Flu vaccine doing a relatively good job this season
By MIKE STOBBE
AP Medical Writer
Thursday, February 14
NEW YORK (AP) — The flu vaccine is doing a relatively good job this season, protecting about half the people who got it, U.S. health officials said Thursday.
Preliminary figures suggest the vaccine is 47 percent effective in preventing flu illness severe enough to send someone to the doctor’s office. Health officials are generally pleased if a flu vaccine works in 40 to 60 percent of people.
“These are early estimates, but they are encouraging,” said Dr. Alicia Fry of the U.S. Centers for Disease Control and Prevention.
Somewhere between 10,000 and 16,000 people have died from flu and its complications so far this season, according to new estimates released Thursday.
Last winter was dominated by a nasty kind of flu, and the vaccine’s weakness against it was one reason it was the deadliest flu season in at least four decades. An estimated 80,000 Americans died of flu and its complications.
This winter, in most parts of the country, most illnesses are being caused by a somewhat milder virus that vaccines tend to perform better against.
Overall, flu is widespread in 47 states, according to the most recent CDC data. Health officials don’t know if flu season has peaked yet, Fry said.
They also are seeing evidence that a more severe flu virus is spreading to more states.
It’s unusual to see a later surge of nastier illnesses in a season initially dominated by a milder flu bug, and it’s not clear why that’s happening, said Dr. William Schaffner, a Vanderbilt University infectious diseases expert.
The early estimates on the vaccine’s potency offer only a fuzzy picture. For example, there weren’t enough sick patients of different ages to produce a reliable estimate of how it did in the elderly, who are at greater risk from flu and its complications.
Some other types of vaccines — like the one against measles, mumps and rubella — are far more effective in preventing people from getting sick than the flu vaccine. But experts say flu is a quick-changing and elusive target.
A flu vaccine that works around half the time “is the best that science can produce at the current time,” Schaffner said.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
EPA too slow on limiting toxic chemicals, critics say
By JOHN FLESHER and ELLEN KNICKMEYER
Thursday, February 14
Under pressure from Congress, the Environmental Protection Agency said Thursday it would move toward setting safety limits for a class of highly toxic chemicals contaminating drinking water around the country. Environmentalists, congressional Democrats and state officials countered that the agency wasn’t moving fast enough.
Acting EPA Administrator Andrew Wheeler released an “action plan” for dealing with the long-lasting substances, which have been linked to health threats ranging from cancer to decreased fertility. The perfluoroalkyl and polyfluoroalkyl substances, known collectively as PFAS, have turned up increasingly in public water systems and private wells.
Wheeler said the agency’s plan would help communities monitor, detect and address PFAS pollution.
But environmentalists and some members of Congress said the strategy wasn’t aggressive enough on dealing with the chemicals, which are found in firefighting foam, nonstick pots and pans, water-repellent clothing and many other household and personal items.
“This is a non-action plan, designed to delay effective regulation of these dangerous chemicals in our drinking water,” said Wenonah Hauter, executive director of Food & Water Watch.
Former EPA chief Scott Pruitt described PFAS contamination as a “national priority” and pledged swift action last May. Wheeler has served as the EPA’s acting head since Pruitt’s resignation in July amid ethics scandals, and the agency’s handling of PFAS contamination was raised as an issue in Wheeler’s confirmation hearings.
Scientific studies have found “associations” between the chemicals and cancer, thyroid disease, ulcerative colitis and other health issues.
Sen. Tom Carper of Delaware, the top Democrat on the Environment and Public Works Committee, said the EPA plan doesn’t include a commitment to set safety limits for the chemicals in drinking water and prolongs the evaluation for at least another year.
“It has taken the EPA nearly a year to just kick the can even further down the road,” Carper said. “While EPA acts with the utmost urgency to repeal regulations, the agency ambles with complacency when it comes to taking real steps to protect the water we drink and the air we breathe.”
David Ross, assistant administrator for EPA’s Office of Water, said the agency intends to set the standards. Doug Benevento, head of the EPA regional office representing a number of Western states, tweeted: “We are moving through the regulatory process required under the Safe Water Drinking Act before we make a determination.”
Speaking at a news conference in Pennsylvania, Wheeler said Americans “count on EPA every time they turn on their faucet” and that the agency’s plan provides a comprehensive approach to dealing with PFAS.
But Mark Favors, a New York City resident who attended the event and was critical of the plan, said members of his family had been affected by PFAS contamination from an Air Force base in Colorado. Military installations are among the leading generators of the pollutants because of their extensive use of firefighting foam in training exercises.
“My cousin, he did two tours in Iraq. His children drank PFAS for the entire time he was there for the U.S. Army,” Favors said. “For an administration that touts that they go above and beyond for the military, I find this a bit underwhelming.”
The EPA strategy focuses largely on two of the oldest and most common PFAS chemicals, both of which have been phased out by manufacturers but remain widespread in the environment.
By the end of this year, the EPA will “propose a regulatory determination” for those chemicals, known as PFOS and PFOA, the next step toward establishing limits under the Safe Drinking Water Act, Wheeler said.
Sen. John Barrasso, a Wyoming Republican and chairman of the Senate Environment and Public Works Committee, described the plan as “a first step” but said the EPA “must be willing to take decisive action where it is warranted.”
The EPA also is moving toward listing PFOA and PFOS as hazardous substances, which could make them eligible for cleanups under the Superfund program, and will issue interim groundwater cleanup recommendations for contaminated sites, Wheeler said. The agency will propose adding PFAS chemicals to a drinking water monitoring program and develop new methods for detecting them in water, soil and groundwater.
Democratic and Republican lawmakers have pressed him to establish mandatory limits for PFAS in public water systems.
Republican Sen. Shelley Moore Capito, whose state of West Virginia was one of the first where PFAS contamination was linked to health problems, said she voted for Wheeler’s nomination in committee this month only after he privately assured her the EPA would tackle the problem.
Capito was one of 20 senators who wrote to Wheeler demanding ceilings on two phased-out types of PFAS chemicals.
Thousands of distinct PFAS chemicals, which resist heat and repel grease, water and oil, have been in production since the 1940s. They’ve been labeled “forever chemicals” because they break down slowly, if at all. Testing of water systems around the nation has turned up varying levels of the compounds.
The EPA has established a nonbinding “advisory level” of 70 parts per trillion for the two older versions, PFOA and PFOS, which the federal Agency for Toxic Substances and Disease Registry has described as too weak. Some states have imposed tougher limits.
Michigan, one of the states that have used the EPA level and looked to the agency for guidance, said it was “concerned that the timeline for federal action on PFAS standards and regulations is not more aggressive.”
Flesher reported from Traverse City, Michigan, and Knickmeyer from Washington, D.C. AP writer Mike Casey in Concord, New Hampshire and AP photographer Matt Rourke contributed to this report.
Llewellyn King: Go Green on the High-Tech Bandwagon
By Llewellyn King
The newly seated Democrats in the House have lessons to learn, but none more than not to tell people what you’re going to take away from them.
That was the great mistake Alexandria Ocasio-Cortez made when she laid out her Green New Deal. It sounds like big stick from big government.
She said everything should be done, from rebuilding the entire stock of American housing (which can’t be done) to phasing out air transport (which would never happen) to tackling cow flatulence (which is a smelly challenge). Dreamy nonsense is nonetheless nonsense, and nonetheless has a political price.
It is a bad posture to say to people that you’re going to take things away from them — whether it’s their money in taxes or their way of life — to achieve environmental goals.
The problem with Ocasio-Cortez’s statements is that she’s seen, wrongly, as the new face of the new, far-left Democratic Party. Come the election, Democrats will have to spend time distancing themselves from the Ocasio-Cortez brand of utopian dreaming while capitalizing on their environmental brio.
Foolish extreme suggestions neither woo those who are going to decide the next election nor are they in the dynamic tradition of successful politics. You tell people you are going to fix things, not take them away.
Underlying the Ocasio-Cortez argument, which was codified in a non-binding joint resolution, is the basic idea that the only way to save the planet is to cut all carbon emissions in a very short time and to substitute solar, wind and hydro energy.
Omitted from the statements by Ocasio-Cortez and her Senate collaborator, Edward Markey, D-Massachusetts, is any mention of nuclear, which is still the largest carbon-free source of electricity and hardly scars the face of the earth compared to wind and solar. Maybe that is because Markey has spent his whole career in public life trying to shut down nuclear.
In fact, the environmental movement spent long years fighting nuclear. When I would ask, in conferences in the 1980s, what they would use in lieu of a robust nuclear regime, they would answer coal. But to make it sound environmentally acceptable, they said it should be burned in circulating fluidized bed boilers. These offer some advantage, using limestone to precipitate out sulfate.
Missing from the Green New Deal is any sense of the new, i.e. how technology can help.
Take aircraft. They are in the early stages of development, but an electric airplane is in the sights of the big airframe manufacturers. Boeing, for one, is working hard on electric airplanes. Electric air taxis are being experimented with in Dubai and about to be tried in Frankfurt.
The Green New Deal, which is short on details, only endorses one technology outside of wind and solar: high-speed rail. Unfortunately, Ocasio-Cortez is boosting it at a time when California is drastically cutting back on the U.S. entry into the high-speed rail game. The United States sat that one out, and it may be too late to get into the game.
But there is hope.
The success of Amtrak’s electrified Northeast Corridor points the way: People will use regular trains if they are available and the track is good enough for them to travel at a reasonable speed of about 150 mph. The immediate answer is better track allowing more express trains, like Washington to Boston or Los Angeles to San Francisco without stops.
Nearly all the problems of the climate are amenable to technological solutions. The new fusion of high technology across the board in smart cities will, among other things, reduce the carbon footprint through efficiency and electrified transportation.
Ocasio-Cortez is a fresh voice in the nation: brave and as yet unbeholden. If she can grasp that we are on the threshold of a brave new world of technology, called the Fourth Industrial Revolution, she’ll see how it can solve many problems, including those it seems to create in climate. Then she’ll have a political product to sell that people will buy.
ABOUT THE WRITER
Llewellyn King is executive producer and host of “White House Chronicle” on PBS. His email is firstname.lastname@example.org. He wrote this for InsideSources.com.
To end the HIV epidemic, addressing poverty and inequities one of most important treatments
February 14, 2019
Author: Maria De Jesus, Associate Professor, American University and Research Fellow at Center on Health, Risk, and Society, American University School of International Service
Disclosure statement: Maria De Jesus does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Partners: American University School of International Service provides funding as a member of The Conversation US.
In his State of the Union speech, President Trump called for ending the HIV epidemic in the United States within 10 years. Health and Human Services Secretary Alex Azar and senior public health officials stated that the government plans to focus on highly impacted areas and getting drugs to people at risk.
I am a social scientist with over 10 years of expertise in the area of health disparities. My research interests include understanding and addressing disparities in HIV and cancer outcomes, particularly among immigrant and minority populations, using a social determinants of health framework.
While remarkable progress has been made in the fight against HIV/AIDS, ending the epidemic will likely take longer than 10 years and will take more than drugs. That’s because the main driver of the disease has more to do with social inequity than with the virus alone.
The overall annual number of new HIV diagnoses has remained stable in recent years in the U.S., but this has not been the case for all groups. In fact, data from the Centers for Disease Control and Prevention reveal that major racial, ethnic, socioeconomic and even geographical inequities still exist. These inequities exist at every step in the HIV care continuum, from testing to mortality.
This means that there are gaps along the continuum and these individuals are being lost at each step, including HIV testing and diagnosis, linkage to appropriate HIV care, support while in care, access to antiretroviral treatment, and support while on treatment. These gaps exist due to barriers such as poor access to services, poverty, food insecurity and homelessness, and stigma and discrimination.
A HIV hot spot: The South
Among the CDC’s most distressing recent findings: More than half of new HIV diagnoses in the United States occur in the South. The heavy burden of HIV in the South is driven by factors such as concentrated poverty in cities, suburban areas and rural counties, high levels of unemployment, inadequate local health care infrastructure, and a lack of access to health insurance and quality health care services. Other important factors include increased stigma and discrimination toward those living with HIV. This can lead to people being afraid to get tested or seek treatment for fear that someone may find out they have HIV.
Gay and bisexual men account for 66 percent (25,748) of all diagnoses and 82 percent of HIV diagnoses among males. And, although African-Americans represent 13 percent of the U.S. population, they account for 43 percent (16,694) of HIV diagnoses. Likewise, Latinos represent 18 percent of the population but account for 26 percent (9,908) of HIV diagnoses.Racial and ethnic minority women account for a disproportionate share of diagnoses of HIV infection among women.
An arsenal beyond the medicine chest
HIV interventions that focus narrowly on pharmaceutical or drug innovations alone or individual behavior change cannot effectively address the magnitude and complexity of the HIV epidemic, as I explain in my recently published article with co-researcher David R. Williams, Ph.D. at Harvard T.H. Chan School of Public Health, in Public Health Reports. What we need most urgently today is a new generation of rigorously evaluated, cost-effective HIV interventions focused on the fundamental contextual factors for disease. These factors include:
- access to adequate housing
- access to quality health care and health insurance
- access to child care
- education, employment status, gender equality and income.
These factors are known generally as the social determinants of health (SDH) and have been viewed as the drivers of health for decades by many public health experts.
To cite a few examples, in one scientific study, structural community factors, such as poverty and poor employment opportunities, limited access to health care resources among women in the Deep South. In addition, stigma, transportation challenges, and access to illicit substances impacted health-seeking behavior and decision-making, and the ability to engage in HIV care.
Similarly, another study found that homeless individuals were more likely to be uninsured and less likely to adhere to their HIV anti-retroviral medication, demonstrating that housing is an important mechanism for improving the health of this vulnerable group.
Moreover, racial/ethnic stereotypes are deeply embedded in American culture and, whether consciously or not, can adversely affect the care that providers give to their patients. Evidence indicates that interventions that address implicit racial bias among providers can improve the quality of care and reduce racial/ethnic disparities in HIV outcomes.
With this scientific evidence in mind, it is perhaps unsurprising then, that despite three decades of public education and clinical campaigns, more than half of all the new infections in the entire region of North America, Western Europe and Central Europe occur in the U.S.
Make things fair
So what will it take to end the epidemic in the U.S.?
Put simply, to fight HIV, we need to address poverty and social inequity. This approach is the vital game-changer needed to eradicate the HIV epidemic in the U.S. Whenever feasible, social determinants need to be incorporated into behavioral and biomedical strategies to increase their likelihood of success. A new generation of HIV interventions focused on the fundamental SDHs should be the centerpiece of efforts to address HIV-related disparities.
There is growing scientific evidence documenting that interventions that address poverty and inequities in social and living conditions can be effective in reducing risks of HIV infection. Numerous studies reveal that improving education and affordable housing can reduce incidence rates of HIV and AIDS, because low levels of education and unstable housing have been found to decrease social stability and increase HIV risk behaviors.
These studies reveal that interventions that strengthen women’s income, housing stability and gender empowerment are associated with improved psychological well-being, economic productivity and reduced HIV risk. Improving access to care and enhancing quality of care can also contribute to reducing disparities in the incidence of HIV.
It is time to recognize that every government action has the potential to affect health and health equity, including policies dealing with finance, education, housing, employment, transportation and health. Economic studies also support the fact that most rigorously evaluated interventions focused on SDHs have been shown to be cost-effective and save society money in the long run. It is therefore important to integrate this Health in All Policies approach to have the widest impact on the HIV epidemic.
I believe Americans must commit to making it clear to our leaders and to all Americans that all sectors of society gain when we invest in tackling inequities in the most vulnerable areas. HIV/AIDS is not a partisan issue. Political will – and good will toward our most vulnerable fellow citizens – can engender a national “culture of health” that shatters boundaries, equalizes access, and makes HIV/AIDS a fading spectre from the past.