Checking Up On Health: March 15, 2020

Medical Monday: A weekly post of healthcare- and technology-related policy news, views and commentaries.

One concern amid COVID-19 lockdowns, shutdowns, mandates, sheltering at home, isolation and telemedicine is the dangerous decline in routine vaccinations among children. As communities open up again, increasing socialization and interactions, many children – and the vulnerable adults around them – may be susceptible to childhood illnesses such as measles, mumps, rubella and chickenpox, and there is an opportunity for dangerous outbreaks and rapid spread of such ailments.

In a January article in the journal Pediatrics, researchers note that one dose of the measles-mumps-rubella (MMR) vaccine provides about 93% protection against measles. In 2017, just 10% of U.S. children ages 19 to 35 months had not received the MMR vaccine. In May 2020, the Centers for Disease Control and Prevention reported a precipitous drop in vaccination in Michigan after the pandemic began. “Among children aged 5 months, up‐to‐date status for all recommended vaccines declined from approximately two thirds of children during 2016‐2019 … to fewer than half (49.7%) in May 2020.”

“Lower MMR vaccination rates raise serious concerns about a possible measles resurgence in the United States because of the high level of herd immunity needed to prevent community transmission,” according to researchers in the journal Pediatrics. They added, “the pandemic-related decline in MMR vaccination has persisted, as has the decline in preventive care visits. The fourfold decrease in vaccination outside of preventive visits is an important contributor to the drop in the MMR vaccination rate.”

Vaccine opportunities: March 15 is the day Georgia Gov. Brian Kemp has authorized to expand the eligibility for COVID-19 vaccinations to Georgians 55 and older, as well as those with a broad range of health conditions, from asthma to being overweight. Find out here whether you’re eligible and register online for an appointment at myvaccinegeorgia.com.

AstraZeneca: A comprehensive review has found “no evidence” that AstraZeneca’s COVID-19 vaccine causes an increased risk of blood clots, the manufacturer announced Sunday.  Authorities in Ireland, the Netherlands, Denmark, Norway and Iceland have paused administering the vaccine because of clotting concerns, according to news reports. AstraZeneca said that of the 17 million people so far inoculated with its vaccine, there have only been 15 cases of deep vein thrombosis and 22 pulmonary embolisms. “This is much lower than would be expected to occur naturally in a general population of this size and is similar across other licensed covid-19 vaccines,” the company said. The United States is using Pfizer, Moderna and Johnson & Johnson vaccines, with AstraZeneca expected to seek authorization in the coming weeks.

Baby blues: The worldwide fertility rate has already dropped more than 50% in the past 50 years, from 5.1 births per woman in 1964 to 2.4 in 2018, according to the World Bank. In 2020, the 20% “shortfall below replacement rate” in U.S. fertility, together with low net immigration, produced the lowest population growth on record of 0.35%, below even the flu pandemic of 1918, Financial Times reports. The coronavirus pandemic is also having a profound incremental impact, with provisional fertility declines of 5-15% in most developed countries. South Korea recently reported a 2020 fertility rate of 0.84, the only country whose total fertility rate stayed below 1% among 37 member countries of the Organization for Economic Cooperation and Development (OECD). Source: News reports

Telehealth: Before the pandemic, telehealth consultations, by computer or phone, were rare: Just 2.4% of enrollees in large-employer health plans used a telehealth service in 2018, according to the Kaiser Family Foundation. States and federal rules that limited telehealth services were temporarily relaxed in more than 40 states, including allowing out-of-state providers to hold remote patient visits. A year into the pandemic, some states are considering making it permanent. Now in-state providers are complaining their private patients are being poached, while allegations of fraud and access problems are being raised, according to Kaiser Health News.

Good luck with that: Bad news for any parent who has tried to get a toddler to put on a T-shirt. The Centers for Disease Control and Prevention has updated its coronavirus guidance for child care providers, which stresses the importance of mask use for anyone 2 years and older. The updated guidance comes as some states begin to reopen and relax COVID-19 restrictions.

Good news in nursing homes:  After the rollout of vaccines, the number of new COVID-19 cases among nursing home staff members fell 83%, from 28,802 for the week ending December 20 to 4,764 for the week ending February 14. The vaccination rate among staffers is far lower than that of residents, however: Initially, from mid-December to mid-January, a median of 78% of nursing home residents took a dose, while the median for staff was only 38%, according to the CDC. Now several nursing home associations say the rate of staff vaccination has been climbing, based on informal surveys. Source: Kaiser Health News

Top 10: Two Georgia healthcare organizations are ranked among Fortune’s Best Healthcare Workplaces. On the list of Top 10 Places to Work in Healthcare (large companies) are Marietta-based WellStar Health System at No. 9 and Alpharetta-based Jackson Healthcare at No. 10. Topping the list is Texas Health Resources (Arlington, Texas).

Notable Quote

“Healthcare organizations and their front-line clinical workforce have absorbed the brunt of the pandemic and the emotional toll of witnessing the deaths of hundreds of thousands who could not have loved ones present. Physicians are now dealing with sicker patients because of delayed care during the pandemic. The healthcare system in 2021 also faces a tremendous challenge in responding to the nation’s mental health crisis, as 32% of U.S. consumers surveyed by HRI said they had experienced anxiety or depression as a result of the pandemic.” – Becker’s Hospital Review, Top Healthcare Industry Issues of 2021


Compiled by Benita M. Dodd, vice president of the Georgia Public Policy Foundation.

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