Category: Morbidity

Death of an Elder Raises Uncomfortable Questions About Adequacy of Care

Mary Pat Campbell

Link: https://www.nakedcapitalism.com/2022/12/death-of-an-elder-raises-uncomfortable-questions-about-adequacy-of-care.html

Excerpt:

Yves here. I’ve taken the liberty of changing the title of this Kaiser Health New from A Family Death During the Holidays Prompts Questions and Reflection. The piece pulls its punches, perhaps because the health care journalist author Judith Graham, who regularly writes about aging, is hesitant to come off as an advocate and/or potentially alienate future sources. But you can see she is clearly not happy with the caliber of care her father-in-law received in his final days.

I’ve heard similar stories from readers and I saw it first hand with my mother, who like Graham’s father died at 94. I would be curious if practices are better or worse with the moderately and very old in other countries, particularly in Asia. The two times my mother was hospitalized in her final year, the care was horrid. And it wasn’t as if the staff was overburdened due to Covid. My mother’s aides would call for help, and after >10 minutes of getting no answer, would then go to the nurses’ station to find them doing their nails and watching TV. They also failed to keep her well hydrated and bruised her horribly.

….

But more broadly, an anti-aged attitude was evident. No one seemed willing to work that hard to save an old woman, or even help her have a more dignified death, particularly since she didn’t look that swell. Thanks to Covid, her hair and nails hadn’t been done for over a year and she came to the hospital in flannel pajamas. Notice the photos of the father in law below. Despite the upscale sweater, watch and glass frames, I suspect his very aged skin was held against him.

BTW, according to the Social Security life expectancy table, an average women my mother’s age typically would have lived another 3.8 years. So to hell with the bigots on staff.

And this sorry picture is set to get worse with Covid, with repeat infections reducing health baselines generally and resulting in more demands on doctors, nurses and hospitals that have no ability to increase capacity in less than many years. A sicker population will also produce more prejudice against older patients, even if they are robust and have managed to stay Covid-free.

Author(s): Yves Smith, Judith Graham

Publication Date: 9 December 2022

Publication Site: naked capitalism

As the Monkeypox Spread Recedes, There Are Lessons To Learn

Mary Pat Campbell

Link: https://reason.com/2022/12/01/as-the-monkeypox-spread-recedes-there-are-lessons-to-learn/

Graphic:

Excerpt:

After close to 30,000 infections, 15 reported deaths, and more than one million doses of vaccine, it appears as though the widespread nature of the U.S. monkeypox outbreak may be nearing an end.

The most recent data from the Centers for Disease Control and Prevention (CDC) show a seven-day average of seven new monkeypox cases per day. This is a massive decline from the more than 400 cases per day reported during the height of the outbreak in late July and early August. Though, to be clear, it may be some time before we have no cases of monkeypox in the U.S. at all.

There are several explanations for this success, some more obvious than others. The most obvious: This strain of monkeypox was overwhelmingly spread between men who have sex with other men. While monkeypox is technically not a sexually transmitted infection—it can be spread through physical contact with rashes and sores of an infected person—this particular strain seemed stubbornly resistant to nonsexual spread. Los Angeles County data, for example, shows that only 43 of the 2,388 confirmed cases were in women. So, the number of demographic groups at risk of infection was much lower than the number at risk of catching COVID-19.

Author(s): SCOTT SHACKFORD

Publication Date: 1 Dec 2022

Publication Site: Reason

Why Do Vaccinated People Represent Most COVID-19 Deaths Right Now?

Mary Pat Campbell

Link: https://www.kff.org/policy-watch/why-do-vaccinated-people-represent-most-covid-19-deaths-right-now/

Graphic:

Excerpt:

The waning protection from vaccines is why CDC recommends recent booster shots, and why it’s especially important for people at higher risk to stay up-to-date on boosters. Per current recommendations, most adults should have received at least 2-3 booster doses by now (including the new bivalent booster), in addition to their primary series. However, only 14% of adults overall and 31% of older adults (65 years and older) have received the latest bivalent boosters. The CDC data show that about 95% of adults who died from COVID-19 in 2022 in these jurisdictions were over age 50, and about 8 in 10 were age 65 or older, underscoring the need for older adults to stay up-to-date on recommended booster shots.

The fall in the share of deaths that are among unvaccinated people could also be explained by changes in the unvaccinated population. By this far into the pandemic, it is estimated that many unvaccinated people have had COVID-19 at least once and while hundreds of thousands of unvaccinated people have needlessly died from COVID, those who survived may have gained some immune protection against the virus that can help protect them against severe outcomes when they have subsequent infections. However, this protection from a past infection can also diminish over time, which is why it is still recommended that unvaccinated people with prior COVID-19 infections get vaccinated and stay up-to-date on boosters.

Author(s): Cynthia Cox Follow @cynthiaccox on Twitter , Krutika Amin Follow @KrutikaAmin on Twitter , Jennifer Kates Follow @jenkatesdc on Twitter , and Josh Michaud Follow @joshmich on Twitter

Publication Date: 30 Nov 2022

Publication Site: KFF

Europe faces ‘cancer epidemic’ after estimated 1m cases missed during Covid

Mary Pat Campbell

Link: https://www.theguardian.com/society/2022/nov/15/europe-faces-cancer-epidemic-after-estimated-1m-cases-missed-during-covid

Excerpt:

Experts have warned that Europe faces a “cancer epidemic” unless urgent action is taken to boost treatment and research, after an estimated 1m diagnoses were missed during the pandemic.

The impact of Covid-19 and the focus on it has exposed “weaknesses” in cancer health systems and in the cancer research landscape across the continent, which, if not addressed as a matter of urgency, will set back cancer outcomes by almost a decade, leading healthcare and scientific experts say.

A report, European Groundshot – Addressing Europe’s Cancer Research Challenges: a Lancet Oncology Commission, brought together a wide range of patient, scientific, and healthcare experts with detailed knowledge of cancer across Europe.

One unintended consequence of the pandemic was the adverse effects that the rapid repurposing of health services and national lockdowns, and their continuing legacy, have had on cancer services, on cancer research, and on patients with cancer, the experts said.

“To emphasise the scale of this problem, we estimate that about 1m cancer diagnoses might have been missed across Europe during the Covid-19 pandemic,” they wrote in The Lancet Oncology. “There is emerging evidence that a higher proportion of patients are diagnosed with later cancer stages compared with pre-pandemic rates as a result of substantial delays in cancer diagnosis and treatment. This cancer stage shift will continue to stress European cancer systems for years to come.

Author(s): Andrew Gregory

Publication Date: 15 Nov 2022

Publication Site: The Guardian UK

Covid’s Drag on the Workforce Proves Persistent. ‘It Sets Us Back.’

Mary Pat Campbell

Link: https://www.wsj.com/articles/covid-workforce-absenteeism-productivity-economy-labor-11667831493

Graphic:

Excerpt:

Two-and-a-half years after Covid-19 emerged, reported infections are way down, pandemic restrictions are practically gone and life in many respects is approaching normal. The labor force, however, is not.

Researchers say the virus is having a persistent effect, keeping millions out of work and reducing the productivity and hours of millions more, disrupting business operations and raising costs.

In the average month this year, nearly 630,000 more workers missed at least a week of work because of illness than in the years before the pandemic, according to Labor Department data. That is a reduction in workers equal to about 0.4 percent of the labor force, a significant amount in a tight labor market. That share is up about 0.1 percentage point from the same period last year, the data show.

….

Another half a million workers have dropped out of the labor force due to lingering effects from previous Covid infections, according to research by economists Gopi Shah Goda of Stanford University and Evan J. Soltas at the Massachusetts Institute of Technology. In a Census Bureau survey in October, 1.1 million people said they hadn’t worked the week before because they were concerned about contracting or spreading the virus.

The resulting labor shortages are contributing to upward pressure on wages and inflation, one reason the Fed delivered its fourth consecutive 0.75 percentage point interest rate increase last Wednesday. On Friday, the Labor Department reported brisk job growth in October, but health-related absences remained elevated and the labor force contracted slightly.

Author(s): Gwynn Guilford and Lauren Weber

Publication Date: 7 Nov 2022

Publication Site: WSJ

GE to End $2.5B Long-Term Care Insurance Reinsurance Arrangement

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2022/10/26/ge-to-end-2-5b-long-term-care-insurance-reinsurance-arrangement

Excerpt:

General Electric has agreed to end a long-term care insurance reinsurance relationship backed by $2.5 billion in assets.

The Boston-based company said Tuesday that it hopes to get the assets back by the end of the year.

….

For GE, the end of the reinsurance arrangement means that the company will face less worry about whether it can collect on reinsurance claims.

“This reduces counterparty risk,” Happe said.

GE will also have $2.5 billion in extra cash to reinvest.

Author(s): Allison Bell

Publication Date: 26 Oct 2022

Publication Site: Think Advisor

A colonoscopy study has some wondering if they should have the procedure. What you should know

Mary Pat Campbell

Link: https://www.cnn.com/2022/10/10/health/colonoscopy-study-q-and-a-wellness/index.html

Excerpt:

What did this new study show about the effectiveness of colonoscopies?

In this study, about 12,000 people in Sweden, Poland and Norway got colonoscopies. They saw a 31% reduction in their risk of colon cancer and a 50% reduction in their risk of dying from colon cancer compared with people who were not invited to get a colonoscopy.

Was that about what would be expected?

Some US studies have suggested that colonoscopies are even more effective. One study followed nearly 90,000 health care professionals for 22 years. Some of them chose to receive a screening colonoscopy, and some did not. The researchers estimated that screening colonoscopy was associated with a 40% reduction in the risk of getting colon cancer and a 68% reduction in the risk of dying of colon cancer.

Why would there be different success rates in the three European countries compared with the US?

Dominitz says one reason might be that most people in the European study didn’t have sedation when they got their colonoscopies. Only 23% of the patients in the European study received sedation, but virtually everyone having a colonoscopy in the US gets it. Colonoscopies can be uncomfortable, and doctors might, without even realizing it, be less thorough if people are in pain. Thoroughness – getting the scope into the folds and crevices of the colon – is important for finding growths called polyps. The more polyps doctors are able to find, the more they can reduce the person’s risk of being diagnosed with or dying from colon cancer.

Author(s): Elizabeth Cohen

Publication Date: 11 Oct 2022

Publication Site: CNN

The Economic Cost of Gun Violence

Mary Pat Campbell

Link: https://everytownresearch.org/report/the-economic-cost-of-gun-violence/

Graphic:

Excerpt:

  • Taxpayers, survivors, families, and employers pay an average of $7.79 million daily in health care costs, including immediate and long-term medical and mental health care, plus patient transportation/ambulance costs related to gun violence, and lose an estimated $147.32 million per day related to work missed due to injury or death. 
  • American taxpayers pay $30.16 million every day in police and criminal justice costs for investigation, prosecution, and incarceration. 
  • Employers lose an average of $1.47 million on a daily basis in productivity, revenue, and costs required to recruit and train replacements for victims of gun violence.
  • Society loses $1.34 billion daily in quality-of-life costs from the suffering and lost well-being of gun violence victims and their families.

Author(s):

Publication Date: 19 July 2022

Publication Site: Everytown Research

Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals

Mary Pat Campbell

Link: https://bjsm.bmj.com/content/56/17/975

Abstract:

Objectives Balance quickly diminishes after the mid-50s increasing the risk for falls and other adverse health outcomes. Our aim was to assess whether the ability to complete a 10- s one-legged stance (10-second OLS) is associated with all-cause mortality and whether it adds relevant prognostic information beyond ordinary demographic, anthropometric and clinical data.

Methods Anthropometric, clinical and vital status and 10-s OLS data were assessed in 1702 individuals (68% men) aged 51–75 years between 2008 and 2020. Log-rank and Cox modelling were used to compare survival curves and risk of death according to ability (YES) or inability (NO) to complete the 10-s OLS test.

Results Overall, 20.4% of the individuals were classified as NO. During a median follow-up of 7 years, 7.2% died, with 4.6% (YES) and 17.5% (NO) on the 10-s OLS. Survival curves were worse for NO 10-s OLS (log-rank test=85.6; p<0.001). In an adjusted model incorporating age, sex, body mass index and comorbidities, the HR of all-cause mortality was higher (1.84 (95% CI: 1.23 to 2.78) (p<0.001)) for NO individuals. Adding 10-s OLS to a model containing established risk factors was associated with significantly improved mortality risk prediction as measured by differences in −2 log likelihood and integrated discrimination improvement.

Conclusions Within the limitations of uncontrolled variables such as recent history of falls and physical activity, the ability to successfully complete the 10-s OLS is independently associated with all-cause mortality and adds relevant prognostic information beyond age, sex and several other anthropometric and clinical variables. There is potential benefit to including the 10-s OLS as part of routine physical examination in middle-aged and older adults.

Author(s): Araujo CG, de Souza e Silva CG, Laukkanen JA, et al

Publication Date:

Publication history
Accepted April 19, 2022
First published June 21, 2022.
Online issue publication
August 24, 2022

Publication Site: British Journal of Sports Medicine

Citation:

Araujo CG, de Souza e Silva CG, Laukkanen JA, et al

Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals

British Journal of Sports Medicine 2022;56:975-980.

doi: http://dx.doi.org/10.1136/bjsports-2021-105360

What we learned from a massive survey on America’s mental health crisis

Mary Pat Campbell

Link: https://www.cnn.com/2022/10/08/politics/cnn-kff-mental-health-survey-what-matters/index.html

Excerpt:

The vast majority of Americans of all ages, races, generations and backgrounds say the US has a mental health crisis.

Nine in 10 Americans in a new survey from CNN and the Kaiser Family Foundation say the country as a whole is facing a crisis on this front and about half of adults say they’ve experienced a severe mental health crisis in their family.

CNN published a series of stories this week based on the poll in conjunction with KFF. Read the main report here. And read this from CNN’s polling team about how the survey was conducted.

There’s also 988 – the three-digit number anyone in crisis can call, but which the survey found few people know about.

Author(s): Zachary B. Wolf

Publication Date: 8 Oct 2022

Publication Site: CNN

State Surgeon General Dr. Joseph A. Ladapo Issues New mRNA COVID-19 Vaccine Guidance

Mary Pat Campbell

Link: https://content.govdelivery.com/accounts/FLDOH/bulletins/3312697

Guidance: https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-doc.pdf?utm_medium=email&utm_source=govdelivery

Analysis: https://floridahealthcovid19.gov/wp-content/uploads/2022/10/20221007-guidance-mrna-covid19-vaccines-analysis.pdf?utm_medium=email&utm_source=govdelivery

Graphic:

Excerpt:

Today, State Surgeon General Dr. Joseph A. Ladapo has announced new guidance regarding mRNA vaccines. The Florida Department of Health (Department) conducted an analysis through a self-controlled case series, which is a technique originally developed to evaluate vaccine safety.

This analysis found that there is an 84% increase in the relative incidence of cardiac-related death among males 18-39 years old within 28 days following mRNA vaccination. With a high level of global immunity to COVID-19, the benefit of vaccination is likely outweighed by this abnormally high risk of cardiac-related death among men in this age group. Non-mRNA vaccines were not found to have these increased risks.

As such, the State Surgeon General recommends against males aged 18 to 39 from receiving mRNA COVID-19 vaccines. Those with preexisting cardiac conditions, such as myocarditis and pericarditis, should take particular caution when making this decision.

Author(s): Joseph A. Ladapo

Publication Date: 7 Oct 2022

Publication Site: Florida Dept of Health

KFF COVID-19 Vaccine Monitor: September 2022

Mary Pat Campbell

Link: https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-september-2022/

Graphic:

Excerpt:

Overall adult vaccination rates have been relatively steady over the past year. The latest COVID-19 Vaccine Monitor finds that nearly eight in ten adults (77%) say they have gotten at least one dose of a COVID-19 vaccine, including about half who say they are fully vaccinated and also received at least one booster dose (47%), about a quarter who have been fully vaccinated but have not gotten a booster (26%), and a small share who are partially vaccinated (3%). Twenty-three percent remain unvaccinated, the vast majority of whom say they will “definitely not” get the COVID-19 vaccine (88% of unvaccinated, or 21% of all adults). For the latest breakdown of self-reported vaccination rates by demographic group, see the Vaccine Monitor Dashboard.

In late August, the Food and Drug Administration authorized the use of new, updated COVID-19 vaccine boosters that target both the new omicron variants and the original strain of the virus. The bivalent boosters (one by Moderna and one by Pfizer) are now authorized for use by those ages 12 and older who have gotten an initial series of a COVID-19 vaccine, including those who have already received one or more boosters.

Awareness of the new boosters is modest, with about half of adults saying they have heard “a lot” (17%) or “some” (33%) about updated booster, 31% saying they have heard “a little,” and one in five saying they have heard “nothing at all” about the new booster doses.

Older adults and Democrats are somewhat more likely than their counterparts to say they have heard at least “some” about the new boosters, but fewer than a quarter across these groups report hearing “a lot” about the new shots.

Author(s): Grace Sparks Follow @gracesparks on Twitter , Lunna Lopes , Liz Hamel Follow @lizhamel on Twitter , Alex Montero , Marley Presiado , and Mollyann Brodie Follow @Mollybrodie on Twitter

Publication Date: 30 Sept 2022

Publication Site: Kaiser Family Foundation