WP Perspectives – December 27, 2022

The Dope: The Surging Fentanyl Scourge

The US Drug Enforcement Administration seized more than 379 million doses of illegal fentanyl this year—“enough deadly doses of fentanyl to kill every American,” the DEA’s chief said, as the agency struggles to clamp down on the drug’s staggering proliferation. 

The seizure included 10,000 pounds of fentanyl powder and 50.6 million fentanyl-laced pills—twice the number of tablets seized in 2021, the Washington Post reports.  

• The pills in particular are a potent threat: Teens are likely to encounter them disguised as ADHD medications and other prescriptions, making them especially vulnerable to exposure, reports Axios. 
• The flood of fentanyl correlates to a surge of US deaths: Deaths related to the drug have spiked 94% since 2019, a recent Post investigation found. 
• The pipeline has been expanded by Mexican drug-trafficking organizations, whose defeat the DEA described as its “top operational priority.” 

The Growing Expense of Gun Violence 

The toll of gun violence in the US is physical, mental, and—as more studies show—deeply financial.

• Go-Fund-Me can’t cut it: One study published this year found that the average of initial hospital charges for patients injured during a mass shooting between 2012 and 2019 was more than $64,900 per person.
• Hospitalization is just the beginning: Survivors of shootings need follow-up surgeries, therapies, and mental health care. Many are unable to return to work because of disabilities.
• Public cost: A 2021 report found that initial hospital costs for gun injury care surpassed $1 billion each year. 60% of patients in that study were on Medicaid or Medicare.

“We end up as a society paying a huge amount for these injuries,” said the lead author of another study on costs.    CNN 

All I want for Christmas is Dental Equity: Mounting Evidence and Need for Action

There is a tremendous amount of evidence demonstrating the very real existence of racial inequality in the area of dental care that is incongruous with the amount of attention the issue receives. That being said, this information has led to some progress in reducing obstacles to care — reaching as far back as ending segregation, as well as (more recently) positively affecting dental insurance coverage and patient education. Additionally, many broad efforts that employ community partnerships have also helped to narrow the gap of care. School-based dental sealant programs, for example, have been proven to be a cost-effective way to improve dental outcomes for many children who would have otherwise not received care. And several individual endeavors are also making inroads, especially in the area of mentoring aspiring African American dentists.

Yet, experts agree that before this imbalance of care can be corrected, its multitude of causes must be met with a multitude of solutions. One examination of the issue suggests the solution lies in intervention at all levels: financial support, structural change, conscious effort, and education; and must incorporate a ‘fundamental-social-cause approach’ that benefits all patients. Read more here Racial Disparity in Dental Care. The Numbers Tell the Story - Group Dentistry Now

Pamela Chitwood, Population Health Community Coordinator, Pamela.chitwood@vdh.virginia.gov 540-484-0292 ext. 223

Passing Over Women’s Pain. 
 
From the emergency room to the delivery room, women in pain are consistently dismissed by providers. 
 
  *   A “pain gap”: Women may be ignored for societal reasons, but there’s also poor understanding of women’s unique sensitivities to pain, which appear to be more pronounced than in men. 
 
  *   Blaming “hysteria”: Women complaining of pain are more likely to be considered “emotional” or “fabricating the pain,” research shows. 
 
  *   Further disparities: There’s also abundant evidence of racial bias in pain treatment, leading many Black women to face more skepticism from doctors. 
 
The consequences of ignoring this pain can affect outcomes for heart problems, chronic illnesses, stroke, cancer, and other neglected conditions. The Washington Post

Epidemiology is the science at center of public health.

Defenses down: COVID Antibodies in Nose Decline First  

Researchers think they’ve figured out why people can become reinfected with COVID-19, despite immunity gained from either vaccination or a previous infection.  

It turns out that antibodies produced in the nose — the first line of defense against respiratory viruses like COVID — 

decline faster than antibodies found in the bloodstream, British scientists say.  

Nasal antibodies tend to drop nine months after COVID-19 infection, while antibodies in the blood last at least a year, according to findings published online Dec. 19 in the journal eBioMedicine.  

The study also found that vaccination is very effective in creating and boosting blood-borne antibodies that protect against severe disease but had very little effect on nasal antibodies. Roanoke Times  12/21/22

What are the side effects of Paxlovid? 

Paxlovid is a pill authorized in December 2021 by the FDA and is one of the treatments used to combat a coronavirus infection. The antiviral treatment is commonly prescribed after a patient tests positive for the coronavirus and has a higher risk of becoming severely ill. The recommended dosage is three pills taken twice a day for five days. 

As with other medications and pharmaceutical treatments, there can be side effects, including a foul taste in the mouth that some refer to as “Paxlovid mouth.” According to clinical trials from the drug’s maker, Pfizer, an “altered sense of taste” was one of the possible side effects. Other reactions include diarrhea, muscle aches and abdominal pain. The good news is “Paxlovid mouth” should cease once a person stops taking the medication. 

Despite the possible side effects, recent studies have shown positive results after using this drug: A study published in November  found that the drug may reduce the likelihood of long COVID. The same month, the CDC  published findings showing the benefits of taking Paxlovid in the first five days after being infected with the coronavirus — there was a 51 percent lower hospitalization rate among those who received the treatment.   Washington Post 12/19/22 

Don't Kiss the Baby!  Close your mouth and step away from the human. 

Barack Obama did it. Donald Trump did it. Joe Biden, of course, has done it too. But each of them was wrong: Kissing another person’s baby is just not a good idea. 

That rule of lip, experts told me, should be a top priority during the brisk fall and winter months, when flu, RSV, and other respiratory viruses tend to go hog wild (as they are doing  right this very moment). “But actually, this is year-round advice,” says Tina Tan, a pediatrician at Lurie Children’s Hospital of Chicago. Rain, wind, or shine, outside of an infant’s nuclear family, people should just keep their mouths to themselves. Leave those soft, pillowy cheeks alone! 

A moratorium on infant smooching might feel like a bit of a downer—even counterintuitive, given how essential it is for infants and caregivers to touch. But kissing isn’t the only way to show affection to a newborn, and the rationale for cutting back on it specifically is one that most can get behind: keeping those same wee bebes safe. An infant’s immune system is still fragile and unlearned; it struggles to identify infectious threats and can’t marshal much of a defense even when it does. Annette Cameron, a pediatrician at Yale, told me she usually advises parents to avoid public places—church, buses, stores—until their baby is about six weeks old, and able to receive their first big round of immunizations. (And even then, shots take a couple of weeks to kick in.)  The Atlantic 12/20/22

We hope you had a safe and wonderful Christmas holiday! Our New Year's wish for you and everyone in our community is for health and wellness all year long! 

All West Piedmont Health District offices will be closed on January 2 and will reopen January 3, 2023.