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"content": "\u003cp>Starting today, doctors at UCSF may be able to prescribe medications with a lot more accuracy.\u003c/p>\n\u003cp>The hospital says it’s the first in California to test a patient’s genes to see how they respond to drugs using a process called pharmacogenetics.\u003c/p>\n\u003cp>Traditionally, doctors have relied on trial-and-error to determine how a patient responds to medication, offering a prescription usually based on gender, weight and age.\u003c/p>\n\u003cp>But now, using a blood test, UCSF can examine with precision how variants in a person’s DNA could influence how they respond to particular drugs.\u003c/p>\n\u003cp>The new program will alert physicians “at that moment when they’re prescribing that this is going on with the genetics and this is what we recommend,” said Dr. Bani Tamraz, professor of clinical pharmacy at UCSF, who co-leads the UCSF pharmacogenetics program. “It’s all very nicely integrated into the system.”\u003c/p>\n\u003cfigure id=\"attachment_1982638\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0165-1-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1982638\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0165-1-800x532.jpg\" alt=\"A woman wearing a grey dress holds a yellow pill box in one hand and container of prescription bottles in the other while standing in a bedroom.\" width=\"800\" height=\"532\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0165-1-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0165-1-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0165-1-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0165-1-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0165-1-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0165-1-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0165-1-1920x1277.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christine Von Raesfeld holds her new medications in one hand and a tub of her old prescriptions in the other at her home in San Jos\u003cem>é\u003c/em>, on May 5, 2023. After decades of dealing with the destructive side effects of harmful medications, new pharmacogenetics tests mean that Von Raesfeld’s prescriptions are finally helping more than hurting. \u003ccite>(Kori Suzuki/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Pharmacogenetics is a game changer for patients like 47-year-old Christine Von Raesfeld, who looks exceedingly happy and healthy, with a warm smile and curly black hair. Raesfeld has been diagnosed with many conditions including lupus, thrombotic thrombocytopenic purpura and autoimmune autonomic ganglionopathy and experiences a long list of associated symptoms: chronic pain, fatigue, insomnia, brain fog and joint tenderness.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I’ve got over 40 diagnoses in my charts at this point,” she said.\u003c/p>\n\u003cp>The Stanford medical library has been a refuge for Von Raesfeld. “I would spend hours as a kid just pouring over medical books, just trying to find information on me,” she recalled.\u003c/p>\n\u003cp>For a while, doctors treating Von Raesfeld’s symptoms with drugs only made things worse, especially with three medications she took to treat lupus in her late 20s that she says resulted in three joint replacements, toxic encephalopathy and night-vision loss.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Richard Weinshiloboum, professor of medicine and pharmacology, Mayo Clinic\"]‘These are powerful drugs. They can do great good, but occasionally they can do great harm. Those things are sometimes due to differences in your genetics.’[/pullquote]“I’m half Asian,” she said. “So, a lot of those drugs are tested on white populations. And so I think some of my genetics played a role in causing these adverse reactions.”\u003c/p>\n\u003cp>Finally, she took a genetic test that showed many of her prescriptions were either the wrong dose or the wrong drug. For example, her psychiatric medications were too high of a dosage, and she doesn’t respond at all to opioids.\u003c/p>\n\u003cp>The test also explained why the steroids she took in her 20s failed miserably: She metabolized them slowly.\u003c/p>\n\u003cp>“It was working,” she explained, “but they kept feeding me the drug and it was just sitting in my system. They were then doubling and tripling the dose.”\u003c/p>\n\u003cp>That was until, she says, she gained 70 pounds and her skin began ripping and bleeding.\u003c/p>\n\u003cp>With pharmacogenetics, doctors can see exactly why a person is experiencing a side effect, Tamraz of UCSF explained.\u003c/p>\n\u003cp>“You can see, ‘Oh, well, no wonder,’” he said. “Because they have this particular gene that is causing them to accumulate more of the drug in their system. They’re not clearing it. And so we either pick a different drug or we need to adjust the dose.”\u003c/p>\n\u003cp>Tamraz hopes the new program will reduce negative side effects.\u003c/p>\n\u003cp>UCSF plans to bill each patient’s insurance, but not all insurers cover the test. Companies argue that more evidence is needed to demonstrate it improves care and lowers cost.\u003c/p>\n\u003cp>Also, pharmacogenetics currently is offered only at a select number of U.S. hospitals with large academic institutions, like the Mayo Clinic, where Dr. Richard Weinshiloboum is a professor of medicine and pharmacology.\u003c/p>\n\u003cp>“There continues to be a controversy about how valuable this is, but the one thing I can say for sure is that increasingly this is becoming a standard part of drug therapy for specific drugs that could have a serious adverse reaction,” he said.\u003c/p>\n\u003cp>For example, a chemotherapy treatment for leukemia can be deadly for certain children. Estimates vary but studies suggest medications accidentally kill more than \u003ca href=\"https://www.fda.gov/drugs/drug-interactions-labeling/preventable-adverse-drug-reactions-focus-drug-interactions#:~:text=These%20studies%20estimate%20that%206.7,a%20fatality%20rate%20of%200.32%25.&text=If%20these%20estimates%20are%20correct,causing%20over%20106%2C000%20deaths%20annually\">100,000 people a year across the country\u003c/a>.\u003c/p>\n\u003cp>“These are powerful drugs,” Weinshiloboum said. “They can do great good, but occasionally they can do great harm. Those things are sometimes due to differences in your genetics.”\u003c/p>\n\u003cfigure id=\"attachment_1982640\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1982640\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-800x532.jpg\" alt=\"A woman wearing a grey dress with a yellow sweater wrapped around her waste stands outside in front of a house.\" width=\"800\" height=\"532\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-1920x1277.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christine Von Raesfeld walks through her neighborhood in San Jos\u003cem>é\u003c/em> on May 5, 2023. For Von Raesfeld, who deals with several chronic illnesses, neighborhood walks are a key part of her daily routine. \u003ccite>(Kori Suzuki/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Von Raesfeld hopes pharmacogenetics is more widely available soon.\u003c/p>\n\u003cp>“My whole life has been turned upside down from damage from medications,” she said. “And so, the only thing I can think of is to get testing like this out to the public so that no one else has to deal with these things.”\u003c/p>\n\u003cp>Today Von Raesfeld is taking four medications — down from 40.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It’s the first time in her life she says her treatment is helping rather than hurting her.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“I’m half Asian,” she said. “So, a lot of those drugs are tested on white populations. And so I think some of my genetics played a role in causing these adverse reactions.”\u003c/p>\n\u003cp>Finally, she took a genetic test that showed many of her prescriptions were either the wrong dose or the wrong drug. For example, her psychiatric medications were too high of a dosage, and she doesn’t respond at all to opioids.\u003c/p>\n\u003cp>The test also explained why the steroids she took in her 20s failed miserably: She metabolized them slowly.\u003c/p>\n\u003cp>“It was working,” she explained, “but they kept feeding me the drug and it was just sitting in my system. They were then doubling and tripling the dose.”\u003c/p>\n\u003cp>That was until, she says, she gained 70 pounds and her skin began ripping and bleeding.\u003c/p>\n\u003cp>With pharmacogenetics, doctors can see exactly why a person is experiencing a side effect, Tamraz of UCSF explained.\u003c/p>\n\u003cp>“You can see, ‘Oh, well, no wonder,’” he said. “Because they have this particular gene that is causing them to accumulate more of the drug in their system. They’re not clearing it. And so we either pick a different drug or we need to adjust the dose.”\u003c/p>\n\u003cp>Tamraz hopes the new program will reduce negative side effects.\u003c/p>\n\u003cp>UCSF plans to bill each patient’s insurance, but not all insurers cover the test. Companies argue that more evidence is needed to demonstrate it improves care and lowers cost.\u003c/p>\n\u003cp>Also, pharmacogenetics currently is offered only at a select number of U.S. hospitals with large academic institutions, like the Mayo Clinic, where Dr. Richard Weinshiloboum is a professor of medicine and pharmacology.\u003c/p>\n\u003cp>“There continues to be a controversy about how valuable this is, but the one thing I can say for sure is that increasingly this is becoming a standard part of drug therapy for specific drugs that could have a serious adverse reaction,” he said.\u003c/p>\n\u003cp>For example, a chemotherapy treatment for leukemia can be deadly for certain children. Estimates vary but studies suggest medications accidentally kill more than \u003ca href=\"https://www.fda.gov/drugs/drug-interactions-labeling/preventable-adverse-drug-reactions-focus-drug-interactions#:~:text=These%20studies%20estimate%20that%206.7,a%20fatality%20rate%20of%200.32%25.&text=If%20these%20estimates%20are%20correct,causing%20over%20106%2C000%20deaths%20annually\">100,000 people a year across the country\u003c/a>.\u003c/p>\n\u003cp>“These are powerful drugs,” Weinshiloboum said. “They can do great good, but occasionally they can do great harm. Those things are sometimes due to differences in your genetics.”\u003c/p>\n\u003cfigure id=\"attachment_1982640\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-scaled.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1982640\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-800x532.jpg\" alt=\"A woman wearing a grey dress with a yellow sweater wrapped around her waste stands outside in front of a house.\" width=\"800\" height=\"532\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-800x532.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-1020x679.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-768x511.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-1536x1022.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-2048x1363.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/05/05052023_ksuzuki_pharmacogeneticspatient-0294-1920x1277.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Christine Von Raesfeld walks through her neighborhood in San Jos\u003cem>é\u003c/em> on May 5, 2023. For Von Raesfeld, who deals with several chronic illnesses, neighborhood walks are a key part of her daily routine. \u003ccite>(Kori Suzuki/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Von Raesfeld hopes pharmacogenetics is more widely available soon.\u003c/p>\n\u003cp>“My whole life has been turned upside down from damage from medications,” she said. “And so, the only thing I can think of is to get testing like this out to the public so that no one else has to deal with these things.”\u003c/p>\n\u003cp>Today Von Raesfeld is taking four medications — down from 40.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It’s the first time in her life she says her treatment is helping rather than hurting her.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "New Bill Could Ease Teenagers' Access to Opioid Treatment Amid Ongoing Fentanyl Epidemic",
"headTitle": "New Bill Could Ease Teenagers’ Access to Opioid Treatment Amid Ongoing Fentanyl Epidemic | KQED",
"content": "\u003cp>Three little girls gathered around 20-year-old Charlotte Bleu at a preschool in San José, and squealed, “I like Miss Charlotte! She’s a good teacher.”\u003c/p>\n\u003cp>Bleu beamed, as she looked down at her doting students.\u003c/p>\n\u003cp>She said she’s grateful her life is back on track, just a few years after struggling with depression and numbing her pain with heroin and crystal meth.\u003c/p>\n\u003cp>“I had a plan one day to try to commit suicide, and my plan was to use fentanyl to do it,” said Bleu, recalling a moment of despair when she was just 18. “I wanted all my problems to go away.”\u003c/p>\n\u003cp>In 2021, fentanyl, which can be up to 50 times more potent than heroin, was \u003ca href=\"https://skylab.cdph.ca.gov/ODdash/?tab=CA\">responsible for roughly 20% of deaths among 15- to 24-year-olds in California\u003c/a>. That same year, the state’s \u003ca href=\"https://skylab.cdph.ca.gov/ODdash/?tab=CA\">overall fentanyl-related death toll\u003c/a> was more than six times higher than just three years earlier.[aside postID=news_11945418 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63872_012_KQED_SOMABuprenorphineDelivery_03232023-qut-1020x680.jpg']While overdose deaths among young people have skyrocketed across the country in recent years, \u003ca href=\"https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-age-group/?dataView=1¤tTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\">rates in the Golden State are even higher than the national average\u003c/a>.\u003c/p>\n\u003cp>The night Bleu smoked fentanyl for the first time, she overdosed. “I was out for 30 minutes,” she said. “It was crazy. I almost didn’t survive.”\u003c/p>\n\u003cp>Bleu’s friends eventually sprayed three doses of \u003ca href=\"https://nida.nih.gov/publications/drugfacts/naloxone\">Narcan\u003c/a>, which reverses opioid overdoses, into her nose to restore her breathing.\u003c/p>\n\u003cp>That was the beginning of her downward spiral into fentanyl addiction. It was cheap and easy to buy from street dealers in the Tenderloin neighborhood. Every time she tried to quit, withdrawal symptoms — like intense itching, nausea and cold sweats — struck with a vengeance.\u003c/p>\n\u003cp>“I remember laying in bed all day feeling like complete garbage and not knowing if I was going to make it out or not,” Bleu said. “Every few days I would just give up and smoke again because I couldn’t handle the feeling of withdrawal.”\u003c/p>\n\u003cp>She says she had to lose everything before she sought help. “I lost my car, I lost my friends, my boyfriend. I just kind of lost touch with myself,” she said.\u003c/p>\n\u003cp>Bleu was able to start getting help through a Santa Clara County drug counselor who eventually directed her to a \u003ca href=\"https://www.scvmc.org/hospitals-clinics/valley-homeless-health-care-program-vhhp\">new treatment program for youth\u003c/a>.\u003c/p>\n\u003cp>“They were there for me when no one else was,” said Bleu. “They helped me get on Suboxone to get off of the drugs, and help with the withdrawals.”[pullquote align=\"right\" size=\"medium\" citation=\"Dr. Lee Trope, pediatrician, San José\"]‘We’ve been shocked by how many teens and young adults in the community have come to us desperate for help … Some of them are using every two to three hours, like 10 fentanyl pills a day.’[/pullquote]Suboxone, the brand name of the drug \u003ca href=\"https://psychiatry.uams.edu/clinical-care/cast/buprenorphine/\">buprenorphine\u003c/a>, is available as a pill or as a film that dissolves under the tongue. It binds to opioid receptors in the brain but doesn’t activate them all the way, so patients don’t feel high, but also don’t experience withdrawal symptoms.\u003c/p>\n\u003cp>Bleu felt immediate relief when she started taking Suboxone daily, and within a month she started to slowly turn her life around. Now, two years later, she’s still clean, and when she is not teaching preschool, Bleu is in community college studying dental hygiene.\u003c/p>\n\u003cp>“We’ve been shocked by how many teens and young adults in the community have come to us desperate for help,” said Dr. Lee Trope, a pediatrician in San José. “Some of them are using every two to three hours, like 10 fentanyl pills a day.”\u003c/p>\n\u003cp>The fentanyl crisis is actually \u003ca href=\"https://www.mercurynews.com/2022/10/30/we-are-not-trying-to-scare-you-in-california-fentanyl-now-behind-1-out-every-5-youth-deaths/\">much worse in other Bay Area counties like San Francisco and Contra Costa\u003c/a>, according to data-crunching from the Mercury News.\u003c/p>\n\u003cp>But Trope says she often can’t prescribe Suboxone to many of the adolescents who need it most because California requires consent from a parent (or legal guardian) to begin what’s known as medical-assisted treatment (or MAT) for 16- to 18-year-olds.\u003c/p>\n\u003cp>“It’s not uncommon that they’re living on the street,” Trope said. “Many of them are living with grandparents or aunts or uncles because their guardians are in the grips of addiction themselves.”\u003c/p>\n\u003cp>To address that, San Francisco Democratic Assemblymember Matt Haney in February introduced a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB816\">bill\u003c/a> that would allow anyone 16 and over to start Suboxone treatment without the need for parental consent.\u003c/p>\n\u003cfigure id=\"attachment_1982217\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1982217\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2023/04/GettyImages-1353920451-800x534.jpg\" alt=\"Headshot of a lightly bearded white man with brown short-cropped hair gesticulating with his left hand and wearing a suit and tie as he speaks into a microphone.\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Former San Francisco Supervisor and current Assemblymember Matt Haney speaks during a press conference on Nov. 16, 2021, at City Hall in San Francisco. \u003ccite>(Gabrielle Lurie/The San Francisco Chronicle via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Teenagers who, for a variety of reasons, can’t talk to their parents about their addiction shouldn’t be prohibited from getting help,” Haney said. “Suboxone is the most effective form of treatment for opioid-use disorder, and it’s critical that we get people enrolled in it as soon as possible.”\u003c/p>\n\u003cp>But Assemblymember Bill Essayli, a Riverside County Republican, worries the proposed legislation will encourage kids to hide their addiction from their parents.\u003c/p>\n\u003cp>“I think it is too sweeping, it’s too broad, and it covers a bigger class of people and minors than the bill is intended to target,” he said.\u003c/p>\n\u003cp>Essayli said he would rather see much narrower legislation limited to kids who are estranged from their parents, and that focuses to a greater degree on connecting them to social services.\u003c/p>\n\u003cp>But Charlotte Bleu in San José isn’t sure she would be here today if she had needed her parents’ permission to start Suboxone treatment.\u003c/p>\n\u003cp>“My parents were very against it,” Bleu said. “They thought that it was an easy way out. They still believed that it was a drug to make me high.”\u003c/p>\n\u003cp>She tried to explain to them that Suboxone only partially activates the opioid receptors, so it does not stimulate euphoria — but she said they didn’t believe her.\u003c/p>\n\u003cp>“I’m so thankful that I did survive, because if I didn’t,” Bleu said, “I wouldn’t have been able to learn all these valuable lessons and get to the healthy point that I am today.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "San Francisco Assemblymember Matt Haney introduced a bill that would allow some teenagers to receive Suboxone/buprenorphine to ease opiate withdrawals without their parents' consent, lifting what he argues is a key barrier to treatment.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Three little girls gathered around 20-year-old Charlotte Bleu at a preschool in San José, and squealed, “I like Miss Charlotte! She’s a good teacher.”\u003c/p>\n\u003cp>Bleu beamed, as she looked down at her doting students.\u003c/p>\n\u003cp>She said she’s grateful her life is back on track, just a few years after struggling with depression and numbing her pain with heroin and crystal meth.\u003c/p>\n\u003cp>“I had a plan one day to try to commit suicide, and my plan was to use fentanyl to do it,” said Bleu, recalling a moment of despair when she was just 18. “I wanted all my problems to go away.”\u003c/p>\n\u003cp>In 2021, fentanyl, which can be up to 50 times more potent than heroin, was \u003ca href=\"https://skylab.cdph.ca.gov/ODdash/?tab=CA\">responsible for roughly 20% of deaths among 15- to 24-year-olds in California\u003c/a>. That same year, the state’s \u003ca href=\"https://skylab.cdph.ca.gov/ODdash/?tab=CA\">overall fentanyl-related death toll\u003c/a> was more than six times higher than just three years earlier.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>While overdose deaths among young people have skyrocketed across the country in recent years, \u003ca href=\"https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-age-group/?dataView=1¤tTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\">rates in the Golden State are even higher than the national average\u003c/a>.\u003c/p>\n\u003cp>The night Bleu smoked fentanyl for the first time, she overdosed. “I was out for 30 minutes,” she said. “It was crazy. I almost didn’t survive.”\u003c/p>\n\u003cp>Bleu’s friends eventually sprayed three doses of \u003ca href=\"https://nida.nih.gov/publications/drugfacts/naloxone\">Narcan\u003c/a>, which reverses opioid overdoses, into her nose to restore her breathing.\u003c/p>\n\u003cp>That was the beginning of her downward spiral into fentanyl addiction. It was cheap and easy to buy from street dealers in the Tenderloin neighborhood. Every time she tried to quit, withdrawal symptoms — like intense itching, nausea and cold sweats — struck with a vengeance.\u003c/p>\n\u003cp>“I remember laying in bed all day feeling like complete garbage and not knowing if I was going to make it out or not,” Bleu said. “Every few days I would just give up and smoke again because I couldn’t handle the feeling of withdrawal.”\u003c/p>\n\u003cp>She says she had to lose everything before she sought help. “I lost my car, I lost my friends, my boyfriend. I just kind of lost touch with myself,” she said.\u003c/p>\n\u003cp>Bleu was able to start getting help through a Santa Clara County drug counselor who eventually directed her to a \u003ca href=\"https://www.scvmc.org/hospitals-clinics/valley-homeless-health-care-program-vhhp\">new treatment program for youth\u003c/a>.\u003c/p>\n\u003cp>“They were there for me when no one else was,” said Bleu. “They helped me get on Suboxone to get off of the drugs, and help with the withdrawals.”\u003c/p>\u003c/div>",
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"content": "‘We’ve been shocked by how many teens and young adults in the community have come to us desperate for help … Some of them are using every two to three hours, like 10 fentanyl pills a day.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Suboxone, the brand name of the drug \u003ca href=\"https://psychiatry.uams.edu/clinical-care/cast/buprenorphine/\">buprenorphine\u003c/a>, is available as a pill or as a film that dissolves under the tongue. It binds to opioid receptors in the brain but doesn’t activate them all the way, so patients don’t feel high, but also don’t experience withdrawal symptoms.\u003c/p>\n\u003cp>Bleu felt immediate relief when she started taking Suboxone daily, and within a month she started to slowly turn her life around. Now, two years later, she’s still clean, and when she is not teaching preschool, Bleu is in community college studying dental hygiene.\u003c/p>\n\u003cp>“We’ve been shocked by how many teens and young adults in the community have come to us desperate for help,” said Dr. Lee Trope, a pediatrician in San José. “Some of them are using every two to three hours, like 10 fentanyl pills a day.”\u003c/p>\n\u003cp>The fentanyl crisis is actually \u003ca href=\"https://www.mercurynews.com/2022/10/30/we-are-not-trying-to-scare-you-in-california-fentanyl-now-behind-1-out-every-5-youth-deaths/\">much worse in other Bay Area counties like San Francisco and Contra Costa\u003c/a>, according to data-crunching from the Mercury News.\u003c/p>\n\u003cp>But Trope says she often can’t prescribe Suboxone to many of the adolescents who need it most because California requires consent from a parent (or legal guardian) to begin what’s known as medical-assisted treatment (or MAT) for 16- to 18-year-olds.\u003c/p>\n\u003cp>“It’s not uncommon that they’re living on the street,” Trope said. “Many of them are living with grandparents or aunts or uncles because their guardians are in the grips of addiction themselves.”\u003c/p>\n\u003cp>To address that, San Francisco Democratic Assemblymember Matt Haney in February introduced a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB816\">bill\u003c/a> that would allow anyone 16 and over to start Suboxone treatment without the need for parental consent.\u003c/p>\n\u003cfigure id=\"attachment_1982217\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1982217\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2023/04/GettyImages-1353920451-800x534.jpg\" alt=\"Headshot of a lightly bearded white man with brown short-cropped hair gesticulating with his left hand and wearing a suit and tie as he speaks into a microphone.\" width=\"800\" height=\"534\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2023/04/GettyImages-1353920451.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Former San Francisco Supervisor and current Assemblymember Matt Haney speaks during a press conference on Nov. 16, 2021, at City Hall in San Francisco. \u003ccite>(Gabrielle Lurie/The San Francisco Chronicle via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Teenagers who, for a variety of reasons, can’t talk to their parents about their addiction shouldn’t be prohibited from getting help,” Haney said. “Suboxone is the most effective form of treatment for opioid-use disorder, and it’s critical that we get people enrolled in it as soon as possible.”\u003c/p>\n\u003cp>But Assemblymember Bill Essayli, a Riverside County Republican, worries the proposed legislation will encourage kids to hide their addiction from their parents.\u003c/p>\n\u003cp>“I think it is too sweeping, it’s too broad, and it covers a bigger class of people and minors than the bill is intended to target,” he said.\u003c/p>\n\u003cp>Essayli said he would rather see much narrower legislation limited to kids who are estranged from their parents, and that focuses to a greater degree on connecting them to social services.\u003c/p>\n\u003cp>But Charlotte Bleu in San José isn’t sure she would be here today if she had needed her parents’ permission to start Suboxone treatment.\u003c/p>\n\u003cp>“My parents were very against it,” Bleu said. “They thought that it was an easy way out. They still believed that it was a drug to make me high.”\u003c/p>\n\u003cp>She tried to explain to them that Suboxone only partially activates the opioid receptors, so it does not stimulate euphoria — but she said they didn’t believe her.\u003c/p>\n\u003cp>“I’m so thankful that I did survive, because if I didn’t,” Bleu said, “I wouldn’t have been able to learn all these valuable lessons and get to the healthy point that I am today.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The pandemic created a perfect financial storm for California hospitals, and some, reeling from that stress, have even gone bankrupt.\u003c/p>\n\u003cp>In Madera County near Yosemite, \u003ca href=\"https://fresnoland.org/2023/01/14/patients-are-going-to-die-the-human-cost-of-madera-county-losing-its-only-hospital/\">the area’s only general hospital closed\u003c/a> in January. That left 150,000 residents without an emergency room or specialty care, and many of the hospital’s 700 employees without a job. State lawmakers and industry officials warn many more facilities will be forced to reduce services and some will shutter.\u003c/p>\n\u003cp>The moment COVID-19 started spreading in California, hospitals started losing money.\u003c/p>\n\u003cp>First, patient volumes dropped drastically because, well, a deadly virus was spreading and people didn’t want to catch it at the hospital. Then, \u003ca href=\"https://www.kqed.org/science/1962104/thousands-of-bay-area-patients-wait-for-surgery-while-hospitals-brace-for-coronavirus-surge\">facilities postponed profitable elective procedures\u003c/a>. Shortages of ventilators, masks and gloves led to substantial cost increases. Hospitals scrambled to implement new protocols, construct specialized COVID-19 units, and build vaccine sites. During each surge in infections, a lot of hospitals depended on travel nurses — who charge upwards of $250 an hour.\u003c/p>\n\u003cp>“The net impact of that was that \u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2023/02/KH-CHA-2021-Financial-Analysis-Ebook-final-4-18-22.pdf\">California’s hospitals during the two years of the pandemic, at its peak, lost $20 billion [PDF]\u003c/a>,” said Carmela Coyle, president and CEO of the California Hospital Association, referring to findings in a report from the consulting firm KaufmanHall. “The federal government provided $8 billion in relief. But that has left California hospitals with $12 billion in losses.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Coyle argued in a \u003ca href=\"https://calhospital.org/hospital-fragility-spells-danger-for-ca-patients/\">recent blog post\u003c/a> that what “transpired in Madera County will be replicated in other parts of California” unless the hospitals receive financial assistance from the state. The hospital association has asked the state for $1.5 billion in immediate relief.\u003c/p>\n\u003cp>“While the floodwaters of the COVID pandemic may have receded,” Coyle told KQED, “the damage that was done remains widespread. We have more than half of all California hospitals are operating in the red, \u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2023/02/KH-CHA-2021-Financial-Analysis-Ebook-final-4-18-22.pdf\">losing money on every patient that they care for (PDF)\u003c/a>.”\u003c/p>\n\u003cp>Last year \u003ca href=\"https://www.kaufmanhall.com/sites/default/files/2023-01/KH_NHFR_2023-01.pdf\">hospital margins in the Western United States were down 69% compared to 2019 (PDF)\u003c/a>. Coyle said that hospital profits being low or negative can lead to fewer nurses, X-ray technicians and behavioral health specialists, and reduced supplies like blood.\u003c/p>\n\u003cp>“These disruptions led to unexpected, unbudgeted cash shortfalls,” said Glenn Melnick, USC professor and health economist. “I think there will be more [hospitals] that just don’t have enough cash or financial reserves to weather the downturn.”\u003c/p>\n\u003cp>Even today, nearly three years after the pandemic started, many facilities are still depending on costly temporary or contract labor.\u003c/p>\n\u003cp>“The nurses all quit,” said Dr. Guy Shochat, who works in the ER at UCSF’s Parnassus campus in San Francisco. “We lost 20 nurses in the first year and a half of the pandemic. And they were senior nurses, so this was well over 200 years of institutional memory just disappearing. And it’s hurt us. Everyone’s just well and truly burnt out. And patient care suffers when staff are overwhelmed.”\u003c/p>\n\u003cp>This is especially true for emergency departments.\u003c/p>\n\u003cp>“There is no bed with which to see the patient,” said Dr. Nicole Braxley, an emergency medicine physician who worked in Sacramento during the pandemic and recently transferred to the East Coast. “And all I want to do is see the patient.”\u003c/p>\n\u003cp>She says patients all across the state and the country are waiting six, eight and sometimes 24 hours for care in the emergency department.\u003c/p>\n\u003cp>Lengthy wait times recently were driven partly by this winter’s \u003ca href=\"https://www.kqed.org/news/11935500/this-is-chaos-hospitalizations-surge-amid-mounting-winter-tripledemic\">tripledemic\u003c/a>, when respiratory syncytial virus, or RSV, influenza and a wave of COVID-19 slammed the state, all at once. The problem gets exacerbated by the fact that many Californians \u003ca href=\"https://letsgethealthy.ca.gov/goals/redesigning-the-health-system/increasing-access-to-healthcare-providers/#:~:text=2%2C000%20per%20provider.-,Access%20to%20Primary%20Care%20Providers,available%20is%2044.8%20(2018).\">do not have a primary care doctor\u003c/a>. Not a new issue, this forces people to use the ER for all their medical needs. And emergency departments often cannot transfer patients to severely short-staffed rehabilitation hospitals or long-term care facilities.\u003c/p>\n\u003cp>According to a 2021 UCSF report, \u003ca href=\"https://healthworkforce.ucsf.edu/sites/healthworkforce.ucsf.edu/files/Impact%20of%20the%20COVID-19%20Pandemic%20on%20California%E2%80%99s%20Registered%20Nurse%20Workforce%20-%20Preliminary%20Data.pdf\">the percentage of registered nurses planning to retire by 2023 more than doubled in 2020 (PDF)\u003c/a>. And that was before the pandemic fueled a severe rise in burnout. The forecast for 2022 remained bleak, with \u003ca href=\"https://www.rn.ca.gov/pdfs/forms/forecast2022.pdf\">a follow-up report (PDF)\u003c/a> in 2022 stressing the “need to rapidly develop and implement strategies to mitigate the potential harm of shortages.”\u003c/p>\n\u003cp>Increasingly, hospitals are training doctors to treat people in the lobby of the ER.\u003c/p>\n\u003cp>“We call it vertical care,” Braxley said. “We say if a patient can stay vertical and they don’t need to be horizontal on a bed, they don’t get a bed. You sit in a chair.”\u003c/p>\n\u003cp>Patients can still receive blood tests, electrocardiograms and even an IV in the waiting room. Braxley says doctors use safety pins or coat hooks to hang IV bags. She admits lobby medicine is miserable for both patients and doctors, but it’s often the only option.\u003c/p>\n\u003cp>“Patients sit for days, unbathed, not ambulated, using urinals standing in corners in view of everyone. A patient I admitted three days ago stopped me, asking, ‘Why?’ Hands reach out from gurneys as I pass asking for food, water, help to the bathroom, a blanket, or someone to simply talk to and show they care,” wrote an ER doctor in a report titled \u003ca href=\"https://www.acep.org/boarding-stories\">\u003cem>A Nation in Crisis\u003c/em>.\u003c/a> The American College of Emergency Physicians published a collection of 100 harrowing stories from practitioners all across the country on the front lines.\u003c/p>\n\u003cp>Then, inflation gets added to the mix. \u003ca href=\"https://www.kaufmanhall.com/insights/research-report/analysis-california-hospitals-endured-significant-financial-strain-2021#:~:text=Analysis%3A%20California%20Hospitals%20Endured%20Significant%20Financial%20Strain%20in%202021,-April%2019%2C%202022&text=COVID%2D19%20continued%20to%20place,more%20than%20triple%20previous%20projections\">Labor costs have increased by 19%. Pharmaceutical prices are up 40%.\u003c/a> And finally, there’s Medi-Cal reimbursements: \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/statistics/Pages/RASD_Statistical_Briefs.aspx#:~:text=Data%20Symposium%20on%20High%20Utilizers,the%20nation's%20largest%20Medicaid%20program.\">A third of Californians are enrolled\u003c/a> in the state’s lower-income health plan.\u003c/p>\n\u003cp>“But the state pays only $0.74 for every dollar of care that’s provided to a Medi-Cal enrollee,” said Coyle.\u003c/p>\n\u003cp>Historically, private insurance payers typically make up Medi-Cal losses, but Coyle says that scale is beginning to tip in the wrong direction.\u003c/p>\n\u003cp>Many towns are in danger of losing critical medical services, like \u003ca href=\"https://sjvsun.com/uncategorized/as-pressure-mounts-kaweah-health-set-to-shed-200-jobs/\">Kaweah Health\u003c/a> in Tulare County, \u003ca href=\"https://www.ksbw.com/article/hazel-hawkins-receives-loan-extending-timeline-to-solve-fiscal-emergency/42477641\">Hazel Hawkins Memorial Hospital\u003c/a> in Hollister, and \u003ca href=\"https://www.ivpressonline.com/featured/el-centro-regional-medical-center-keeps-base-hospital-status-for-now/article_41fdde22-9c4d-11ed-af8c-f3d5bd41e009.html\">El Centro Regional Medical Center\u003c/a> in Imperial County.\u003c/p>\n\u003cp>“When will this implode? 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The pandemic created a perfect financial storm for California hospitals, and some, reeling from that stress, have even gone bankrupt.\u003c/p>\n\u003cp>In Madera County near Yosemite, \u003ca href=\"https://fresnoland.org/2023/01/14/patients-are-going-to-die-the-human-cost-of-madera-county-losing-its-only-hospital/\">the area’s only general hospital closed\u003c/a> in January. That left 150,000 residents without an emergency room or specialty care, and many of the hospital’s 700 employees without a job. State lawmakers and industry officials warn many more facilities will be forced to reduce services and some will shutter.\u003c/p>\n\u003cp>The moment COVID-19 started spreading in California, hospitals started losing money.\u003c/p>\n\u003cp>First, patient volumes dropped drastically because, well, a deadly virus was spreading and people didn’t want to catch it at the hospital. Then, \u003ca href=\"https://www.kqed.org/science/1962104/thousands-of-bay-area-patients-wait-for-surgery-while-hospitals-brace-for-coronavirus-surge\">facilities postponed profitable elective procedures\u003c/a>. Shortages of ventilators, masks and gloves led to substantial cost increases. Hospitals scrambled to implement new protocols, construct specialized COVID-19 units, and build vaccine sites. During each surge in infections, a lot of hospitals depended on travel nurses — who charge upwards of $250 an hour.\u003c/p>\n\u003cp>“The net impact of that was that \u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2023/02/KH-CHA-2021-Financial-Analysis-Ebook-final-4-18-22.pdf\">California’s hospitals during the two years of the pandemic, at its peak, lost $20 billion [PDF]\u003c/a>,” said Carmela Coyle, president and CEO of the California Hospital Association, referring to findings in a report from the consulting firm KaufmanHall. “The federal government provided $8 billion in relief. But that has left California hospitals with $12 billion in losses.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Coyle argued in a \u003ca href=\"https://calhospital.org/hospital-fragility-spells-danger-for-ca-patients/\">recent blog post\u003c/a> that what “transpired in Madera County will be replicated in other parts of California” unless the hospitals receive financial assistance from the state. The hospital association has asked the state for $1.5 billion in immediate relief.\u003c/p>\n\u003cp>“While the floodwaters of the COVID pandemic may have receded,” Coyle told KQED, “the damage that was done remains widespread. We have more than half of all California hospitals are operating in the red, \u003ca href=\"https://ww2.kqed.org/app/uploads/sites/35/2023/02/KH-CHA-2021-Financial-Analysis-Ebook-final-4-18-22.pdf\">losing money on every patient that they care for (PDF)\u003c/a>.”\u003c/p>\n\u003cp>Last year \u003ca href=\"https://www.kaufmanhall.com/sites/default/files/2023-01/KH_NHFR_2023-01.pdf\">hospital margins in the Western United States were down 69% compared to 2019 (PDF)\u003c/a>. Coyle said that hospital profits being low or negative can lead to fewer nurses, X-ray technicians and behavioral health specialists, and reduced supplies like blood.\u003c/p>\n\u003cp>“These disruptions led to unexpected, unbudgeted cash shortfalls,” said Glenn Melnick, USC professor and health economist. “I think there will be more [hospitals] that just don’t have enough cash or financial reserves to weather the downturn.”\u003c/p>\n\u003cp>Even today, nearly three years after the pandemic started, many facilities are still depending on costly temporary or contract labor.\u003c/p>\n\u003cp>“The nurses all quit,” said Dr. Guy Shochat, who works in the ER at UCSF’s Parnassus campus in San Francisco. “We lost 20 nurses in the first year and a half of the pandemic. And they were senior nurses, so this was well over 200 years of institutional memory just disappearing. And it’s hurt us. Everyone’s just well and truly burnt out. 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The problem gets exacerbated by the fact that many Californians \u003ca href=\"https://letsgethealthy.ca.gov/goals/redesigning-the-health-system/increasing-access-to-healthcare-providers/#:~:text=2%2C000%20per%20provider.-,Access%20to%20Primary%20Care%20Providers,available%20is%2044.8%20(2018).\">do not have a primary care doctor\u003c/a>. Not a new issue, this forces people to use the ER for all their medical needs. And emergency departments often cannot transfer patients to severely short-staffed rehabilitation hospitals or long-term care facilities.\u003c/p>\n\u003cp>According to a 2021 UCSF report, \u003ca href=\"https://healthworkforce.ucsf.edu/sites/healthworkforce.ucsf.edu/files/Impact%20of%20the%20COVID-19%20Pandemic%20on%20California%E2%80%99s%20Registered%20Nurse%20Workforce%20-%20Preliminary%20Data.pdf\">the percentage of registered nurses planning to retire by 2023 more than doubled in 2020 (PDF)\u003c/a>. And that was before the pandemic fueled a severe rise in burnout. The forecast for 2022 remained bleak, with \u003ca href=\"https://www.rn.ca.gov/pdfs/forms/forecast2022.pdf\">a follow-up report (PDF)\u003c/a> in 2022 stressing the “need to rapidly develop and implement strategies to mitigate the potential harm of shortages.”\u003c/p>\n\u003cp>Increasingly, hospitals are training doctors to treat people in the lobby of the ER.\u003c/p>\n\u003cp>“We call it vertical care,” Braxley said. “We say if a patient can stay vertical and they don’t need to be horizontal on a bed, they don’t get a bed. You sit in a chair.”\u003c/p>\n\u003cp>Patients can still receive blood tests, electrocardiograms and even an IV in the waiting room. Braxley says doctors use safety pins or coat hooks to hang IV bags. She admits lobby medicine is miserable for both patients and doctors, but it’s often the only option.\u003c/p>\n\u003cp>“Patients sit for days, unbathed, not ambulated, using urinals standing in corners in view of everyone. A patient I admitted three days ago stopped me, asking, ‘Why?’ Hands reach out from gurneys as I pass asking for food, water, help to the bathroom, a blanket, or someone to simply talk to and show they care,” wrote an ER doctor in a report titled \u003ca href=\"https://www.acep.org/boarding-stories\">\u003cem>A Nation in Crisis\u003c/em>.\u003c/a> The American College of Emergency Physicians published a collection of 100 harrowing stories from practitioners all across the country on the front lines.\u003c/p>\n\u003cp>Then, inflation gets added to the mix. \u003ca href=\"https://www.kaufmanhall.com/insights/research-report/analysis-california-hospitals-endured-significant-financial-strain-2021#:~:text=Analysis%3A%20California%20Hospitals%20Endured%20Significant%20Financial%20Strain%20in%202021,-April%2019%2C%202022&text=COVID%2D19%20continued%20to%20place,more%20than%20triple%20previous%20projections\">Labor costs have increased by 19%. Pharmaceutical prices are up 40%.\u003c/a> And finally, there’s Medi-Cal reimbursements: \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/statistics/Pages/RASD_Statistical_Briefs.aspx#:~:text=Data%20Symposium%20on%20High%20Utilizers,the%20nation's%20largest%20Medicaid%20program.\">A third of Californians are enrolled\u003c/a> in the state’s lower-income health plan.\u003c/p>\n\u003cp>“But the state pays only $0.74 for every dollar of care that’s provided to a Medi-Cal enrollee,” said Coyle.\u003c/p>\n\u003cp>Historically, private insurance payers typically make up Medi-Cal losses, but Coyle says that scale is beginning to tip in the wrong direction.\u003c/p>\n\u003cp>Many towns are in danger of losing critical medical services, like \u003ca href=\"https://sjvsun.com/uncategorized/as-pressure-mounts-kaweah-health-set-to-shed-200-jobs/\">Kaweah Health\u003c/a> in Tulare County, \u003ca href=\"https://www.ksbw.com/article/hazel-hawkins-receives-loan-extending-timeline-to-solve-fiscal-emergency/42477641\">Hazel Hawkins Memorial Hospital\u003c/a> in Hollister, and \u003ca href=\"https://www.ivpressonline.com/featured/el-centro-regional-medical-center-keeps-base-hospital-status-for-now/article_41fdde22-9c4d-11ed-af8c-f3d5bd41e009.html\">El Centro Regional Medical Center\u003c/a> in Imperial County.\u003c/p>\n\u003cp>“When will this implode? It’s not a matter of if, but when will this implode?” Braxley said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Elizabeth Holmes, the former CEO of blood-testing startup Theranos once seen as a Silicon Valley star, was sentenced on Friday to more than 11 years in prison after being \u003ca href=\"https://www.npr.org/2022/01/03/1063973490/elizabeth-holmes-trial-verdict-guilty-theranos\" target=\"_blank\" rel=\"noopener noreferrer\">convicted\u003c/a> of fraud earlier this year.\u003c/p>\n\u003cp>“Looking back, there are so many things I would do differently if I had the chance. I regret my failings with every cell of my body,” Holmes told U.S. District Judge Edward Davila before he handed down the sentence in a federal courthouse in San Jose, Calif.\u003c/p>\n\u003cp>He directed Holmes to spend three years under supervised release after completing her sentence.\u003c/p>\n\u003cp>Prosecutors asked for Holmes to serve 15 years behind bars, citing the whopping financial loss and the need to deter future fraudulent schemes in the tech industry. Her defense lawyers had sought home confinement.\u003c/p>\n\u003cp>Holmes, 38, who is pregnant with her second child, is expected to report to prison in April.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In January, a jury convicted Holmes on four wire fraud-related counts for her role in deceiving investors about a supposedly groundbreaking technology that could scan for hundreds of conditions with just a few drops of blood. It is a feat laboratory scientists around the world for years have tried to accomplish, but Holmes, a Stanford dropout, claimed she had perfected it.\u003c/p>\n\u003cp>She drummed up nearly $1 billion in investment based on the premise that her proprietary blood-testing devices would revolutionize health care, but prosecutors argued during the trial that Holmes fudged test results, flagrantly lied about the capabilities of her tests and tried to cover it up when whistleblowers and journalists began drew scrutiny to what was really going on at the company.\u003c/p>\n\u003cp>It is nearly unheard of in Silicon Valley for an executive to face criminal prosecution in the wake of a business collapse. But legal experts said the egregiousness of Holmes’ crimes, and the fact that she was operating in the highly-regulated health care world, made the Theranos case exceptional.\u003c/p>\n\u003cp>Still, Holmes’ prosecution \u003ca href=\"https://www.npr.org/2021/09/25/1040442689/elizabeth-holmes-trial-why-her-not-other-ceos\">stirred debate\u003c/a> in tech circles about possible sexism, with some wondering why men who led tech startups that failed after unrealized promises have never faced criminal charges.\u003c/p>\n\u003cp>There appears to be more scrutiny on high-flying tech startups now, however. The Justice Department is reportedly investigating the \u003ca href=\"https://www.npr.org/2022/11/15/1136641651/ftx-bankruptcy-sam-bankman-fried-ftt-crypto-cryptocurrency-binance\">now-bankrupt FTX\u003c/a>, an exchange for trading crypto. Its recent implosion wiped out former CEO Sam Bankman-Fried’s wealth of $16 billion, which \u003ca href=\"https://www.bloomberg.com/news/articles/2022-11-10/ftx-latest-bankman-fried-shuts-down-trading-firm-alameda?sref=h2AwP2mF\">Bloomberg called\u003c/a> “one of history’s greatest-ever destructions of wealth.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Federal investigators are probing the unwinding of the company, with the specter of possible criminal charges being discussed among legal experts.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2022 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Elizabeth+Holmes+sentenced+to+11+years+in+prison+for+Theranos+fraud+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Elizabeth Holmes, the former CEO of blood-testing startup Theranos once seen as a Silicon Valley star, was sentenced on Friday to more than 11 years in prison after being \u003ca href=\"https://www.npr.org/2022/01/03/1063973490/elizabeth-holmes-trial-verdict-guilty-theranos\" target=\"_blank\" rel=\"noopener noreferrer\">convicted\u003c/a> of fraud earlier this year.\u003c/p>\n\u003cp>“Looking back, there are so many things I would do differently if I had the chance. I regret my failings with every cell of my body,” Holmes told U.S. District Judge Edward Davila before he handed down the sentence in a federal courthouse in San Jose, Calif.\u003c/p>\n\u003cp>He directed Holmes to spend three years under supervised release after completing her sentence.\u003c/p>\n\u003cp>Prosecutors asked for Holmes to serve 15 years behind bars, citing the whopping financial loss and the need to deter future fraudulent schemes in the tech industry. Her defense lawyers had sought home confinement.\u003c/p>\n\u003cp>Holmes, 38, who is pregnant with her second child, is expected to report to prison in April.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In January, a jury convicted Holmes on four wire fraud-related counts for her role in deceiving investors about a supposedly groundbreaking technology that could scan for hundreds of conditions with just a few drops of blood. It is a feat laboratory scientists around the world for years have tried to accomplish, but Holmes, a Stanford dropout, claimed she had perfected it.\u003c/p>\n\u003cp>She drummed up nearly $1 billion in investment based on the premise that her proprietary blood-testing devices would revolutionize health care, but prosecutors argued during the trial that Holmes fudged test results, flagrantly lied about the capabilities of her tests and tried to cover it up when whistleblowers and journalists began drew scrutiny to what was really going on at the company.\u003c/p>\n\u003cp>It is nearly unheard of in Silicon Valley for an executive to face criminal prosecution in the wake of a business collapse. But legal experts said the egregiousness of Holmes’ crimes, and the fact that she was operating in the highly-regulated health care world, made the Theranos case exceptional.\u003c/p>\n\u003cp>Still, Holmes’ prosecution \u003ca href=\"https://www.npr.org/2021/09/25/1040442689/elizabeth-holmes-trial-why-her-not-other-ceos\">stirred debate\u003c/a> in tech circles about possible sexism, with some wondering why men who led tech startups that failed after unrealized promises have never faced criminal charges.\u003c/p>\n\u003cp>There appears to be more scrutiny on high-flying tech startups now, however. The Justice Department is reportedly investigating the \u003ca href=\"https://www.npr.org/2022/11/15/1136641651/ftx-bankruptcy-sam-bankman-fried-ftt-crypto-cryptocurrency-binance\">now-bankrupt FTX\u003c/a>, an exchange for trading crypto. Its recent implosion wiped out former CEO Sam Bankman-Fried’s wealth of $16 billion, which \u003ca href=\"https://www.bloomberg.com/news/articles/2022-11-10/ftx-latest-bankman-fried-shuts-down-trading-firm-alameda?sref=h2AwP2mF\">Bloomberg called\u003c/a> “one of history’s greatest-ever destructions of wealth.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Federal investigators are probing the unwinding of the company, with the specter of possible criminal charges being discussed among legal experts.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2022 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Elizabeth+Holmes+sentenced+to+11+years+in+prison+for+Theranos+fraud+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Patients are flooding Bay Area hospitals as a common respiratory virus sweeps across the region, mirroring a similar surge that has ravaged the East Coast this month.\u003c/p>\n\u003cp>“Last night I admitted a 3-year-old child from the emergency department who spent nine hours in the emergency room waiting for a bed in the hospital,” said Dr. David Cornfield, pediatric pulmonologist at Stanford University. “And that’s not terrifically unusual [right now].”\u003c/p>\n\u003cp>The main culprit is respiratory syncytial virus, or RSV, which feels like a bad cold. Symptoms can include a runny nose, a barking cough, wheezing or rapid breathing. Nearly every child on the planet has had RSV by the time they are 3 years old, and many catch it before they are 1 year old. However, the pandemic broke this pattern because older kids may have escaped it as an infant. Now they are catching RSV for the first time.\u003c/p>\n\u003cp>“It’s almost as if we’re seeing a stacking up of the infectious risk that was deferred in recent years when viruses weren’t exchanged as readily because people were in isolation, wearing masks and not going to school,” said Cornfield.\u003c/p>\n\u003cp>He says the emergency department at Stanford’s Lucile Packard Children’s Hospital is full. Doctors at UCSF Benioff Children’s Hospitals and Kaiser Permanente also say patient volume is unusually high, although they still have capacity.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"https://wastewaterscan.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Wastewater data\u003c/a> from San Francisco, Santa Clara and Sacramento and other Northern California communities show RSV levels are sky-high, similar to last winter’s peak in January. Scientists sampling sewage can measure the genomic material of viruses circulating in mucus, feces and urine to determine how much a bug is spreading within a community.\u003c/p>\n\u003cp>“There’s a really large increasing trend across all of our wastewater treatment plants that we are monitoring in the Bay Area as well as in Sacramento,” said Alexandria Boehm, who monitors the data and is a Stanford University environmental engineering professor.\u003c/p>\n\u003cp>The good news is most people recover from RSV in a week or two. Doctors recommend drinking lots of fluids, resting and taking medications like ibuprofen or acetaminophen to reduce fever. You can clear mucus from an infant’s nasal passage with a \u003ca href=\"nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/suctioning-the-nose-with-a-bulb-syringe\">bulb\u003c/a> \u003ca href=\"nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/suctioning-the-nose-with-a-bulb-syringe\">syringe\u003c/a>.\u003c/p>\n\u003cp>“If they breathe and you see the skin around their bones kind of sink in and it looks like they’re really sucking, that should certainly be a red flag to take your kid to the clinic or to the hospital,” said Dr. Ted Ruel, chief of pediatric infectious disease at UCSF.\u003c/p>\n\u003cp>He recommends people wash their hands frequently and stay home if they are sick. He’s also warning a nasty “tripledemic” could hit this year with flu, RSV and COVID-19 surging all at once. Ruel urges people to get a flu shot and stay current on coronavirus vaccines.\u003c/p>\n\u003cp>Current COVID-19 rates have been decreasing and flattened in the Bay Area, but experts say a \u003ca href=\"https://www.npr.org/sections/health-shots/2022/10/07/1127017062/early-signs-a-new-u-s-covid-surge-could-be-on-its-way\" target=\"_blank\" rel=\"noopener noreferrer\">winter wave is likely\u003c/a>. New omicron variants are circulating in Germany and France, and European surges have been harbingers of what’s to come in California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We are absolutely worried about overlaps of all three viruses colliding at the same time,” said Ruel. “I think we’re still in the watch-and-see phase.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Patients are flooding Bay Area hospitals as a common respiratory virus sweeps across the region, mirroring a similar surge that has ravaged the East Coast this month.\u003c/p>\n\u003cp>“Last night I admitted a 3-year-old child from the emergency department who spent nine hours in the emergency room waiting for a bed in the hospital,” said Dr. David Cornfield, pediatric pulmonologist at Stanford University. “And that’s not terrifically unusual [right now].”\u003c/p>\n\u003cp>The main culprit is respiratory syncytial virus, or RSV, which feels like a bad cold. Symptoms can include a runny nose, a barking cough, wheezing or rapid breathing. Nearly every child on the planet has had RSV by the time they are 3 years old, and many catch it before they are 1 year old. However, the pandemic broke this pattern because older kids may have escaped it as an infant. Now they are catching RSV for the first time.\u003c/p>\n\u003cp>“It’s almost as if we’re seeing a stacking up of the infectious risk that was deferred in recent years when viruses weren’t exchanged as readily because people were in isolation, wearing masks and not going to school,” said Cornfield.\u003c/p>\n\u003cp>He says the emergency department at Stanford’s Lucile Packard Children’s Hospital is full. Doctors at UCSF Benioff Children’s Hospitals and Kaiser Permanente also say patient volume is unusually high, although they still have capacity.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://wastewaterscan.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Wastewater data\u003c/a> from San Francisco, Santa Clara and Sacramento and other Northern California communities show RSV levels are sky-high, similar to last winter’s peak in January. Scientists sampling sewage can measure the genomic material of viruses circulating in mucus, feces and urine to determine how much a bug is spreading within a community.\u003c/p>\n\u003cp>“There’s a really large increasing trend across all of our wastewater treatment plants that we are monitoring in the Bay Area as well as in Sacramento,” said Alexandria Boehm, who monitors the data and is a Stanford University environmental engineering professor.\u003c/p>\n\u003cp>The good news is most people recover from RSV in a week or two. Doctors recommend drinking lots of fluids, resting and taking medications like ibuprofen or acetaminophen to reduce fever. You can clear mucus from an infant’s nasal passage with a \u003ca href=\"nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/suctioning-the-nose-with-a-bulb-syringe\">bulb\u003c/a> \u003ca href=\"nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/suctioning-the-nose-with-a-bulb-syringe\">syringe\u003c/a>.\u003c/p>\n\u003cp>“If they breathe and you see the skin around their bones kind of sink in and it looks like they’re really sucking, that should certainly be a red flag to take your kid to the clinic or to the hospital,” said Dr. Ted Ruel, chief of pediatric infectious disease at UCSF.\u003c/p>\n\u003cp>He recommends people wash their hands frequently and stay home if they are sick. He’s also warning a nasty “tripledemic” could hit this year with flu, RSV and COVID-19 surging all at once. Ruel urges people to get a flu shot and stay current on coronavirus vaccines.\u003c/p>\n\u003cp>Current COVID-19 rates have been decreasing and flattened in the Bay Area, but experts say a \u003ca href=\"https://www.npr.org/sections/health-shots/2022/10/07/1127017062/early-signs-a-new-u-s-covid-surge-could-be-on-its-way\" target=\"_blank\" rel=\"noopener noreferrer\">winter wave is likely\u003c/a>. New omicron variants are circulating in Germany and France, and European surges have been harbingers of what’s to come in California.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We are absolutely worried about overlaps of all three viruses colliding at the same time,” said Ruel. “I think we’re still in the watch-and-see phase.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Monkeypox Vaccines: California and FDA Do Not Agree on How to Stretch Meager Supply",
"headTitle": "Monkeypox Vaccines: California and FDA Do Not Agree on How to Stretch Meager Supply | KQED",
"content": "\u003cp>As monkeypox spreads rapidly, everyone agrees that the meager supply of vaccine needs to be improved.\u003c/p>\n\u003cp>But how exactly to stretch the limited supply? That’s where California and its progressive cities have diverged from federal regulators.\u003c/p>\n\u003cp>California’s top health officials advised local agencies in a July 27 memo to \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Monkeypox-vaccine-doses.aspx#\">prioritize a single dose of the two-dose monkeypox vaccine for people who are most at risk\u003c/a>. For weeks, San Francisco has used this strategy to spread its limited supply of monkeypox vaccine to people in the city who are at high risk of contracting the disease.\u003c/p>\n\u003cp>Officials with the Centers for Disease Control and Prevention and the Food and Drug Administration \u003ca href=\"https://www.statnews.com/2022/07/15/nyc-one-dose-monkeypox-strategy-cdc-fda-warnings-against/\">have warned health providers against deviating from the approved schedule\u003c/a>. The vaccine is supposed to be given in two doses, with the second one administered 28 days after the first.\u003c/p>\n\u003cp>“We do not recommend to go off of the recommended schedule here,” said Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, \u003ca href=\"https://www.statnews.com/2022/07/15/nyc-one-dose-monkeypox-strategy-cdc-fda-warnings-against/\" target=\"_blank\" rel=\"noopener noreferrer\">at a press conference organized by the Department of Health and Human Services\u003c/a>. For people most at risk, he added, “A single dose of this vaccine will not provide the kind of protection over time that is necessary.”[aside postID=news_11920455 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/07/RS57399_GettyImages-1408879341-qut-1020x765.jpg']\u003c/p>\n\u003ch2>‘Dose sparing’\u003c/h2>\n\u003cp>Now, the FDA is considering a “dose sparing” proposal that would allow health providers to use a single-dose vial of vaccine to administer a total of up to five separate doses. The plan would require changing how the vaccine is administered. Rather than an injection that goes into the fatty tissues underneath the skin, known as subcutaneous administration, people would receive it through a small needle placed delicately under the top layer of skin.\u003c/p>\n\u003cp>This is called intradermal administration, and giving vaccines intradermally can also result in a strong immune response.\u003c/p>\n\u003cp>“The FDA has identified a potential solution that would allow us to significantly increase the number of doses available [for] administration,” an agency spokesperson told KQED in an emailed statement on Friday.\u003c/p>\n\u003cp>“It’s important to note that overall safety and efficacy profile would not be sacrificed with this approach,” the statement said. “The virus has continued to spread at a pace and rate in recent weeks that made it clear to all of us that we would not meet current demand with the current supply.”\u003c/p>\n\u003cp>The FDA’s alternate strategy is now under consideration and not yet approved — nor is it clear when it might be.\u003c/p>\n\u003ch2>The single dose strategy\u003c/h2>\n\u003cp>Health experts warn that the U.S. might not be able to contain the monkeypox outbreak, which has already infected thousands of Americans. And San Francisco has said it is important to take quick action in order to protect the most people.\u003c/p>\n\u003cp>KQED’s Community Engagement Reporter Carlos Cabrera-Lomelí reported that people seeking a jab at a vaccine clinic at Zuckerberg San Francisco General Hospital and Trauma Center are not being offered second shots right now.\u003c/p>\n\u003cp>https://twitter.com/LomeliCabrera/status/1554845594161598464?s=20&t=AM_k84nHNl35wO0Z-3GI8w\u003c/p>\n\u003cp>Instead, San Francisco’s health department is prioritizing first doses of Jynneos, delaying the second. Cabrera-Lomelí reported that patients attending the clinic at Zuckerberg San Francisco General Hospital and Trauma Center\u003cstrong>,\u003c/strong> the city’s only walk-in monkeypox vaccine clinic, were told by hospital staff that their second shot could safely be delayed as long as two years.\u003c/p>\n\u003cp>City officials told KQED in an email that “although data on the full efficacy of a first dose of the Jynneos monkeypox vaccine is not fully known, the information that we do have and relevant studies on the topic, allows us to take this temporary harm reduction approach while vaccine supply increases.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Monkeypox-vaccine-doses.aspx#\">California’s health department laid out a rationale for a single shot plan\u003c/a> in the memo it sent to local agencies, noting that in the eradication of smallpox — a poxvirus genetically very similar to monkeypox — the first vaccine dose provided quick protection. Clinical trials in humans and animals measuring immunity from the Jynneos have produced similar results.\u003c/p>\n\u003cp>“While supplies remain scarce, vaccinators in California may offer first doses of JYNNEOS [sic] to additional persons at risk rather than retain inventory as second doses for immunocompetent persons, even if second doses are consequently administered at an interval greater than 28 days,” the memo said.\u003c/p>\n\u003cp>The health department said people who are immunocompromised are still eligible to received two doses. \u003cspan style=\"font-weight: 400\">[aside postID=news_11919070 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/07/RS57170_GettyImages-1401390462-qut.jpg']\u003c/span>\u003c/p>\n\u003cp>UCSF’s Dr. Peter Chin-Hong told KQED in an email that it “is indeed safe not to get a second dose of the vaccine at 28 days, on time.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.statnews.com/2022/07/15/nyc-one-dose-monkeypox-strategy-cdc-fda-warnings-against/\">New York, the United Kingdom and Canada are delaying the vaccine boosters\u003c/a>, too. Science magazine reported that \u003ca href=\"https://www.science.org/content/article/there-s-shortage-monkeypox-vaccine-could-one-dose-instead-two-suffice\">Paul Chaplin, an immunologist and CEO of Bavarian Nordic \u003c/a>— the company that manufactures the vaccine — also endorses the single dose plan.\u003c/p>\n\u003cp>\u003ca href=\"https://www.science.org/content/article/there-s-shortage-monkeypox-vaccine-could-one-dose-instead-two-suffice\">Federal scientists have cautioned that a single dose regime of vaccine hasn’t been studied\u003c/a> in an actual outbreak.\u003c/p>\n\u003cp>Jynneos is the only vaccine currently approved for the prevention of monkeypox in the United States.\u003c/p>\n\u003cp>San Francisco health officials say people, “especially those who have only received one dose,” should limit their risk of exposure to monkeypox before and after being vaccinated and second doses will be offered “once supply allows.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "California advises health providers to use a single dose of vaccine; the FDA is considering a proposal that would allow health providers to use a smaller amount—but it's not ready yet. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As monkeypox spreads rapidly, everyone agrees that the meager supply of vaccine needs to be improved.\u003c/p>\n\u003cp>But how exactly to stretch the limited supply? That’s where California and its progressive cities have diverged from federal regulators.\u003c/p>\n\u003cp>California’s top health officials advised local agencies in a July 27 memo to \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Monkeypox-vaccine-doses.aspx#\">prioritize a single dose of the two-dose monkeypox vaccine for people who are most at risk\u003c/a>. For weeks, San Francisco has used this strategy to spread its limited supply of monkeypox vaccine to people in the city who are at high risk of contracting the disease.\u003c/p>\n\u003cp>Officials with the Centers for Disease Control and Prevention and the Food and Drug Administration \u003ca href=\"https://www.statnews.com/2022/07/15/nyc-one-dose-monkeypox-strategy-cdc-fda-warnings-against/\">have warned health providers against deviating from the approved schedule\u003c/a>. The vaccine is supposed to be given in two doses, with the second one administered 28 days after the first.\u003c/p>\n\u003cp>“We do not recommend to go off of the recommended schedule here,” said Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, \u003ca href=\"https://www.statnews.com/2022/07/15/nyc-one-dose-monkeypox-strategy-cdc-fda-warnings-against/\" target=\"_blank\" rel=\"noopener noreferrer\">at a press conference organized by the Department of Health and Human Services\u003c/a>. For people most at risk, he added, “A single dose of this vaccine will not provide the kind of protection over time that is necessary.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch2>‘Dose sparing’\u003c/h2>\n\u003cp>Now, the FDA is considering a “dose sparing” proposal that would allow health providers to use a single-dose vial of vaccine to administer a total of up to five separate doses. The plan would require changing how the vaccine is administered. Rather than an injection that goes into the fatty tissues underneath the skin, known as subcutaneous administration, people would receive it through a small needle placed delicately under the top layer of skin.\u003c/p>\n\u003cp>This is called intradermal administration, and giving vaccines intradermally can also result in a strong immune response.\u003c/p>\n\u003cp>“The FDA has identified a potential solution that would allow us to significantly increase the number of doses available [for] administration,” an agency spokesperson told KQED in an emailed statement on Friday.\u003c/p>\n\u003cp>“It’s important to note that overall safety and efficacy profile would not be sacrificed with this approach,” the statement said. “The virus has continued to spread at a pace and rate in recent weeks that made it clear to all of us that we would not meet current demand with the current supply.”\u003c/p>\n\u003cp>The FDA’s alternate strategy is now under consideration and not yet approved — nor is it clear when it might be.\u003c/p>\n\u003ch2>The single dose strategy\u003c/h2>\n\u003cp>Health experts warn that the U.S. might not be able to contain the monkeypox outbreak, which has already infected thousands of Americans. And San Francisco has said it is important to take quick action in order to protect the most people.\u003c/p>\n\u003cp>KQED’s Community Engagement Reporter Carlos Cabrera-Lomelí reported that people seeking a jab at a vaccine clinic at Zuckerberg San Francisco General Hospital and Trauma Center are not being offered second shots right now.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Instead, San Francisco’s health department is prioritizing first doses of Jynneos, delaying the second. Cabrera-Lomelí reported that patients attending the clinic at Zuckerberg San Francisco General Hospital and Trauma Center\u003cstrong>,\u003c/strong> the city’s only walk-in monkeypox vaccine clinic, were told by hospital staff that their second shot could safely be delayed as long as two years.\u003c/p>\n\u003cp>City officials told KQED in an email that “although data on the full efficacy of a first dose of the Jynneos monkeypox vaccine is not fully known, the information that we do have and relevant studies on the topic, allows us to take this temporary harm reduction approach while vaccine supply increases.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Monkeypox-vaccine-doses.aspx#\">California’s health department laid out a rationale for a single shot plan\u003c/a> in the memo it sent to local agencies, noting that in the eradication of smallpox — a poxvirus genetically very similar to monkeypox — the first vaccine dose provided quick protection. Clinical trials in humans and animals measuring immunity from the Jynneos have produced similar results.\u003c/p>\n\u003cp>“While supplies remain scarce, vaccinators in California may offer first doses of JYNNEOS [sic] to additional persons at risk rather than retain inventory as second doses for immunocompetent persons, even if second doses are consequently administered at an interval greater than 28 days,” the memo said.\u003c/p>\n\u003cp>The health department said people who are immunocompromised are still eligible to received two doses. \u003cspan style=\"font-weight: 400\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>UCSF’s Dr. Peter Chin-Hong told KQED in an email that it “is indeed safe not to get a second dose of the vaccine at 28 days, on time.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.statnews.com/2022/07/15/nyc-one-dose-monkeypox-strategy-cdc-fda-warnings-against/\">New York, the United Kingdom and Canada are delaying the vaccine boosters\u003c/a>, too. Science magazine reported that \u003ca href=\"https://www.science.org/content/article/there-s-shortage-monkeypox-vaccine-could-one-dose-instead-two-suffice\">Paul Chaplin, an immunologist and CEO of Bavarian Nordic \u003c/a>— the company that manufactures the vaccine — also endorses the single dose plan.\u003c/p>\n\u003cp>\u003ca href=\"https://www.science.org/content/article/there-s-shortage-monkeypox-vaccine-could-one-dose-instead-two-suffice\">Federal scientists have cautioned that a single dose regime of vaccine hasn’t been studied\u003c/a> in an actual outbreak.\u003c/p>\n\u003cp>Jynneos is the only vaccine currently approved for the prevention of monkeypox in the United States.\u003c/p>\n\u003cp>San Francisco health officials say people, “especially those who have only received one dose,” should limit their risk of exposure to monkeypox before and after being vaccinated and second doses will be offered “once supply allows.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "The Omicron Subvariant BA.2 Has Been in the Bay Area for Weeks — With Limited Impact",
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"content": "\u003cp>We’ve seen this play out before: Just as we start letting down our guard, the coronavirus mutates into another insidious version, wreaking havoc on our plans.\u003c/p>\n\u003cp>Cue BA.2, or \u003ca href=\"https://www.ama-assn.org/delivering-care/public-health/what-ba2-or-stealth-omicron-subvariant\">stealth omicron\u003c/a>.\u003c/p>\n\u003cp>Earlier this month when mask mandates started falling away, the subvariant struck parts of Europe and Asia, driving \u003ca href=\"https://www.cnbc.com/2022/03/23/omicrons-subvariant-bapoint2-could-spread-wildly-in-europe-epidemiologist.html\">unprecedented spikes\u003c/a>. Now, it’s traveling fast within the U.S.\u003c/p>\n\u003cp>BA.2 is both the dominant strain globally and, now, nationally, according to the \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#variant-proportions\" target=\"_blank\" rel=\"noopener noreferrer\">Centers for Disease Control and Prevention\u003c/a>, which credits more than half of U.S. cases to stealth omicron. Infections are edging up in parts of the Northeast, and \u003ca href=\"https://soe-wbe-pilot.wl.r.appspot.com/charts#page=overview\">recent wastewater data\u003c/a> from Palo Alto, Sunnyvale and Davis suggest BA.2 is starting to push cases up around Northern California — the first real sign that it’s having an impact in the region.\u003c/p>\n\u003cp>But the data does not suggest a repeat of last winter’s surge.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s not that sharp, dramatic increase from the beginning of the omicron wave,” said Marlene Wolfe of Emory University, one of the researchers who monitors wastewater sites across Northern California. “It’s something to watch, something to be careful of, something that we are glad we have this data to speak to.”\u003c/p>\n\u003ch2>Here’s what you need to know about BA.2 across California\u003c/h2>\n\u003cp>BA.2 is really good at its job: To date, it’s the most transmissible strain of the coronavirus. A \u003ca href=\"https://www.medrxiv.org/content/10.1101/2022.01.28.22270044v1\" target=\"_blank\" rel=\"noopener noreferrer\">Danish study\u003c/a> shows the virus spreads very quickly inside households, and a recent \u003ca href=\"https://www.medrxiv.org/content/10.1101/2022.03.26.22272984v1\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s2\">Swedish study\u003c/span>\u003c/a> shows that the viral loads are twice as high as the original omicron, which helps to explain why the latest strain of COVID-19 is furiously outcompeting its predecessor.\u003c/p>\n\u003cp>The good news is BA.2 does not appear to lead to more severe symptoms than the original omicron. Patients complain of cough, fatigue, congestion, dizziness and a runny nose.\u003c/p>\n\u003cp>“It’s not causing more intensive care hospital admissions in Europe,” said Dr. Susan Philip, San Francisco’s health officer. “[This is] a positive thing when we look at the characteristics of this virus.”\u003c/p>\n\u003ch2>How worried should we be?\u003c/h2>\n\u003cp>Not too worried, according to Dr. Bob Wachter, chair of UCSF’s department of medicine. “It might well lead to a small increase in cases, which we should watch carefully,” he said in an email. “It is unlikely to cause a major surge given the extent of [local] vax and infection-related immunity.”\u003c/p>\n\u003cp>That sentiment is shared by other local experts. UCSF epidemiologist Dr. George Rutherford suspects the impact in Northern California will be “relatively minor.” He estimates immunity coverage in the Bay Area is hovering around 90% due to high vaccine rates and the recent omicron wave, which left many people with natural immunity, at least in the short term. Those two factors wrap the region in a protective layer.\u003c/p>\n\u003cp>Rutherford points to what he sees as hopeful signs unfolding overseas. “Look at Western European data,” he said. “Cases are going up in some countries and not in others. A surge is not inevitable.”\u003c/p>\n\u003ch2>California cases continue to plummet\u003c/h2>\n\u003cp>It’s not time to panic. \u003ca href=\"https://covid19.ca.gov/?gclid=Cj0KCQjw3IqSBhCoARIsAMBkTb0HWWvfRHDNjPLxgEaX7PUdfx_IgCF7LJ77g3o8FIZ0HxBPJmRdTDIaAtYAEALw_wcB\">Cases across the state\u003c/a> have fallen about 32% over the past two weeks. Hospitalizations are not increasing and death rates continue to fall. Some regions are experiencing very slight upticks, but nothing concerning to public health officials.\u003c/p>\n\u003cp>Still, BA.2 poses the highest risk to anyone who is not vaccinated and did not catch omicron during the last surge. “The consequences for hospitalizations and deaths will be largely determined by how many people are vaccinated and how many older people are boosted,” said Bill Hanage, a Harvard epidemiologist.\u003c/p>\n\u003cp>This means children who are not yet old enough for a vaccine, as well as many disabled and immunocompromised people, remain at high risk.\u003c/p>\n\u003cp>If an actual surge were to form, regions with low vaccination rates would be the most vulnerable. In California that means rural areas and parts of the Central Valley.\u003c/p>\n\u003ch2>How can I protect myself?\u003c/h2>\n\u003cp>At this point California health officials are not recommending people make any course corrections to their daily lives. The state has a \u003ca href=\"https://files.covid19.ca.gov/pdf/smarter-plan--en.pdf\">road map for potential surges\u003c/a>, if the situation were to change.\u003c/p>\n\u003cp>“If we do start to see concerning increases in cases, increased severity or increasing hospitalization — we may need to reinstate some of our prior tools, things like masking,” California State Epidemiologist Dr. Erica Pan told KQED.\u003c/p>\n\u003cp>She recommends making sure you’re up to date on your vaccinations, and stocking up on \u003ca href=\"https://www.kqed.org/news/11901928/you-can-now-order-free-covid-at-home-tests-via-usps\"> home testing kits\u003c/a> to protect loved ones.\u003c/p>\n\u003ch2>Should I get a 4th dose if I’m over age 50?\u003c/h2>\n\u003cp>The U.S. Food and Drug Administration announced Tuesday that it has approved a fourth shot for people over 50. Until now the only people authorized for a fourth dose were those \u003ca href=\"https://www.nytimes.com/2022/01/09/health/immunocompromised-fourth-dose-booster.html\">with weakened immune systems\u003c/a>.\u003c/p>\n\u003cp>UCSF’s Wachter recommends a fourth shot for older adults who didn’t catch omicron in the last wave. This is especially critical if folks are engaging in riskier behaviors like eating inside restaurants. For those who caught the virus recently, Wachter suggests holding off on a fourth shot for a few months because a recent infection offers similar protection.\u003c/p>\n\u003cp>There’s \u003ca href=\"https://www.medrxiv.org/content/10.1101/2022.02.01.22270232v1.full.pdfre-pharmaceuticals/israeli-study-2nd-vaccine-booster-significantly-lowers-covid-death-rate-2022-03-27/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s2\">compelling mortality data out of Israel\u003c/span>\u003c/a> suggesting a fourth shot dramatically lowers severe illness. However, the available data is preliminary and it’s not clear how long the benefits of a fourth dose will last.\u003c/p>\n\u003cp>https://twitter.com/Bob_Wachter/status/1508444987783929858?s=20&t=yr0py0rn9KRqRoEXy1Nb6Q\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I’m going to get it when I can,” \u003ca href=\"https://twitter.com/Bob_Wachter/status/1508446942887485440?s=20&t=yr0py0rn9KRqRoEXy1Nb6Q\">Wachter said in another tweet\u003c/a>. “I see the advantages of the 2nd boost as outweighing the small potential downside.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>We’ve seen this play out before: Just as we start letting down our guard, the coronavirus mutates into another insidious version, wreaking havoc on our plans.\u003c/p>\n\u003cp>Cue BA.2, or \u003ca href=\"https://www.ama-assn.org/delivering-care/public-health/what-ba2-or-stealth-omicron-subvariant\">stealth omicron\u003c/a>.\u003c/p>\n\u003cp>Earlier this month when mask mandates started falling away, the subvariant struck parts of Europe and Asia, driving \u003ca href=\"https://www.cnbc.com/2022/03/23/omicrons-subvariant-bapoint2-could-spread-wildly-in-europe-epidemiologist.html\">unprecedented spikes\u003c/a>. Now, it’s traveling fast within the U.S.\u003c/p>\n\u003cp>BA.2 is both the dominant strain globally and, now, nationally, according to the \u003ca href=\"https://covid.cdc.gov/covid-data-tracker/#variant-proportions\" target=\"_blank\" rel=\"noopener noreferrer\">Centers for Disease Control and Prevention\u003c/a>, which credits more than half of U.S. cases to stealth omicron. Infections are edging up in parts of the Northeast, and \u003ca href=\"https://soe-wbe-pilot.wl.r.appspot.com/charts#page=overview\">recent wastewater data\u003c/a> from Palo Alto, Sunnyvale and Davis suggest BA.2 is starting to push cases up around Northern California — the first real sign that it’s having an impact in the region.\u003c/p>\n\u003cp>But the data does not suggest a repeat of last winter’s surge.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s not that sharp, dramatic increase from the beginning of the omicron wave,” said Marlene Wolfe of Emory University, one of the researchers who monitors wastewater sites across Northern California. “It’s something to watch, something to be careful of, something that we are glad we have this data to speak to.”\u003c/p>\n\u003ch2>Here’s what you need to know about BA.2 across California\u003c/h2>\n\u003cp>BA.2 is really good at its job: To date, it’s the most transmissible strain of the coronavirus. A \u003ca href=\"https://www.medrxiv.org/content/10.1101/2022.01.28.22270044v1\" target=\"_blank\" rel=\"noopener noreferrer\">Danish study\u003c/a> shows the virus spreads very quickly inside households, and a recent \u003ca href=\"https://www.medrxiv.org/content/10.1101/2022.03.26.22272984v1\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s2\">Swedish study\u003c/span>\u003c/a> shows that the viral loads are twice as high as the original omicron, which helps to explain why the latest strain of COVID-19 is furiously outcompeting its predecessor.\u003c/p>\n\u003cp>The good news is BA.2 does not appear to lead to more severe symptoms than the original omicron. Patients complain of cough, fatigue, congestion, dizziness and a runny nose.\u003c/p>\n\u003cp>“It’s not causing more intensive care hospital admissions in Europe,” said Dr. Susan Philip, San Francisco’s health officer. “[This is] a positive thing when we look at the characteristics of this virus.”\u003c/p>\n\u003ch2>How worried should we be?\u003c/h2>\n\u003cp>Not too worried, according to Dr. Bob Wachter, chair of UCSF’s department of medicine. “It might well lead to a small increase in cases, which we should watch carefully,” he said in an email. “It is unlikely to cause a major surge given the extent of [local] vax and infection-related immunity.”\u003c/p>\n\u003cp>That sentiment is shared by other local experts. UCSF epidemiologist Dr. George Rutherford suspects the impact in Northern California will be “relatively minor.” He estimates immunity coverage in the Bay Area is hovering around 90% due to high vaccine rates and the recent omicron wave, which left many people with natural immunity, at least in the short term. Those two factors wrap the region in a protective layer.\u003c/p>\n\u003cp>Rutherford points to what he sees as hopeful signs unfolding overseas. “Look at Western European data,” he said. “Cases are going up in some countries and not in others. A surge is not inevitable.”\u003c/p>\n\u003ch2>California cases continue to plummet\u003c/h2>\n\u003cp>It’s not time to panic. \u003ca href=\"https://covid19.ca.gov/?gclid=Cj0KCQjw3IqSBhCoARIsAMBkTb0HWWvfRHDNjPLxgEaX7PUdfx_IgCF7LJ77g3o8FIZ0HxBPJmRdTDIaAtYAEALw_wcB\">Cases across the state\u003c/a> have fallen about 32% over the past two weeks. Hospitalizations are not increasing and death rates continue to fall. Some regions are experiencing very slight upticks, but nothing concerning to public health officials.\u003c/p>\n\u003cp>Still, BA.2 poses the highest risk to anyone who is not vaccinated and did not catch omicron during the last surge. “The consequences for hospitalizations and deaths will be largely determined by how many people are vaccinated and how many older people are boosted,” said Bill Hanage, a Harvard epidemiologist.\u003c/p>\n\u003cp>This means children who are not yet old enough for a vaccine, as well as many disabled and immunocompromised people, remain at high risk.\u003c/p>\n\u003cp>If an actual surge were to form, regions with low vaccination rates would be the most vulnerable. In California that means rural areas and parts of the Central Valley.\u003c/p>\n\u003ch2>How can I protect myself?\u003c/h2>\n\u003cp>At this point California health officials are not recommending people make any course corrections to their daily lives. The state has a \u003ca href=\"https://files.covid19.ca.gov/pdf/smarter-plan--en.pdf\">road map for potential surges\u003c/a>, if the situation were to change.\u003c/p>\n\u003cp>“If we do start to see concerning increases in cases, increased severity or increasing hospitalization — we may need to reinstate some of our prior tools, things like masking,” California State Epidemiologist Dr. Erica Pan told KQED.\u003c/p>\n\u003cp>She recommends making sure you’re up to date on your vaccinations, and stocking up on \u003ca href=\"https://www.kqed.org/news/11901928/you-can-now-order-free-covid-at-home-tests-via-usps\"> home testing kits\u003c/a> to protect loved ones.\u003c/p>\n\u003ch2>Should I get a 4th dose if I’m over age 50?\u003c/h2>\n\u003cp>The U.S. Food and Drug Administration announced Tuesday that it has approved a fourth shot for people over 50. Until now the only people authorized for a fourth dose were those \u003ca href=\"https://www.nytimes.com/2022/01/09/health/immunocompromised-fourth-dose-booster.html\">with weakened immune systems\u003c/a>.\u003c/p>\n\u003cp>UCSF’s Wachter recommends a fourth shot for older adults who didn’t catch omicron in the last wave. This is especially critical if folks are engaging in riskier behaviors like eating inside restaurants. For those who caught the virus recently, Wachter suggests holding off on a fourth shot for a few months because a recent infection offers similar protection.\u003c/p>\n\u003cp>There’s \u003ca href=\"https://www.medrxiv.org/content/10.1101/2022.02.01.22270232v1.full.pdfre-pharmaceuticals/israeli-study-2nd-vaccine-booster-significantly-lowers-covid-death-rate-2022-03-27/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s2\">compelling mortality data out of Israel\u003c/span>\u003c/a> suggesting a fourth shot dramatically lowers severe illness. However, the available data is preliminary and it’s not clear how long the benefits of a fourth dose will last.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003c/p>\n\u003cp>“I’m going to get it when I can,” \u003ca href=\"https://twitter.com/Bob_Wachter/status/1508446942887485440?s=20&t=yr0py0rn9KRqRoEXy1Nb6Q\">Wachter said in another tweet\u003c/a>. “I see the advantages of the 2nd boost as outweighing the small potential downside.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Omicron Was in California Before It Was Named Omicron, According to Sewage Samples",
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"content": "\u003cp>We’ve learned a lot about COVID-19 by examining what we’ve flushed down the toilet.\u003c/p>\n\u003cp>Here are a few of those things.\u003c/p>\n\u003cp>The variant was in a waste sample collected in Merced County on Nov. 25 — that’s a day before the World Health Organization named it omicron.\u003c/p>\n\u003cp>Scientists in New York found it in a sample collected even earlier, on Nov. 21, predating the alarms from leaders in South Africa about a troubling new variant.\u003c/p>\n\u003cp>Officials in Texas also detected omicron early through wastewater surveillance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A new \u003ca href=\"https://www.cdc.gov/mmwr/volumes/71/wr/mm7103a5.htm?s_cid=mm7103a5_w&utm_source=STAT+Newsletters&utm_campaign=6439030dc2-MR_COPY_01&utm_medium=email&utm_term=0_8cab1d7961-6439030dc2-151495997#T1_down\">\u003cspan class=\"s1\">report\u003c/span>\u003c/a> last week from the Centers for Disease Control and Prevention outlined these facts.\u003c/p>\n\u003cp>Agency scientists describe this as “strong early evidence that the Omicron variant was likely present or more widely distributed in these communities than originally indicated by clinical testing alone.”\u003c/p>\n\u003cp>The report makes a case that by the time officials have detected a new variant, it likely has spread to numerous other countries.\u003c/p>\n\u003cp>In this light, travel bans look ineffective and like “closing the barn door after the horses have fled,” as researchers from the University of Illinois argued in a \u003ca href=\"https://thehill.com/opinion/healthcare/583337-omicron-is-already-global-tests-for-international-flights-are-far-better\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">recent op-ed\u003c/span>\u003c/a>.\u003c/p>\n\u003cp>Requiring testing on international flights would be a much more effective policy, they wrote.\u003c/p>\n\u003cp>The study also underscores the potency of this new surveillance tool, which counties increasingly rely on as demand for COVID-19 tests outpace supply.\u003c/p>\n\u003cp>“The ability to ramp up the infrastructure to test the number of people that need to be tested right now is an enormous strain on the health care system and on our testing systems that we’ve set up,” said Marlene Wolfe of Emory University, one of the researchers who monitors sites across Northern California. “But with this wastewater data, we have not had to increase our capacity at all. We are doing exactly what we’ve been doing for a year.”\u003c/p>\n\u003cp>Wolfe’s method can detect as few as one or two cases per 100,000 people.\u003c/p>\n\u003cp>“We’re in close communication with public health officials,” she said. “They’re able to use that data to plan for what’s next. It’s similar to how they would use clinical case data but is actually more reliable. We are not biased by the fact that it’s so difficult to find a test right now.”\u003c/p>\n\u003cp>Wolfe says this moment is a good opportunity to expand the surveillance regime and collect data on other diseases.\u003c/p>\n\u003cp>“We’re starting to monitor for \u003ca href=\"https://www.cdc.gov/rsv/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">respiratory syncytial virus\u003c/a> and influenza,” she said. “There are a lot of areas where we can provide very useful public health data using wastewater because we have developed these tools so fully over the course of this pandemic.”\u003c/p>\n\u003cp>Not all of the information in the CDC’s report is new, although now it’s been verified by federal scientists.\u003c/p>\n\u003cp>KQED’s Raquel Maria Dillon was the first to \u003ca href=\"https://www.kqed.org/news/11898161/scientists-find-traces-of-omicron-in-sewage-from-sacramento-and-merced\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">report\u003c/span>\u003c/a> on the detection in Merced, as well as a similar sample found in Sacramento on Nov. 30 — that’s a day before health officials confirmed the \u003ca href=\"https://www.kqed.org/science/1977807/first-u-s-case-of-omicron-variant-found-in-california\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">first U.S. case in a San Francisco resident on Dec. 1\u003c/span>\u003c/a>.\u003cspan class=\"Apple-converted-space\"> \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Researchers notified Sacramento of the findings, and officials there described the data as useful and “one of the tools that helps us identify new variants.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A new \u003ca href=\"https://www.cdc.gov/mmwr/volumes/71/wr/mm7103a5.htm?s_cid=mm7103a5_w&utm_source=STAT+Newsletters&utm_campaign=6439030dc2-MR_COPY_01&utm_medium=email&utm_term=0_8cab1d7961-6439030dc2-151495997#T1_down\">\u003cspan class=\"s1\">report\u003c/span>\u003c/a> last week from the Centers for Disease Control and Prevention outlined these facts.\u003c/p>\n\u003cp>Agency scientists describe this as “strong early evidence that the Omicron variant was likely present or more widely distributed in these communities than originally indicated by clinical testing alone.”\u003c/p>\n\u003cp>The report makes a case that by the time officials have detected a new variant, it likely has spread to numerous other countries.\u003c/p>\n\u003cp>In this light, travel bans look ineffective and like “closing the barn door after the horses have fled,” as researchers from the University of Illinois argued in a \u003ca href=\"https://thehill.com/opinion/healthcare/583337-omicron-is-already-global-tests-for-international-flights-are-far-better\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">recent op-ed\u003c/span>\u003c/a>.\u003c/p>\n\u003cp>Requiring testing on international flights would be a much more effective policy, they wrote.\u003c/p>\n\u003cp>The study also underscores the potency of this new surveillance tool, which counties increasingly rely on as demand for COVID-19 tests outpace supply.\u003c/p>\n\u003cp>“The ability to ramp up the infrastructure to test the number of people that need to be tested right now is an enormous strain on the health care system and on our testing systems that we’ve set up,” said Marlene Wolfe of Emory University, one of the researchers who monitors sites across Northern California. “But with this wastewater data, we have not had to increase our capacity at all. We are doing exactly what we’ve been doing for a year.”\u003c/p>\n\u003cp>Wolfe’s method can detect as few as one or two cases per 100,000 people.\u003c/p>\n\u003cp>“We’re in close communication with public health officials,” she said. “They’re able to use that data to plan for what’s next. It’s similar to how they would use clinical case data but is actually more reliable. We are not biased by the fact that it’s so difficult to find a test right now.”\u003c/p>\n\u003cp>Wolfe says this moment is a good opportunity to expand the surveillance regime and collect data on other diseases.\u003c/p>\n\u003cp>“We’re starting to monitor for \u003ca href=\"https://www.cdc.gov/rsv/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">respiratory syncytial virus\u003c/a> and influenza,” she said. “There are a lot of areas where we can provide very useful public health data using wastewater because we have developed these tools so fully over the course of this pandemic.”\u003c/p>\n\u003cp>Not all of the information in the CDC’s report is new, although now it’s been verified by federal scientists.\u003c/p>\n\u003cp>KQED’s Raquel Maria Dillon was the first to \u003ca href=\"https://www.kqed.org/news/11898161/scientists-find-traces-of-omicron-in-sewage-from-sacramento-and-merced\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">report\u003c/span>\u003c/a> on the detection in Merced, as well as a similar sample found in Sacramento on Nov. 30 — that’s a day before health officials confirmed the \u003ca href=\"https://www.kqed.org/science/1977807/first-u-s-case-of-omicron-variant-found-in-california\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">first U.S. case in a San Francisco resident on Dec. 1\u003c/span>\u003c/a>.\u003cspan class=\"Apple-converted-space\"> \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Researchers notified Sacramento of the findings, and officials there described the data as useful and “one of the tools that helps us identify new variants.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Walking Out on a Job She Loved: Why One Santa Clara Doctor Left COVID Care Behind",
"headTitle": "Walking Out on a Job She Loved: Why One Santa Clara Doctor Left COVID Care Behind | KQED",
"content": "\u003cp>Dr. Molly Phelps was an emergency room physician for nearly two decades until she walked away from her job at Kaiser in Santa Clara County, no longer sleeping and barely eating.\u003c/p>\n\u003cp>Sure, Phelps was burned out — a feeling she shared with many \u003ca href=\"https://www.statnews.com/2021/12/16/health-care-workers-suffering-goes-far-beyond-burnout-self-care-isnt-the-cure/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">doctors and nurses working the front lines of this pandemic\u003c/span>\u003c/a>. But this was more than fatigue. She survived the pandemic’s first year, she says, fueled by a sense of purpose. New vaccines brought relief and hope, but these feelings waned. She found herself angry at her patients who had chosen not to get vaccinated.[pullquote align='right' citation='Dr. Molly Phelps, former ER physician']‘The hospital itself was so full that in a nine-hour shift, I almost felt like Willy Wonka with one single golden ticket that I got to pick the person who was ill enough that they got to jump the line and actually have a bed inside the hospital proper.’[/pullquote]\u003c/p>\n\u003cp>“It occurred to me all of a sudden I think that I can walk away and actually be happy,” Phelps told KQED’s Morning Edition Host Brian Watt when they spoke last week.\u003c/p>\n\u003cp>“It was the job that I loved with everything that I had, and I thought that I would do it forever,” she said, explaining her decision to leave the profession as “death by a thousand cuts.”\u003c/p>\n\u003cp>\u003cem>Their conversation has been lightly edited for length and clarity.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cb>Brian Watt: Was there a single moment when you decided it was time to step away from this?\u003c/b>\u003c/p>\n\u003cp>Dr. Molly Phelps: I waited until my husband was in the shower and I threw open the door and I said, I’m leaving medicine and he’s like, ‘Oh, OK, good morning, honey.’ But he’s been wonderfully supportive.\u003c/p>\n\u003cp>I personally didn’t even know that I was having any thoughts of leaving. Even the day that I had the epiphany. I [had] stopped eating and went down to my junior high weight, and I stopped sleeping and was really kind of a shell of a human being. I spent the majority of last winter in our massive COVID tent that filled the ER’s parking lot. And typically, it was lined with two neat rows of gurneys. And every last one of them had someone in it who was struggling to breathe to some extent. And at the peak, the hospital itself was so full that in a nine-hour shift, I almost felt like Willy Wonka with one single golden ticket that I got to pick the person who was ill enough that they got to jump the line and actually have a bed inside the hospital proper.\u003c/p>\n\u003cp>\u003cb>And how much longer did you last?\u003c/b>\u003c/p>\n\u003cp>My last shift in the ER was an overnight shift on Labor Day, and then I did part-time work in the vaccine clinic before I officially separated from the hospital entirely last week.\u003c/p>\n\u003cp>\u003cb>Was there a point where you felt like you and your colleagues were doing all you could to fight COVID, but maybe the general public wasn’t?\u003c/b>\u003c/p>\n\u003cp>We were six months into having a life-saving, readily accessible free vaccine, and there was a segment of the population that deliberately chose not to get it and not to protect themselves and not to protect their community. And yet they didn’t want our advice to get the vaccine, but they still wanted our help as soon as they started feeling achy. It felt really insulting, and I also felt like I had given nearly everything that I had, I almost destroyed myself with the winter surge, and I would do it again, but I didn’t feel like I wanted to give the last bit of me that I had left to the unvaccinated.\u003c/p>\n\u003cp>\u003cb>And now, omicron, a variant that has spread so fast. What is it like to watch this surge from outside the hospital?\u003c/b>\u003c/p>\n\u003cp>This is the disease that I literally bruised my cheeks and had blood on the bridge of my nose from my N95 [mask] to try not to get this virus. And yet, it’s on the other side of my door right now. Ironically, my wonderful, goody-two-shoes, rule-following 12-year-old, who even wears a mask during his school lunch, just came down with COVID last night. And my daughter, who is 9 years old, is achy.\u003c/p>\n\u003cp>\u003cb>If you’re not watching it from inside the hospital, you are now living with people who tested positive.\u003c/b>\u003c/p>\n\u003cp>Exactly. It’s a different world.\u003c/p>\n\u003cp>\u003cb>So what now, if not medicine in the ER?\u003c/b>\u003c/p>\n\u003cp>I am actually working on a memoir about my time on the front lines. So it has brought up a lot of old stuff and a lot of painful stuff. It feels like a really interesting and helpful opportunity to work through that.\u003c/p>\n\u003cp>\u003cb>I think we’re going to need these memoirs. I know it’s hard, but thanks for working through it.\u003c/b>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Thank you so much.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Molly Phelps was an emergency room physician for nearly two decades until she walked away from her job at Kaiser in Santa Clara County, no longer sleeping and barely eating.\u003c/p>\n\u003cp>Sure, Phelps was burned out — a feeling she shared with many \u003ca href=\"https://www.statnews.com/2021/12/16/health-care-workers-suffering-goes-far-beyond-burnout-self-care-isnt-the-cure/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan class=\"s1\">doctors and nurses working the front lines of this pandemic\u003c/span>\u003c/a>. But this was more than fatigue. She survived the pandemic’s first year, she says, fueled by a sense of purpose. New vaccines brought relief and hope, but these feelings waned. She found herself angry at her patients who had chosen not to get vaccinated.\u003c/p>\u003c/div>",
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"content": "‘The hospital itself was so full that in a nine-hour shift, I almost felt like Willy Wonka with one single golden ticket that I got to pick the person who was ill enough that they got to jump the line and actually have a bed inside the hospital proper.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It occurred to me all of a sudden I think that I can walk away and actually be happy,” Phelps told KQED’s Morning Edition Host Brian Watt when they spoke last week.\u003c/p>\n\u003cp>“It was the job that I loved with everything that I had, and I thought that I would do it forever,” she said, explaining her decision to leave the profession as “death by a thousand cuts.”\u003c/p>\n\u003cp>\u003cem>Their conversation has been lightly edited for length and clarity.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>Brian Watt: Was there a single moment when you decided it was time to step away from this?\u003c/b>\u003c/p>\n\u003cp>Dr. Molly Phelps: I waited until my husband was in the shower and I threw open the door and I said, I’m leaving medicine and he’s like, ‘Oh, OK, good morning, honey.’ But he’s been wonderfully supportive.\u003c/p>\n\u003cp>I personally didn’t even know that I was having any thoughts of leaving. Even the day that I had the epiphany. I [had] stopped eating and went down to my junior high weight, and I stopped sleeping and was really kind of a shell of a human being. I spent the majority of last winter in our massive COVID tent that filled the ER’s parking lot. And typically, it was lined with two neat rows of gurneys. And every last one of them had someone in it who was struggling to breathe to some extent. And at the peak, the hospital itself was so full that in a nine-hour shift, I almost felt like Willy Wonka with one single golden ticket that I got to pick the person who was ill enough that they got to jump the line and actually have a bed inside the hospital proper.\u003c/p>\n\u003cp>\u003cb>And how much longer did you last?\u003c/b>\u003c/p>\n\u003cp>My last shift in the ER was an overnight shift on Labor Day, and then I did part-time work in the vaccine clinic before I officially separated from the hospital entirely last week.\u003c/p>\n\u003cp>\u003cb>Was there a point where you felt like you and your colleagues were doing all you could to fight COVID, but maybe the general public wasn’t?\u003c/b>\u003c/p>\n\u003cp>We were six months into having a life-saving, readily accessible free vaccine, and there was a segment of the population that deliberately chose not to get it and not to protect themselves and not to protect their community. And yet they didn’t want our advice to get the vaccine, but they still wanted our help as soon as they started feeling achy. It felt really insulting, and I also felt like I had given nearly everything that I had, I almost destroyed myself with the winter surge, and I would do it again, but I didn’t feel like I wanted to give the last bit of me that I had left to the unvaccinated.\u003c/p>\n\u003cp>\u003cb>And now, omicron, a variant that has spread so fast. What is it like to watch this surge from outside the hospital?\u003c/b>\u003c/p>\n\u003cp>This is the disease that I literally bruised my cheeks and had blood on the bridge of my nose from my N95 [mask] to try not to get this virus. And yet, it’s on the other side of my door right now. Ironically, my wonderful, goody-two-shoes, rule-following 12-year-old, who even wears a mask during his school lunch, just came down with COVID last night. And my daughter, who is 9 years old, is achy.\u003c/p>\n\u003cp>\u003cb>If you’re not watching it from inside the hospital, you are now living with people who tested positive.\u003c/b>\u003c/p>\n\u003cp>Exactly. It’s a different world.\u003c/p>\n\u003cp>\u003cb>So what now, if not medicine in the ER?\u003c/b>\u003c/p>\n\u003cp>I am actually working on a memoir about my time on the front lines. So it has brought up a lot of old stuff and a lot of painful stuff. It feels like a really interesting and helpful opportunity to work through that.\u003c/p>\n\u003cp>\u003cb>I think we’re going to need these memoirs. I know it’s hard, but thanks for working through it.\u003c/b>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Thank you so much.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Now that Steph Curry set the NBA career record for 3-pointers, all eyes are back on Klay Thompson.\u003c/p>\n\u003cp>During the 2019 NBA Finals, Thompson suffered a torn anterior cruciate ligament, or ACL, in his left knee. The ACL is a strip of tissue that runs through the middle of a knee and acts as a stabilizer. A year later, he tore his right Achilles tendon.\u003c/p>\n\u003cp>Many Warriors fans are wondering when the team’s sharp-shooting guard could be ready to \u003ca href=\"https://nba.nbcsports.com/2021/12/06/klay-thompson-says-return-could-be-in-few-weeks-maybe-a-month/\" target=\"_blank\" rel=\"noopener noreferrer\">hit the court.\u003c/a>\u003c/p>\n\u003cp>Find hope in a recent Stanford \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/34778484/\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> that links NBA playing styles and their impact on certain knee injuries, like ACL tears. Basketball players who often drive to the hoop are more likely to suffer a tear, but also more likely to make a full recovery, researchers found.\u003c/p>\n\u003cp>“It always takes a little bit of time to ease back into things. But in general, from our study, that’s what we found,” said Kevin Thomas, a lead author on the study and a graduate student at Stanford, studying medicine and biomedical informatics. “[And that’s] we can hopefully expect from players like him over the long run.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>KQED morning host Brian Watt talked about this research with Thomas, who said he and his team looked at four decades of data and media reports on NBA players.\u003c/p>\n\u003cp>This interview has been edited for brevity and clarity.\u003c/p>\n\u003cp>\u003cstrong>Brian Watt: What did your study conclude about the ACL injury?\u003c/strong>\u003c/p>\n\u003cp>Kevin Thomas: We were interested in identifying how a basketball player’s style of play, or their way of scoring points, affects their risk of getting an ACL tear. And we also wanted to know when ACL tears do happen in players — whether they’re able to make a full recovery and play at the same level of play that you’d expect them to have if they didn’t get injured.\u003c/p>\n\u003cp>\u003cstrong>So this comes down to whether a player drives, penetrates through the lane or has to weave through defenders. Is that what we’re talking about?\u003c/strong>\u003c/p>\n\u003cp>That’s right. We identified that for players who frequently drive the ball to the basket in order to score their points, they typically have a higher risk of ACL tears relative to other players.\u003c/p>\n\u003cp>\u003cstrong>So those guys have a higher risk, and once they come back from a surgery that sort of reconstructs the ACL, they’re still good. They haven’t lost a step.\u003c/strong>\u003c/p>\n\u003cp>We found that when you take a player, just before their injury happens, and you find other similar players to them, and then you follow them over the next several years, the players that get injured and then are able to come back are playing at the same level as their peer players, who never had the injury in the first place. So they’re able to make a full comeback and perform at the same level.\u003c/p>\n\u003cp>\u003cstrong>I have to assume you’re a basketball fan. You’re speaking clinically about this stuff, but I hear a fan.\u003c/strong>\u003c/p>\n\u003cp>You know, I’m living in the Bay Area now, but I grew up in Phoenix. I’m a Phoenix [Suns] guy. It was heartbreaking to see Dario [Saric] \u003ca href=\"https://www.nba.com/news/suns-dario-saric-torn-acl-out-indefinitely\">tear\u003c/a> his ACL last season, but hopefully he’ll be able to come back and make a full recovery.\u003c/p>\n\u003cp>\u003cstrong>So do you think Klay Thompson has read your study?\u003c/strong>\u003c/p>\n\u003cp>Well, hopefully after being on the radio with you, we might be able to get a little bit more attention from the Warriors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>https://www.instagram.com/p/CWJ-kq-v_n3/?utm_source=ig_web_copy_link\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Now that Steph Curry set the NBA career record for 3-pointers, all eyes are back on Klay Thompson.\u003c/p>\n\u003cp>During the 2019 NBA Finals, Thompson suffered a torn anterior cruciate ligament, or ACL, in his left knee. The ACL is a strip of tissue that runs through the middle of a knee and acts as a stabilizer. A year later, he tore his right Achilles tendon.\u003c/p>\n\u003cp>Many Warriors fans are wondering when the team’s sharp-shooting guard could be ready to \u003ca href=\"https://nba.nbcsports.com/2021/12/06/klay-thompson-says-return-could-be-in-few-weeks-maybe-a-month/\" target=\"_blank\" rel=\"noopener noreferrer\">hit the court.\u003c/a>\u003c/p>\n\u003cp>Find hope in a recent Stanford \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/34778484/\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> that links NBA playing styles and their impact on certain knee injuries, like ACL tears. Basketball players who often drive to the hoop are more likely to suffer a tear, but also more likely to make a full recovery, researchers found.\u003c/p>\n\u003cp>“It always takes a little bit of time to ease back into things. But in general, from our study, that’s what we found,” said Kevin Thomas, a lead author on the study and a graduate student at Stanford, studying medicine and biomedical informatics. “[And that’s] we can hopefully expect from players like him over the long run.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>KQED morning host Brian Watt talked about this research with Thomas, who said he and his team looked at four decades of data and media reports on NBA players.\u003c/p>\n\u003cp>This interview has been edited for brevity and clarity.\u003c/p>\n\u003cp>\u003cstrong>Brian Watt: What did your study conclude about the ACL injury?\u003c/strong>\u003c/p>\n\u003cp>Kevin Thomas: We were interested in identifying how a basketball player’s style of play, or their way of scoring points, affects their risk of getting an ACL tear. And we also wanted to know when ACL tears do happen in players — whether they’re able to make a full recovery and play at the same level of play that you’d expect them to have if they didn’t get injured.\u003c/p>\n\u003cp>\u003cstrong>So this comes down to whether a player drives, penetrates through the lane or has to weave through defenders. Is that what we’re talking about?\u003c/strong>\u003c/p>\n\u003cp>That’s right. We identified that for players who frequently drive the ball to the basket in order to score their points, they typically have a higher risk of ACL tears relative to other players.\u003c/p>\n\u003cp>\u003cstrong>So those guys have a higher risk, and once they come back from a surgery that sort of reconstructs the ACL, they’re still good. They haven’t lost a step.\u003c/strong>\u003c/p>\n\u003cp>We found that when you take a player, just before their injury happens, and you find other similar players to them, and then you follow them over the next several years, the players that get injured and then are able to come back are playing at the same level as their peer players, who never had the injury in the first place. So they’re able to make a full comeback and perform at the same level.\u003c/p>\n\u003cp>\u003cstrong>I have to assume you’re a basketball fan. You’re speaking clinically about this stuff, but I hear a fan.\u003c/strong>\u003c/p>\n\u003cp>You know, I’m living in the Bay Area now, but I grew up in Phoenix. I’m a Phoenix [Suns] guy. It was heartbreaking to see Dario [Saric] \u003ca href=\"https://www.nba.com/news/suns-dario-saric-torn-acl-out-indefinitely\">tear\u003c/a> his ACL last season, but hopefully he’ll be able to come back and make a full recovery.\u003c/p>\n\u003cp>\u003cstrong>So do you think Klay Thompson has read your study?\u003c/strong>\u003c/p>\n\u003cp>Well, hopefully after being on the radio with you, we might be able to get a little bit more attention from the Warriors.\u003c/p>\n\u003cp>\u003c/p>\u003c/p>\u003c/div>",
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"title": "First U.S. Case of Omicron Variant Found in San Francisco Resident",
"headTitle": "First U.S. Case of Omicron Variant Found in San Francisco Resident | KQED",
"content": "\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">Updated 3:10 p.m. Wednesday \u003c/span>\u003c/i>\u003c/p>\n\u003cp>California and San Francisco health officials have detected the first U.S. case of the omicron variant in a San Francisco resident.\u003c/p>\n\u003cp>The individual “was a traveler who returned from South Africa on November 22, 2021,” the Centers for Disease Control and Prevention wrote in a \u003ca href=\"https://www.cdc.gov/media/releases/2021/s1201-omicron-variant.html\" target=\"_blank\" rel=\"noopener noreferrer\">statement\u003c/a>. The individual, who was fully vaccinated with Moderna’s shot, has mild symptoms that are improving and is “self-quarantining and has been since testing positive,” the CDC wrote, adding that “all close contacts have been contacted and have tested negative.”\u003c/p>\n\u003cp>Grant Colfax, San Francisco’s director of health, urged caution and said in a statement the city is “relatively well positioned to handle COVID-19 and its variants because of our high vaccination rates, our high booster uptake, and other local health measures such as masking and testing.”\u003c/p>\n\u003cp>https://twitter.com/RaquelMDillon/status/1466132121974497283?s=20\u003c/p>\n\u003cp>“We will stay alert and vigilant and do what we need to do to protect ourselves,” he said. “This means getting vaccinated, getting your booster, wearing a mask indoors, and taking the other steps we know help slow the spread.”[aside postID=news_11890031 hero='https://ww2.kqed.org/app/uploads/sites/10/2021/09/RS52115_GettyImages-1344323369-qut.jpg']\u003c/p>\n\u003ch3>California’s robust surveillance system\u003c/h3>\n\u003cp>Gov. Gavin Newsom said in a Wednesday press conference that on Nov. 28 the infected individual took a COVID-19 test, which returned positive the following day.\u003c/p>\n\u003cp>The testing company sent the sample to a UCSF lab, which quickly detected the omicron variant using genomic sequencing. Scientists working with the CDC later confirmed their work. [pullquote size=\"medium\" align=\"right\" citation=\"California and San Francisco departments of public health\"]‘Despite the detection of Omicron, Delta remains the predominant strain in the United States.’[/pullquote]Newsom applauded California’s aggressive approach to testing.\u003c/p>\n\u003cp>“We have the most robust testing program and protocols in the nation,” he said.\u003c/p>\n\u003cp>Earlier this year, the U.S. struggled to keep pace with the need for genomic sequencing to track mutant variants of COVID-19, spurring President Joe Biden to spend roughly $1 billion to ramp up federal testing capability.\u003c/p>\n\u003cp>In January, the U.S. sequenced just 8,000 COVID-19 samples per week, but last month the country sequenced 10 times that many — roughly 1 in 7 positive cases, \u003ca href=\"https://www.whitehouse.gov/briefing-room/press-briefings/2021/11/30/press-briefing-by-white-house-covid-19-response-team-and-public-health-officials-70/\">according to the CDC\u003c/a>.\u003c/p>\n\u003cp>California, which last May \u003ca href=\"https://www.whitehouse.gov/briefing-room/statements-releases/2021/04/16/fact-sheet-biden-administration-announces-1-7-billion-investment-to-fight-covid-19-variants/\" target=\"_blank\" rel=\"noopener noreferrer\">received\u003c/a> $17 million of Biden’s nationwide investment, sequenced 16% of its positive cases in August 2021, \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/COVID-Variants.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">the latest numbers posted publicly\u003c/a> by the state health department.\u003c/p>\n\u003cp>“I’ll remind people it’s not surprising in many respects that California is announcing the first case,” Newsom said. “This state is the birthplace of, after all, of the biotech [industry]. UCSF is one of the leading genomic sequencing institutions in the world, and we are blessed to have their partnership and have their expertise.”\u003c/p>\n\u003cp>Peter Chin-Hong, a professor at UCSF’s medical school, told KQED that California has a robust surveillance system for tracking COVID-19 variants. That system is more advanced than the nation’s, he said.\u003c/p>\n\u003cp>The U.S. “has not been at the forefront of genomic sequencing for variants in general,” he said.\u003c/p>\n\u003cp>“California Department of Public Health is doing better,” he said. “It’s easier in California, because of a close partnership between politicians, academics and private labs, and a really strong public health department.”\u003c/p>\n\u003cp>State and city health departments say they’re continuing to monitor for the variant using the genomic sequence surveillance system.\u003c/p>\n\u003ch3>Aggressive testing underway\u003c/h3>\n\u003cp>Newsom said officials cannot reveal too much information about the person’s private situation, but in broad strokes: They are not hospitalized, and no one they’ve come into contact with has tested positive “yet to our knowledge,” he said.\u003c/p>\n\u003cp>“To help detect and prevent the spread of this new variant, the State of California is increasing COVID-19 testing at our airports for arrivals from countries identified by the Centers for Disease Control and Prevention (CDC),” state health officials said in a statement.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“CDC has been actively monitoring and preparing for this variant, and we will continue to work diligently with other U.S. and global public health and industry partners to learn more. Despite the detection of Omicron, Delta remains the predominant strain in the United States.”\u003c/p>\n\u003ch3>California COVID cases inch upward\u003c/h3>\n\u003cp>California’s test positivity rate ticked up a percentage point this past week, from 1.9% to 3%, according to state health statistics. Officials are still evaluating new data for signs of Thanksgiving-related coronavirus spread.\u003c/p>\n\u003cp>“The next few days, we’ll have a sense of what that Thanksgiving spread may have looked like,” Newsom said.\u003c/p>\n\u003cp>But the governor pointed out that the state’s test positivity rate is far lower now compared to last year at this time, when cases were spiking at the beginning of a winter surge.\u003c/p>\n\u003cp>The upcoming holiday season is another reason, among many, to ensure that people are vaccinated and boosted, said Mark Ghaly, California’s health secretary.\u003c/p>\n\u003cp>“This one individual, indeed, I want to highlight — fully vaccinated,” Ghaly said. “And some people might say, well, is that of concern? Does that mean the vaccines aren’t working? We have been talking for months about the fact that vaccinations do one really, really important thing: protect against severe disease, against hospitalization and death.”\u003c/p>\n\u003cp>The fact that the person who tested positive for omicron has mild symptoms “is a testament to the importance of vaccinations,” Ghaly said.\u003c/p>\n\u003cp>That also was the message from the White House, Wednesday.\u003c/p>\n\u003cp>Federal COVID-19 Response Coordinator Jeff Zients said, in a statement, that “it was only a matter of time” before omicron was detected here.\u003c/p>\n\u003cp>“This new variant is cause for continued vigilance, not panic,” he said.\u003c/p>\n\u003cp>\u003cem>KQED’s Natalia Navarro contributed reporting. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">Updated 3:10 p.m. Wednesday \u003c/span>\u003c/i>\u003c/p>\n\u003cp>California and San Francisco health officials have detected the first U.S. case of the omicron variant in a San Francisco resident.\u003c/p>\n\u003cp>The individual “was a traveler who returned from South Africa on November 22, 2021,” the Centers for Disease Control and Prevention wrote in a \u003ca href=\"https://www.cdc.gov/media/releases/2021/s1201-omicron-variant.html\" target=\"_blank\" rel=\"noopener noreferrer\">statement\u003c/a>. The individual, who was fully vaccinated with Moderna’s shot, has mild symptoms that are improving and is “self-quarantining and has been since testing positive,” the CDC wrote, adding that “all close contacts have been contacted and have tested negative.”\u003c/p>\n\u003cp>Grant Colfax, San Francisco’s director of health, urged caution and said in a statement the city is “relatively well positioned to handle COVID-19 and its variants because of our high vaccination rates, our high booster uptake, and other local health measures such as masking and testing.”\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>“We will stay alert and vigilant and do what we need to do to protect ourselves,” he said. “This means getting vaccinated, getting your booster, wearing a mask indoors, and taking the other steps we know help slow the spread.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>California’s robust surveillance system\u003c/h3>\n\u003cp>Gov. Gavin Newsom said in a Wednesday press conference that on Nov. 28 the infected individual took a COVID-19 test, which returned positive the following day.\u003c/p>\n\u003cp>The testing company sent the sample to a UCSF lab, which quickly detected the omicron variant using genomic sequencing. Scientists working with the CDC later confirmed their work. \u003c/p>\u003c/div>",
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"content": "‘Despite the detection of Omicron, Delta remains the predominant strain in the United States.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Newsom applauded California’s aggressive approach to testing.\u003c/p>\n\u003cp>“We have the most robust testing program and protocols in the nation,” he said.\u003c/p>\n\u003cp>Earlier this year, the U.S. struggled to keep pace with the need for genomic sequencing to track mutant variants of COVID-19, spurring President Joe Biden to spend roughly $1 billion to ramp up federal testing capability.\u003c/p>\n\u003cp>In January, the U.S. sequenced just 8,000 COVID-19 samples per week, but last month the country sequenced 10 times that many — roughly 1 in 7 positive cases, \u003ca href=\"https://www.whitehouse.gov/briefing-room/press-briefings/2021/11/30/press-briefing-by-white-house-covid-19-response-team-and-public-health-officials-70/\">according to the CDC\u003c/a>.\u003c/p>\n\u003cp>California, which last May \u003ca href=\"https://www.whitehouse.gov/briefing-room/statements-releases/2021/04/16/fact-sheet-biden-administration-announces-1-7-billion-investment-to-fight-covid-19-variants/\" target=\"_blank\" rel=\"noopener noreferrer\">received\u003c/a> $17 million of Biden’s nationwide investment, sequenced 16% of its positive cases in August 2021, \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/COVID-Variants.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">the latest numbers posted publicly\u003c/a> by the state health department.\u003c/p>\n\u003cp>“I’ll remind people it’s not surprising in many respects that California is announcing the first case,” Newsom said. “This state is the birthplace of, after all, of the biotech [industry]. UCSF is one of the leading genomic sequencing institutions in the world, and we are blessed to have their partnership and have their expertise.”\u003c/p>\n\u003cp>Peter Chin-Hong, a professor at UCSF’s medical school, told KQED that California has a robust surveillance system for tracking COVID-19 variants. That system is more advanced than the nation’s, he said.\u003c/p>\n\u003cp>The U.S. “has not been at the forefront of genomic sequencing for variants in general,” he said.\u003c/p>\n\u003cp>“California Department of Public Health is doing better,” he said. “It’s easier in California, because of a close partnership between politicians, academics and private labs, and a really strong public health department.”\u003c/p>\n\u003cp>State and city health departments say they’re continuing to monitor for the variant using the genomic sequence surveillance system.\u003c/p>\n\u003ch3>Aggressive testing underway\u003c/h3>\n\u003cp>Newsom said officials cannot reveal too much information about the person’s private situation, but in broad strokes: They are not hospitalized, and no one they’ve come into contact with has tested positive “yet to our knowledge,” he said.\u003c/p>\n\u003cp>“To help detect and prevent the spread of this new variant, the State of California is increasing COVID-19 testing at our airports for arrivals from countries identified by the Centers for Disease Control and Prevention (CDC),” state health officials said in a statement.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“CDC has been actively monitoring and preparing for this variant, and we will continue to work diligently with other U.S. and global public health and industry partners to learn more. Despite the detection of Omicron, Delta remains the predominant strain in the United States.”\u003c/p>\n\u003ch3>California COVID cases inch upward\u003c/h3>\n\u003cp>California’s test positivity rate ticked up a percentage point this past week, from 1.9% to 3%, according to state health statistics. Officials are still evaluating new data for signs of Thanksgiving-related coronavirus spread.\u003c/p>\n\u003cp>“The next few days, we’ll have a sense of what that Thanksgiving spread may have looked like,” Newsom said.\u003c/p>\n\u003cp>But the governor pointed out that the state’s test positivity rate is far lower now compared to last year at this time, when cases were spiking at the beginning of a winter surge.\u003c/p>\n\u003cp>The upcoming holiday season is another reason, among many, to ensure that people are vaccinated and boosted, said Mark Ghaly, California’s health secretary.\u003c/p>\n\u003cp>“This one individual, indeed, I want to highlight — fully vaccinated,” Ghaly said. “And some people might say, well, is that of concern? Does that mean the vaccines aren’t working? We have been talking for months about the fact that vaccinations do one really, really important thing: protect against severe disease, against hospitalization and death.”\u003c/p>\n\u003cp>The fact that the person who tested positive for omicron has mild symptoms “is a testament to the importance of vaccinations,” Ghaly said.\u003c/p>\n\u003cp>That also was the message from the White House, Wednesday.\u003c/p>\n\u003cp>Federal COVID-19 Response Coordinator Jeff Zients said, in a statement, that “it was only a matter of time” before omicron was detected here.\u003c/p>\n\u003cp>“This new variant is cause for continued vigilance, not panic,” he said.\u003c/p>\n\u003cp>\u003cem>KQED’s Natalia Navarro contributed reporting. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">T\u003c/span>\u003c/span>he past two months have brought extremely good news in the fight against COVID-19. Two different oral treatments have proved effective at both preventing people newly diagnosed with COVID-19 from entering the hospital and from dying.\u003c/p>\n\u003cp>“We’re accelerating our path out of this pandemic,” President Biden said after data on the second COVID pill became available. The wide availability of oral drugs could make COVID-19 less lethal, making it less risky for people to return to in-person work and to their normal lives.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2021/10/01/mercks-antiviral-pill-reduces-hospitalization-of-covid-patients-a-possible-game-changer-for-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">first results\u003c/a>, from Merck and Ridgeback Therapeutics, were released in October and will be considered by an advisory panel to the Food and Drug Administration in December. That could lead to an emergency use authorization in the U.S. by the end of the year. That drug, molnupiravir, reduced hospitalizations by 50% and prevented deaths entirely a large randomized clinical trial when it was given within five days of when symptoms began. The pill is given as a five-day course during which patients take a total of 40 pills.\u003c/p>\n\u003cp>In November, Pfizer announced that its COVID pill, Paxlovid, reduced hospitalizations by 89% and also prevented deaths in its own large randomized study. As with the Merck drug, Paxlovid is given as a five-day course. It must be given with a second medicine, a booster, called ritonavir, which is made by AbbVie, another large drug firm. The Pfizer regimen involves taking 30 pills over a five-day period.\u003c/p>\n\u003cp>Though the topline results are similar, the medicines could have different risks and benefits. The companies have only issued data in press releases, not scientific articles, and doctors need to know a lot more about both. Here is an overview of what we still don’t know about the COVID pills and when we might learn it.\u003c/p>\n\u003ch3>Which one works better?\u003c/h3>\n\u003cp>At the headline level, Pfizer’s pill reduced the risk of hospitalization and death \u003ca href=\"https://www.statnews.com/2021/11/05/experimental-pfizer-pill-prevents-covid-hospitalizations-and-deaths/\" target=\"_blank\" rel=\"noopener noreferrer\">by 89%,\u003c/a> while Merck showed \u003ca href=\"https://www.statnews.com/2021/10/01/mercks-antiviral-pill-reduces-hospitalization-of-covid-patients-a-possible-game-changer-for-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">a reduction of 50%\u003c/a>. But neither firm has disclosed detailed data from its pivotal studies, and the trials were not identically designed.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The studies enrolled similar populations — unvaccinated people with mild to moderate COVID-19 and at least one risk factor for severe disease — but they had slightly different measures of efficacy. Pfizer’s 89% figure comes from patients who started getting its pill, Paxlovid, within three days of their first COVID-19 symptoms. Merck’s 50% applies to patients who began treatment within five days. In the Paxlovid study, patients who started treatment within five days saw an 85% improvement in hospitalization or death versus placebo. Merck has not shared data on patients who got its drug within three days of symptom onset.\u003c/p>\n\u003cp>What the studies had in common was 100% efficacy against death, regardless of when patients started treatment. Merck’s study counted eight deaths among patients on placebo, and Pfizer’s observed 10.\u003c/p>\n\u003cp>On the safety side, the rate of side effects in both studies was similar between the treatment groups and placebo groups. In each study, fewer patients in the treatment group left the study due to side effects compared to those in the placebo group. Neither company has disclosed detailed data on the type and severity of side effects.\u003c/p>\n\u003cp>Each treatment is administered twice a day for five total days, amounting to 10 doses in total. Pfizer’s drug is co-administered with a common antiviral called ritonavir.\u003c/p>\n\u003ch3>Will the antiviral be available for vaccinated patients with breakthrough infections?\u003c/h3>\n\u003cp>Both companies conducted their studies entirely in patients who were at high risk of complications if they caught COVID and who also had not been vaccinated. That leads to a big question for policymakers: Should those who have been vaccinated, but who develop a breakthrough infection of SARS-CoV-2, be given the pills?\u003c/p>\n\u003cp>Right now that is a question without data. A third antiviral pill, from the biotech firm Atea and the large drug firm Roche, failed to prove it was effective in its own study, and Wall Street analysts suspect the reason is that the companies included vaccinated patients in the research. For those who have received the vaccine, hospitalization and death are much less likely. This means that it is harder for a drug to show efficacy, because there are fewer infections to prevent.\u003c/p>\n\u003cp>So regulators and public health officials will have to make a judgement on the risks and benefits of the COVID pills for people with breakthrough infections — without direct data in these populations.\u003c/p>\n\u003cp>Pfizer is running a clinical trial, with results due next year, that does include vaccinated patients, and the company’s executives have expressed confidence based on the results so far that the treatment should work. Both Merck and Pfizer are also running studies to show that the drugs can prevent people from developing symptoms if they take the antivirals after they are exposed to the virus.\u003c/p>\n\u003ch3>Do the drugs work the same way?\u003c/h3>\n\u003cp>No, not really. While both drugs interfere with the process the coronavirus uses to reproduce itself, each drug interferes at a very different point.\u003c/p>\n\u003cp>Merck’s drug throws a wrench into the works quite early. After someone takes molnupiravir, the drug is transformed into something uncannily similar to one of RNA’s chemical building blocks.\u003c/p>\n\u003cp>The modification is so subtle that not only will the coronavirus use molnupiravir in place of other building blocks when it replicates itself, but coronaviruses’ unusual proofreading mechanism can’t even pick up on the imposter compound. Over time, the drug will encourage the virus to introduce even more mistakes.\u003c/p>\n\u003cp>“Ultimately, this leads to what’s known as error catastrophe. It’s introducing so many different mutations that, eventually, nothing further can happen,” said Katherine Seley-Radtke, a medicinal chemist at the University of Maryland, Baltimore County. “You’ve got this completely mutated RNA.”\u003c/p>\n\u003cp>Pfizer’s drug, Paxlovid, acts at a completely different point in the virus’ reproductive process.\u003c/p>\n\u003cp>“It’s apples and oranges,” said Ronald Swanstrom, a biochemistry professor at the University of North Carolina School of Medicine.\u003c/p>\n\u003cp>Unlike molnupiravir, Paxlovid allows the strings of viral RNA to be assembled correctly. It even allows those strings to be used to create viral proteins, which are initially produced in one big chunk. Like a bolt of fabric before it’s cut to a clothing pattern, this protein needs to be chopped down to size before it can work.\u003c/p>\n\u003cp>That cutting is what Paxlovid prohibits. The drug is designed to bind to a particularly important point in an enzyme called a protease which slices up proteins. Without a functioning protease, the virus can’t create functional copies; no working virus, no problem.\u003c/p>\n\u003cp>Protease inhibitors have been used for decades to create more than a dozen drugs for HIV and hepatitis C; in some cases, they’ve also been used as cancer drugs.\u003c/p>\n\u003cp>“There’s a long history of medicinal chemistry targeting proteases,” said Bryan Dickinson, a chemical biologist at the University of Chicago.\u003c/p>\n\u003cp>Paxlovid is designed with a SARS-CoV-2-specific protease in mind, so it works more specifically on this coronavirus than molnupiravir.\u003c/p>\n\u003cp>But Paxlovid can’t work as well if it’s taken on its own. The body’s defense mechanisms will get rid of anything that it doesn’t recognize — including drugs, which can be digested by enzymes in a person’s liver. Another drug called ritonavir blocks the liver enzyme that would likely chew up Paxlovid, which gives the latter drug the space it needs to work.\u003c/p>\n\u003ch3>How do they compare with monoclonal antibodies?\u003c/h3>\n\u003cp>Regeneron Pharmaceuticals and Eli Lilly have each won FDA authorization for antibody combination therapies that keep recently diagnosed COVID-19 patients from hospitalization and death. In a Phase 3 study enrolling recently diagnosed patients at high risk for severe disease, Regeneron’s treatment reduced the risk of hospitalization or death \u003ca href=\"https://investor.regeneron.com/news-releases/news-release-details/phase-3-trial-shows-regen-covtm-casirivimab-imdevimab-antibody\" target=\"_blank\" rel=\"noopener noreferrer\">by 70%\u003c/a> compared to placebo. In a similar study, Lilly’s therapy showed \u003ca href=\"https://www.prnewswire.com/news-releases/lillys-bamlanivimab-and-etesevimab-together-reduced-hospitalizations-and-death-in-phase-3-trial-for-early-covid-19-301243984.html\" target=\"_blank\" rel=\"noopener noreferrer\">an 87% reduction\u003c/a>.\u003c/p>\n\u003cp>The biggest difference is one of convenience. The antibody treatments are administered intravenously in a one-time, roughly hour-long process (Regeneron’s is authorized for subcutaneous injection when an IV procedure is not feasible). That could make the treatments from Pfizer and Merck, taken orally at home, preferable to patients unable to visit an infusion center.\u003c/p>\n\u003cp>There’s also a difference in cost. Regeneron and Lilly have signed deals with the federal government to sell their treatments at about $1,250 per dose. Merck’s agreement with the U.S. works out to about $700 for a five-day course of molnupiravir. Pfizer is still negotiating contracts but is expected to set a similar price for Paxlovid.\u003c/p>\n\u003ch3>How easy will they be to get?\u003c/h3>\n\u003cp>A pill is a huge leap in terms of logistical ease over infused therapies like monoclonal antibodies. For those treatments, not only did people have to make their way to clinics for their infusions, but hospitals and other facilities had to set up places where people who were actively infectious could come get treated without risking others’ health. (The other antiviral authorized to treat COVID-19, Gilead’s remdesivir, is an infusion and approved only for hospitalized patients, but some data indicate that if it were to be given to patients earlier in their infections, it could have a greater effect. If its approval ever covered outpatients, however, it would still run into the same logistical challenges of an infused therapy.)\u003c/p>\n\u003cp>Still, the COVID pills come with a key challenge of their own. They’re most effective when given early in the infection, so people need to be able to get tested and get their prescription rapidly. And the U.S. testing landscape is still limited. PCR tests can take days to return a result, and though the Biden administration has upped its effort to expand the availability of at-home rapid tests, finding one at a store is still hit or miss — success feels like scoring this holiday season’s hottest gift. Any delay in getting diagnosed undercuts the power of these pills; even a day or two has real implications for a treatment meant to clear out an acute infection like COVID-19.\u003c/p>\n\u003ch3>Will it affect a patient’s DNA?\u003c/h3>\n\u003cp>This is really a question only for Merck’s molnupiravir, since it works by sneaking subtly corrupted parts into the coronavirus’s RNA sequence.\u003c/p>\n\u003cp>Once the virus has mutated too much, it can’t work — mission accomplished. But there’s a theoretical chance that molnupiravir could also influence normal human DNA when it replicates, too. If mutations happen during that process, it could spell real trouble.\u003c/p>\n\u003cp>Merck did some tests during molnupiravir’s development to check this possibility out. In two different types of animal studies using higher and longer doses than are given to humans, Merck’s scientists didn’t see any increased risk of unwanted mutations.\u003c/p>\n\u003cp>“We are very confident in the safety profile of molnupiravir based on our preclinical and clinical data,” executive vice president Dean Li told investors in an October conference call, according to a transcript in the financial database Sentieo.\u003c/p>\n\u003cp>But UNC’s Swanstrom isn’t completely convinced that the tests Merck did were sensitive enough. In August, he and his colleagues \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/33961695/\" target=\"_blank\" rel=\"noopener noreferrer\">published a paper in\u003c/a> the Journal of Infectious Diseases showing that a key metabolite of molnupiravir could mutate DNA in animal cells.\u003c/p>\n\u003cp>Given these results, Swanstrom said he would be particularly interested in seeing a long-term study of people who took molnupiravir to continue to monitor this potential effect over the next 10 or 20 years.\u003c/p>\n\u003cp>“This thing is going to go into thousands of people. And are we just going to ignore the fact that there’s this potential risk?” he said. “The risk could be zero. It could be no worse than going to get a dental X-ray — or it could do something more. But unless we find out, you know, we’re going to learn this lesson the hard way, way later than we should.”\u003c/p>\n\u003ch3>What might the new antivirals mean for cancer patients?\u003c/h3>\n\u003cp>Because the new antiviral Pfizer is developing is a protease inhibitor, infectious disease specialists are familiar with how it works. So we already know: These drugs have the potential to interfere with many therapies used to treat cancer, Tobias Hohl, chief of the infectious diseases service at Memorial Sloan Kettering Cancer Center in New York, told STAT.\u003c/p>\n\u003cp>“They’re going to be very helpful [in our] armamentarium, but they will not substitute for prevention or vaccination efforts because these are not medicines that are completely benign and harmless in terms of their drug-drug interactions and toxicity,” he said. “So we’re going to have to be careful and thoughtful about how we use our protease inhibitors.”\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2020/08/10/winter-is-coming-as-flu-season-nears-americas-window-of-opportunity-to-beat-back-covid-19-is-narrowing/\" target=\"_blank\" rel=\"noopener noreferrer\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Matthew Herper, Damian Garde, Kate Sheridan, Adam Feuerstein, Andrew Joseph, and Elizabeth Cooney contributed reporting.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">T\u003c/span>\u003c/span>he past two months have brought extremely good news in the fight against COVID-19. Two different oral treatments have proved effective at both preventing people newly diagnosed with COVID-19 from entering the hospital and from dying.\u003c/p>\n\u003cp>“We’re accelerating our path out of this pandemic,” President Biden said after data on the second COVID pill became available. The wide availability of oral drugs could make COVID-19 less lethal, making it less risky for people to return to in-person work and to their normal lives.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2021/10/01/mercks-antiviral-pill-reduces-hospitalization-of-covid-patients-a-possible-game-changer-for-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">first results\u003c/a>, from Merck and Ridgeback Therapeutics, were released in October and will be considered by an advisory panel to the Food and Drug Administration in December. That could lead to an emergency use authorization in the U.S. by the end of the year. That drug, molnupiravir, reduced hospitalizations by 50% and prevented deaths entirely a large randomized clinical trial when it was given within five days of when symptoms began. The pill is given as a five-day course during which patients take a total of 40 pills.\u003c/p>\n\u003cp>In November, Pfizer announced that its COVID pill, Paxlovid, reduced hospitalizations by 89% and also prevented deaths in its own large randomized study. As with the Merck drug, Paxlovid is given as a five-day course. It must be given with a second medicine, a booster, called ritonavir, which is made by AbbVie, another large drug firm. The Pfizer regimen involves taking 30 pills over a five-day period.\u003c/p>\n\u003cp>Though the topline results are similar, the medicines could have different risks and benefits. The companies have only issued data in press releases, not scientific articles, and doctors need to know a lot more about both. Here is an overview of what we still don’t know about the COVID pills and when we might learn it.\u003c/p>\n\u003ch3>Which one works better?\u003c/h3>\n\u003cp>At the headline level, Pfizer’s pill reduced the risk of hospitalization and death \u003ca href=\"https://www.statnews.com/2021/11/05/experimental-pfizer-pill-prevents-covid-hospitalizations-and-deaths/\" target=\"_blank\" rel=\"noopener noreferrer\">by 89%,\u003c/a> while Merck showed \u003ca href=\"https://www.statnews.com/2021/10/01/mercks-antiviral-pill-reduces-hospitalization-of-covid-patients-a-possible-game-changer-for-treatment/\" target=\"_blank\" rel=\"noopener noreferrer\">a reduction of 50%\u003c/a>. But neither firm has disclosed detailed data from its pivotal studies, and the trials were not identically designed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The studies enrolled similar populations — unvaccinated people with mild to moderate COVID-19 and at least one risk factor for severe disease — but they had slightly different measures of efficacy. Pfizer’s 89% figure comes from patients who started getting its pill, Paxlovid, within three days of their first COVID-19 symptoms. Merck’s 50% applies to patients who began treatment within five days. In the Paxlovid study, patients who started treatment within five days saw an 85% improvement in hospitalization or death versus placebo. Merck has not shared data on patients who got its drug within three days of symptom onset.\u003c/p>\n\u003cp>What the studies had in common was 100% efficacy against death, regardless of when patients started treatment. Merck’s study counted eight deaths among patients on placebo, and Pfizer’s observed 10.\u003c/p>\n\u003cp>On the safety side, the rate of side effects in both studies was similar between the treatment groups and placebo groups. In each study, fewer patients in the treatment group left the study due to side effects compared to those in the placebo group. Neither company has disclosed detailed data on the type and severity of side effects.\u003c/p>\n\u003cp>Each treatment is administered twice a day for five total days, amounting to 10 doses in total. Pfizer’s drug is co-administered with a common antiviral called ritonavir.\u003c/p>\n\u003ch3>Will the antiviral be available for vaccinated patients with breakthrough infections?\u003c/h3>\n\u003cp>Both companies conducted their studies entirely in patients who were at high risk of complications if they caught COVID and who also had not been vaccinated. That leads to a big question for policymakers: Should those who have been vaccinated, but who develop a breakthrough infection of SARS-CoV-2, be given the pills?\u003c/p>\n\u003cp>Right now that is a question without data. A third antiviral pill, from the biotech firm Atea and the large drug firm Roche, failed to prove it was effective in its own study, and Wall Street analysts suspect the reason is that the companies included vaccinated patients in the research. For those who have received the vaccine, hospitalization and death are much less likely. This means that it is harder for a drug to show efficacy, because there are fewer infections to prevent.\u003c/p>\n\u003cp>So regulators and public health officials will have to make a judgement on the risks and benefits of the COVID pills for people with breakthrough infections — without direct data in these populations.\u003c/p>\n\u003cp>Pfizer is running a clinical trial, with results due next year, that does include vaccinated patients, and the company’s executives have expressed confidence based on the results so far that the treatment should work. Both Merck and Pfizer are also running studies to show that the drugs can prevent people from developing symptoms if they take the antivirals after they are exposed to the virus.\u003c/p>\n\u003ch3>Do the drugs work the same way?\u003c/h3>\n\u003cp>No, not really. While both drugs interfere with the process the coronavirus uses to reproduce itself, each drug interferes at a very different point.\u003c/p>\n\u003cp>Merck’s drug throws a wrench into the works quite early. After someone takes molnupiravir, the drug is transformed into something uncannily similar to one of RNA’s chemical building blocks.\u003c/p>\n\u003cp>The modification is so subtle that not only will the coronavirus use molnupiravir in place of other building blocks when it replicates itself, but coronaviruses’ unusual proofreading mechanism can’t even pick up on the imposter compound. Over time, the drug will encourage the virus to introduce even more mistakes.\u003c/p>\n\u003cp>“Ultimately, this leads to what’s known as error catastrophe. It’s introducing so many different mutations that, eventually, nothing further can happen,” said Katherine Seley-Radtke, a medicinal chemist at the University of Maryland, Baltimore County. “You’ve got this completely mutated RNA.”\u003c/p>\n\u003cp>Pfizer’s drug, Paxlovid, acts at a completely different point in the virus’ reproductive process.\u003c/p>\n\u003cp>“It’s apples and oranges,” said Ronald Swanstrom, a biochemistry professor at the University of North Carolina School of Medicine.\u003c/p>\n\u003cp>Unlike molnupiravir, Paxlovid allows the strings of viral RNA to be assembled correctly. It even allows those strings to be used to create viral proteins, which are initially produced in one big chunk. Like a bolt of fabric before it’s cut to a clothing pattern, this protein needs to be chopped down to size before it can work.\u003c/p>\n\u003cp>That cutting is what Paxlovid prohibits. The drug is designed to bind to a particularly important point in an enzyme called a protease which slices up proteins. Without a functioning protease, the virus can’t create functional copies; no working virus, no problem.\u003c/p>\n\u003cp>Protease inhibitors have been used for decades to create more than a dozen drugs for HIV and hepatitis C; in some cases, they’ve also been used as cancer drugs.\u003c/p>\n\u003cp>“There’s a long history of medicinal chemistry targeting proteases,” said Bryan Dickinson, a chemical biologist at the University of Chicago.\u003c/p>\n\u003cp>Paxlovid is designed with a SARS-CoV-2-specific protease in mind, so it works more specifically on this coronavirus than molnupiravir.\u003c/p>\n\u003cp>But Paxlovid can’t work as well if it’s taken on its own. The body’s defense mechanisms will get rid of anything that it doesn’t recognize — including drugs, which can be digested by enzymes in a person’s liver. Another drug called ritonavir blocks the liver enzyme that would likely chew up Paxlovid, which gives the latter drug the space it needs to work.\u003c/p>\n\u003ch3>How do they compare with monoclonal antibodies?\u003c/h3>\n\u003cp>Regeneron Pharmaceuticals and Eli Lilly have each won FDA authorization for antibody combination therapies that keep recently diagnosed COVID-19 patients from hospitalization and death. In a Phase 3 study enrolling recently diagnosed patients at high risk for severe disease, Regeneron’s treatment reduced the risk of hospitalization or death \u003ca href=\"https://investor.regeneron.com/news-releases/news-release-details/phase-3-trial-shows-regen-covtm-casirivimab-imdevimab-antibody\" target=\"_blank\" rel=\"noopener noreferrer\">by 70%\u003c/a> compared to placebo. In a similar study, Lilly’s therapy showed \u003ca href=\"https://www.prnewswire.com/news-releases/lillys-bamlanivimab-and-etesevimab-together-reduced-hospitalizations-and-death-in-phase-3-trial-for-early-covid-19-301243984.html\" target=\"_blank\" rel=\"noopener noreferrer\">an 87% reduction\u003c/a>.\u003c/p>\n\u003cp>The biggest difference is one of convenience. The antibody treatments are administered intravenously in a one-time, roughly hour-long process (Regeneron’s is authorized for subcutaneous injection when an IV procedure is not feasible). That could make the treatments from Pfizer and Merck, taken orally at home, preferable to patients unable to visit an infusion center.\u003c/p>\n\u003cp>There’s also a difference in cost. Regeneron and Lilly have signed deals with the federal government to sell their treatments at about $1,250 per dose. Merck’s agreement with the U.S. works out to about $700 for a five-day course of molnupiravir. Pfizer is still negotiating contracts but is expected to set a similar price for Paxlovid.\u003c/p>\n\u003ch3>How easy will they be to get?\u003c/h3>\n\u003cp>A pill is a huge leap in terms of logistical ease over infused therapies like monoclonal antibodies. For those treatments, not only did people have to make their way to clinics for their infusions, but hospitals and other facilities had to set up places where people who were actively infectious could come get treated without risking others’ health. (The other antiviral authorized to treat COVID-19, Gilead’s remdesivir, is an infusion and approved only for hospitalized patients, but some data indicate that if it were to be given to patients earlier in their infections, it could have a greater effect. If its approval ever covered outpatients, however, it would still run into the same logistical challenges of an infused therapy.)\u003c/p>\n\u003cp>Still, the COVID pills come with a key challenge of their own. They’re most effective when given early in the infection, so people need to be able to get tested and get their prescription rapidly. And the U.S. testing landscape is still limited. PCR tests can take days to return a result, and though the Biden administration has upped its effort to expand the availability of at-home rapid tests, finding one at a store is still hit or miss — success feels like scoring this holiday season’s hottest gift. Any delay in getting diagnosed undercuts the power of these pills; even a day or two has real implications for a treatment meant to clear out an acute infection like COVID-19.\u003c/p>\n\u003ch3>Will it affect a patient’s DNA?\u003c/h3>\n\u003cp>This is really a question only for Merck’s molnupiravir, since it works by sneaking subtly corrupted parts into the coronavirus’s RNA sequence.\u003c/p>\n\u003cp>Once the virus has mutated too much, it can’t work — mission accomplished. But there’s a theoretical chance that molnupiravir could also influence normal human DNA when it replicates, too. If mutations happen during that process, it could spell real trouble.\u003c/p>\n\u003cp>Merck did some tests during molnupiravir’s development to check this possibility out. In two different types of animal studies using higher and longer doses than are given to humans, Merck’s scientists didn’t see any increased risk of unwanted mutations.\u003c/p>\n\u003cp>“We are very confident in the safety profile of molnupiravir based on our preclinical and clinical data,” executive vice president Dean Li told investors in an October conference call, according to a transcript in the financial database Sentieo.\u003c/p>\n\u003cp>But UNC’s Swanstrom isn’t completely convinced that the tests Merck did were sensitive enough. In August, he and his colleagues \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/33961695/\" target=\"_blank\" rel=\"noopener noreferrer\">published a paper in\u003c/a> the Journal of Infectious Diseases showing that a key metabolite of molnupiravir could mutate DNA in animal cells.\u003c/p>\n\u003cp>Given these results, Swanstrom said he would be particularly interested in seeing a long-term study of people who took molnupiravir to continue to monitor this potential effect over the next 10 or 20 years.\u003c/p>\n\u003cp>“This thing is going to go into thousands of people. And are we just going to ignore the fact that there’s this potential risk?” he said. “The risk could be zero. It could be no worse than going to get a dental X-ray — or it could do something more. But unless we find out, you know, we’re going to learn this lesson the hard way, way later than we should.”\u003c/p>\n\u003ch3>What might the new antivirals mean for cancer patients?\u003c/h3>\n\u003cp>Because the new antiviral Pfizer is developing is a protease inhibitor, infectious disease specialists are familiar with how it works. So we already know: These drugs have the potential to interfere with many therapies used to treat cancer, Tobias Hohl, chief of the infectious diseases service at Memorial Sloan Kettering Cancer Center in New York, told STAT.\u003c/p>\n\u003cp>“They’re going to be very helpful [in our] armamentarium, but they will not substitute for prevention or vaccination efforts because these are not medicines that are completely benign and harmless in terms of their drug-drug interactions and toxicity,” he said. “So we’re going to have to be careful and thoughtful about how we use our protease inhibitors.”\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2020/08/10/winter-is-coming-as-flu-season-nears-americas-window-of-opportunity-to-beat-back-covid-19-is-narrowing/\" target=\"_blank\" rel=\"noopener noreferrer\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Matthew Herper, Damian Garde, Kate Sheridan, Adam Feuerstein, Andrew Joseph, and Elizabeth Cooney contributed reporting.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"order": 9
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"order": 18
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"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
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"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
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"source": "American Public Media"
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"masters-of-scale": {
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"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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},
"mindshift": {
"id": "mindshift",
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"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
"id": "morning-edition",
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"order": 11
},
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"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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},
"link": "/radio/program/on-the-media",
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},
"pbs-newshour": {
"id": "pbs-newshour",
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"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
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},
"link": "/radio/program/pbs-newshour",
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"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
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},
"perspectives": {
"id": "perspectives",
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"order": 14
},
"link": "/perspectives",
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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},
"link": "/radio/program/planet-money",
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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"rss": "https://feeds.npr.org/510289/podcast.xml"
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
},
"link": "/podcasts/politicalbreakdown",
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
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"rss": "https://ww2.kqed.org/news/tag/political-breakdown/feed/podcast"
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
"meta": {
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"source": "Possible"
},
"link": "/radio/program/possible",
"subscribe": {
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
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