January 24, 2022

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New CDC isolation guidelines should include negative test experts argue : Shots

2 weeks ago Sechan

People wait in line at a testing site to receive a free COVID-19 PCR test in Washington, D.C. On Monday, the CDC announced that people can isolate for five days, instead of 10, after they’ve tested positive for the coronavirus and have no symptoms.

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People wait in line at a testing site to receive a free COVID-19 PCR test in Washington, D.C. On Monday, the CDC announced that people can isolate for five days, instead of 10, after they’ve tested positive for the coronavirus and have no symptoms.

Anna Moneymaker/Getty Images

More than 200,000 people are testing positive for COVID-19 in the U.S. each day. Until this week, a positive test meant you should stay home for 10 days to avoid infecting others. Now, those who don’t have symptoms after five days can go back to their regular activities as long as they wear a mask, according to updated guidance from the Centers for Disease Control and Prevention.

The change in guidance released Monday was “motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness,” according to the CDC.

CDC director Dr. Rochelle Walensky says the change was also motivated by economic and societal concerns. “With a really large anticipated number of cases [from omicron], we also want to make sure we can keep the critical functions of society open and operating,” she told NPR on Tuesday. “We can’t take science in a vacuum. We have to put science in the context of how it can be implemented in a functional society.”

What our family learned from our post-Thanksgiving coronavirus outbreak

Public health experts say a shorter isolation period may be reasonable at this point in the pandemic, but they say the agency’s new guidance is problematic because it relies on people’s self-judgment to assess their transmission risk — and could lead to more spread and more COVID-19 cases if people aren’t careful.

“The CDC is right. The vast majority of the transmissions happen in the first couple of days after the onset of symptoms … but the data shows that about 20 to 40% of people are still going to be able to transmit COVID after five days,” says Dr. Emily Landon, an infectious disease specialist at UChicago Medicine. “Is that person [leaving isolation after five days] really safe to carpool with or have close contact with or have them take care of your unvaccinated kids?”

Dr. Anthony Fauci, who is the White House chief medical adviser and director of the NIAID, and Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention. Walensky defends the new CDC isolation and quarantine guidelines, saying she “trusts” the public to follow them.

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Carolyn Kaster/AP

Dr. Anthony Fauci, who is the White House chief medical adviser and director of the NIAID, and Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention. Walensky defends the new CDC isolation and quarantine guidelines, saying

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2 min read

Physician assistants prefer ‘associate.’ Doctors suspect a power grab : Shots

2 months ago Sechan

Leslie Clayton, a physician assistant in Minnesota, says a name change for her profession is long overdue. “We don’t assist,” she says. “We provide care as part of a team.”

Liam James Doyle for KHN


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Liam James Doyle for KHN

Leslie Clayton, a physician assistant in Minnesota, says a name change for her profession is long overdue. “We don’t assist,” she says. “We provide care as part of a team.”

Liam James Doyle for KHN

After 23 years as a physician assistant, Leslie Clayton remains rankled by one facet of her vocation: its title. Specifically, the word “assistant.”

Patients have asked if she’s heading to medical school or in the middle of it. The term confounded even her family, she says: It took years for her parents to understand she does more than take blood pressure and perform similar basic tasks.

“There is an assumption that there has to be some sort of direct, hands-on oversight for us to do our work, and that’s not been accurate for decades,” says Clayton, who practices at a clinic in Golden Valley, Minn. “We don’t assist. We provide care as part of a team.”

Seeking greater understanding for and appreciation of their profession, physician assistants are pushing to rebrand themselves as “physician associates.” Their national group formally replaced “assistant” with “associate” in its name in May, transforming into the American Academy of Physician Associates. The group hopes state legislatures and regulatory bodies will legally enshrine the name change in statutes and rules. The total cost of the campaign, which began in 2018, will reach nearly $22 million, according to a consulting firm hired by the association.

Doctors are pushing back

But rechristening the PA name has spiked the blood pressure of physicians, who complain that some patients will wrongly assume a “physician associate” is a junior doctor — much as an attorney who has not yet made partner is an associate. The head of the American Medical Association has warned that the change “will undoubtedly confuse patients and is clearly an attempt to advance their pursuit toward independent practice.” The American Osteopathic Association, another group that represents doctors, accused PAs and other nonphysician clinicians of trying “to obfuscate their credentials through title misappropriation.”

In medicine, seemingly innocuous title changes are inflamed by the unending turf wars between various levels of practitioners who jealously guard their professional prerogatives and the kind of care they are authorized to perform. Just this year, the National Conference of State Legislatures catalogued 280 bills introduced in statehouses to modify scope-of-practice laws that set the practice boundaries of nurses, physician assistants, pharmacists, paramedics, dental hygienists, optometrists and addiction counselors.

The Knee Surgeon Was In-Network. The Surgical Assistant Wasn't, And Billed $1,167

Lawmakers allowed North Carolina dental hygienists to administer local anesthetics; permitted Wyoming optometrists — who, unlike ophthalmologists, do not attend medical school — to use lasers and perform surgeries in certain circumstances; and authorized Arkansas certified nurse practitioners to practice independently. Meanwhile, the physicians’ lobby aggressively fights these kinds of proposals in state legislatures, accusing other

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3 min read

COVID hit this family twice, but vaccines blunted reinfections : Shots

2 months ago Sechan

Three generations, (from left to right) grandmother Genoveva Calloway, daughter Petra Gonzales, and granddaughter Vanesa Quintero, live next door to each other in San Pablo, Calif. Recently their extended family was hit with a second wave of COVID infections a year after the first.

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Beth LaBerge/KQED

Three generations, (from left to right) grandmother Genoveva Calloway, daughter Petra Gonzales, and granddaughter Vanesa Quintero, live next door to each other in San Pablo, Calif. Recently their extended family was hit with a second wave of COVID infections a year after the first.

Beth LaBerge/KQED

On a Friday afternoon in early October this year, 8-year-old Maricia Redondo came home from her third grade class in the San Francisco Bay Area with puffy eyes, a runny nose and a cough.

“On Saturday morning we both got tested,” says Vanessa Quintero, Maricia’s 31-year-old mother. “Our results came back Monday that we were both positive.”

Vanessa stared at her phone in shock and called her doctor’s test-result hotline again, in disbelief. “This is wrong,” she thought. “I hung up and dialed again. It’s positive. This is wrong. I hung up again. And then I did it again!”

She was freaking out for two reasons. First, her large, extended family had already fought a harrowing battle against COVID-19 last year — in the fall of 2020. The virus had traveled fast and furious through their working class neighborhood back then, in the East Bay city of San Pablo. Four generations of Vanessa’s family live next door to each other in three different houses there, all connected by a backyard.

Vanessa was also terrified because she couldn’t fathom another round of treatment against a more dangerous variant than she’d faced before. The pandemic has disproportionately struck Latino families across the United States, and delta is currently the predominant variant in the U.S., according to the U.S. Centers for Disease Control and Prevention. It’s twice as contagious and may cause more severe illnesses than previous variants in unvaccinated people.

I'm fully vaccinated and I also had COVID. Do I need a booster?

Some parents want to wait to vaccinate their kids. Here's why doctors say do it now

The family’s bad luck was uncanny. Research suggests immunity against a natural infection lasts about a year. And here it was almost exactly the same time of year and the family was fighting COVID-19 again.

“Reinfection is a thing,” says Dr. Peter Chin-Hong, a specialist in infections diseases and professor of medicine at the University of California, San Francisco. “It probably manifests itself more when the variant in town looks different enough from the previous variants. Or enough time has elapsed since you first got it, [and] immunity has waned.” He says a second infection is still not common, but doctors are starting to see more cases.

Welcoming family into your home for Thanksgiving? Here's how to keep COVID out

CDC backs expansion of COVID boosters for all adults

Computer models in a recent study suggest that people who have been infected by the virus can expect a reinfection within a year or two if they do not wear a mask or receive a vaccination. The findings show that the risk of a second bout rises over time. A person has a 5% chance

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3 min read

Clues to what causes long COVID are starting to emerge : Shots

2 months ago Sechan

Eugene Mymrin/Getty Images

Conceptual paper illustration of human hands and coronavirus in a lab.

Eugene Mymrin/Getty Images

Kelly LaDue thought she was done with COVID-19 in the fall of 2020 after being tormented by the virus for a miserable couple of weeks.

“And then I started with really bad heart-racing with any exertion. It was weird,” says LaDue, 54, of Ontario, N.Y. “Walking up the stairs, I’d have to sit down and rest. And I was short of breath. I had to rest after everything I did.”

A year later, LaDue still feels like a wreck. She gets bad headaches and wakes up with pain all over her body on more days than not. She also experiences a sudden high-pitched whistling in her ears, bizarre phantom smells and vibrations in her legs. Her brain is so foggy most of the time that she had to quit her job as a nurse and is afraid to drive.

“These symptoms, they come and go,” she says. “You think: ‘It’s gone.’ You think: ‘This is it. I’m getting better.’ And then it’ll just rear back up again.”

Kelly LaDue, of Ontario, N.Y., was working as a nurse when she got COVID-19 and recovered. But a year later, she’s still grappling with a strange constellation of symptoms.

Kelly LaDue


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Kelly LaDue

Kelly LaDue, of Ontario, N.Y., was working as a nurse when she got COVID-19 and recovered. But a year later, she’s still grappling with a strange constellation of symptoms.

Kelly LaDue

Patients like LaDue have researchers scrambling to figure out why some people experience persistent, often debilitating symptoms after catching SARS-CoV-2. It remains unclear how often it occurs. But if only a small fraction of the hundreds of millions of people who’ve had COVID-19 are left struggling with long-term health problems, it’s a major public health problem.

“I think it’s the post-pandemic pandemic,” says Dr. Angela Cheung, who’s studying long COVID-19 at the University of Toronto. “If we are conservative and think that only 10% of patients who develop COVID-19 would get long COVID, that’s a huge number.”

“Not caused by one thing”

So far there are more theories than clear answers for what’s going on, and there is good reason to think the varied constellation of symptoms could have different causes in different people. Maybe, in some, the virus is still hiding in the body somewhere, directly damaging nerves or other parts of the body. Maybe the chronic presence of the virus, or remnants of the virus, keeps the immune system kind of simmering at a low boil, causing the symptoms. Maybe the virus is gone but left the immune system out of whack, so it’s now attacking the body. Or maybe there’s another cause.

“It’s still early days. But we believe that long COVID is not caused by one thing. That there are multiple diseases that are happening,” says Akiko Iwasaki, a professor of immunobiology at Yale University who is also studying long COVID-19.

What Causes Long COVID Is A Mystery. Here's How Scientists Are Trying To Crack It

But Iwasaki and others have started finding some tantalizing clues in the

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2 min read

Biden’s plan to add dental coverage to Medicare faces pushback : Shots

3 months ago Sechan

Like many seniors, William Stork of Cedar Hill, Mo., lacks dental insurance and doesn’t want to pay $1,000 for a tooth extraction he needs. Health advocates see President Biden’s Build Back Better agenda as a once-in-a-generation opportunity to provide dental coverage to people like Stork who are on Medicare. An unlikely adversary: the American Dental Association.

Joe Martinez for Kaiser Health News


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Joe Martinez for Kaiser Health News

Like many seniors, William Stork of Cedar Hill, Mo., lacks dental insurance and doesn’t want to pay $1,000 for a tooth extraction he needs. Health advocates see President Biden’s Build Back Better agenda as a once-in-a-generation opportunity to provide dental coverage to people like Stork who are on Medicare. An unlikely adversary: the American Dental Association.

Joe Martinez for Kaiser Health News

William Stork needs a tooth out. That’s what the 71-year-old retired truck driver’s dentist told him during a recent checkup.

That kind of extraction requires an oral surgeon, which could cost him around $1,000 because, like most seniors, Stork does not have dental insurance, and Medicare won’t cover his dental bills. Between Social Security and his pension from the Teamsters union, Stork says, he is able to live comfortably in Cedar Hill, Mo., about 30 miles southwest of St. Louis.

But that $1,000 cost is significant enough that he has decided to wait until the tooth absolutely must come out.

Stork’s predicament is at the heart of a long-simmering rift within the dental profession that has reemerged as a battle over how to add dental coverage to Medicare, the public insurance program for people 65 and older — if a benefit can pass at all.

A once-in-a-generation opportunity

Health equity advocates see President Biden’s Build Back Better agenda as a once-in-a-generation opportunity to provide dental coverage for those on Medicare, nearly half of whom did not visit a dentist in 2018 — well before the pandemic paused dental appointments for many people. The rates were even higher for Black (68%), Hispanic (61%) and low-income (73%) seniors.

The coverage was left out of a new framework announced by Biden on Thursday, but proponents still hope they can get the coverage in a final agreement. Complicating their push is a debate over how many of the nation’s more than 60 million Medicare beneficiaries should receive it.

Democrats Hope To Beef Up Medicare With Dental, Vision And Hearing Benefits

Advocates of dental coverage for everyone on Medicare find themselves up against an unlikely adversary: the American Dental Association, which is backing an alternative plan that would give dental benefits only to low-income Medicare recipients.

Medicare has excluded dental (and vision and hearing) coverage since its inception in 1965. That exclusion was by design: The dental profession has long fought to keep itself separate from the traditional medical system in order to preserve the field’s autonomy.

Dental care and health are intertwined

More recently, however, dentists have stressed the link between oral and overall health. Most infamously, the 2007 death of a 12-year-old boy that might have been prevented by an $80

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