WP Perspectives – December 27, 2022

Posted on December 22, 2022December 27, 2022 by krislandrum

COVID-19 treatment Paxlovid has been free so far. Next year, sticker shock awaits.

Nearly 6 million Americans have taken Paxlovid for free, courtesy of the federal government. The Pfizer pill has helped prevent many people infected with COVID-19 from being hospitalized or dying, and it may even reduce the risk of developing long COVID. But the government plans to stop footing the bill within months, and millions of people who are at the highest risk of severe illness and are least able to afford the drug — the uninsured and seniors — may have to pay the full price. https://www.pbs.org/newshour/
health/covid-19-treatment-paxlovid-has-been-free-so-far-next-year-sticker-shock-awaits Health 12/18/22

The Latest on the Latest Variants.

This comprehensive article talks about the latest variant symptoms, how long they last, and testing/isolation/ guidelines.

Prior immunity may play a role in symptoms appearing sooner after infection. That’s because the immune cells attacking the virus, rather than the virus itself, can be the cause of symptoms.

“Now that most of us have some combination of vaccine or infection that our immune system has seen Covid, it’s almost like you have an army of immune cells ready to pounce once the virus enters you,” said Dr. Joseph Khabbaza, a pulmonary and critical care physician at the Cleveland Clinic. Omicron subvariant symptoms: How quickly do omicron symptoms appear? (nbcnews.com)

Make My Test Count Project - This is a National Institutes of Health website for anonymous and secure reporting of BOTH positive and negative at-home COVID-19 test results. The goal is to see how fast and where COVID-19 is spreading, and to see where there are surges. For more information, visit the Make My Test Count website.

-According to a recent report, among immunocompetent adults aged ≥65 years who were hospitalized, a bivalent booster dose provided 73% additional protection against COVID-19 hospitalization compared with past monovalent mRNA vaccination only. To maximize protection against severe COVID-19 this winter, the authors recommend all eligible persons, especially adults aged ≥65 years, should receive a bivalent booster dose and consider additional prevention strategies, including masking in indoor public spaces. VDH 12/21/22

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.

WP Perspectives – December 19, 2022

Posted on December 15, 2022December 19, 2022 by krislandrum

Before and after you celebrate Christmas and New Years with friends and family, unwrap a little time to test for COVID-19. Free test kits will be given, first come-first served, on December 21 and 28 at:

Franklin County & Henry-Martinsville Health Departments - 2-5 p.m.
Patrick County Health Department - 1-4:30 p.m.

Two kits per person, or four kits per family. Persons picking up kits must be symptom-free. People who have no insurance, or who are under-insured are encouraged to pick up test kits.

Please note: this is NOT a drive-through event.

Immunization ROI

COVID-19 vaccines have saved over 3 million lives in the US and averted more than 18 million hospitalizations since they were first rolled out 2 years ago, according to an updated study published by the Commonwealth Fund.

The shots are also a massive money saver, allowing the country to avoid $1 trillion in additional medical costs. When considering the long COVID cases likely avoided because of vaccines, the actual savings are likely much greater, CNN notes.

The research underscores that the shots work best against severe illness and death than against infection itself. Without vaccines the country would have seen 4X more deaths from the virus and 3.8X more hospitalizations—but only 1.5X more infections.

The numbers: More than 3,500 Americans died of long-covid-related illness in the first 2½ years of the coronavirus pandemic, according to a CDC study released recently.
Why it matters: Millions of people still have symptoms three or more months after getting infected. This study highlights how serious that can be, particularly for older people.
Boosters still need a boost, officials caution: ~14% of eligible Americans have gotten theirs, according to the CDC.

Ho-Ho-Holiday! West Piedmont Health District will be closed Dec. 23 & 26 and Jan. 2 for the holidays. Stay safe, West Piedmont!

Pediatric Vaccine for Under Five

Parents of young children in Virginia are now able to seek a free bivalent pediatric COVID-19 vaccine for their children aged six months and older. The Pfizer-BioNTech bivalent vaccine, previously available only to persons aged five years and older, is now available for children aged six months through four years as a third primary series dose. At this time, children aged 6 months through four years who received three doses of Pfizer-BioNTech vaccine to complete their primary series are not authorized to receive a booster dose of bivalent vaccine. The Moderna bivalent vaccine, previously available for persons aged six years and older, is now available for children aged six months through five years as a booster dose at least two months after completion of a Moderna primary series.

VDH advises parents to discuss this option with their child’s healthcare provider. Vaccination opportunities may be found at Vaccinate.Virginia.gov. Information about all the COVID-19 vaccines authorized for administration in the U.S. is available at the VDH COVID-19 vaccine website. The Vaccinate Virginia Call Center is an additional source of information; call (877) VAX-IN-VA – (877) 829-4682 – Monday through Friday from 8 a.m. to 5 p.m. Information is available in English, Spanish and more than 100 other languages. TTY users should call 7-1-1.

Free COVID-Tests Offered Again

The White House has relaunched its COVID-19 home testing program as part of preparations for a wintertime surge of cases. Households can obtain four free at-home tests, which will be mailed for free starting the week of Dec. 19.

Place Your Order for Free At-Home COVID-19 Tests: Residential households in the U.S. can order one set of 4 free at-home tests from USPS.com. To order go to COVID.gov/tests.

Before You Throw Out "Expired" Tests: Check to see if your COVID-19 tests' expiration dates have been extended.

Detect Brand Kit Recall

Please note that several production lots of COVID-19 tests are being recalled because there is an increased chance they may give false negative results. (These are not part of the distribution mentioned above.) The FDA said the recall involves around 11,102 Detect COVID-19 Tests. The tests were shipped to customers from Jul 26, 2022, through Aug. 26, 2022. Detect Inc. says that while they have not received any reports of false positives, it is recalling the tests out of an abundance of caution. The lot numbers being recalled at HB264, HY263, and HY264 and can be found on the side of the box as shown below. The expiration date for all these kits is 1/1/23.

Anyone with the recalled COVID-19 tests should throw them away and contact Detect Inc. for a full refund. The company said if a person tries to use the recalled tests in the company’s app, they will be alerted about the recall. Anyone with questions can contact Detect Inc. at (855) 322 3692 or email the company at support@detect.com.

Inequities in the cost of pharmaceuticals.

The United States has the highest drug prices in the world and it’s not even close (to other countries' drug costs). For millions in the country, the cost of prescription drugs is an ever-growing barrier to proper disease treatment. This is most often the case for minority groups, who have long experienced disproportionally adverse health access and outcomes. But high drug prices alone do not explain the inequity we see. Though cost is a major factor, Colon, et al. found that disparities are not simply a function of socioeconomic status—the story is more complicated.

Minorities face many barriers to prescription medicines such as cost, lack of insurance and implicit racial bias in the prescribing practices. Though the Affordable Care Act (ACA) reduced the number of uninsured Americans, over 28 million remain without insurance. More than half (55%) of uninsured Americans under the age of 65 are people of color. For those with no insurance, paying retail prices for medications is often financially impossible. There are policy options for addressing racial disparities in access to prescription medication. Read more at Racial Disparities, Prescription Medications, and Promoting Equity - Public Health Post

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

“If you live in Martinsville/Henry County, we want to hear from you!” The West Piedmont Health District (WPHD) and its partners are looking for vital feedback from residents.

Through a brief online survey, area residents will be asked to share their input on quality-of-life issues. The public's comments will serve to guide important decisions made within three years. It is important to know where residents feel available funding should be invested, as well as the issues needing the most focus. The survey can be accessed via social media at WPHD Facebook, on the West Piedmont Health District website, and through this link: Community Equity Survey.

"We want to give everyone the opportunity to have a voice by sharing their opinions about the priorities needing the most attention over the next few years," said Project Leader Pamela Chitwood, Population Health Community Coordinator for the West Piedmont Health District. The survey will be available in English and Spanish. For census purposes, respondents will be asked to provide a street address. This will not be used for any type of identification as this information will remain confidential.

"We are striving to get an overwhelming response to this survey as it will serve as a guide to indicate what is most important to our residents," Chitwood said. "We are hoping the community will help us spread the word about this opportunity," she added.

Once all survey results are collected and analyzed, the results are expected to be shared during the spring of 2023. For information about the Henry County Equity Collaborative or the survey, please contact: Pamela Chitwood at pamela.chitwood@vdh.virginia.gov or (540) 484-0292 Ext. 223.

Opioids, Guns, the flu -- even loneliness are threats to community health.

In rural America, the deadly costs of opioids outweigh the dollars tagged to address them

Rural communities across America were harbingers of the opioid crisis. In the 1990s, misleading marketing by opioid companies helped drive up prescription rates, particularly in coal, lumber, and manufacturing towns across Appalachia and Maine. As painkillers flooded communities, some residents became addicted. Over time, they started using heroin and fentanyl, and the deadly epidemic spilled into suburbs and cities across the nation. Read more about this national, regional and local threat in Kaiser Health News.

Guns are the biggest kid-killer in this country.

Guns are now the No. 1 cause of deaths among American children and teens, ahead of car crashes, other injuries and congenital disease. In other rich countries, gun deaths are not even among the top four causes of death, a recent Kaiser Family Foundation report found. The U.S. accounts for 97 percent of gun-related child deaths among similarly large and wealthy countries, despite making up just 46 percent of this group’s overall population. … If the U.S. had gun death rates similar to Canada’s, about 26,000 fewer children would have died since 2010, according to Kaiser. But the trend has been going in the opposite direction: Gun deaths among teens and younger kids have gone up in the U.S., while they have declined elsewhere. . . The U.S. has more guns than people. New York Times 12/15/22

Flu season may be worst in a decade.

“As the country heads into its third pandemic winter, covid-19 cases are on the rise, and the 2022-23 flu season is shaping up to be the worst in a decade — there have already been 4,500 deaths from flu, including 14 children, according to the Centers for Disease Control and Prevention.” That’s why experts are renewing their advice to wear a high-quality medical mask on public transportation, in airports and on planes, while shopping and in other crowded public spaces. Washington Post 12/9/22

Loneliness can kill you.

The holiday season can be a time for community and family gatherings. But for some, it can be a season of more complicated feelings, including increased loneliness and isolation….A 2021 study from Morning Consult found that 58 percent of Americans are lonely. Some are lonely by circumstance and others by choice, but Dr. Jeremy Nobel (Harvard University) says societal expectations play a role in loneliness during the holiday season.

“It’s not just the isolation — it’s the expectation that’s created by culture, by advertising that the only normal way to be in the holidays, the only way to access joy and celebration is to be with others,”

Loneliness and isolation are often associated with their effects on mental and emotional health. But Nobel says it’s also important to understand the impact on physical health that can come from experiencing those feelings.

“What’s only recently come to light is that loneliness won’t just make you miserable, it’ll kill you. And not just from suicide or drug overdose, but from heart disease, cancer or other kinds of physical ailments,” Nobel said. “It turns out that loneliness increases risk of early death by 30 percent — as much as smoking 15 cigarettes a day.” Read more about the dangers of loneliness.

WP Perspectives – December 12, 2022

Posted on December 12, 2022December 12, 2022 by krislandrum

'Tis the Season . . . for overeating. And that's not good for you.

-Diets that draw more than 20% of daily calories from ultraprocessed foods could up the risk for cognitive decline, a study published yesterday in JAMA Neurology found; that adds up to ~400 calories (food for thought: the tally for a small order of fries and regular cheeseburger from McDonald’s? 530). CNN

-An analysis of post-mortem brain samples published yesterday in Nature Aging reveals a link between severe COVID-19 and changes in the brain that mimic markers of old age. Nature

-Emergency benefits for Virginia’s Supplemental Nutrition Assistance Program will continue through December, according to the Virginia Department of Social Services. Officials say the increased benefits will be loaded onto EBT cards on Friday, Dec. 16.

-Heads up, Henry County! Fatal drug overdoses continue to be the leading cause of unnatural death in Virginia since 2013, followed by gun and motor vehicle-related deaths, according to recent VDH data. Fatal overdoses are still projected to be higher than pre-pandemic. The Virginia areas with the most opioid overdose deaths in 2021 are Petersburg, Richmond, Hopewell and Portsmouth cities and Henry County, respectively, according to a VDH forensic epidemiologist.

Virginia localities can now get a look at the estimated money they will receive from multibillion-dollar national opioid settlements, to help with prevention and treatment in the ongoing opioid crisis. The recently established Opioid Abatement Authority released a lookup tool for localities to search the projected settlement funds estimated through fiscal year 2039.

COVID Updates

Yes, it's still with us....

Here we go again: For the first time in several months, another wave seems to be on the horizon in the United States. In the past two weeks, reported cases have increased by 53 percent, and hospitalizations have risen by 31 percent. Virus levels in wastewater, which can provide an advance warning of spread, are following a similar trajectory. After the past two years, a winter surge “was always expected,” Nash said. Respiratory illnesses thrive in colder weather, when people tend to spend more time indoors. Thanksgiving travel and gatherings were likewise predicted to drive cases, Anne Rimoin, an epidemiologist at UCLA, said. If people were infected then, their illnesses will probably start showing up in the data around now. “We’re going to see a surge [that is] likely going to start really increasing in velocity,” she said. . . . It is maddening that, this far into the pandemic, “stay put and watch” seems to be the only option when cases start to rise. It is not, of course: Plenty of tools—masking, testing, boosters—are within our power to deploy to great effect. They could flatten the wave, if enough people use them. “We have the tools,” said Nash. The Atlantic 12/9/22

-On November 22, the Biden Administration announced a six-week campaign through the end of the year urging Americans to get their updated COVID-19 vaccine. ● As winter and holiday gatherings approach, more Americans getting their updated vaccine will help avoid thousands of preventable COVID-19 deaths. ● The six-week campaign will focus on reaching seniors and the communities that were hardest hit by COVID-19, by making it even more convenient to get vaccinated and increasing awareness through paid media. VDH 12/8/22

-On December 8, the FDA amended the emergency use authorizations (EUAs) of the updated (bivalent) Moderna and Pfizer-BioNTech COVID-19 vaccines to include use in children down to 6 months of age. ● Children 6 months through 5 years of age who received the original (monovalent) Moderna COVID-19 Vaccine are now eligible to receive a single booster of the updated Moderna COVID19 Vaccine two months after completing a primary series with the monovalent Moderna COVID19 Vaccine. ● Children 6 months through 4 years of age who have not yet begun their three-dose primary series of the Pfizer-BioNTech COVID-19 Vaccine or have not yet received the third dose of their primary series will now receive the updated (bivalent) Pfizer-BioNTech COVID-19 vaccine as the third dose in their primary series following two doses of the monovalent Pfizer-BioNTech COVID19 Vaccine. ● Children 6 months through 4 years of age who have already completed their three-dose primary series with the monovalent Pfizer-BioNTech COVID-19 Vaccine will not be eligible for a booster dose of an updated bivalent vaccine at this time. VDH 12/8/22

What Is Health Equity? A Definition

Starting with the same glossary of terms is important. For general purposes, health equity can be defined as:

Everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.

The following should be added when the definition is used to guide measurement; without measurement there is no accountability:

For the purposes of measurement, health equity means reducing and ultimately eliminating disparities in health and its determinants that adversely affect excluded or marginalized group.

This definition comes to us from Robert Wood Johnson Foundation’s (RWJF) Culture of Health Action Framework Measuring What Matters.

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

‘Willpower Does Not Differ by Neighborhood’

Philadelphia Health Commissioner Cheryl Bettigole called on public health leaders and society at large to revisit their perceptions of American youth amid nationwide crises of overdose, gun violence, and youth mental health.

Speaking at the 5th annual Bloomberg American Health Summit recently in her city, Bettigole said adolescence is an “amazing moment” where public health professionals can change the course of a person’s life. But too often, teens are viewed “as individual bad actors who are responsible for their own problems through bad decisions,” she said. “Willpower does not differ by neighborhood,” said Bettigole. “The urge to pick up a gun has everything to do with the things around the teen and not the teen themselves.” Bettigole urged public health practitioners to dig into the systemic contributors to the challenges youth face—from lead poisoning and asthma to drugs and, of course, gun violence. Global Health News 12/7/22

WP Perspectives – December 5, 2022

Posted on December 5, 2022December 5, 2022 by krislandrum

A post-Thanksgiving uptick in COVID-19 patients at U.S. hospitals is arriving even as health systems contend with waves of feverish, coughing people stricken with RSV and influenza infections. COVID hospitalizations last week reached their highest level in three months, with more than 35,000 patients being treated, according to Washington Post data tracking. National hospitalizations had stagnated throughout fall but started rising in the days leading up to Thanksgiving. All but a few states reported per capita increases in the past week. 12/5/22

Here We Go . . . Misinformation on the Rise

For Long COVID, Stock Up On … Crushed Worms?

Earthworm extract. Horse dewormer. Blood washing.

They’re just a few of the unorthodox, expensive, and potentially harmful so-called treatments being purchased by long COVID sufferers desperate for relief from debilitating symptoms. Frustrated by the slow pace of government-sponsored science and months-long clinic waits, some long COVID patients are seeking remedies—primarily unproven and unregulated—on their own. . .

Twitter content policy change fuels rise in misinformation

As of last week, Twitter has stopped enforcing its COVID-19 misinformation policy, which allowed users to flag content promoting false or misleading information about COVID-19 for review and potential removal from the platform.

Twitter’s COVID-19 guidelines were launched in January 2020 to combat misinformation in real time and make it easier for users to find accurate information about COVID-19 on the platform. The rules, while imperfect, have led to the suspension of over 11,000 accounts circulating COVID-19 misinformation. With the end of the policy, some large accounts that fueled early waves of COVID-19 misinformation and contributed to enduring vaccine hesitancy have returned to the site. Other prominent anti-vaccine accounts that have been flagged by public health and fact-checking organizations are expected to return soon. Public Health Communications Collaborative 11/29/22

It's More Than Just a Number

If asked to predict life expectancy, you might think to factor in genetics, habits, gender, or even profession. But a strong determinant of life expectancy is simply a five-letter zip code.

The average life expectancy in the United States of America is 77 years old, but there is significant variation in that average if you look at individual neighborhoods. The data shows that life expectancy gaps in neighborhoods within the same city can be as drastic as 30 years.

Access to healthy food, medical care, stable jobs, quality education, and safe housing is not equitably distributed or available across all neighborhoods. Residents of low-income communities are more likely to develop chronic health conditions and be less healthy than their higher-earning counterparts.

Like with everything in life, statistics and averages do not have to define an individual. We must, as a society, create equitable opportunities for health and well-being regardless of socioeconomic status, race, or geography.

Learn more at Zip Codes are connected to life expectancy. @helunahealth.org

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

Monkeypox Name Change: The World Health Organization (WHO) announced it will adopt “mpox” in place of the “monkeypox” naming convention. Both names will be used simultaneously for one year while “monkeypox” is phased out. Mpox will become a preferred term, replacing monkeypox, after a transition period of one year.

- WHO will adopt the term “mpox” in its communications, and encourages others to follow these recommendations, to minimize any ongoing negative impact of the current name and from adoption of the new name.
- Reasoning for this change included “rationale, scientific appropriateness, extent of current usage, pronounceability, usability in different languages, absence of geographical or zoological references, and the ease of retrieval of historical scientific information.” Virginia Department of Health – 11/28/22

Epidemiology is the science at center of public health.

Not Vaccinated for MMR? Think Again . . .

There were 46 cases in Greater Columbus (Ohio) as of last Wednesday, according to the Columbus Public Health dashboard.... "The message is clear: If you have a child who is 12 months of age and older and has not received their MMR (measles, mumps and rubella) vaccine, please make every effort you can do to get them vaccinated this week," …. All 46 children were unvaccinated for the measles, with 19 hospitalized for the illness. Fifty-four percent of infections have occurred in children between the ages of 1 and 2, and 17% of cases occurred in children between the ages of 3 and 5. Eighteen of those cases occurred at schools and day cares….

About one in five people in the U.S. who get measles will be hospitalized, according to the CDC. About one in 1,000 people who contract the measles could develop brain swelling, which could lead to serious brain damage, according to the agency…..The disease is also highly contagious as around 90% of unvaccinated individuals who are exposed to measles will become infected, according to Columbus Public Health and Franklin County Public Health. Symptoms of the measles include fever, cough, rash, runny nose and red or watery eyes. The Columbus Dispatch 11/30/22

WP Perspectives – November 28, 2022

Posted on November 26, 2022November 28, 2022 by krislandrum

“You can decide to trust America’s physicians or you can trust some random dude on Twitter.”

-- Ashish Jha, the White House COVID-19 coordinator.

The new booster added 30%–56% protection against symptomatic infection—depending on the number and timing of prior vaccinations, and the person’s age.
The previously unboosted saw the biggest benefit—but even those boosted in the summer demonstrated 30%–40% greater protection with the updated booster than those who skipped. Global Health News 11/23/22

Reporting at home COVID-19 test results is now easier thanks to the National Institutes of Health. MakeMyTestCount.org allows users to anonymously report the results of any brand of at-home COVID-19 test.

COVID-19 testing remains an essential tool as we head into the holiday. While taking a rapid COVID-19 test is now common, test results are not often reported. COVID-19 test results provide valuable data that public health departments can use to assess the needs and modify the responses in the local community, the state or the nation.

The US had “higher COVID-19 death rates and excess, all-cause mortality” than 20 peer countries from mid-2021 to early this year, according to a new JAMA study; adjusting for population size, the US had 155,000 to 466,000 more deaths than peer nations. CIDRAP

Six Easy Steps . . .

The coronavirus threat that kept many home the last two holiday seasons isn’t gone, and it’s joined by more respiratory illnesses like the flu and respiratory syncytial virus (RSV) that are sending people to the hospital this year. … Michelle Barron, senior medical director of infection prevention at UC Health in Colorado, said this time of year often brings norovirus outbreaks as well.

“People have been talking about the ‘tripledemic’” — referring to COVID, flu and RSV, a common virus that usually causes mild, cold-like symptoms — “I’m like no, this is just the season of grossness,” she said.

Six simple steps can help keep you and your family healthier as you visit friends and family during the holidays.

1 – Vaccinate for flu and COVID-19. Unfortunately there is still no vaccine for RSV.

2 – Be cautious. Stay home and/or away from crowds for a week before you travel or visit people who may be more vulnerable to illness.

3 – Mask while traveling/in crowds. Yes, it's no longer required by law, but be that person who takes the extra step for others.

4 – Wash. Are you washing your hands less than at the peak of the pandemic? Pick it back up!

5 – Test. Test for coronavirus three days before traveling and on the day of travel as a precaution.

6 – Bow out. If you aren't feeling your best or have symptoms, bow out. Don't be that person who makes everyone around you sick.

Washington Post 11/23/22. For details, read the article.

World AIDS Day is December 1 of every year, when we show support for people living with HIV and remember those we lost in the fight against HIV/AIDS. We also strengthen our resolve to end HIV.

Equity. The 2022 theme for World AIDS Day is “Putting Ourselves to the Test: Achieving Equity to End HIV.” Many still experience inequalities when accessing basic health services. Not everyone has the same opportunity for HIV testing, treatment, and even condoms. This is even truer for newer technologies, such as HIV pre-exposure prophylaxis (PrEP). PrEP for HIV is medicine given that prevents HIV.

We identified the first cases of HIV more than 40 years ago. Yet, there are many who do not know basic facts about HIV. Many do not know how to protect themselves and others from HIV. Stigma and discrimination remain a reality for many living with HIV.

West Piedmont Health District offers confidential AIDS/HIV Testing. Contact your local health department for times and appointments.

Dr. Anthony Fauci recently appeared at his final White House press briefing, as he prepares to leave government next month following a half-century on the front lines of the world's gravest public health crises.

Fauci, the director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Joe Biden, said “the final message I give you from this podium is that please, for your own safety, for that of your family, get your updated Covid-19 shot as soon as you’re eligible.”

…he said that he eventually expects the virus to reach low levels in the U.S., but how soon we get there depends on how many people continue to get vaccinated and boosted.

“We can get there with less suffering if we use the interventions that we have,” Fauci said. “If you want to let nature take its course, we’re ultimately going to get there but we’re going to loose a lot more people than we need to.” NBC Right Now 11/22/22

WP Perspectives – November 21, 2022

Posted on November 18, 2022November 18, 2022 by krislandrum

-The COVID-19 public health emergency will remain in effect until at least mid-January. The public health emergency was first declared in January 2020 and has been renewed every 90 days since. It helped get treatments and vaccines approved at breakneck speed and meant Americans did not have to pay for them. The extension ensures that policies such as expanded Medicaid benefits, telehealth coverage, and extra payments to hospitals and doctors will continue. Once the public health emergency ends, the federal government will stop paying for COVID-19 vaccines, tests and treatments, shifting the costs to the commercial sector. The Hill 11/14/22

-RSV hospitalizations in seniors is much higher than at any point in prior seasons. Doctors say kids infected by the latest surge are, in turn, infecting adults. ABC News 11/15/22

-Moderna said its targeted booster shot increases the body’s defense against omicron subvariants. “In blood drawn from people who received the bivalent booster, omicron-blocking antibody levels shot up 15 times higher than their pre-booster levels.” Washington Post 11/14/22

-Keeping indoor humidity levels at a “sweet spot” may reduce spread of COVID-19. A Massachusetts Institute of Technology (MIT) team reports that maintaining an indoor relative humidity between 40 and 60 percent is associated with relatively lower rates of COVID-19 infections and deaths. For perspective, most people are comfortable between 30 and 50 percent relative humidity, and an airplane cabin is at around 20 percent relative humidity. MIT News 11/16/22

-Traveling during the holidays? See below for tips on staying healthy.

-U.S. Antibiotic Awareness Week is November 18-24, 2022. During U.S. #AntibioticAwareness Week, #BeAntibioticsAware and learn when #antibiotics are needed and when they’re not. More about antibiotics. #USAAW22 Test your antibiotic knowledge. Take the quiz.

-More than 100,000 Americans missed work last month because of child-care problems, an all-time high that’s surprisingly even greater than during the height of the pandemic, according to new data from the Bureau of Labor Statistics. Washington Post 11/15/22

-Public schools that continued to require students to wear masks reported fewer coronavirus infections, Washington Post reports. The study was based on schools in the Boston area and found ending mask requirements was “associated with an additional 45 coronavirus cases per 1,000 students and staff members.”

Improve Your Indoor Air Quality to Defend Against a ‘Tripledemic’

Health Action Alliance 11/16/22

Nationally, doctor visits for flu-like illness are at levels we don’t usually see until late December, when the flu season hits its first peak. Hospitalizations for flu are higher now than at any similar point of the flu season since 2010.

Whether this means we’re in for a long, brutal flu season, or simply that the peak is coming earlier, is too soon to say.

On top of all this, COVID-19 levels are holding steady, and we are already seeing peak levels of respiratory syncytial virus (RSV) — putting the U.S. in what’s being called a “tripledemic.”

RSV is a common respiratory virus that usually causes mild, cold-like symptoms — but it can cause serious illness in young children, older adults and people with immunodeficiency.

WHAT COMPANIES CAN DO

Improving your indoor air quality through ventilation (bringing in outside air to dilute the virus) and filtration (removing virus particles from circulation) is one of the most effective actions you can take against COVID-19, RSV and the flu virus.

· Upgrade air filters. HEPA filters are best (capturing over 99.9% of COVID-sized particles). If that’s not an option, install filters rated MERV-13 or higher. MERV-13 filters are 85% efficient at capturing COVID-sized particles; MERV-14 are 90% efficient. By contrast, a MERV-8 filter is only 20% effective.

· Double up. A new study out of the University of Southern California indicates that running a portable air purifier with a HEPA filter at top speed while also running HVAC system with a MERV 13 or 14 filter can further “drastically” reduce COVID-sized particles in a classroom-sized room, in just 15 minutes.

· Do it yourself. As a temporary measure, you can build a simple air cleaner from HVAC filters and box fans.

· Ventilate ahead of time. Run the HVAC system at maximum outside airflow for 1-2 hours before and after the workplace is occupied, or at the end of the day.

· Assess your indoor airflow. Revisit the layout of workspaces (including employee movement) to ensure an airflow that moves from “clean” to “less clean” and not the other way around.

· Go further. Implement additional tips to improve ventilation from the Centers for Disease Control and Prevention and the Environmental Protection Agency.

THE BUSINESS CASE

· By investing $40 per person per year to double the ventilation rate, employers can recoup $6,000-$7,000 per person per year in higher productivity, apart from the protection from infectious disease.

· Having about twice as much clean air moving into rooms reduced sick leave by 35%, in a study of 4,000 employees in over 40 buildings.

The Importance of Smartphones for Lower-Income Americans

Often, we think of smartphones as a luxury only the upper and middle class can afford, but that simply isn’t the case. It may seem surprising, but many lower income families are switching to a mobile plan and abandoning broadband service to access the internet at home.

From 2013 to 2021, reliance on smartphones rather than broadbands increased from 12% to 27% for people with average incomes less than $30,000. In contrast, households with incomes over $100,000 increased from 5% to 6%. With such a variety of “pay as you go” plans and devices available to the public, purchasing a smartphone has become much easier—and more affordable—than it used to be. While wealthier Americans can diversify their internet usage across different devices (i.e tablets, laptops, mobile phones), smartphones have become the cheapest way for lower-income Americans to talk to their families, look for jobs, and access their bank accounts on the go.

Low-income families are far more likely than others to rely on a smartphone as their only internet connection. Think of ways you can connect by using this nationwide trend. Read more.

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

How to minimize coronavirus exposure while flying.

For the past 2½ years, travel has been upended by the pandemic, and this holiday season could lead to a surge of coronavirus infections. The COVID protocols we saw in 2020 and 2021 to limit exposures are no longer in place.

The biggest concern with flying is waiting in security lines and boarding and disembarking from the aircraft. Many planes are equipped with HEPA filters, and the circulation onboard helps to minimize the risk of infection.

But these filters do not guarantee that a person will not contract the coronavirus, which is why many health experts still recommend wearing masks during air travel and “throughout the entire flight,” according to Daniel Culver, a pulmonologist at the Cleveland Clinic.

Travelers can also protect themselves by being vaccinated. “Even if you get sick during your travels, the new vaccines will prevent you from becoming hospitalized,” Culver said. Washington Post 11/14/22

Ticks are still here.

In Virginia, the blacklegged tick can carry Lyme Disease, Powassan Virus and several other illnesses that you may not have heard about. These diseases can cause severe illness and some could be fatal if they aren’t treated. VDH has a tick activity dashboard and is asking citizens who find ticks on themselves to send them in to be identified as part of the Virginia Tick Survey.

WP Perspectives – November 14, 2022

Posted on November 11, 2022November 14, 2022 by krislandrum

-Telepsychiatry is available locally thanks to a grant from the Harvest Foundation to the Martinsville-Henry County Coalition for Health and Wellness. The program is in response to the growing need for access to psychiatric care, thanks in part to the effects of the COVID-19 pandemic. This is "especially important as we, unfortunately, live in a culture where often a negative stigma is attached to mental health symptoms and services..." according to a Harvest Foundation official. Cardinal News 11/11/22

-More than 5.6 million COVID vaccine and booster shots were administered in the past week, the highest seven-day total in the U.S. since January.

- Paxlovid, the antiviral pill that reduces the risk of hospitalization and death from COVID-19, also reduces the risk of long COVID, according to a new study by researchers at the US Department of Veterans Affairs. The study analyzed electronic records for more than 56,000 veterans with COVID-19, including more than 9,000 who were treated with Paxlovid within the first five days of their infection.

The analysis showed people treated with Paxlovid had a 26% reduced risk of developing several long COVID conditions, including heart disease, blood disorders, fatigue, liver disease, kidney disease, muscle pain, neurocognitive impairment and shortness of breath. CNN 11/6/22

For the best protection by Thanksgiving, get your flu and COVID vaccinations NOW!

It takes about two weeks for the vaccines and boosters to be fully effective, so if you plan to gather with friends and family during the holidays, it is best to get your shots as soon as possible.

Flu severity changes from year to year, but flu season always brings serious consequences. Flu outbreaks were limited in the 2020–2022 seasons due to widespread use of COVID-19 prevention measures like masks and social distancing. But flu viruses never went completely away. As COVID-19 prevention measures were relaxed, flu viruses and flu-related complications like pneumonia and heart attacks resurfaced. Flu outbreaks are unpredictable.

Virginia is rated as one of the states with very high levels of flu-like illnesses. Click the map to go to the CDC's FLUVIEW map, which is updated weekly.

Flu vaccination is the best way to prevent flu and its complications. Everyone age 6 months and older is recommended to get a yearly flu vaccine. This can markedly lower the risk of influenza-related illness, hospitalization, and death. And because flu and COVID-19 share many symptoms, preventing flu means fewer people will need to seek medical care and testing for flu and COVID-19, saving time, money, and stress. Flu vaccine may be given at the same time as COVID-19 vaccine.

Since flu, colds, COVID-19 and RSV share common symptoms such as fever; cough; fatigue; stuffy, runny nose; and congestion, this chart can help distinguish between the illnesses.

Besides vaccination, washing your hands, keeping the air fresh and circulating, and masking can help keep you healthy! -- Sources: CDC, Immunize.org

Create an equitable classroom environment - equity versus equality

Equity and equality in the classroom aren’t the same thing. Equality means every student gets the same resources and support, which sounds good in theory but doesn’t always work in practice. Imagine handing out a math assignment to students. Every student has their assignment, plus a calculator, pencil and paper. Equal, right?

But it’s not equitable.

To make the assignment equitable, teachers have to understand their students and provide targeted support. This could include helping ESL students understand instructions in an unfamiliar language, providing text-to-speech technology for visually impaired students or giving students with ADHD a quiet space to complete the assignment.

When you provide these supports for your students, you’re making sure physical ability, language skills and other needs don’t negatively impact their ability to do well. Equity often depends on a school’s culture and leadership, but there are always ways to promote it at a classroom level. Small classroom changes can have a big impact on teacher’s and their students. Equity isn’t just a one-time action, it’s an ongoing process that should be baked into the classroom expectations and procedures.

Equity in the classroom means making sure every student has the resources and support they need to be successful.

Learn more with the Hanover Research which highlights everyday ways teachers can promote equity in the classroom.

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

Epidemiology is the science at center of public health.

Return of the mask? What experts say about having kids mask up again amid rising RSV, flu cases.

girl getting vaccinated — Teen girl taking a selfie while taking vaccine.

For the past few years, COVID-19 has been a major concern heading into winter. But now, there's a so-called tripledemic of illnesses circulating — and cases are piling up.

Currently in the U.S., cases of the flu are starting to soar, with 9% of tests for viruses coming back positive for influenza, per data from the Centers for Disease Control and Prevention (CDC). The CDC also notes that 4.3% of visits to healthcare professionals right now are for a respiratory illness which is "above baseline."

At the same time, COVID-19 cases are ticking up again, per CDC data. That's not all, though. Cases of respiratory syncytial virus (RSV) are skyrocketing. A jaw-dropping 18.2% of tests for RSV have recently come back positive, according to the CDC, with a graph that tracks nationwide cases showing a near-vertical climb in the past few weeks.

Reports are trickling in of schools closing due to outbreaks of the flu, RSV and COVID, signaling that respiratory viruses are poised to bring some chaos this season. With all of that, it's understandable to have questions about whether you should put your child in a mask again to protect them against respiratory illness.

Dr. Betty Choi, a pediatrician, children’s book author and mother of two children in central California, tells Yahoo Life that she's having her 6- and 9-year-old kids mask up again after previously allowing them to go mask-free during small gatherings.

"Mask-wearing is a normal and simple public health strategy in many countries, well before the COVID-19 pandemic."

Read the entire article.

WP Perspectives – November 7, 2022

Posted on November 4, 2022November 5, 2022 by krislandrum

-Pfizer and BioNTech have started an early-stage study to evaluate a combination vaccine targeting COVID-19 and influenza. The single-dose vaccine candidate is a combination of Pfizer's mRNA-based flu shot and the companies' Omicron-tailored COVID-19 booster shot. The trial is being conducted in the United States and the companies aim to enroll 180 volunteers between the ages of 18 and 64. The first participant in the study was dosed last week. Rivals Moderna Inc (MRNA.O) and Novavax Inc (NVAX.O) are also developing combination vaccines targeting both COVID-19 and influenza. Reuters, 11/3/22

-George Mason University Launches Virginia's First College of Public Health. GMU announced the first and only College of Public Health in the Commonwealth of Virginia to meet the critical growing need for skilled, interdisciplinary health professionals and research across the state. With Mason's new College of Public Health, Virginia is now the 36th state in the country to have a College of Public Health and will benefit from increased community engagement, workforce development initiatives, and research of consequence with a focus on eliminating health disparities. Read about it.

Opioid Epidemic Cost Virginian’s Three And A Half Billion Dollars In 2020.

VDH’s online calculator shows the three and a half billion dollar economic impact to Virginia in lost labor, healthcare, crime and other costs in 2020, with an average of more than four people dying of an opioid drug overdose every day in the Commonwealth. The opioid cost calculator was developed by Virginia Commonwealth University, in hopes of helping support ongoing policy changes at the state and local levels.

Virginia families and businesses take on a large amount of these costs, mostly due to lost future worker productivity, according to the cost calculator. Federal, state, and local governments also see increased healthcare and government costs and lost future tax revenues. But by far, the human toll is the highest. Deaths from opioid drug overdose are estimated at nearly $1.9 billion. In calculating the economic costs of loss of life, it’s important to remember that these estimates do not include the value of lives lost, which are measureless.

For a closer look at how the epidemic hits here at home, visit the website. In the meantime, consider that Henry County and Martinsville rank among the localities with the largest impact per capita in the Commonwealth, and the highest overall of the regions served by the West Piedmont Health District (Henry County, Martinsville, Franklin County, and Patrick County).

What do mild, moderate and severe COVID symptoms mean? Many of these terms are subjective and can vary depending on the person. But providers consider severe COVID symptoms to be those requiring acute medical care or hospitalization.

“Moderate COVID symptoms often require the infected person to need more extensive rest, or they have more robust coughing, nasal congestion, fever, vomiting and diarrhea, but they can be cared for at home,” Priya Duggal, an epidemiologist from the Johns Hopkins Bloomberg School of Public Health, said. “Mild symptoms usually don't incapacitate the person, and although they are isolating, they have the energy and minimal symptoms to read, watch television or do remote work.”

Because COVID is an illness mainly targeting the respiratory system, one thing to be aware of is any changes to a person's breathing, which should raise a red flag.

“What we have said from the beginning is that you should be checking your oxygen levels (via [a] pulse ox) at home — and if those numbers are not near the high 90s, reach out to your doctor,” Duggal said. It's “the best way to determine how severe your symptoms are.”

According to the CDC, an adult or child should have oxygen levels between 95 and 100 percent. A health-care provider should be called if those numbers fall below that, based on a reading by a pulse oximeter, a device that measures the oxygen saturation of the blood. - Washington Post

Addressing and Managing Unconscious Bias

To better understand what unconscious bias is (also called implicit bias), it helps to have a basic understanding of the general concept of bias. Bias is a preference for or against something, someone, or group. Having biases isn’t necessarily a bad thing. Problems occur when a bias affects someone in a positive or negative way and creates an unfair advantage or disadvantage.

Unconscious bias can have a significant influence on any workplace decision — including hiring, recruiting, promotions, performance reviews, and discipline. Unconscious bias can also affect interactions with people outside of the organization, such as customers, vendors, partners, and association members. There are many different types of biases — based on a wide range of characteristics and assumptions — and all of them can result in poor decisions or discriminatory behavior. For example, dismissing a qualified candidate because they aren’t a good ‘cultural fit’ or have a ‘foreign sounding name.’

Increasing awareness and understanding of unconscious bias is an ongoing process. Monitor hiring policies and promotion criteria and include a diverse team to weigh in on key decisions to reduce the risk of implicit bias. Have a system for anonymously reporting incidents and conduct regular surveys to uncover unconscious bias. Also, regular discussions and conversations between different groups and departments, promoting mentoring and support, and creating a sense of belonging can also help reduce unconscious bias and its impact on workplace culture.

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

November is American Diabetes Month

In Virginia, more than 740,000 people are at a higher risk of severe complications from the flu that can lead to hospitalization or sometimes death, says the Centers for Disease Control and Prevention. In recent flu seasons, about 30 percent of adults with flu in hospitals had diabetes.

People who have diabetes have a higher risk of heart disease, stroke or other problems such as kidney failure, blindness, and amputation of a toe, foot, or leg.

Diabetes Month also is an opportunity to learn more about the disease and the challenges of managing diabetes.

One in three Virginians has prediabetes, and most do not know it. To learn whether you are at risk for prediabetes, take the Prediabetes Risk Test. Prediabetes can be reversed before it becomes Type 2 Diabetes.

WP Perspectives – October 31, 2022

Posted on October 28, 2022October 31, 2022 by krislandrum

-Healthy habits can help prevent the spread of infectious diseases, including flu, RSV, and COVID-19, this fall and winter. o Cover your cough and sneezes, o wash your hands often with soap and water to help stop the spread of germs and prevent respiratory illnesses. o Stay home from work and school when ill and stay away from people who are sick. o Improve ventilation and wear a mask if you are feeling ill and need to go out. o Stay updated on vaccines, including flu and COVID-19 booster shots. VDH 10/26/22

They say bad things come in threes . . .

RSV cases have more than doubled in 25 states, straining hospitals, CBS reported. . . Adults typically shake off RSV quickly, but it’s harder on young children with smaller, developing airways:

(As of this writing on 10/24) an estimated 58,000 children under 5 are hospitalized, and 100-500 children under 5 die of RSV annually in the US. There’s no government-approved vaccine.

Why is this year so bad? Pandemic precautions—masks, social distancing—were necessary because of COVID-19 but likely lowered resilience to other diseases. Plus, there are troubling signs that flu and COVID-19 are likely to rise sharply in the coming weeks, The New York Times reports.

Flu fears: Flu vaccination rates dipped slightly across all ages last year, per the CDC, especially among young kids.

COVID-19 concerns: US cases are still low, but climbing hospitalizations and deaths in Europe are a troubling omen.

Winter warning: Even if most COVID-19, flu and RSV cases are mild, the triple threat could overwhelm hospitals.

Experts advise flu shots and COVID-19 boosters, as soon as possible. Global Health News 10/24/22

Choosing Words Carefully

People who have cancer are not referred to as cancers; those with depression are not referred to as depressives, notes Lev Facher—but the vocabulary around addiction is very different, with judgment-laden words like “alcoholic” or “addict” commonplace.

Replacing stigmatizing labels with words that recognize addiction as a disease, not a moral failing, acknowledges that the people with addictions deserve to be treated as human beings.

It’s not about political correctness: It makes a big difference in the treatment they receive.

The Quote: “Those that use the most stigmatizing language, and also have the strongest negative associations [about people with substance use disorders], are health care professionals,” says researcher Robert Ashford. “It prevents opportunities to have meaningful conversations about getting help, because nobody wants to put themselves in a situation where they’ll be further discriminated against.” STAT

Ask yourself: Who gets better medical care in the United States: “addicts,” or “people with substance use disorders”?

-October marks National Youth Substance Abuse Prevention Month to highlight the vital role of substance abuse prevention in both individual and community health and to remember those who have lost their lives to substance abuse.

Millions of Americans suffer from substance abuse, which includes underage drinking, alcohol dependency, non-medical use of prescription drugs, abuse of over-the-counter medications, and illicit drug use. … Prevention strategies targeting the root of the problem are essential to curb drug use and help people lead healthier lives. Early intervention helps prevent substance abuse and reduce the negative consequences of addiction before they occur.

-VDH and the Virginia Commonwealth University (VCU) Center on Society and Health have developed an opioid cost calculator which estimates of how much the opioid epidemic costs Virginians in multiple categories: lost labor, healthcare, crime, household costs, state costs, and federal costs. The data from the calculator paints a more complete picture of the devastating impact of the opioid epidemic in Virginia and will be useful in supporting ongoing efforts for prevention and reduction activities at the state and local levels.

Epidemiology is the science at center of public health.

RSV is surging among kids—but scientists have a plan to stop it

RSV virus image from a microscope from the Public Health Image Library — Public Health Image Library: RSV virus through a microscope.

New antibody treatments and vaccine candidates promise long-awaited relief from the respiratory virus that’s a leading cause of childhood death worldwide.

In recent weeks, children’s hospitals across the United States have raised the alarm that their beds have filled up with young patients struggling to breathe and in dire need of oxygen. This year, the culprit is not coronavirus but respiratory syncytial virus—more commonly known as RSV.

RSV is not a new pathogen. The virus infects some 64 million people a year worldwide. But it poses a particularly high risk to adults over 65 and to children, who are more likely to require hospitalization. Globally, RSV causes about 160,000 deaths a year—including more than 100,000 children under the age of five. Still, there isn’t a vaccine for the disease or any treatments available for general use.

But solutions are on the way. Experts say that a monoclonal antibody treatment for RSV could be approved by the end of the year, and a vaccine could be rolled out in time for the 2023 RSV season.

National Geographic 10/27/22 Read the article to learn more.

The Great American Smokeout®

Quitting smoking isn’t easy. It takes time. And a plan. You don’t have to stop smoking in one day. Start with day one. Let the Great American Smokeout event on the third Thursday in November be your day to start your journey toward a smoke-free life. You’ll be joining thousands of people who smoke across the country in taking an important step toward a healthier life and reducing your cancer risk. Plus, the American Cancer Society can help you access the resources and support you need to quit.

November 17, 2022 is
The Great American Smokeout.

WP Perspectives – October 24, 2022

Posted on October 22, 2022October 22, 2022 by krislandrum

-"A CDC advisory committee on Thursday voted that the agency should update its recommended immunization schedules to add the COVID-19 vaccine, including to the schedule for children. But in the lead-up to the vote by the Advisory Committee on Immunization Practices, false claims spread widely that it would mean the vaccine would be required to attend school." - Fact Focus by ABC News Many other media, including the Martinsville Bulletin, have published articles about the recommendation and reactions. VDH has clarified that the CDC recommendation has "no direct, immediate impact on COVID-19 vaccine being added to the Immunization Schedule on school required vaccines in Virginia."

-Two new COVID-19 subvariants are gaining traction in the U.S. The CDC estimates two omicron subvariants, BQ.1 and BQ.1.1, accounted for 11% of new cases this past week. … “It really hit me. I had every single symptom and sign that you could possibly have. Now, I have a lingering cough that comes and goes," said Diane Gately, a nurse with the Chesapeake Health Department. … VDH Physician Specialist Doctor Brooke Rossheim said the preliminary data shows that BQ.1 and BQ. 1.1 have mutations that are better at evading immunity, whether from COVID-19 vaccines or prior infection to the virus. He said the new subvariants may also be more transmissible and the antibodies someone may have might not be enough to fight these strains. … ABC News Now

-U.S. regulators on Wednesday authorized a booster dose of the COVID-19 vaccine made by Novavax. The FDA said the new booster option is for people 18 and older who can’t get the updated omicron-targeting Pfizer or Moderna boosters for medical or accessibility reasons — or who otherwise would not receive a COVID-19 booster shot at all. The FDA specified the additional Novavax shot was to be used as a first booster — not for people who’ve already had one or more booster doses — at least six months after completing their primary shots. WFXR TV - AP 10/19

-US life expectancy continued to decline in 2021 even as other countries’ eked back up; data from 29 countries show that countries in Western Europe saw a big uptick in life expectancy, while the US reported the third-largest decline, following behind Bulgaria and Slovakia. USA Today

The High Costs of Couch Potato-ing

Half a billion people worldwide will develop a noncommunicable disease like diabetes or heart disease because of a lack of physical activity by 2030, according to WHO’s first-ever Global Status Report on Physical Activity.

Disturbing data:
*81% of adolescents and 27.5% of adults are not meeting WHO’s recommended physical activity levels.

*The cost of not exercising will add $27 billion in extra health care costs per year.

*47% of the new NCD cases will result from hypertension.

*43% will result from depression.

*Fewer than half of 194 countries studied have a national policy on physical activity; and of those, less than 40% were “operational.”

The prevention mission: Governments need to urgently promote exercise and its benefits, said WHO chief Tedros Adhanom Ghebreyesus, per The Guardian.

The evidence of exercise’s benefits is “convincing, cost effective and practical,” the report notes, adding that regular exercise trims the risk for premature death by 20% to 30%. Global Health News 10/19/22

What is Cultural Humility?

Cultural humility is the act of acknowledging one’s own biases and limitations in order to more deeply understand another culture.

It is not enough to be aware of one’s own cultural biases. One needs to be mindful of the differences in other cultures and how they may affect their interactions with others.

Cultural humility requires a certain level of self-awareness, empathy, and an understanding that people are different from one another. These traits make us more likely to understand how our actions affect others and how the way we live affects the world. If we are unable to identify when our cultural behavior is harmful, then this trait is not present in our daily lives. Cultural humility includes viewing oneself as being on a spiritual journey and learning from other cultures in order to grow spiritually.

Read on at The Difference Between Cultural Competence and Cultural Humility by Tasnim Sulaiman | May 12, 2022 | Health & Wellbeing

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

Giving Toledo, Brazil, a Shot

Last May, a researcher approached Gabriela Kucharski, the secretary of health in Toledo, Brazil, with a proposal from Pfizer: As part of a vaccination study in Brazil, the company wanted to find out if COVID-19 could be stopped by vaccinating an entire city. Was Toledo interested? Since COVID-19 vaccines were scarce in the country at the time, it was a boon she couldn’t turn away.

Knowing only 1 city of 8 could be chosen, Kucharski and colleagues got to work meticulously compiling metrics for the study application. Toledo got the vote.

Within a week of the vaccine rollout, ~1/3 of the city's population showed up for the shot. By January 2022, 91% of citizens ages 12+ were fully vaccinated, and as the next wave rolled in, the death rate plummeted tenfold.
NPR Goats and Soda

Epidemiology is the science at center of public health.

A new, deadlier form of fentanyl has arrived in Virginia, worrying officials charged with curbing Virginia’s resurgent opioid epidemic. The drugs are lab-made opioids known as nitazenes, and are estimated to be several times more potent than fentanyl, the opioid responsible for three out of every four overdose deaths in Virginia …

. . . because the drugs are more potent, they may require several doses of naloxone to actually reverse an overdose, according to early research on nitazenes published by the CDC.

“We don’t know that they’re resistant; we just don’t know what the protocols are for using naloxone for these other drugs,” said Michelle Peace, forensic toxicologist at Virginia Commonwealth University.

Peace said it’s become far easier to find and buy synthetic drugs online by way of forums and that the more powerful nitazenes are attractive to users who have become tolerant of other opioids, even fentanyl.

“The piece that the public needs to know is that they can’t really trust what they’re buying on the internet. That sounds like it should be obvious, but it’s not,” said Peace. Richmond.com

Focus on Facts

News You Can Use

Equity Tip

Health Disparities

The Epi-Center

COVID-19 Data

Cases

Deaths

Free COVID Test Kits

Focus on Facts

Ho-Ho-Holiday! West Piedmont Health District will be closed Dec. 23 & 26 and Jan. 2 for the holidays. Stay safe, West Piedmont!

News You Can Use

Equity Tip

Your Opinion, Please!

Other Public Health Issues

COVID-19 Data

Cases

Deaths

Focus on Facts

News You Can Use

Equity Tip

Change the Perception

COVID-19 Data

Cases

Deaths

Focus on Facts

News You Can Use

Equity Tip

Not Just Semantics

The Epi-Center

COVID-19 Data

Cases

Deaths

Focus on Facts

Your voice matters!

“You can decide to trust America’s physicians or you can trust some random dude on Twitter.”

News You Can Use

Equity Tip

Thanks, Dr. Fauci!

COVID-19 Data

Cases

Deaths

Focus on Facts

News You Can Use

Improve Your Indoor Air Quality to Defend Against a ‘Tripledemic’

Equity Tip

The Importance of Smartphones for Lower-Income Americans

Travel Tip

Ticks are still here.

COVID-19 Data

Cases

Deaths

Focus on Facts

News You Can Use

Equity Tip

The Epi-Center

Return of the mask? What experts say about having kids mask up again amid rising RSV, flu cases.

COVID-19 Data

Cases

Deaths

Focus on Facts

News You Can Use

Annual Economic Burden of Opioids - 2020

Cost by Sector

Mild, Moderate or Severe?

Equity Tip

COVID-19 Data

Cases

Deaths

November is American Diabetes Month

Focus on Facts

News You Can Use

Equity Tip

Choosing Words Carefully

Substance Abuse Prevention Month

The Epi-Center

RSV is surging among kids—but scientists have a plan to stop it

COVID-19 Data

Cases

Deaths