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Monday Medical News Clips from My In-Box

Summary:
Quite a few commentaries about Covid and a lasting impact from Covid as it migrates to various organs in both the old, young, and healthy. Of course, there are more articles than what I listed here. Waning Immunity Is Not a Crisis, Right Now – The Atlantic Waning is not disappearance, though. Even if vaccinated people sometimes do get infected and sick, it will happen less often, and less severely. That, in turn, makes it much harder for the virus to stick around and spread. The goal of vaccination, Çevik told me, is to tame the virus, gradually, into something less formidable, more weatherable. Infection will no longer have to be a crisis. “The point isn’t to protect you from getting even a tiny amount of virus in your body,” she said. We’re

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Quite a few commentaries about Covid and a lasting impact from Covid as it migrates to various organs in both the old, young, and healthy. Of course, there are more articles than what I listed here.

Waning Immunity Is Not a Crisis, Right Now – The Atlantic

Waning is not disappearance, though. Even if vaccinated people sometimes do get infected and sick, it will happen less often, and less severely. That, in turn, makes it much harder for the virus to stick around and spread. The goal of vaccination, Çevik told me, is to tame the virus, gradually, into something less formidable, more weatherable. Infection will no longer have to be a crisis. “The point isn’t to protect you from getting even a tiny amount of virus in your body,” she said. We’re not out to eradicate positive test results: “That’s not what vaccines do.”

Why some COVID-19 infections may be free of symptoms but not free of harm (nationalgeographic.com)

A study of 104 passengers found that 76 of them had COVID but were asymptomatic. Of that group, CT scans showed that 54 percent had lung abnormalities—patchy gray spots known as ground glass opacities that signal fluid build-up in the lungs.

These CT scans were “disturbing,” wrote Topol, founder and director of the Scripps Research Translational Institute, with co-author Daniel Oran in a narrative review of asymptomatic disease published in the Annals of Internal Medicine. “If confirmed, this finding suggests that the absence of symptoms might not necessarily mean the absence of harm.”

CHIP has Proven Its Worth, It’s Time to Modernize it and Make it a Permanent Part of Children’s Health Coverage – Center For Children and Families (georgetown.edu)

Though children enrolled in separate CHIP programs do not have the same coverage guarantee as children in Medicaid, the coverage provided to children under CHIP is more comprehensive and responsive to their needs than benefits provided through federal and state marketplaces and likely more affordable than employer-sponsored insurance in most cases. While having health insurance is not enough to ensure that kids grow and thrive, it is the price of admission to our health care system.

The government pays us less than they pay their plumber’: Anesthesia leaders on reimbursement challenges (beckersasc.com)

Anesthesiology practices with a large governmental payer mix require a substantive subsidy from the sites they staff. Anesthesiologists may provide on average 10,000-15,000 [American Society of Anesthesiologists] relative value units of work per year. In most states, Medicaid pays approximately half what Medicare does. So, the biggest reimbursement challenge is to not succumb with commercial payers to a “multiple of Medicare contract” when Medicare is so grossly underpaying anesthesiologists to begin with. Further, many anesthesiology groups have experienced commercial payer contracts unilaterally revoked and rates significantly decreased before the end of the written contract cycle.    

Make sure you read the comments section as one doctor answers the wage issue cited in several of the points in this article.

From The Archives: Prices And Consumer Shopping | Health Affairs

While the path forward for health reform is now somewhat unclear, the trend of higher consumer cost sharing will likely continue. Higher deductibles and cost sharing are often touted as ways for individuals to have “skin in the game” in health care costs and to help consumers be better shoppers. But what does the research say about the ability to truly shop for health care services? Is it possible? Does it save money? And do consumers even want to do it? Here’s what we know based on research published in the pages of Health Affairs.

I will have more on pricing variations between hospital chargess and healthcare insurance payouts. I will also be tackling value-added pricing which can be seen in pharmaceuticals when new uses are discovered and do not impact costs.

Fauci: ‘Good Idea’ to Implement School Vaccine Mandates (medscape.com)

COVID-19 vaccine mandates in schools are a “good idea” for ages 12 and older who are eligible to receive a shot, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said Sunday.

Fauci said he expects the FDA and the CDC’s Advisory Committee on Immunization Practices to establish a “strong benefit-risk ratio” for children.

“When that gets established, which I believe it certainly will … I believe that mandating vaccines for children to appear in school is a good idea,” Fauci said on CNN’s “State of the Union.”

We Can All Benefit From Helping Patients Understand Breakthrough COVID | MedPage Today

The recent change in masking guidance from the CDC and reinstated public health measures from local and state governments have been met with frustration and defiance, with people understandably questioning why they got vaccinated if they have to go back to masking and distancing anyway. The answer is in the degree of exposure to SARS-CoV-2, and the explanation lies in the way vaccines work. We can help our patients understand this with three talking points:

Medicaid Expansion Reduced Uninsured Surgical Hospitalizations And Associated Catastrophic Financial Burden | Health Affairs

An important function of health insurance is protecting enrollees from excessively burdensome charges for unanticipated medical events. Unexpected surgery can be financially catastrophic for uninsured people. By targeting the low-income uninsured population, Medicaid expansion had the potential to reduce the financial risks associated with these events.

This is a “no access” article. Reading the abstract will give you a good idea of the article’s content. I do just read abstracts.

A Long Look at Long Haulers (medscape.com)

In a recent Guest Essay in the New York Times, two medical school professors attempt to inject some common sense into the long hauler phenomenon. (“The Truth About Long Covid is Complicated. Better Treatment Isn’t,” Adam Gaffney and Zackary Berger, The New York Times, Aug. 18, 2021).

The authors divide the patients with long COVID into three categories. 

If you are thinking Covid is just a one time occurrence for a couple of weeks, it may end up to being a lifetime ailment from the injuries it leaves behind.

COVID-19 LongHaulers Are Fighting for Their Future – The Atlantic

The common wisdom was that people infected with SARS-CoV-2 mostly get mild symptoms that resolve after two weeks. And yet, thousands of “long-haulers” had already been debilitated by months of extreme fatigue, brain fog, breathing difficulties, and other relentless, rolling problems. More than a year later, several clinics care for long-haulers, while the biomedical community, like the ents, has begun to identify long-COVID patients as long-COVID patients. But some researchers still hesitate to recognize long COVID if it doesn’t present in certain ways; they’re running studies without listening to patients, and they’ve come up with their own arguably unhelpful name for the disease. 

Another article on Covid long haulers or those who having lingering issues from Covid.. There can be more than just a two week stint with Covid and it is affecting many young, healthy, and athletic people,

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