It’s been a rough couple of years for the Centers for Disease Control and Prevention. Facing a barrage of criticism for repeatedly mishandling its response to the covid-19 pandemic and more recently monkeypox, the agency has acknowledged it failed and needs to change. CDC Director Dr. Rochelle Walensky has tapped Mary Wakefield — an Obama administration veteran and nurse — to helm a major revamp of the sprawling agency and its multibillion-dollar budget. Making the changes will require winning over wary career CDC scientists, combative members of Congress, and a general public that in many cases has stopped looking to the agency for guidance. “If she can’t fix it, she’ll say, ‘It’s not fixable, here’s why, and here’s what needs to be done next,’” said Eileen Sullivan-Marx, dean of the New York University Rory Meyers College of Nursing, who has known Wakefield professionally for decades.
If it seems as though the anti-abortion movement has gotten more extreme in recent months, that’s because it has. But it’s not the first time — positions taken by both sides of the abortion debate have ebbed and flowed repeatedly in the 49 years since the Supreme Court declared abortion a constitutional right. Abortion opponents and those supporting abortion rights expect the Supreme Court to soon overturn its 1973 Roe v. Wade decision, and both groups have reacted strongly. Abortion rights supporters unsuccessfully pushed Congress to pass the Women’s Health Protection Act, which would not only codify abortion rights but also eliminate lots of popular restrictions the court has allowed since 1973, most notably parental involvement laws. But it’s abortion opponents’ efforts in many conservative states to exclude most exceptions — for rape or incest or to save the life of the mother — that have drawn headlines recently.
Tiffanie Jones was a few tanks of gas into her drive from Tampa, Florida, to Cheyenne, Wyoming, when she found out her travel nurse contract had been canceled. Jones, who has been a nurse for 17 years, caught up with a Facebook group for travel nurses and saw she wasn’t alone. Nurses had reported abruptly losing jobs and seeing their rates slashed as much as 50% midcontract. “One lady packed up her whole family and was canceled during orientation,” she said. Many career nurses like Jones turned to travel gigs during the pandemic, when hospitals crowded with covid-19 patients urgently needed the help.
BySam Whitehead and Julie Appleby, Kaiser Health News |
The role that the federal government plays in containing future epidemics will hinge on the outcome of an appeal of this week’s court ruling that overturned the mask mandate for travelers on airlines, trains, and the nation’s mass transit systems.
A federal court judge in Florida said the Centers for Disease Control and Prevention had overstepped its authority in requiring masks on public transportation, a mandate that legal experts considered well within the bounds of the agency’s charge to prevent the spread of covid-19 across the nation. The CDC said late Wednesday that it had asked the Department of Justice to appeal the decision — a move the DOJ left up to the agency. That will put the issue before one of the nation’s most conservative-leaning appellate courts, the 11th U.S. Circuit Court of Appeals. Public health experts worry the ruling, unless overturned, will hamper the agency’s ability to respond to future outbreaks. “If CDC can’t impose an unintrusive requirement to wear a mask to prevent a virus from going state to state, then it literally has no power to do anything,” said public health law expert Lawrence Gostin, faculty director of the O’Neill Institute for National and Global Health Law at Georgetown University.
At Whitman-Walker Health, Dr. David Fessler and his staff administer high-dose influenza vaccine to all HIV-positive and senior patients. Although the vaccine is roughly three times as expensive as standard flu vaccine, it seems to do a better job at protecting those with weakened immune systems — a major focus of the nonprofit’s Washington, D.C., clinics. At the University of New Mexico Hospital in Albuquerque, meanwhile, Dr. Melissa Martinez runs a drive-thru clinic providing 10,000 influenza vaccines each year for a community made up largely of Black and Hispanic residents. It’s open to all comers, and they all get the standard vaccine. These different approaches to preventing influenza, a serious threat to the young and old even with covid-19 on the scene, reflect the fact that federal health officials haven’t taken a clear position on whether the high-dose flu vaccine — on the market since 2010 — is the best choice for the elderly.
A barrage of abortion restrictions rippling across the country, from Florida to Texas to Idaho, is shrinking the already limited training options for U.S. medical students and residents who want to learn how to perform abortion procedures. The American College of Obstetricians and Gynecologists recommends standardized training on abortion care during medical residency, the training period after medical school that provides future physicians on-the-job experience in a particular specialty. But the number of residency programs located in states where hospital employees are prohibited from performing or teaching about abortion — or at Catholic-owned hospitals with similar bans — has skyrocketed in recent years, an overlooked byproduct of anti-abortion legislation taking root in the American South, Midwest, and Mountain states. Danna Ghafir, a born and bred Texan and third-year medical student in her home state, will leave Texas when the time comes for residency training. “How does legislation inform my approach to preparing for residency applications?
Divya Goel, a 35-year-old deaf-blind woman in Orlando, Florida, has had two telemedicine doctors’ appointments during the pandemic. Each time, she was denied an interpreter. Her doctors told her she would have to get insurance to pay for an interpreter, which is incorrect: Under federal law, it is the physician’s responsibility to provide one. Goel’s mother stepped in to interpret instead. But her signing is limited, so Goel, who has only some vision, is not sure her mother fully conveyed what the doctors said.
The Supreme Court on Friday took up one of the most contentious issues of the covid-19 pandemic, hearing a series of cases challenging the Biden administration’s authority to require workers to get a covid vaccine or be tested for the virus regularly. The issue in the cases, which challenge rules set in November by the Occupational Safety and Health Administration and Centers for Medicare & Medicaid Services, is not directly whether the rules are legal but whether they can take effect while the cases are heard in detail by courts of appeals. The arguments lasted more than 3½ hours. A decision by the justices is expected within days. The OSHA rule says that businesses with more than 100 employees must require their workers to either be vaccinated or wear masks and undergo weekly testing.
In Northern California, the pastor of a megachurch hands out religious exemption forms to the faithful. A New Mexico state senator will “help you articulate a religious exemption” by pointing to the decades-old use of aborted fetal cells in the development of some vaccines. And a Texas-based evangelist offers exemption letters to anyone — for a suggested “donation” starting at $25. With workplace vaccine mandates in the offing, opponents are turning to a tried-and-true recourse for avoiding a covid-19 shot: the claim that vaccination interferes with religious beliefs. No major denomination opposes vaccination.
ByElisabeth Rosenthal and Glenn Kramon, Kaiser Health News |
America’s covid-19 vaccination rate is around 60% for ages 12 and up. That’s not enough to reach so-called herd immunity, and in states like Missouri — where a number of counties have vaccination rates under 25% — hospitals are overwhelmed by serious outbreaks of the more contagious delta variant. The vaccine resisters offer all kinds of reasons for refusing the free shots and for ignoring efforts to nudge them to get inoculated. Campaigns urging Americans to get vaccinated for their health, for their grandparents, for their neighbors, or to get free doughnuts or a free joint haven’t done the trick. States have even held lotteries with a chance to win millions or a college scholarship.