Disasters are an important public health issue; however, there is scarce evidence to date on what happens when communities and populations experience more than one disaster. This scoping review identifies literature on the effects of multiple disasters published until Aug 2, 2021, 1425 articles were identified, of which 150 articles were included. We analysed direct and indirect public health implications of multiple disasters. Our analysis suggests that exposure to multiple disasters can affect mental health, physical health, and wellbeing, with some evidence that the potential risks of multiple disaster exposure exceed those of single disaster exposure. We also identified indirect public health implications of multiple disaster exposure, related to changes in health-care facilities, changes in public risk perception, and governmental responses to multiple disasters. We present findings on community recovery and methodological challenges to the study of multiple disasters, and directions for future research.  [Lancet Public Health 1.19.2022] 

Download full article here> 

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NEW YORK (AP) — Three studies released Friday offered more evidence that COVID-19 vaccines are standing up to the omicron variant, at least among people who received booster shots.

[The Journal of the American Medical Association published the third study, also led by CDC researchers. It looked at people who tested positive for COVID-19 from Dec. 10 to Jan. 1 at more than 4,600 testing sites across the U.S.] 

They are the first large U.S. studies to look at vaccine protection against omicron, health officials said.

The papers echo previous research — including studies in Germany, South Africa and the U.K. — indicating available vaccines are less effective against omicron than earlier versions of the coronavirus, but also that boosters doses rev up virus-fighting antibodies to increase the chance of avoiding symptomatic infection.

The first study looked at hospitalizations and emergency room and urgent care center visits in 10 states, from August to this month.

Full article here> 

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Omicron and staffing constraints pushed hospitals and health systems to once again suspend nonurgent, elective procedures — a move that hurts patients and their care teams.

Physicians told The Washington Post that notifying patients of their surgeries being postponed is one of the most difficult things they do during the pandemic, and the idea of prolonging patients' suffering is anguishing. In interviews, a patient rated the pain he felt from a ruptured cervical disk — for which his surgery has been indefinitely postponed at Mercy Health-St. Rita's Medical Center in Lima, Ohio — as a 12 out of 10. 

In addition to extended pain, pushed back surgeries leave more time for disease advancement. Certain cancers can advance to later stages in four to eight weeks, for instance. Even procedures considered low acuity, such as joint replacements or bariatric cases, will have material implications from delays through reduced activity, mobility and quality of life for patients. Delays in surgery have also been shown to result in higher rates of surgical site infections.

"I'd say it's a bona fide mess right now," Kenneth Kaufman, chair and founding partner of Kaufman Hall, told The Washington Post. "We seem to be back to square one. Omicron has significantly compounded staffing shortages in a very profound way."

Full article here>

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Chicago's top doctor said Wednesday the city has passed the peak of the current omicron-fueled COVID-19 surge, while state officials said they were "cautiously optimistic" Illinois has done so as well. [Health News Illinois 1.20.2022] Department of Public Health Director Dr. Allison Arwady said new cases peaked on Dec. 27, while test positivity peaked on Jan. 1. “We are a long way from being out of the woods," she said. "However, I'm really pleased to have seen this turnaround." The seven-day average for new daily cases in Chicago is 2,819, a 50 percent decrease from the prior week. The seven-day test positivity rate is 11.9 percent, a 5.5 percentage point decrease from the prior week. Omicron makes up 99.3 percent of new cases being reported, Arwady said. Hospitalizations have slowly started to plateau, though she said they remain concerned with the overall high number. Chicago is averaging 203 COVID-19-related hospitalizations per day, down six from the prior week. “I want to emphasize we probably will continue to see hundreds of Chicagoans being admitted to the hospital, so the threat is in no way over,” Arwady said. About 78.6 percent of eligible Chicagoans have received at least one dose of vaccine, while 70.1 percent are fully vaccinated. State officials said at a later press conference they were hopeful that Illinois has seen the worst of the current surge. “I am cautiously optimistic in reporting the decreasing trends in the number of cases and the number of emergency department visits, as well as the number of hospitalizations over the past week,” Illinois Department of Public Health Director Dr. Ngozi Ezike told reporters, noting there still are more people in Illinois hospitals during this surge than at any other point in the pandemic. Gov. JB Pritzker said they look at hospitalization, ICU bed and ventilator usage to determine whether Illinois has passed its peak, and those "all seem to be going the right direction." As of Tuesday, 6,507 Illinoisans were in the hospital with COVID-19, down 188 from Monday and down 712 from the prior week. Of the patients in the hospital, 1,085 were in intensive care units, down 35 from Monday and down 46 from the prior week. There were 608 patients on ventilators, down 20 from Monday and down 42 from the prior week. There were 26,491 new COVID-19 cases and 160 deaths reported on Wednesday. The new cases bring the state total to 2,709,474, while the death toll increased to 29,510. The seven-day average for new cases on Friday was 26,646, down 5,855 from the prior week. The seven-day average for daily deaths is 101, up eight from the prior week. The seven-day statewide positivity rate for cases as a percent of total tests is 12 percent. The seven-day statewide test positivity using the number of COVID-19 positive tests over total tests is 15 percent. About 78.9 percent of eligible Illinoisans ages 5 and older have received at least one dose of a COVID-19 vaccine, while 69.4 percent are fully vaccinated. Illinois vaccinators have administered 20,110,501 COVID-19 vaccines, per state data, including 3,657,437 booster doses. The seven-day average of doses administered is 46,866. ###

Months after stakeholders publicly said they were getting close to an agreement to reform the Medicaid reimbursement system for Illinois’ long-term care facilities, a schism has developed between the state and Illinois’ largest nursing home association on how to go forward during the spring session. [Health News Illinois 1.13.2022] Legislation supported by the Department of Healthcare and Family Services was filed last week. It includes many of the details laid out last fall during multiple legislative hearings, including a patient-driven payment model and dedicated funding for staffing increases and workforce transformation. It would also reward providers for achieving higher levels of care. But, a spokesman for the Health Care Council of Illinois said this week they are opposed to the HFS-backed plan. They are behind a separate proposal filed Monday that calls for increasing the skilled nursing facility bed tax to the federal maximum, which the association says will allow facilities to increase wages, hire additional staff and expand access to care for underserved communities. It also distributes additional funding to facilities that primarily serve Medicaid members. Additionally, the measure creates a committee appointed by the four legislative leaders that would oversee, assess and provide direction to HFS on long-term care services. Health Care Council of Illinois Executive Director Matt Pickering said their plan is a “common-sense” approach toward addressing funding and staffing shortages in the nursing home industry. “By increasing Medicaid funding for skilled nursing facilities with high percentages of low-income residents, we can prioritize quality care for our state’s most vulnerable residents - especially those in minority communities, increase wages, create more jobs and ultimately stabilize the Illinois long-term care safety net system,” he said in a statement. HFS Director Theresa Eagleson told Health News Illinois Wednesday the Health Care Council of Illinois-backed plan is a "distraction" from the work that has been done over the past 18 months to pass agreed-upon language. “We're going to focus our efforts on continuing to move the language that's already been out there, that language that's been vetted and discussed with not only legislators, but many interest groups for months,” she said. “We've said for 18 months now that we don't think the industry should get any more money that's not tied to actual improvements in quality and stuff.” Eagleson said stakeholders have been negotiating in recent months with the idea they had a "conceptual agreement" in place on the key issues. “Most of what we've seen, unfortunately, has been ways to elongate movement on the reform side or to continue to stall reforms,” she said. Illinois’ two other nursing home associations said this week they support the HFS-backed plan. “​​There's a lot that gives me concern in the HCCI approach,” said Matt Hartman, executive director of the Illinois Health Care Association. Among those concerns is allowing a bed tax to be implemented without corresponding rate reform. Such a move would lead to the postponement of funding and accountability for staffing and quality, said LeadingAge Illinois CEO Angela Schnepf. “To increase the tax on quality providers, particularly nonprofits that reinvest money back into resident care, and not require rate reform, is similar to taking money away from resident care and putting it into the pockets of private owners and shareholders,” she said. The Health Care Council of Illinois is concerned about how the HFS-backed plan could affect certain nursing homes. The association reiterated Wednesday that the HFS-backed plan will put up to 50 nursing homes, predominantly those that serve Medicaid populations, at risk of closing. “Closure at this scale would displace an estimated 5,000 nursing facility residents located mostly in rural areas and communities of color,” they said. Andy Allison, HFS’ deputy director for strategic planning and analytics, said Wednesday they disagree with that analysis. He said assuming those 50 homes are at risk of closures means their management would not adapt to changes in the rate reform proposal, such as additional funding to support staffing. “That's not the business of the state, to spend billions of dollars on naive assumptions about the future,” he said. ###

Wednesday, January 26, 2022
12:00 - 1:30 PM (Central Standard Time)

Register  here

Speakers:

Dr. Allison Arwady, Commissioner, Chicago Department of Public Health

Dr. Pastor Castell-Florit, Director, National School of Cuban Public Health (ENSAP)

Dr. Emilio Delgado, Director of Public Health, Havana Province, Cuba

Dr. Ngozi Ezike, Director, Illinois Department of Public Health

Dr. Wayne Giles, Dean, University of Illinois Chicago School of Public Health

Dr. Pedro Más Bermejo, Professor, Pedro Kourí Tropical Medicine Institute, Havana, Coordinator of Epidemiology & Modeling, National COVID-19 Group, Ministry of Public Health, Cuba

Ms. Gail Reed, Executive Editor, MEDICC Review

Dr. Peter Orris, Global Health Program, UIC School of Public Health 

The event will take place via Zoom. Simultaneous translation between English and Spanish will be available.

Cosponsored by the University of Illinois Chicago School of Public Health Global Health Program, National School of Cuban Public Health, and MEDICC Review

Download Flyer here

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CHICAGO — Millions of people in Illinois will soon have access to free at-home COVID-19 testing under a new Biden administration rule that will require insurance companies to cover the cost of tests. [Patch 1.11.2022]

Those in Illinois covered by private insurance will have free access to over-the-counter, at-home COVID-19 tests starting Jan. 15. Tests can be purchased online or at a pharmacy or store, and they will be covered upfront by a health plan or through reimbursement.

"We are requiring insurers and group health plans to make tests free for millions of Americans. This is all part of our overall strategy to ramp-up access to easy-to-use, at-home tests at no cost," Health and Human Services Secretary Xavier Becerra said in a news release Monday.

Under the rule, insurance companies and health plans will be required to cover eight free at-home tests per covered individual per month. A doctor's note isn't required to obtain the tests, which must be authorized, cleared or approved by the U.S. Food and Drug Administration.

This means a family of four on the same insurance plan would be eligible for up to 32 free tests per month; however, there is no limit on the number of tests covered if ordered or administered by a health care provider.

The Biden Administration also said it's "incentivizing" insurers and group health plans to set up programs allowing people in Illinois to get over-the-counter tests directly through preferred pharmacies, retailers or other entities with no out-of-pocket costs.

Looking for an at-home test in Illinois? Here are some stores and pharmacies you can check:

• Walgreens (Has a purchase limit in place)
• CVS (Purchase limit in place)
• Walmart: (Some stores may have purchase limits in place)
• Jewel-Osco stores have offered both swab and spit at-home tests in the past

If you don't have private insurance or coverage through a group plan, you still have access to free tests in Chicago. Head to any of the following community testing sites or locations offering free at-home tests.

• RUSH LITTLE VILLAGE: Second Federal Credit Union, 3960 W. 26th St.
• ESPERANZA BRIGHTON PARK: 4700 S. California Ave. Testing available Mondays, Tuesdays, Wednesdays, Fridays, and Saturdays from 8:00 a.m. to 3:50 p.m. (no testing on Thursdays or Sundays)
• Dirksen U.S. Courthouse (starting Wednesday): 219 S. Dearborn St. Testing Available Monday-Friday from 9 a.m.-4 p.m.
• Other State of Illinois Community testing sites around the greater Chicago area may be found by clicking here. 

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Over the past 20 months, we have all been bombarded with information about COVID-19. From professional journals to Facebook, it has been nearly impossible to stay away from data for more than a few minutes. Every conversation with family and friends, every news report, every work-related policy, every travel plan, and every wedding invitation and dinner plan have had at least a few minutes of discussion about COVID-19. Truth and lies have comingled in ways that I had not seen before in my life. Nor had I ever thought carefully about politics as another determinant of health. [American Public Health Association, January 2022 by José Ramón Fernández-Peña, MD, MPA] 

But, as president of the American Public Health Association (APHA), I’ve had the opportunity over the past year to hear from people around the country about their stories and about how they are coping with this pandemic. I have heard from colleagues who remained determined to do the right thing for the health of their communities, even when their employment was in jeopardy and they and their families received threats. I have heard from some friends and relatives who think that this is all a big hoax and that I should really read this or that thing their friend posted on Twitter. I have been moved to tears by the dedication of so many, and I have been—and remain—incensed at the intentional disinformation campaigns.

I’ve read about the impact on the economy, on the health sector, on educational achievement, and on the food chain, to name a few. But the report that struck me the most was one that stated that, on average, every person who dies from COVID-19 leaves behind nine mourners. This means there are almost 42 million people in the world mourning the loss of a loved one, 6 million of those in the United States.

I try to grasp the impact of this pandemic on the emotional well-being of the world I live in. Besides everything else, how do we come back from this pain? How do we heal from these losses and attempt to return to some semblance of normalcy in our everyday lives? How do we heal the social wounds that have been inflicted on this nation by a false narrative that has only fostered a longer agony? I am no thanatologist but can offer some thoughts about what I’m doing in this regard. 

First, I acknowledge the losses and build healing spaces for individuals and communities to mourn in their own ways.

Second, I redouble my efforts to remove the structural inequities that foster the uneven distribution of the burden of disease.

Third, I recommit to redressing the pervasive racist practices that continue to keep historically marginalized communities out of the rooms where decisions are made.

Fourth, I look back and examine how we have managed the situation, what we did right, and what we did wrong.

Fifth, I continue to advocate adequate funding for the public health infrastructure and emergency preparedness systems.

Sixth, I amplify my work in the realm of civic engagement and voter registration to ensure that every voice is heard.

Seventh, I work to strengthen our ability to respond quickly and assertively to disinformation campaigns.

Eighth, I seek to partner with key players outside our field to better understand the issues and to help us extend our reach.

Ninth, I renew my efforts to develop a health workforce that mirrors the population it serves.

Tenth, I don’t forget to allow myself to laugh, to weep, and to take a break.

It’s been an honor to be the “virtual president” of the APHA.

Download full article here> 

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JEFFERSON CITY, Mo. (AP) — In Democratic-led Washington state, just four lawmakers were present in the 98-member House this week as they convened a mostly remote session with an abundance of caution. Anyone working there is required to be tested for COVID-19 three days a week and show proof of vaccination — including a booster shot — to step onto the House floor. [MedScape 1.12.2022] 

By contrast, Missouri's Republican-led Legislature began a fully in-person session with no COVID-19 screening at the Capitol and no requirement to be vaccinated or wear masks. One week into their session, lawmakers already have filed nearly three dozen bills banning, discouraging or providing exemptions from vaccination requirements.

The differing approaches highlight a persistent partisan gap in pandemic policy as states begin a third year of legislative sessions amid a virus outbreak that many had assumed would be waning but is instead surging to near peak levels of hospitalizations because of the omicron variant.

As lawmakers in some Democratic-led states meet remotely because of renewed COVID-19 concerns, their counterparts in many Republican-led legislatures are beginning their 2022 sessions on a quest to outlaw vaccine mandates and roll back pandemic precautions.

"We have in effect pulled into two different camps with two different views of reality," said Georges Benjamin, executive director of the American Public Health Association, who described the "intellectual schism" as "very disturbing."

"In many ways, the data around vaccines, masks and all these things is kind of bearing out as a proxy for the role of government," Benjamin said.

The political divisions that began over government-ordered shutdowns, social distancing and mask mandates in the early stages of the pandemic have progressed as governments have shifted to vaccinations as a primary means of a combating a virus that has killed more than 835,000 in the U.S.

Republican legislation opposing vaccine mandates has been spurred largely by rules from President Joe Biden's administration requiring COVID-19 vaccinations or regular testing for large and medium-sized employers, health care providers and federal contractors. Many Democratic governors also have issued vaccine or testing requirements for government workers, heath care facilities, schools or child-care providers.

Though not always preventing illness, vaccines have proved effective at decreasing severe COVID-19 cases leading to hospitalization or death. Republican objections are rooted largely in libertarian ideology.

"To have something injected into your body as a condition of employment lest you be fired or not hired, well it's not American," said Missouri state Rep. Brian Seitz, a Republican from Branson. "It tends toward socialism, communism and whatever other -ism you want to talk about."

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The Illinois Department of Public Health said Thursday it expects to receive two new COVID-19 oral antiviral treatments in the coming weeks for patients with mild to moderate disease. [Health News Illinois] Paxlovid and molnupiravir will be available by prescription only, and the agency said it is currently working with pharmacies around the state to offer them to patients. "While vaccination, including boosters, is still the best way to avoid infection and prevent severe illness from COVID-19, these new antivirals given emergency use authorization by the Food and Drug Administration can help treat those who get infected and have a higher risk of becoming severely ill,” said IDPH Director Dr. Ngozi Ezike. The agency did not say how many of each antiviral it expects to receive in its initial shipment. Illinois will receive a renewed allocation of antivirals every two weeks. The Food and Drug Administration has issued emergency use authorizations for the two antiviral pills to be taken at home within five days of when symptoms begin. Paxlovid is for those over 12, and molnupiravir is for those over 18. IDPH said paxlovid is expected to reduce the risk of hospitalizations by 89 percent and molnupiravir by about 30 percent. The announcement comes as Illinois’ post-holiday COVID-19 surge continued Thursday, with IDPH reporting pandemic highs in hospitalizations and COVID-19 cases. As of Wednesday, 7,098 Illinoisans were in the hospital with COVID-19, up 256 from Tuesday and up 1,409 from the prior week. Of the patients in the hospital, 1,119 were in intensive care units, down 16 from Tuesday and up 109 from the prior week. There were 646 patients on ventilators, down 17 from Tuesday and up 81 from the prior week. Those numbers include a rise in pediatric hospitalizations. There has been a three-fold increase at Advocate Children’s Hospital in Oak Lawn over the last month, with about 25 to 38 patients per day, Dr. Frank Belmonte, chief medical officer, said during a Thursday virtual event hosted by the health system. Ninety-four percent are unvaccinated, with many coming from households where no one has received the vaccine.  “We’re really encouraging parents to vaccinate their child if they’re eligible,” Belmonte told reporters.  About half are younger than 5, the age at which children become eligible for the COVID-19 vaccine. A quarter of pediatric patients hospitalized are in the intensive care unit.  Meanwhile, seven out of 10 school-aged children are testing positive in outpatient offices, up from one to two out of 10 previously. There were 44,089 new COVID-19 cases reported in Illinois on Thursday, shattering the previous single-day high of 32,279 cases set on Wednesday. The total COVID-19 case count is 2,339,534. The death toll is 28,260 after 104 deaths were reported Thursday. It’s the first time deaths have hit triple-digits since 102 were reported on Feb. 11, 2021 The seven-day average for new cases is 27,141, up 8,820 from a week ago. The seven-day average for daily deaths is 63, up eight from the prior week. The seven-day statewide positivity rate for cases as a percent of total tests is 14.7 percent. The seven-day statewide test positivity using the number of COVID-19 positive tests over total tests is 18.6 percent. About 77.3 percent of eligible Illinoisans ages 5 and older have received at least one dose of a COVID-19 vaccine, while 68.6 percent are fully vaccinated. Illinois vaccinators have administered 19,475,871 COVID-19 vaccines, including 3,275,652 booster doses. The seven-day average of doses administered is 43,690. ###