Three health stories you may have missed

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Today’s edition: A deep dive into the rare oversight and fraud within the hospice industry via the Resident of New York and Propublica. Federal health officials are cautiously optimistic that RSV cases are peaking. But first…

Your post-Thanksgiving catch-up: lengthy covid treatments, abortion in Georgia and federal judges

Welcome back from the Thanksgiving break, where on Capitol Hill it’s a sprint to the next holiday break. This morning we dive into three stories you may have missed and why they matter.

  • Covid long-timers are turning to treatments without robust scientific evidence as the slow pace of research into the condition frustrates advocates.
  • Georgia’s Supreme Court reinstated a ban on most abortions as access to the procedure remains limited throughout the South.
  • Senate Democrats will continue to confirm federal judges next year, but the composition of the courts over the past two years has not changed materially.

Manufacturers are pushing a wave of drugs onto the market that claim to treat long covid, often with little data behind them. But the sluggish pace of research into the condition has left Covid truckers desperate for relief and turning to expensive unproven treatments, our colleague Frances Stead Sellers reports.

One nonprofit is promoting ivermectin, which the Food and Drug Administration approved to treat some parasitic worms. Large professional groups, such as the American Medical Association, is opposed to using the drug outside of clinical trials, and it has not been shown to effectively treat acute covid-19. Others suggest dietary supplements not regulated by the FDA, a process known as “blood washing” in Cyprus or $25,000 stem cell treatments in the Cayman Islands.

Yet government-funded research into the condition has been slow. The National Institute of Health is working to understand the biological basis of prolonged Covid, and recently announced its intention to investigate whether the antiviral drug Paxlovid helps with long covid – but the results are not expected until 2024.

Why it matters: Some outside experts argue that more federal funding is needed to speed up the nation’s understanding of long covid and develop treatments. But as we reported last week, Congress is highly unlikely to comply with the Biden administration’s request $750 million for long covid amid Republican resistance to more pandemic aid.

Most abortions are back in Georgia after the Supreme Court reinstated a ban on the procedure after fetal heart activity can be detected.

The one-page order Wednesday came in response to an emergency petition from the state, The Post’s Kim Bellware reports. Georgia’s Republican attorney general immediately appealed a Nov. 15 ruling from a Fulton County judge, who wrote that key parts of the law “were clearly unconstitutional when drafted, voted on and enacted.”

That legal rationale was new, and essentially said that abortion bans were unconstitutional as before Roe v. Wade‘s decades-old protections were overturned The state’s abortion providers cautiously resumed scheduling abortions up to 22 weeks when the pause on Georgia’s ban was lifted, while anti-abortion advocates expressed confidence that the state Supreme Court would reinstate the restrictions.

Why it matters: Georgia was poised to become an abortion destination for patients across the South if the procedure remained legal. Last week’s order is not the final word on the ban, but instead allows the restrictions to continue while the Georgia Supreme Court considers the state’s appeal.

  • At least one major anti-abortion group in the state recently told The Health 202 that it will not pursue new legislation until the state Supreme Court settles the matter for good. “If we open up any of those code sections while it’s still pending in court, I think it can only create a lot of confusion,” Elizabeth Edmonds, the leadership director of the antiabortion group Georgia Life Alliance, said in an interview shortly after the November 15 break on the ban.

Democrats kept the Senate tight in the midterm elections and conceded President Biden the ability to continue to shape the federal judiciary. Although at this point in his presidency Biden has appointed more judges than his predecessor, they will not have the same impact as those appointed under ex-pres. donald trump, The Post’s Aaron Blake write.

The reasons for this are complex, but are largely due to the fact that the GOP ex-pres Barack Obama’s picks for justices in 2015 and 2016. That strategy gave Trump 17 appeals court vacancies to fill when he took office in 2017, allowing Republicans to reshuffle the most powerful justices below the nation’s highest court.

Biden reduced the recent shortage of Democratic-appointed judges, but only one appeals court circuit flipped from a majority of Republican nominees to Democratic.

Why it matters: Federal appeals courts have the power to block or uphold Biden administration policies — and administrative actions are likely to increase over the next two years with a divided Congress. For example, such courts have been critical in temporarily blocking or allowing pandemic measures to proceed, such as the whiplash over Biden’s vaccine mandates, before the Supreme Court weighs in.

Fraud and exploitation plague the hospice industry

The hospice boom has spread across the country, but poor oversight of the industry behind the end-of-life service has created widespread opportunities for fraud, abuse and exploitation of the dying and their families, according to a joint investigation released this morning from the Resident of New York and ProPublica.

The point of hospice is to help people experience as little pain as possible and to spend time with loved ones during the last days. The $22 billion operation is primarily funded by Medicare, which pays hospice companies a set rate per patient per day, regardless of how much care they actually provide.

Once the hospices are up and running, however, oversight is generally rare and federal regulators rarely go after bad actors. In an effort to clean up their patient lists, some for-profit hospices have enlisted friends and family to act as bogus clients, tricking people into the program by advertising it as free home health care or stealing personal information to “phantomize” write patients.”

In some ways, the way federal regulators designed the hospice benefit rewards providers for recruiting patients who may not die immediately. That’s because longer stays lead to bigger payouts and stable patients need less expensive drugs and supplies than those in their final days, ProPublica’s Ava Kofman write.

But enrolling in hospice can harm patients who don’t die immediately, as they must agree to forgo curative care to be eligible for the service. For example, some unknowing enrollees report being denied kidney dialysis, mammograms, coverage for life-saving medications, or a place on the waiting list for a liver transplant.

White House directives

Federal health officials say they hope RSV cases have peaked

White House health officials were cautiously optimistic yesterday that acute cases of respiratory syncytial virus (RSV) among children had peaked, offering a glimmer of hope as the country struggles to respond to a trifecta of respiratory illnesses.

“In the past week, we have seen RSV peak and perhaps decline,” Ashish Jhacoordinator of the White House’s coronavirus response, said yesterday ABC‘s “This Week.” “I am obviously hopeful that that trend will continue.”

Anthony Faucioutgoing director of the National Institute of Allergy and Infectious Diseasesechoed Jha CBS’s “Face the nation.” He said to host Margaret Brennan that, based on the virus’s behavior in other countries, he is hopeful that cases in the United States will decline.

Key context: Fears of a possible “triple pandemic” this winter have circulated in recent weeks as health care providers across the country report an increased and early start to flu season that has coincided with rising cases of RSV and the ongoing coronavirus pandemic.

Margaret Brennan, host of “Face the Nation”:

  • New it is: Almost 9 out of 10 covid deaths is in people 65 or older, which is the highest rate ever, our colleagues Ariana Eunjung Cha and Dan Keating reports, citing a Washington Post analysis of CDC data.
  • US abortion rates fell slightly in 2020with more than 80 percent performed at or before nine weeks of pregnancy, according to new data from the CDC.
  • Measles is a “imminent threat in every region of the world,” the World Health Organization and CDC warned in a joint report from last week that found almost 40 million children missed their vaccine doses last year, The Post’s Andrew Jeong reports.

The Senate is back in session today. The House will be back tomorrow. Here’s what we’re looking at this week:

Tuesday: The House Rules Committee will explore legislation aimed at improving the health and well-being of incarcerated pregnant women and their babies. The chamber is expected to vote on the legislation later this week.

Also Tuesday… The Post hosts a conversation with Deputy Secretary of Defense Kathleen Hicks and Fire pits 360 co-founder Rosie Torres on new government investments aimed at supporting the physical and mental health of veterans.

Wednesday: A Senate HELP subcommittee hold a hearing on supporting the mental health of young people as they move from high school to college; the Senate Veterans’ Committee will examine Native American veterans’ access to VA health care and benefits.

And Thursday… The Post’s Yasmeen Abutaleb sit with Anthony Faucidirector of the National Institute of Allergy and Infectious Diseasesto talk about the state of the pandemic, the future of public health and the lessons he’s learned from more than half a century of public service as he prepares to step down from his government post next month.

Covid hospitalized him for 453 days. Now he is home for the holidays. (By Andrea Salcedo | The Washington Post)

The short life of baby Serhii, killed in a Ukraine maternity ward (By Samantha Schmidt and Serhii Korolchuk | The Washington Post)

Rare protests against China’s ‘zero covid’ policy erupt across the country (By Lily Kuo | The Washington Post)

Thanks for reading! See you all tomorrow.

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