Week of Nov. 28–Dec. 2, 2022

General Articles

• After his father died of Covid last fall, Donkan Martinez was overwhelmed by grief and turned to an unlikely outlet: virtual reality. The 24-year-old found himself wading into an emerging field of virtual mental health care, via a service called Innerworld, which offers peer-led mental health support through its app. The idea is to bring the principles of cognitive behavioral therapy, or CBT, into the metaverse and enable users to interact with others as anonymous avatars through voice- and text-based chat.  Read more here.
• New York City’s mayor said he was directing police and city medics to be more aggressive about getting severely mentally ill people off the streets and subways and into treatment, even if it means involuntarily hospitalizing some people who refuse care. The mayor’s directive marks the latest attempt to ease a crisis decades in the making. It would give outreach workers, city hospitals and first responders, including police, discretion to involuntarily hospitalize anyone they deem a danger to themselves or unable to care for themselves. Read more here.
• Countless central Ohioans will make New Year’s resolutions. Read more here.
• A suicide prevention net on San Francisco’s Golden Gate Bridge that is already years behind schedule will cost about $400 million, more than double its original price, because of problems sparked by the government agency that manages the span, the lead contractors allege. The allegations filed Monday in state court say that changes to and flaws in the government’s net design and the lack of transparency about the deterioration of the bridge’s maintenance platforms have raised the construction price from $142 million to at least $398 million. Read more here.

Youth Mental Health

• Between falling test scores and rising rates of mental illness, U.S. kids are not alright. COVID-19 is an easy villain, but signs of strain were showing up well before this virus took hold: Anxiety among children was up 27% and depression 24% between 2016 and 2019, according to data from the National Survey of Children’s Health. Global, national, and city-level studies show the pandemic exacerbated an already worrisome trend. Read more here.

 Impact of the Pandemic

• Long Covid has affected as many as 23 million Americans to date — and it’s poised to have a financial impact rivaling or exceeding that of the Great Recession. Costs on a household and national scale are tough to quantify because the illness — also known as long-haul Covid, post-Covid or post-acute Covid syndrome — is so new. Anyone with a prior Covid-19 infection is susceptible, regardless of factors such as age, health, or vaccine status. Read more here.
•  A new study looks at excess deaths by partisan affiliation in two states during the pandemic. The study finds that excess deaths during the pandemic were 76% higher among Republicans than Democrats in two states, Ohio and Florida. What’s more, the partisan gap in death rates increased significantly after vaccines were introduced. While the research doesn’t definitively prove that low vaccine uptake among Republicans explains the mortality gap, “it points to this as a potential mechanism.” Read more here.

Firearms and Suicide 

• Mental health challenges grew throughout the pandemic and violence increased, but a separate analysis from researchers at Johns Hopkins University found that guns made those things significantly more deadly. Between 2019 and 2021, all of the increase in suicides and most of the increase in homicides was due to guns. The gun suicide rate increased 10% while the non-gun suicide rate decreased by 8%, and the gun homicide rate increased 45% while the non-gun homicide rate increased only 6%. Read more here.

The Opioid Crisis and Addiction Issues

• A bipartisan bill to increase access to treatment for opioid addiction has a good chance of being rolled into a year-end package during the lame-duck session, congressional aides tell Axios. How it works: The bill would remove a requirement that health care providers get a special waiver from the Drug Enforcement Administration before they can prescribe buprenorphine, an addiction treatment that reduces the risk of future overdoses. Read more here.
• For the 52 million Americans age 65 and older, Medicare is a lifesaver, providing health insurance regardless of income, medical history, or health status. But for the growing number of older adults who need treatment for an alcohol or drug use disorder, the federal program falls woefully short, according to experts, advocates and medical groups. Of those who didn't receive treatment, 38 percent cited financial barriers. Read more here.
• Unlike methadone, the traditional medication to wean people off heroin or other opioids, buprenorphine can be prescribed at primary care clinics and dispensed at neighborhood pharmacies. Federal and state authorities have encouraged more front-line health care professionals to prescribe Suboxone and other medications containing buprenorphine for patients trying to overcome opioid addiction. Federal regulators have made it easier for doctors, nurse practitioners, and physician assistants to become certified to offer the service. Read more here.
• Iowa and local governments are set to receive $42.6 million from a settlement with an opioid manufacturer and a pharmaceutical company. Iowa Attorney General Tom Miller announced a final settlement has been reached in the lawsuit against Allergan, which is now part of AbbVie, and Teva Pharmaceuticals for its role in the ongoing opioid epidemic. A dozen states, including Iowa, argued the companies failed to take sufficient action in preventing opioid drugs from being diverted to illegal trade. In total, the settlements will provide around $6.6. billion nationwide. Read more here.
• The state of Indiana and all of its cities, towns and counties are set to receive up to $507 million as part of a massive settlement from lawsuits against drug manufacturer Johnson & Johnson and national distributors Cardinal Health, McKesson, and AmerisourceBergen for their roles in the opioid crisis. The funds will help Indiana communities fight the drug crisis, bolster law enforcement and task forces, and fund treatment and other programs, Indiana Attorney General Todd Rokita said in a February announcement calling the settlement a "huge win" for the state. Read more here.
• Deaths related to drug misuse and alcohol abuse appear to be on the rise among older adults in the United States, similar to the recent increases seen among younger adults, according to two new reports from the U.S. Centers for Disease Control and Prevention. Rates of deaths from drug overdoses among seniors have more than tripled in the past two decades, according to one report published Wednesday by the CDC’s National Center for Health Statistics. Read more here.

Research

• The experimental drug Lecanemab shows “potential” as an Alzheimer’s disease treatment, according to new Phase 3 trial results, but the findings raise some safety concerns because of its association with certain serious adverse events. Lecanemab has become one of the first experimental dementia drugs to appear to slow the progression of cognitive decline. The long-awaited trial data, published in the New England Journal of Medicine, comes about two months after drug makers Biogen and Eisai announced that Lecanemab had been found to reduce cognitive and functional decline by 27% in their Phase 3 trial. Read more here.
• Using state-of-the-art whole-genome sequencing and machine learning techniques, the UNC School of Medicine lab of Jin Szatkiewicz, PhD, associate professor of genetics, and colleagues conducted one of the first and the largest investigations of tandem repeats in schizophrenia, elucidating their contribution to the development of this devastating disease. Published in the journal Molecular Psychiatry, the research shows that individuals with schizophrenia had a significantly higher rate of rare tandem repeats in their genomes—7% more than individuals without schizophrenia. Read more here.

Social Determinants

• Young children living in neighborhoods with high rates of poverty are more likely to be exposed to many different air pollutants, and that can harm their development during early childhood, according to a study. The children’s increased exposure to air toxins during infancy can reduce reading and math abilities and cause them to fall behind — for some, the effect is equivalent to losing an entire month of elementary school. Read more here. (Free registration is required to read this article.) 

Federal and State Policy

• The lame-duck Congress is back in Washington with a long list of bills it would like to pass and a short time to do it before Republicans take over the House majority in January. How many health-related items can be accomplished depends largely on how much money Congress agrees to spend overall, as it hashes out the annual federal spending bills. Meanwhile, some of the remaining states that have not yet expanded the Medicaid program may be warming up to the idea, particularly North Carolina and Kansas, which have Democratic governors and Republican legislatures. Read more here.
• A recent federal court ruling has cleared the path for Georgia to move forward with its limited expansion of Medicaid. The idea, originally proposed by Republican Governor Brian Kemp when he took office in 2019, would require new participants to work or volunteer 80 hours each month. Following the federal court’s decision and Kemp’s winning reelection, it appears the plan will move forward unless the federal government chooses to intervene. Read more here.
• When Dylan Brandt looks back on the time before he started receiving gender-affirming care, he remembers feeling trapped "in a pretty bad place." He says the treatment was "lifesaving." "I felt better because I was looking better. I felt free. I felt happy." Today, that joy is overshadowed by fear that his access to treatment may soon disappear because of a 2021 law passed in Arkansas, Brandt's home state, that bans gender-affirming care for transgender youth like himself. Read more here.