks, which can support focus and creativity for more complex tasks.
Think of typical morning routines that existed before the pandemic: helping family members get on their way, taking a usual route to work, grabbing a warm beverage along the way, saying hello to coworkers, flipping on a computer or opening a calendar. Having habits like these can set the stage for a productive work day.
A review of the daily rituals of influential artists found that many artists have well-defined work routines which may support their creativity rather than constrain it. Memory research shows that regular routines and habits can support older adults to function better in their home environments.
If taking medications at the same time and putting the keys in their spot is part of a daily routine, less energy will be spent looking for lost objects and worrying about maintaining one’s health, freeing up time for other things people want to do in their day.
Routines promote health
Regular routines can also help people feel like they have control over their daily lives and that they can take positive steps in managing their health. For example, making time for exercise within routines can help meet recommended daily activity levels. This is especially relevant now, since research shows that people who reduced their activity levels during the pandemic could experience enduring health effects.
As people increase activity outside their homes, they might consider taking transit to school and work, returning to organized fitness activities and the gym and opportunities to include movement throughout the day. Other ways that routines can support health include regular meal preparation and getting enough sleep, activities that seem simple but can pay dividends in healthy aging over a lifetime.
Making time for exercise within routines can help meet recommended daily activity levels.
Shutterstock
Routines provide meaning
Regular routines can also go beyond the streamlining of daily tasks and add some spice to life. Evidence indicates that a health-promoting activity like walking can offer chances to enjoy nature, explore new places and socialize.
Research on the concept of flow, a state of full absorption in the present moment, shows that activities like sports, games, fine arts and music can be fulfilling and reinforcing. Regular participation in meaningful and engaging activities can also contribute positively to mental health.
Small steps to build routines
If you think your daily routines could use a tune-up, consider some small steps:
Use a day-timer or smartphone app to organize your activities and put the things you want to do in your schedule.
Choose a regular time to wake up and to go to bed and try to stick to it most days of the week.
Make physical activity manageable with neighborhood walks or bike rides a few times a week.
Start a new hobby or re-engage in a past one, like playing sports or games, making arts and crafts, playing an instrument or singing.
Keep an eye out for meaningful activities that may be popping back up in your community, like a book club at the library or a social walking group.
Routines have the power to help us manage our health and our work, home and community lives. Two years after the pandemic changed everyone’s lives, people now have an opportunity to consider the routines they want to keep and the meaningful things they need in their daily lives to stay productive, happy and healthy.
This article is republished fromThe Conversationunder a Creative Commons license.
Millions of Americans gained Medicaid coverage during the pandemic. Starting next year, millions are likely to lose it.
The mammoth spending bill passed by Congress would allow states to kick some people off Medicaid starting in April. Millions would become uninsured, according to estimates from the administration and several health care nonprofits.
The Kaiser Family Foundation estimates that 15 million to 18 million people will lose Medicaid coverage — or about 1 in 5 people currently in the program.
“The reality is that millions of people are going to lose Medicaid coverage,” said Jennifer Tolbert, the foundation’s associate director of the program on Medicaid and the uninsured.
Public health emergency
Since the coronavirus first struck in 2020, enrollment in Medicaid — the health insurance program for low-income people — has swelled by 20 million, to nearly 84 million people, according to KFF. That’s by design: When the administration first declared the public health emergency (PHE), it also barred states from kicking people off Medicaid.
In a normal year, many people enroll in Medicaid and many others leave as their income or circumstances change. States run routine checks on Medicaid members to make sure they’re still eligible for the program, and throw out anyone who isn’t. The public health emergency halted that process.
“There are lots of reasons people move on and off Medicaid, but what the PHE has done is, for the last few years, no one has moved off Medicaid,” Tolbert said.
New research says 100 million in U.S. saddled with debt from health care
05:24
The spending bill would allow states to start kicking people off starting April 1. The federal government will also wind down extra funds given to states for the added enrolees over the next year under the proposal.
Before states remove Medicaid members, they are required to check patients’ eligibility and notify people if they’re losing coverage.
“What the state is required to do is use available electronic data sources to assess whether the person is still eligible for Medicaid. They will check things lke residency, do they still live in the state, what their current income and family situation is, and. based on that, do they still meet the eligibility requirements,” Tolbert said.
However, she added, it’s not unusual for people who are eligible for Medicaid to nonetheless get dropped from the program because of language barriers or administrative oversight. “Maybe at their annual renewal they missed a notice to provide documentation, or they didn’t know how to provide documentation,” she said.
Advocates have also raised concerns about how states will notify enrolees if they are being kicked off the program and what their options are. The effort will be particularly challenging for some of the country’s poorest people, who may not have a stable home address or access to internet or phone services to check their status.
Expanding postpartum Medicaid coverage in Michigan
04:40
When will people lose coverage?
The omnibus spending bill allows states to drop people from Medicaid starting April 1, but many will likely take longer. The Centers for Medicare and Medicaid has recommended that states take a full year to re-evaluate everyone in the program — although states are not required to follow that guidance.
“Moving these people off Medicaid isn’t going to happen on day one,” said Chris Meekins, an analyst with Raymond James who follows health care. “I expect red states have taken steps already to identify who they believe most likely to be ineligible, to target those people first,” he said.
Many people who lose Medicaid will be able to find other health insurance, such as through an employer, the Affordable Care Act marketplace or, in the case of kids, the Children’s Health Insurance Program. But about 5 million will remain uninsured — a potentially devastating situation.
“Those individuals don’t really have anywhere else to go to get coverage,” Tolbert said. “Because they remain eligible for Medicaid… they cannot go to the marketplace and get coverage.”
Even if those people eventually re-enroll in the program, experts fear that going without health insurance for months could be disruptive for anyone with ongoing health care issues.
“Maybe you go to your doctor’s office and find out you don’t have coverage, and you can’t get services that day because you need to reapply” for Medicaid, Tolbert said.
Health care advocates urge people who are on Medicaid to make sure their contact information is up to date on their accounts and that they check the mail frequently to keep an eye on their eligibility status as that April 1 date nears.
The spending bill also frees up additional funds to pay for more stable health insurance coverage for children in low-income households, by requiring states to keep those children on Medicaid for at least a year once they’ve enrolled.
Grace Elizabeth Elliott was surprised when she got a $1,100 surgery bill from a hospital in Venice, Florida.
The California resident said she initially thought it was a scam but after calling the hospital discovered it was a result of a clerical error.
She was charged for a hospital visit by 81-year-old Grace A. Elliott who had done a shoulder replacement and rehabilitation services at Venice Regional Medical Center, later renamed ShorePoint Health Venice in 2021.
Grace E. Elliott’s information was still in the hospital’s database from a 2013 stay for a kidney infection while she was visiting family.
But despite the hospital admitting the error, Medical Data Systems, a debt collection agency, kept going after Grace E. for the debt.
Worried that this was going to impact her credit score, Grace E. appealed the bill — only to be denied. She tried again and was denied for a second time.
“The debt collector told me, ‘We can’t speak to you about this account. You need to talk to the hospital.’ And the hospital told me. ‘Well, we fixed everything,'” Grace E. said.
The debt collector kept billing the younger Grace Elliott and even sent her the older patient’s medical records.
Frustrated, Grace E. used that information to locate the original patient and inform her of what was happening.
“I wanted to let her know about all of this so that she could, No. 1, know that her personal information was out there,” she said.
After months of frustration, Grace E. asked Kaiser Health News to investigate and soon received a written apology from the hospital.
In a statement, ShorePoint Health told CBS News that “the hospital clearly made a mistake here. The error has been corrected and steps have been taken to ensure it will not happen again.”
Medical Data declines to comment about the case but told Kasier Health News that it “follows all state and federal rules and regulations.”
While Grace E. said the collection letters have stopped, she said that the entire ordeal was a stressful, drawn-out experience.
“We’re coming on a year later and that’s it’s wasted a lot of my time. This could have been fixed so easily,” she said.
Mark Canada is the executive vice chancellor for academic affairs at Indiana University Kokomo and Christina Downey is a professor of psychology at Indiana University.
If you’ve made a New Year’s resolution, your plot for self-improvement probably kicks into gear sometime on Jan. 1, when the hangover wears off and the quest for the “new you” begins in earnest.
But if research on habit change is any indication, only about half of New Year’s resolutions are likely to make it out of January, much less last a lifetime.
It combines insights from psychologists and America’s first self-improvement guru, Benjamin Franklin, who pioneered a habit-change model that was way ahead of its time.
With the “old year” approach, perhaps you can sidestep the inevitable challenges that come with traditional New Year’s resolutions and achieve lasting, positive changes.
First, if you lack the confidence to invest in a full-fledged effort, failure to achieve the goal may become a self-fulfilling prophesy. Furthermore, if you maintain the change but perceive progress as unacceptably slow or inadequate, you may abandon the effort.
The old year’s resolution is different. Instead of waiting until January to start trying to change your life, you do a dry run before the New Year begins.
How does that work?
First, identify a change you want to make in your life. Do you want to eat better? Move more? Sock away more savings? Now, with Jan. 1 days away, start living according to your commitment. Track your progress. You might stumble now and then, but here’s the thing: You’re just practicing.
If you’ve ever rehearsed for a play or played scrimmages, you’ve used this kind of low-stakes practice to prepare for the real thing. Such experiences give us permission to fail.
Psychologist Carol Dweck and her colleagues have shown that when people see failure as the natural result of striving to achieve something challenging, they are more likely to persist to the goal.
However, if people perceive failure as a definitive sign that they are not capable – or even deserving – of success, failure can lead to surrender.
If you become convinced that you cannot achieve a goal, something called “learned helplessness” can result, which means you’re likely to abandon the endeavor altogether.
Many of us unintentionally set ourselves up for failure with our New Year’s resolutions. On Jan. 1, we jump right into a new lifestyle and, unsurprisingly, slip, fall, slip again – and eventually never get up.
The old year’s resolution takes the pressure off. It gives you permission to fail and even learn from failure. You can slowly build confidence, while failures become less of a big deal, since they’re all happening before the official “start date” of the resolution.
A gardener weeding one bed at a time
Benjamin Franklin recorded his slip-ups over the course of a week. The Huntington Library, Art Museum, and Botanical Gardens
The Huntington Library, Art Museum, and Botanical Gardens
Long before he became one of America’s greatest success stories, Franklin devised a method that helped him overcome life’s inevitable failures – and could help you master your old year’s resolutions.
When he was still a young man, Franklin came up with what he called his “bold and arduous project of arriving at moral perfection.” With charming confidence, he set out to master 13 virtues, including temperance, frugality, chastity, industry, order and humility.
In a typically Franklinian move, he applied a little strategy to his efforts, concentrating on one virtue at a time. He likened this approach to that of a gardener who “does not attempt to eradicate all the bad herbs at once, which would exceed his reach and his strength, but works on one of the beds at a time.”
In his autobiography, where he described this project in detail, Franklin did not say that he tied his project to a new year. He also did not give up when he slipped once – or more than once.
“I was surpris’d to find myself so much fuller of faults than I had imagined; but I had the satisfaction of seeing them diminish,” Franklin wrote.
He made his progress visible in a book, where he recorded his slip-ups. One page – perhaps only a hypothetical example – shows 16 of them tied to “temperance” in a single week. (Instead of marking faults, we recommend recording successes in line with the work of habit expert B.J. Fogg, whose research suggests that celebrating victories helps to drive habit change.)
Repeated failures might discourage someone enough to abandon the endeavor altogether. But Franklin kept at it – for years. To Franklin, it was all about perspective: This effort to make himself better was a “project,” and projects take time
“A better and a happier man”
Many years later, Franklin admitted that he never was perfect, despite his best efforts. His final assessment, however, is worth remembering:
“But, on the whole, tho’ I never arrived at the perfection I had been so ambitious of obtaining, but fell far short of it, yet I was, by the endeavour, a better and a happier man than I otherwise should have been if I had not attempted it.”
Treating self-improvement as a project with no rigid time frame worked for Franklin. In fact, his scheme probably helped him succeed wildly in business, science and politics. Importantly, he also found immense personal satisfaction in the endeavor: “This little artifice, with the blessing of God,” he wrote, was the key to “the constant felicity of his life, down to his 79th year, in which this is written.”
You can enjoy the same success Franklin did if you start on your own schedule – now, during the old year – and treat self-improvement not as a goal with a starting date but as an ongoing “project.”
It might also help to remember Franklin’s note to himself on a virtue he called, coincidentally, “Resolution”: “Resolve to perform what you ought; perform without fail what you resolve.”
This article is republished fromThe Conversation, where it was first published in 2021, under a Creative Commons license.
From Jan. 8, visitors will be required to show only a negative P.C.R. test taken within 48 hours. The restrictions had cut the country off from the rest of the world for nearly three years.
Millions of Americans gained Medicaid coverage during the pandemic. Starting next year, millions are likely to lose it.
A mammoth spending bill just passed by Congress would allow states to kick some people off Medicaid starting in April. Millions would become uninsured, according to estimates from the administration and several health care nonprofits.
The Kaiser Family Foundation estimates that 15 to 18 million people will lose Medicaid coverage — or about 1 in 5 people currently in the program.
“The reality is that millions of people are going to lose Medicaid coverage,” said Jennifer Tolbert, the foundation’s associate director of the program on Medicaid and the uninsured.
A public health emergency
Since the coronavirus first struck, enrollment in Medicaid — the health insurance program for low-income people — has swelled from 71 million to 90 million, according to KFF. That’s by design: When the administration first declared the public health emergency (PHE), it also barred states from kicking people off Medicaid.
In a normal year, many people enroll in Medicaid and many others leave as their income or circumstances change. States run routine checks on Medicaid members to make sure they’re still eligible for the program, and throw out anyone who isn’t. The public health emergency halted that process.
“There are lots of reasons people move on and off Medicaid, but what the PHE has done is, for the last few years, no one has moved off Medicaid,” said Tolbert.
New research says 100 million in U.S. saddled with debt from health care
05:24
The spending bill would allow states to start kicking people off starting April 1. The federal government will also wind down extra funds given to states for the added enrolees over the next year under the proposal.
Before states remove Medicaid members, they are required to check patients’ eligibility and notify people that they’re losing coverage. However, it’s not unusual for people who are eligible for Medicaid to nonetheless get dropped from the program because of language barriers or administrative oversight, Tolbert said.
“Maybe at their annual renewal they missed a notice to provide documentation, or they didn’t know how to provide documentation,” she said.
Advocates have also raised concerns about how states will notify enrolees if they are being kicked off the program and what their options are. The effort will be particularly challenging for some of the country’s poorest people, who may not have a stable home address or access to internet or phone services to check their status.
Expanding postpartum Medicaid coverage in Michigan
04:40
When will people lose coverage?
The omnibus spending bill allows states to drop people from Medicaid starting April 1, but many will likely take longer. The Centers for Medicare and Medicaid has recommended that states take a full year to re-evaluate everyone in the program — although states are not required to follow that guidance.
“Moving these people off Medicaid isn’t going to happen on day one,” said Chris Meekins, an analyst with Raymond James who follows health care. “I expect red states have taken steps already to identify who they believe most likely to be ineligible, to target those people first,” he said.
Many people who lose Medicaid will be able to find other health insurance, such as through an employer, the Affordable Care Act marketplace or, in the case of kids, the Children’s Health Insurance Program. But about 5 million will remain uninsured — a potentially devastating situation.
“Those individuals don’t really have anywhere else to go to get coverage,” said Tolbert. “Because they remain eligible for Medicaid… they cannot go to the marketplace and get coverage.”
Health care advocates urge people who are on Medicaid to make sure their contact information is up to date on their accounts and that they check the mail frequently to keep an eye on their eligibility status as that April 1 date nears.
The bill also frees up additional funds to pay for more stable health insurance coverage for children in low-income households, by requiring states to keep those children on Medicaid for at least a year once they’ve enrolled.
A British historian, an Italian archaeologist and an American preschool teacher have never met in person, but they share a prominent pandemic bond.
Plagued by eerily similar symptoms, the three women are credited with describing, naming and helping bring long COVID into the public’s consciousness in early 2020.
Rachel Pope, of Liverpool, took to Twitter in late March 2020 to describe her bedeviling symptoms, then unnamed, after a coronavirus infection. Elisa Perego in Italy first used the term “long COVID,” in a May tweet that year. Amy Watson in Portland, Oregon, got inspiration in naming her Facebook support group from the trucker cap she’d been wearing, and “long hauler” soon became part of the pandemic lexicon.
Nearly three years into the pandemic, scientists are still trying to figure out why some people get long COVID and why a small portion — including the three women — have lasting symptoms.
Millions of people worldwide have had long COVID, reporting various symptoms including fatigue, lung problems, and brain fog and other neurological symptoms. Evidence suggests most recover substantially within a year, but recent data show that it has contributed to more than 3,500 U.S. deaths.
Here’s some of the latest evidence:
Women more at risk?
Many studies and anecdotal evidence suggest that women are more likely than men to develop long COVID.
There could be biological reasons.
Women’s immune systems generally mount stronger reactions to viruses, bacteria, parasites and other germs, noted Sabra Klein, a Johns Hopkins professor who studies immunity.
Women are also much more likely than men to have autoimmune diseases, where the body mistakenly attacks its own healthy cells. Some scientists believe long COVID could result from an autoimmune response triggered by the virus.
Women’s bodies also tend to have more fat tissue and emerging research suggests the coronavirus may hide in fat after infection. Scientists also are studying whether women’s fluctuating hormone levels may increase the risks.
Another possible factor: Women are more likely than men to seek health care and often more attuned to changes in their bodies, Klein noted.
“I don’t think we should ignore that,” she said. Biology and behavior are probably both at play, Klein said.
It may thus be no coincidence that it was three women who helped shine the first light on long COVID.
Pope, 46, started chronicling what she was experiencing in March 2020: flu-like symptoms, then her lungs, heart and joints were affected. After a month she started having some “OK” days, but symptoms persisted.
She and some similarly ill colleagues connected with Perego on Twitter. “We started sort of coming together because it was literally the only place where we could do that,” Pope said. “In 2020, we would joke that we’d get together for Christmas and have a party,” Pope said. “Then obviously it went on, and I think we stopped joking.”
Watson started her virtual long haulers group that April. The others soon learned of that nickname and embraced it.
Long COVID symptoms cost woman her job
02:29
Mono virus
Several studies suggest the ubiquitous Epstein-Barr virus could play a role in some cases of long COVID.
Inflammation caused by coronavirus infection can activate herpes viruses, which remain in the body after causing an acute infection, said Dr. Timothy Henrich, a virus expert at the University of California, San Francisco.
Epstein-Barr virus is among the most common of these herpes viruses: An estimated 90% of the U.S. population has been infected with it. The virus can cause mononucleosis or symptoms that may be dismissed as a cold.
Henrich is among researchers who have found immune markers signaling Epstein-Barr reactivation in the blood of long COVID patients, particularly those with fatigue.
Not all long COVID patients have these markers. But it’s possible that Epstein-Barr is causing symptoms in those who do, although scientists say more study is needed.
Some scientists also believe that Epstein-Barr triggers chronic fatigue syndrome, a condition that bears many similarities to long COVID, but that also is unproven.
Obesity
Obesity is a risk factor for severe COVID-19 infections and scientists are trying to understand why.
Stanford University researchers are among those who have found evidence that the coronavirus can infect fat cells. In a recent study, they found the virus and signs of inflammation in fat tissue taken from people who had died from COVID.
Lab tests showed that the virus can reproduce in fat tissue. That raises the possibility that fat tissue could serve as a “reservoir,” potentially fueling long COVID.
Could removing fat tissue treat or prevent some cases of long COVID? It’s a tantalizing question, but the research is preliminary, said Dr. Catherine Blish, a Stanford infectious diseases professor and a senior author of the study.
Scientists at the University of Texas Southwestern Medical Center are studying leptin, a hormone produced by fat cells that can influence the body’s immune response and promote inflammation.
They plan to study whether injections of a manufactured antibody could reduce leptin levels — and in turn inflammation from coronavirus infections or long COVID.
“We have a good scientific basis together with some preliminary data to argue that we might be on the right track,” said Dr. Philipp Scherer.
Long COVID may leave 1 in 5 people infected with coronavirus with long-term symptoms
06:15
Duration
It has been estimated that about 30% of people infected with the coronavirus will develop long COVID, based on data from earlier in the pandemic.
Most people who have lingering, recurrent or new symptoms after infection will recover after about three months. Among those with symptoms at three months, about 15% will continue to have symptoms for at least nine more months, according to a recent study in the Journal of the American Medical Association.
Figuring out who’s at risk for years-long symptoms “is such a complicated question,” said Dr. Lawrence Purpura, an infectious disease expert at Columbia University.
Those with severe infections seem to be more at risk for long COVID, although it can also affect people with mild infections. Those whose infections cause severe lung damage including scarring may experience breathlessness, coughing or fatigue for more than a year. And a smaller group of patients with mild initial COVID-19 infections may develop neurologic symptoms for more than a year, including chronic fatigue and brain fog, Purpura said.
“The majority of patients will eventually recover,” he said. “It’s important for people to know that.”
It’s small consolation for the three women who helped the world recognize long COVID.
Perego, 44, developed heart, lung and neurologic problems and remains seriously ill.
She knows that scientists have learned a lot in a short time, but she says “there is a gap” between long COVID research and medical care.
“We need to translate scientific knowledge into better treatment and policy,” she said.
Watson, approaching 50, says she has “never had any kind of recovery.” She has had severe migraines, plus digestive, nerve and foot problems. Recently she developed severe anemia.
She wishes the medical community had a more organized approach to treating long COVID. Doctors say not knowing the underlying cause or causes makes that difficult.
“I just want my life back,” Watson said, “and it’s not looking like that’s all that possible.”
Union Budget 2023-24: A Comprehensive Overview
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Introduction The Union Minister of Finance and Corporate Affairs, Smt.
Nirmala Sitharaman, presented the Union Budget 2023-24 in Parliament,
outlining a vi...
