WASHINGTON (AP) — Bleeding and in pain, Kyleigh Thurman didn’t know her doomed pregnancy could kill her. [AP]

Emergency room doctors at Ascension Seton Williamson in Texas handed her a pamphlet on miscarriage and told her to “let nature take its course” before discharging her without treatment for her ectopic pregnancy.

When she returned three days later, still bleeding, doctors finally agreed to give her an injection to end the pregnancy. It was too late. The fertilized egg growing on Thurman’s fallopian tube ruptured it, destroying part of her reproductive system.

That’s according to a complaint Thurman and the Center for Reproductive Rights filed last week asking the government to investigate whether the hospital violated federal law when staff failed to treat her initially in February 2023.

“I was left to flail,” said Thurman, 35. “It was nothing short of being misled.”

The Biden administration says hospitals must offer abortions when needed to save a woman’s life, despite state bans enacted after the Supreme Court overturned the constitutional right to an abortion more than two years ago. Texas is challenging that guidance and, earlier this summer, the Supreme Court declined to resolve the issue.

More than 100 pregnant women in medical distress who sought help from emergency rooms were turned away or negligently treated since 2022, an Associated Press analysis of federal hospital investigations found.

Two women — one in Florida and one in Texas — were left to miscarry in public restrooms. In Arkansas, a woman went into septic shock and her fetus died after an emergency room sent her home. At least four other women with ectopic pregnancies had trouble getting treatment, including one in California who needed a blood transfusion after she sat for nine hours in an emergency waiting room.

More>

###

More than half of US states are reporting signs that COVID levels are poised to continue their summerlong rise. [Medscape & CDC]

The latest CDC wastewater monitoring data shows that 27 US states are detecting "very high" levels of SARS-CoV-2, the virus that causes COVID. The label "very high" indicates the highest viral activity level used by the agency. There are four lower levels that can be reported: minimal, low, moderate, and high. Nationwide, the lowest level being reported is moderate, and there are no states reporting low or minimal levels. 

"If you see increased Wastewater Viral Activity Levels of SARS-CoV-2, it might indicate that there is a higher risk of infection," the CDC warns.

How Do COVID-19 mRNA Vaccines Work?

Some of the COVID-19 vaccines are known as mRNA shots. How are they different from traditional vaccines? And do they contain the real virus?

There are other signs that the summer COVID wave is nowhere near ending its now 13-week consecutive climb. The rate of positive COVID tests reported to the CDC is now more than 17%, up from 0.3% in early May. The rate of positive COVID tests is at its highest level since about 2 years ago. The region of the US that includes Texas, Oklahoma, New Mexico, Louisiana, and Arkansas had the highest combined regional positive rate of 24% for the week ending August 3.

An updated COVID vaccine that is recommend for all people ages 6 months and older will be available later this fall.

###

The US Food and Drug Administration is poised to sign off as soon as this week on updated Covid-19 vaccines targeting more recently circulating strains of the virus, according to two sources familiar with the matter, as the country experiences its largest summer wave in two years. [KFF News]

The agency is expected to greenlight updated mRNA vaccines from Moderna and Pfizer/BioNTech that target a strain of the virus called KP.2, said the sources, who declined to be named because the timing information isn’t public. It was unclear whether the agency simultaneously would authorize Novavax’s updated shot, which targets the JN.1 strain.

More>

Experts also predict next administration's potential moves on the ACA, drug price negotiations

Policy experts and former health officials cast their predictions on what health policy changes to expect from the next administration during an online panel discussion hosted by the healthcare consulting and advisory firm Avalere Health on Wednesday. [MedPage Today]

Medicare Advantage, Medicare
Former HHS Secretary Alex Azar argued that Democrats may soon regret some of their attempts to rein in Medicare Advantage, noting that cuts the Biden administration finalized in April  "may come back to haunt them on October 15, when [the] open enrollment period comes, and we see either increased cost-sharing, reduced benefits, [or] increased premiums, as a result of what they've done."

More>

###

LONDON (AP) — The World Health Organization declared the mpox outbreaks in Congo and elsewhere in Africa a global emergency on Wednesday, with cases confirmed among children and adults in more than a dozen countries and a new form of the virus spreading. Few vaccine doses are available on the continent. [Associated Press]

Earlier this week, the Africa Centers for Disease Control and Prevention announced that the mpox outbreaks were a public health emergency, with more than 500 deaths, and called for international help to stop the virus’ spread.

“This is something that should concern us all ... The potential for further spread within Africa and beyond is very worrying,” said WHO director-general Tedros Adhanom Ghebreyesus.

The Africa CDC previously said mpox, also known as monkeypox, has been detected in 13 countries this year, and more than 96% of all cases and deaths are in Congo. Cases are up 160% and deaths are up 19% compared with the same period last year. So far, there have been more than 14,000 cases and 524 people have died.

More>

###

With this condensed primer, MedPage Today looks at the health policy records of Democratic presidential candidate Kamala Harris and Republican presidential candidate Donald Trump.

Abortion

Harris' Stance:

• Harris supported abortion rights throughout her Senate career; preserving those rights is expected to be a central part of her campaign.
• She is believed to be the first vice president ever to visit an abortion clinic -- a Planned Parenthood facility in Minnesota in March.
• Two months earlier, in Wisconsin, she kicked off her "Fight for Reproductive Freedoms" tour, highlighting the harms of extreme abortion bans.
• In July, Harris pledged that if Congress passed a law to preserve the right to abortion nationwide, she would sign it.
• Abortion-rights groups were quick to endorse Harris after Biden ended his campaign; anti-abortion groups seem alarmed by her unflinching commitment to the issue.

Trump's Stance:

• Trump has called himself "the most pro-life president" in American history.
• He appointed three of the six Supreme Court justices who helped overturn Roe v. Wade.
• Earlier this year, Trump expressed support for a 15-week ban; since then, however, he has stated that abortion is a states' rights issue.
• During the presidential debate in June, Trump falsely accused Democrats of supporting abortions "even after birth."
• The 2024 GOP Platform excludes a definitive call for a national abortion ban for the first time in 40 years, instead stating that the party opposes late-term abortions, and supports prenatal care and access to birth control and in vitro fertilization.
• The platform also supports the 14th Amendment, which protects the rights of "any person" to "due process"; some conservatives have interpreted the words "any person" to include the "unborn."

Why It Matters:

• According to polling by the Pew Research Center, 63% of adults in the U.S. support abortion in all or most cases. Furthermore, in at least seven different states where abortion has been on the ballot (including conservative states like Kansas, Montana, and Kentucky), voters have come down on the side of abortion rights.

• Healthcare Reform

Thirty-two states are experiencing a summertime surge of COVID-19, with infections growing or likely growing based on emergency room visits, according to updated CDC estimates. [CDC and Axios}

Why it matters: Emergency visits for COVID have crept upward since the first half of May, coinciding with a busy travel season and more people congregating indoors to avoid extreme heat.

• Connecticut, Hawai'i and Nevada were the only states with rates declining or likely declining.
• Southern states — including Georgia, Kentucky and South Carolina — had some of the highest probabilities that the outbreak is spreading, the CDC estimated.
• Eight states had rates that were stable or could not be estimated.

Yes, but: Overall COVID case levels remain relatively low. The KP.3 and KP.2 strains, descendants of the highly contagious JN.1 variant and among the so-called FLiRT variants, account for almost 70% of all cases.

CDC advisers in June recommended that people 6 months of age and older receive updated COVID-19 vaccines when they become available this fall.

                                                                                  ###

Youth emergency room visits and hospitalizations for depression and anxiety have decreased for Illinoisans since the height of the COVID-19 pandemic, according to a report last week from researchers at Northwestern Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago. {Health News Illinois]

The study analyzed all emergency room visits and admissions from Illinois youth with a coded primary diagnosis of depression and anxiety from January 2016 to June 2023, with data collected from 232 hospitals across the state. [Health News Illinois]

Outpatient emergency room visits for depression and anxiety — where patients go home rather than be admitted to the hospital — declined the most sharply, with the rates falling to pre-2016 levels in the three-plus years since the start of the pandemic.

“We wanted to see if COVID exacerbated the problem or changed it in any way,” Joe Feinglass, a research professor of medicine at Northwestern and the study’s lead author, said in a statement. “And the answer was, somewhat to our surprise, that COVID actually reduced the number of emergency room visits, which was expected during the shutdown, but was sustained into 2023.”

Inpatient hospitalization rates remained constant across the study timeline, which Feinglass said indicates the youth mental health epidemic is ongoing. Along with increasing the number of psychiatric beds and therapists, more needs to be done to address early mental health interventions and the use of social media, he and his colleagues said.

###

Provisional data from the National Center for Health Statistics (NCHS) on the top causes of deaths in the United States in 2023 shows COVID-19 dropped to the tenth leading cause of death. In 2022, it was the fourth leading cause of death, meaning deaths from COVID dropped by 68.9% in 1 year. [University of Minnesota -CIDRAP- Center for Infectious Disease Research & Policy} 

There were 76,446 deaths from COVID-19 in 2023, and 245,614 in 2022. In 2023, the leading causes of death in the United States were heart disease (680,909 deaths), cancer (613,331), and unintentional injury (222,518).

A provisional total of 3,090,582 deaths occurred in the United States last year, with the age-adjusted death rate per 100,000 population standing at 884.2 among males, and 632.8 among females. The overall death rate, 750.4 per 100,000, was 6.1% lower than in 2022 (798.8).

The overall death rate was highest among non-Hispanic Black or African American persons  (924.3), and lowest among non-Hispanic multiracial persons (352.1).

Deaths highest among those 85 and older

The number of deaths was highest during the week ending January 7 (68,965) and during the week ending December 30 (65,257). 

Similar to previous years, the lowest death rates were among people aged 5 to 14 years (14.7) and highest among persons aged 85 years and older (14,285.8).

For COVID, the death rate decreased from 2022 to 2023 for all age groups, but the age-adjusted COVID-19–associated death rate per 100,000 among males (22.1) was higher than that among females (15.4). COVID-19–associated death rates decreased from 2022 to 2023 for all racial and ethnic groups, the authors said. 

Provisional death estimates can give researchers and policymakers an early signal about shifts in mortality trends and provide actionable information sooner than do the final mortality data.

"Provisional death estimates can give researchers and policymakers an early signal about shifts in mortality trends and provide actionable information sooner than do the final mortality data. These data can guide public health policies and interventions that are intended to reduce mortality," the report concluded.  

See CDC List and more details here> 

###

Cook County Health said Wednesday it plans to open a new medical center in Chicago’s Bronzeville neighborhood by early next year. [Health News Illinois]

The site will serve as an extension of the health system’s Provident Hospital and will offer family medicine, mental healthcare and rehabilitation services, such as physical, occupational and speech therapy.

The 26,000-square-foot facility will have 44 exam rooms and gym space for therapy services, said Cook County Board President Toni Preckwinkle. Once open, she said they expect the site to have 85,000 visits in its first year.

“The health center holds the promise, not only of addressing the immediate health needs of the community, but also fostering long-term improvements in health outcomes on Chicago's south side,” Preckwinkle said. “It will play a critical role in addressing the persistent, systemic barriers to health that we're all aware of. It will also support a healthier and more equitable future for Cook County.”

Officials said the center is part of a larger modernization of services at Provident Hospital. Dr. Erik Mikaitis, interim CEO of Cook County Health, said the new center will give the service lines “room to grow” and open up more clinical space within the hospital to expand care.

“While we're still strategically planning for what that (clinical space) will look like, we know that services will be based on community needs and further enhance access to care on the south side,” Mikaitis said.

###