Proposed changes to school lunches aim to reduce sugar and sodium, but flavored milk stays | CNN



CNN
— 

If new US Department of Agriculture school food guidelines stand as proposed, chocolate milk is in, but for the first time ever, at least some added sugars will be out – and sodium levels will be reduced gradually.

Agriculture Secretary Tom Vilsack publicly announced the changes on Friday.

“The purpose of this is to improve the health and welfare of our children. And I think everybody who comes to this issue shares that goal and hopefully, collectively, we can make sure it happens,” Vilsack told CNN in an interview Thursday ahead of the announcement.

The federally assisted school meal program provides nutritionally balanced meals at school at low or no-cost.

More than 15.3 million kids every day get breakfast at school in the US and 29.6 million get a school lunch, Vilsack said. The numbers were higher earlier in the pandemic, when meals were offered free to all children regardless of their family’s income, but in June, Congress did not extend the Covid-19 pandemic waivers that had expanded the program.

While school meals are paid for by local and federal funding, the standards for what goes on a kids’ cafeteria tray are set by the USDA. The agency’s job is to make sure any meal served at school is nutritious and falls in line with the US Dietary Guidelines.

Flavored milk with “reasonable limits on added sugars” would be allowed under the proposal. Vilsack said school meal administrators tell the USDA that kids just won’t drink much no-fat skim milk or unflavored milk. “That’s not what they get at home,” Vilsack said. “We want to encourage kids to drink milk because there are there’s tremendous nutritional value in milk.”

However, the proposed standards would limit added sugar in certain high-sugar products like prepackaged muffins, yogurt, and cereal. Eventually, the guidelines would then limit added sugars across the weekly menu.

The standards would reduce sodium limits, but that would happen gradually over several school years.

“The [US Food and Drug Administration] provided some insight and direction by suggesting that it is easier for people to accept and adopt to reduced sodium if you do it over a period of time in small increments,” Vilsack said.

A gradual reduction would also give industry time to reformulate their products, said Dr. Lauren Au, an assistant professor at UC Davis’ Department of Nutrition who studies the effectiveness of school nutrition programs.

The guidelines would also place a bigger emphasis on whole grains, but still leave options open for an occasional non-whole grain product.

“Maybe a biscuit can be instituted for a little variety, or grits can be provided where that may make sense from a geographic standpoint. You are sensitive to cultural demands and needs,” Vilsack said.

The proposed rule would also strengthen the Buy American requirements encouraging schools to use more locally grown food.

The USDA will invest $100 million in the Healthy Meals Incentives initiative which offers farm-to-school grants and grants to buy equipment. In the 1980s, schools around the country tore out kitchens and bought prepackaged processed food. To make more nutritious meals, schools have had to rebuild or update kitchens.

“A lot of schools have outdated ovens, freezers, fridges, and that puts limitations on how they can prepare food, so grants that have helped with equipment have been really successful,” Au said.

The money would also reward schools that do a good job providing nutritious meals. Grants would also be aimed at small and rural districts and training.

Vilsack said the USDA created these proposed standards after the USDA received thousands of comments and held 50 listening sessions with parents, school food administrators, the food industry, public health and nutrition experts.

“Establishing these standards are difficult because you have to follow the science you have to follow the dietary guidelines, but you also have to understand that they need to be implemented in the real world which is which is which is tough,” Vilsack said in an interview with CNN.

Real world circumstances are tough already with the higher cost of food, staff shortages and supply chain problems.

Au hasn’t seen all of the proposed policies, but she said what she has seen look good.

“It’s a step forward in terms of promoting healthy nutrition in schools,” Au said. The reduction of added sugar, she added is a big deal.

“Reducing added sugars for this age range is so important,” AU said.

Megan Lott, deputy director for the Robert Wood Johnson Foundation program Healthy Eating Research, said that the policies seem to be heading in the right direction.

“There are a couple of things we would probably like to see strengthened, but it also seems like there are plans to do that over time,” Lott said.

The sugar standard is a good start, she said, but she’d prefer the proposal instead say that no more than 10% of calories should come from added sugars across the meal plan.

“But we recognize that schools might need a little bit of time for implementation,” Lott said.

Lott had also hoped they would take flavored milk off the menu. Research shows that schools that have gotten rid of flavored milk show a drop in milk consumption for a year or two, but milk sales eventually rebound.

School food has become a proverbial hot potato.

After decades of bipartisan support for school meals, the program has been politicized in about the last 10 years Lott says, meaning there is bound to be some pushback.

Friday’s proposed changes would be the first large scale reform of school meal standards since President Barack Obama signed the 2010 Healthy, Hunger-Free Kids Act into law.

The law that went into effect in 2012, championed by first lady Michelle Obama, really did improve US kids’ diet, studies show. The law raised the minimum standards and required schools to serve more whole grains, fruit, vegetables, and fat-free and/or low-fat milk more frequently and serve fewer starchy vegetables and foods high in trans fat and sodium.

Meals that were eaten by students – not just served to students and then tossed into garbage cans – were much healthier and had better overall nutritional quality, the study showed. Students who didn’t participate in the national program did not see an improvement in their diets.

Despite the program’s success, in 2018, the Trump administration announced a proposal to roll back many of the policies in the name of “flexibility,” including ones that involved sodium and whole grains. Trump’s policy would essentially create a loophole letting schools sell more burgers, pizza and french fries and reduce the fruit and vegetables sold. A federal court struck down the rule in April 2020.

During the pandemic, some of the polices were relaxed, like for whole grains, because it was difficult to find products, Lott said.

Studies show kids who eat meals at school ate more fruits, vegetables, whole grains and dairy, compared with those who ate at school less frequently.

Better nutrition can help prevent obesity. About 20% of the US population ages 2 to 19 live with obesity, which can cause kids to have high blood pressure, breathing problems and type 2 diabetes, and lead to lifelong health problems, according to the US Centers for Disease Control and Prevention.

Hungry kids have a hard time paying attention in class. Students who ate healthy meals at school scored better on end-of-year academic tests, studies have shown.

The new standards are just a proposal. The USDA will ask for additional feedback.

Vilsack is hopeful the standards will incentivize more schools to offer more healthy options.

“In terms of future of this program,” Vilsack said, “we want to see more and more school districts push themselves not only to meet the standards, but in some cases to exceed them.”

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Three Wild Technologies About to Change Health Care

Feb. 3, 2023 – When I was a child, I watched syndicated episodes of the original Star Trek. I was dazzled by the space travel, sure, but also the medical technology. 

A handheld “tricorder” detected diseases, while an intramuscular injector (“hypospray”) could treat them. Sickbay “biobeds” came with real-time health monitors that looked futuristic at the time but seem primitive today.

Such visions inspired a lot of us kids to pursue science. Little did we know the real-life advances many of us would see in our lifetimes. 

Artificial intelligence helping to spot disease, robots performing surgery, even video calls between doctor and patient — all these once sounded fantastical but now happen in clinical care.

Now, in the 23rd year of the 21st century, you might not believe what we’ll be capable of next. Three especially wild examples are moving closer to clinical reality. 

Human Hibernation 

Captain America, Han Solo, and Star Trek villain Khan – all were preserved at low temperatures and then revived, waking up alive and well months, decades, or centuries later. These are fictional examples, to be sure, but the science they’re rooted in is real. 

Rare cases of accidental hypothermia prove that full recovery is possible even after the heart stops beating. The drop in body temperature slows metabolism and reduces the need for oxygen, stalling brain damage for an hour or more. (In one extreme case, a climber survived after almost 9 hours of efforts to revive him.) 

Useful for a space traveler? Maybe not. But it’s potentially huge for someone with life-threatening injuries from a car accident or a gunshot wound. 

That’s the thinking behind a breakthrough procedure that came after decades of research on pigs and dogs, now in a clinical trial. The idea: A person with massive blood loss whose heart has stopped is injected with an ice-cold fluid, cooling them from the inside, down to about 50 F

Doctors already induce more modest hypothermia to protect the brain and other organs after cardiac arrest and during surgery on the aortic arch (the main artery carrying blood from the heart). 

But this experimental procedure – called emergency preservation and resuscitation (EPR) – goes far beyond that, dramatically “decreasing the bodys need for oxygen and blood flow,” says Samuel Tisherman, MD, a trauma surgeon at the University of Maryland Medical Center and the trial’s lead researcher. This puts the patient in a state of suspended animation that “could buy time for surgeons to stop the bleeding and save more of these patients.”

The technique has been done on at least six patients, though none were reported to survive. The trial is expected to include 20 people by the time it wraps up in December, according to the listing on the U.S. clinical trials database. Though given the strict requirements for candidates (emergency trauma victims who are not likely to survive), one can’t exactly rely on a set schedule. 

Still, the technology is promising. Someday we may even use it to keep patients in suspended animation for months or years, experts predict, helping astronauts through decades-long spaceflights, or stalling death in sick patients awaiting a cure. 

Artificial Womb

Another sci-fi classic: growing human babies outside the womb. Think the fetus fields from The Matrix, or the frozen embryos in Alien: Covenant.

In 1923, British biologist J.B.S. Haldane coined a term for that – ectogenesis. He predicted that 70% of pregnancies would take place, from fertilization to birth, in artificial wombs by 2074. That may seems unlikely, but the timeline is on track. 

Developing an embryo outside the womb is already routine in in vitro fertilization. And technology enables preterm babies to survive through much of the second half of gestation. Normal human pregnancy is 40 weeks, and the youngest preterm baby ever to survive was 21 weeks and 1 day old, just a few days younger than a smattering of others who lived. 

The biggest obstacle for babies younger than that is lung viability. Mechanical ventilation can damage the lungs and lead to a chronic (sometimes fatal) lung disease known as bronchopulmonary dysplasia. Avoiding this would mean figuring out a way to maintain fetal circulation – the intricate system that delivers oxygenated blood from the placenta to the fetus via the umbilical cord. Researchers at Children’s Hospital of Philadelphia (CHOP) have done this using a fetal lamb.

The key to their invention is a substitute placenta: an oxygenator connected to the lamb’s umbilical cord. Tubes inserted through the umbilical vein and arteries carry oxygenated blood from the “placenta” to the fetus, and deoxygenated blood back out. The lamb resides in an artificial, fluid-filled amniotic sac until its lungs and other organs are developed.

Fertility treatment could benefit, too. “An artificial womb may substitute in situations in which a gestational carrier – surrogate – is indicated,” says Paula Amato, MD, a professor of obstetrics and gynecology at Oregon Health and Science University. (Amato is not involved in the CHOP research.) For example: when the mother is missing a uterus or can’t carry a pregnancy safely.

No date is set for clinical trials yet. But according to the research, the main difference between human and lamb may come down to size. A lamb’s umbilical vessels are larger, so feeding in a tube is easier. With today’s advances in miniaturizing surgical methods, that seems like a challenge scientists can overcome.

Messenger RNA Therapeutics 

Back to Star Trek. The hypospray injector’s contents could cure just about any disease, even one newly discovered on a strange planet. That’s not unlike messenger RNA (mRNA) technology, a breakthrough that enabled scientists to quickly develop some of the first COVID-19 vaccines. 

But vaccines are just the beginning of what this technology can do. 

A whole field of immunotherapy is emerging that uses mRNA to deliver instructions to produce chimeric antigen receptor-modified immune cells (CAR-modified immune cells). These cells are engineered to target diseased cells and tissues, like cancer cells and harmful fibroblasts (scar tissue) that promote fibrosis in, for example, the heart and lungs. 

The field is bursting with rodent research, and clinical trials have started for treating some advanced-stage malignancies.

Actual clinical use may be years away, but if all goes well, these medicines could help treat or even cure the core medical problems facing humanity. We’re talking cancer, heart disease, neurodegenerative disease – transforming one therapy into another by simply changing the mRNA’s “nucleotide sequence,” the blueprint containing instructions telling it what to do, and what disease to attack. 

As this technology matures, we may start to feel as if we’re really on Star Trek, where Dr. Leonard “Bones” McCoy pulls out the same device to treat just about every disease or injury.

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Tracking the opioid crisis: Inside the DEA’s secret lab | CNN

Watch CNN Films’ “American Pain” at 9 p.m. ET Sunday, February 5.



CNN
— 

Sitting among the warehouses of Dulles, Virginia, is one of the US Drug Enforcement Administration’s forensic labs. It’s one of eight across the country where scientists analyze illegal drugs and try to stay ahead of what’s driving deadly overdoses.

Starting in the late 1990s with overprescribing of prescription narcotics, the opioid epidemic has continued to plague the United States for decades. What has changed is the type of drugs that have killed more than half a million people during the past 20 years.

CNN was granted rare access to the secret lab where the DEA tests seized illicit drugs to understand what’s coming next.

“The market is constantly changing, so we are trying to do everything we can from a science base to keep up with that,” Scott Oulton, deputy assistant administrator of the DEA’s Office of Forensic Sciences, told CNN Chief Medical Correspondent Dr. Sanjay Gupta.

Holding a white bag of fentanyl precursor powder – one of the chemicals used to make the opioid – Oulton explained that the illicitly made painkiller continues to be a dominant presence in the drugs officials are finding.

“This kilogram can be converted into fentanyl to make approximately 800 grams,” he said. “So it doesn’t take that much material, it’s fairly cheap, it’s inexpensive to obtain.”

Fentanyl is the deadliest drug in the United States, and it’s often found in combination with other illicit drugs, including cocaine and heroin. But increasingly, fentanyl is showing up in illicit pills disguised as common prescription drugs like oxycodone, hydrocodone, even Adderall.

Users buying drugs on the street that look like prescription pills may end up with a highly potent, potentially deadly drug they never intended to take.

“Over 99% of what we see are fake. They contain fentanyl,” Oulton says of the pills that the agency is seizing.

The 800 grams of fentanyl that Oulton held could be turned into 400,000 to 500,000 potentially lethal pills.

As more and more of these lethal pills circulate, the opioid epidemic is reaching more of the population.

Deena Loudon of Olney, Maryland, is among those living with its effects.

“I truly love sharing Matthew with the world,” Loudon says as she flips through pictures of her son.

One of her favorite memories is Matthew playing hockey – what Loudon calls his happy place.

Matthew Loudon's mom says he turned to drugs after struggling with anxiety.

But she also recalls his struggles with anxiety, which led him to turn to drugs. He started dabbling in them in the 10th grade. By the following year, his grades began to fall, and he couldn’t keep them high enough to stay in hockey.

“He was using Xanax to help self-medicate himself and I think to help get rid of some of that angst so he could live somewhat of a normal life,” Loudon said.

Matthew was always honest, almost to a fault, Loudon says. “He told me he tried everything. Like everything. Heroin, meth, crack, you name it, cocaine, whatever – until I guess he found what made him feel the best, and it was Xanax.”

And as much as a mother can worry, Loudon says, Matthew always tried to reassure her. “I know what I’m doing,” he would tell her.

She had heard about fentanyl showing up in pills in their area.

“But you don’t ever think it’s going to happen to you,” Loudon said.

She said they even had a conversation about fentanyl the day before he died. “I was sort of naive, wanting to stick my head in the sand and thinking ‘I bet he does know what he’s doing.’ ”

On November 3, 2020, she found 21-year-old Matthew on the floor of their basement.

Matthew’s autopsy report lists his cause of death as fentanyl and despropionyl fentanyl intoxication.

“I don’t say he overdosed. I say he died from fentanyl poisoning. … Truthfully, like, at the end of the day, to me, he was murdered, right? Because he asked for one thing. They gave him something different. And it took his life.”

For a parent, she said, the hardest thing is burying their child. It’s a pain she speaks out about in hopes of keeping other families safe.

“It’s Russian roulette,” she warns them. “You never know what you’re gonna get.”

The number of pills the DEA has seized skyrocketed in just three years, from 2.2 million in 2019 to 50.6 million in 2022.

The sheer volume of pills has been one of the biggest challenges for the DEA’s lab, Oulton says. As the fentanyl threat continues to grow, the Virginia facility is expanding to accommodate the analysis needed.

The lab can test for something as simple as the presence of fentanyl, but something called the purity of the pill also offers important insight. This means how much fentanyl is actually in one of these illicit pills.

“Lately, we’ve been seeing a purity increase over the last year, where we used to say roughly four out of the 10 seizures that we were receiving would contain a lethal dose of greater than 2 milligrams. As of October last year, we started reporting that we’ve seen an uptick. Now we’re saying that six out of 10 of the seizures that we’re receiving contain over 2 milligrams,” Oulton said.

He says they’re finding an average of 2.3 milligrams of fentanyl in each pill.

Two milligrams may be the cutoff for what is considered lethal, but Oulton says that doesn’t necessarily mean a pill with 1.99 milligrams of fentanyl can’t be deadly.

“One pill can kill” is his warning.

“The message I would like to send out is, don’t take it,” he said. “Don’t take the chance. It’s not worth your life.”

Oulton says he and his team are constantly finding new and different drugs and substances in pills – things they’ve never seen before.

One machine in the lab is almost the equivalent of an MRI in a medical office, showing the structure and detail of a pill.

“We will do what we call structural elucidation to determine that this is a different version of a fentanyl that’s got a new compound and molecule that’s been added to it,” Oulton said.

They’ve seen “hundreds and hundreds of unique combinations,” he said.

“We’ll see one that contains fentanyl, one with fentanyl and xylazine, one with fentanyl and caffeine, one with fentanyl and acetaminophen, and you don’t know what you’re getting.”

Xylazine, a veterinary tranquilizer, poses a unique problem. It’s not an opioid, so even when it’s mixed with fentanyl, drugs designed to reverse an opioid overdose may not work.

Narcan or naloxone, one of the more common overdose-reversing drugs, has become increasingly necessary as the prevalence and potency of illicit drugs increases. About 1.2 million doses of naloxone were dispensed by retail pharmacies in 2021, according to data published by the American Medical Association – nearly nine times more than were dispensed five years earlier.

Oulton wants to be clear: The problem Isn’t with pills prescribed by your doctor and dispensed by a pharmacy – it’s the pills on the illicit market.

Those, Matthew’s mother warns, are easy to get.

“The first pills [Matthew] got was in high school. And it was just flipping out, floating around, and it was easy for him to get his hands on,” she said.

Loudon’s message for parents now: Keep your eyes open.

“Just be mindful of what your children are doing. You just just have to keep your eyes open. And even sometimes, when you keep your eyes open, you can miss some of the warning signs, but I think a parent knows their child best, so just keep talking.”

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Might Flu Shots Increase COVID-19 Pandemic Risk?

From Dr. Joseph Mercola

Since COVID-19 first entered the scene, exchange of ideas has basically been outlawed. By sharing my views and those from various experts throughout the pandemic on COVID treatments and the experimental COVID jabs, I became a main target of the White House, the political establishment and the global cabal.

Propaganda and pervasive censorship have been deployed to seize control over every part of your life, including your health, finances and food supply. The major media are key players and have been instrumental in creating and fueling fear.

I am republishing this article in its original form so that you can see how the progression unfolded.

Originally published: September 8, 2020

Could a “perfect storm” be brewing, ready to be unleashed this fall? If the regular influenza season ends up converging with a resurgence of SARS-CoV-2 outbreaks, or even a new SARS-CoV-3, the results are anyone’s guess at this point. Confounding matters is the possibility that influenza vaccination may increase people’s risk of other viral infections.

In a June 12, 2020, Science editorial, Michael Osterholm, virologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis, and Edward Belongia, director of the Center for Clinical Epidemiology and Population Health at the Marshfield Clinic Research Institute in Marshfield, Wisconsin write:1

“There are important differences in the epidemiology of COVID-19 and seasonal influenza, but symptoms overlap … The prospect of a second COVID-19 wave requires planning to ensure optimal delivery of influenza vaccines starting in the early fall …

The optimal timing of influenza vaccination in patients with confirmed COVID-19 is uncertain. There are no clinical studies on the effects of influenza vaccination in patients with COVID-19, but it may be prudent to delay vaccine administration until after the acute illness has resolved …

Will there be a perfect storm of COVID-19 and influenza during the 2020–2021 season? We do not yet know, but we must start preparing in the coming months.”

‘False Claim’ Is Based on Published Science

Osterholm and Belongia stress there is a “false claim that influenza vaccination increases the risk of SARS-CoV-2 infection” promoted by Judy Mikovits and circulating online, and that “Scientists, health care providers, and public health leaders must counter these claims with clear, evidence-based information on the importance of influenza vaccination during the COVID-19 pandemic.”

But this so-called “false claim” is not a rumor pulled out of thin air. As is so often the case, Osterholm and Belongia are actually insulting fellow virologists and researchers when slapping a hoax label on such claims, seeing how there is published research showing that, yes, influenza vaccination appears to worsen outcomes during viral pandemics.

If Osterholm and Belongia wanted to be factual and clear, they should dissect the actual studies using scientific methods and reasoning, and not just dismiss them as made-up internet hoaxes.

The fact that peer-reviewed studies have come to the conclusion that previous flu vaccination seems to increase patients’ risk of contracting more severe pandemic illness at least worthy of consideration and review.

I’m not surprised though, seeing how Osterholm appears to routinely ignore the reality of published science. In a March 10, 2020, interview with Joe Rogan,2 in which the question of SARS-CoV-2’s origin came up, Osterholm stated that “we could not have crafted a virus like this to do what it’s doing; I mean we don’t have the creative imagination or the skill set.”

This simply does not line up with reality. Again, published research shows we clearly have the technology, know-how and “creative imagination” to create SARS-CoV-2.

Flu Vaccine Increased Risk of Pandemic H1N1

So, what is the basis for these claims? Research raising serious questions about flu vaccinations and their impact on pandemic viral illnesses include a 2010 review3,4 in PLOS Medicine, led by Dr. Danuta Skowronski, a Canadian influenza expert with the Centre for Disease Control in British Columbia, which found the seasonal flu vaccine increased people’s risk of getting sick with pandemic H1N1 swine flu and resulted in more serious bouts of illness.

People who received the trivalent influenza vaccine during the 2008-2009 flu season were between 1.4 and 2.5 times more likely to get infected with pandemic H1N1 in the spring and summer of 2009 than those who did not get the seasonal flu vaccine.

In all, five observational studies conducted across several Canadian provinces found identical results. These findings also confirmed preliminary data from Canada and Hong Kong. As Australian infectious disease expert professor Peter Collignon told ABC News at the time:5

“Some interesting data has become available which suggests that if you get immunized with the seasonal vaccine, you get less broad protection than if you get a natural infection …

We may be perversely setting ourselves up that if something really new and nasty comes along, that people who have been vaccinated may in fact be more susceptible compared to getting this natural infection.”

Double-Blind Animal Study Confirmed Results

To double-check the findings, Skowronski and other researchers conducted a study on ferrets. Their findings were presented at the 2012 Interscience Conference on Antimicrobial Agents and Chemotherapy. As reported by MedPage Today:6

“A double-blind, placebo-controlled animal study suggests that vaccination with seasonal influenza vaccine did, in fact, worsen symptoms after subsequent exposure to H1N1 flu … The vaccinated ferrets also accumulated significantly greater lung virus titers — 4.96 plot forming units/ml versus 4.23 pfu/ml …

‘We did find that the ferret findings were consistent with our earlier human studies,’ Skowronski said, noting that the scientifically stringent experiment used ferrets, considered to be excellent models of human influenza infection …

‘We needed to follow up on those studies from Canada. They were clearly indicating something important about the interaction between seasonal and pandemic viruses,’ she said.

‘First, people attributed the human findings to bias and confounding. That is a common problem with observational studies … Our ferret studies showed that the findings could not be explained away on the basis of confounding.

There may be a direct vaccine effect in which the seasonal vaccine induced some cross-reactive antibodies that recognized pandemic H1N1 virus, but those antibodies were at low levels and were not effective at neutralizing the virus,’ she continued, explaining that instead of killing the new virus it actually may facilitate its entry into the cells.”

Flu Vaccine Increases Risk of Respiratory Infections

Another study,7 published in the Journal of Virology in 2011, found the seasonal flu vaccine weakens children’s immune systems and increases their chances of getting sick from influenza viruses not included in the vaccine.

Further, when blood samples from 27 healthy, unvaccinated children and 14 children who had received an annual flu shot were compared, the former unvaccinated group was found to have naturally built up more antibodies across a wider variety of influenza strains compared to the latter vaccinated group, which is the type of situation Collignon referred to in the quote above.

Then there’s a 2012 study8,9 in the journal Clinical Infectious Diseases, which found that children receiving inactivated influenza vaccines had a 4.4 times higher relative risk of contracting noninfluenza respiratory virus infections in the nine months following their inoculation.

The authors proposed the theory that “Being protected against influenza, trivalent inactivated influenza vaccine recipients may lack temporary nonspecific immunity that protected against other respiratory viruses.”

Natural Infection, Inoculation Confer Different Protection

So, on the one hand, studies have shown that when you get the flu vaccine, you may become more prone to flu caused by influenza viruses that are not contained in the vaccine, or other noninfluenza viral respiratory illnesses, including coronavirus infections (more on that below).

Conversely, researchers10,11,12 recently found that common colds caused by the betacoronaviruses OC43 and HKU1 might actually make you more resistant to SARS-CoV-2 infection, and that the resulting immunity might last as long as 17 years.

The authors suggest that if you’ve beat a common cold caused by a OC43 or HKU1 betacoronavirus in the past, you may have a 50/50 chance of having defensive T-cells that can recognize and help defend against SARS-CoV-2.

Flu Vaccination Increases Risk of Coronavirus Infection

So, what about SARS-CoV-2? Is there any evidence to suggest influenza vaccines might render people more susceptible to this pandemic virus too? So far, no one has looked at SARS-CoV-2 specifically, but there are recent findings showing seasonal flu vaccinations can worsen coronavirus infections in general.

Remember, SARS-CoV-2 is one of seven different coronaviruses known to cause respiratory illness in humans.13 Four of them cause symptoms associated with the common cold: 229E, NL63, OC43 and HKU1.

In addition to the common cold, OC43 and HKU1 — two of the most commonly encountered betacoronaviruses14 — are also known to cause bronchitis, acute exacerbation of chronic obstructive pulmonary disease and pneumonia in all age groups.15 The other three human coronaviruses — which are capable of causing more serious respiratory illness — are SARS-CoV, MERS-CoV and SARS-CoV-2.

A study16,17 published in the January 10, 2020, issue of the journal Vaccine found people were more likely to get some form of coronavirus infection if they had been vaccinated against influenza. As noted in this study, titled “Influenza Vaccination and Respiratory Virus Interference Among Department of Defense Personnel During the 2017-2018 Influenza Season:”

“Receiving influenza vaccination may increase the risk of other respiratory viruses, a phenomenon known as virus interference. Test-negative study designs are often utilized to calculate influenza vaccine effectiveness.

The virus interference phenomenon goes against the basic assumption of the test-negative vaccine effectiveness study that vaccination does not change the risk of infection with other respiratory illness, thus potentially biasing vaccine effectiveness results in the positive direction.

This study aimed to investigate virus interference by comparing respiratory virus status among Department of Defense personnel based on their influenza vaccination status. Furthermore, individual respiratory viruses and their association with influenza vaccination were examined.”

While seasonal influenza vaccination did not raise the risk of all respiratory infections, it was in fact “significantly associated with unspecified coronavirus (meaning it did not specifically mention SARS-CoV-2) and human metapneumovirus” (hMPV).

Those who had received a seasonal flu shot were 36% more likely to contract coronavirus infection and 51% more likely to contract hMPV infection than unvaccinated individuals.18,19

Looking at the symptoms list for hMPV20 is telling, as the main symptoms include fever, sore throat and cough. The elderly and immunocompromised are at heightened risk for severe hMPV illness, the symptoms of which include difficulty breathing and pneumonia. All of these symptoms also apply for SARS-CoV-2.

Did Flu Shots Increase Mortality in Italy?

In a recent blog post, Dr. Michael Murray discusses the possibility that seasonal influenza vaccinations may have contributed to the dramatically elevated COVID-19 mortality seen in Italy. He writes:21

“… the standard answers of an elderly population and the failure to implement social distancing soon enough just don’t explain what is happening. My colleague, Dr. Alex Vasquez, provided me with a valuable insight.

In September 2019, Italy rolled out an entirely new type of influenza vaccine. This vaccine called VIQCC is different than others. Most available influenza vaccines are produced in embryonated chicken eggs. VIQCC, however, is produced from cultured animal cells rather than eggs and has more of a ‘boost’ to the immune system as a result.

VIQCC also contains four types of viruses — 2 type A viruses (H1N1 and H3N2) and 2 type B viruses.22 It looks like this ‘super’ vaccine impacted the immune system in such a way to increase coronavirus infection through virus interference that set the stage for what happened in Italy.”

Fast-Tracked COVID-19 Vaccine Plus Flu Vaccine This Season?

Needless to say, there’s also no telling what the effects might be if people are vaccinated against both influenza and SARS-CoV-2 in the same season. We don’t even know what the ramifications of the SARS-CoV-2 vaccine might be yet, although, historically, all coronavirus vaccines have resulted in more devastating disease and increased risk of death, as reviewed in my interview with Robert F. Kennedy Jr.

Preliminary results from Moderna’s Phase 1 trial showed the vaccine (mRNA-1273) caused systemic side effects in 80% of participants receiving the 100 microgram (mcg) dose.23,24 Side effects ranged from fatigue (80%), chills (80%), headache (60%) and myalgia or muscle pain (53%). After the second dose, 100% of participants in the 100-mcg group experienced side effects.

This is important to note as, unlike the flu vaccine, the coronavirus vaccine will be a minimum of a two-dose regimen and most likely recommended to be repeated annually, just like the flu vaccine.

The 45 volunteers were divided into three dosage groups — 25 mcg, 100 mcg and 250 mcg — with 15 participants in each. Even in the low-dose group, one participant (6%) got so sick he required emergency medical care. In the high-dose (250 mcg) group, 100% of participants suffered side effects after both the first and second doses, and three of the participants suffered “one or more severe events.”

Keep in mind, these were healthy individuals between the ages of 18 and 55,25 who were not overweight, were lifelong nonsmokers with no family history of respiratory problems or seizures. People with asthma, diabetes, rheumatoid arthritis or other autoimmune diseases were excluded.

What do you think might happen when a vaccine that sends perfectly healthy individuals to the hospital is given to the elderly and/or people with serious health conditions? Then, add to that the possibility of being more prone to respiratory illnesses due to receiving the seasonal flu vaccine. The end result seems pretty obvious, and it’s not going to be a boon to public health.

I’ve written many articles reviewing the ineffectiveness of flu vaccines, and several more on the potential problems facing us from fast-tracked mRNA vaccines for COVID-19. Hopefully, sanity and logical thinking will sprout before it’s too late, but as it stands right now, it appears we’re headed toward a public health disaster.

The way forward is to make sure we defend our right to choose, to opt out, and to fight vaccine mandates wherever they turn up, regardless of the vaccine in question, because ultimately, it is previous precedents that allow government to continue mandating ever more dangerous vaccines.




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Why Are Surgery and Prescriptions Now Advised for Obese Children?

It’s been 15 years since the American Academy of Pediatrics (AAP) updated its guidance on childhood obesity. The new recommendations, however, fall short of providing the needed guidance to address the root causes driving obesity and related conditions.

Instead of tackling the drivers of childhood obesity, AAP gave a wholehearted endorsement for weight loss drugs and surgery in children as young as 12 and 13, respectively. “Waiting doesn’t work,” coauthor Dr. Ihuoma Eneli told The Associated Press. “What we see is a continuation of weight gain and the likelihood that they’ll have (obesity) in adulthood.”1

Unfortunately, by resorting to drugs and surgery, children may be saddled with a lifetime of related side effects, for a condition they could have likely reversed using natural lifestyle strategies.

AAP Pushes Drugs, Surgery for Obese Children

In the U.S., 1 in 5 children and adolescents is obese.2 Among 2- to 19-year-olds, the prevalence of obesity was 19.7% from 2017 to 2020, or 14.7 million individuals affected.3 The AAP guidance recommends “comprehensive treatment,” which includes nutrition support, physical activity, behavioral therapy, medications and metabolic and bariatric surgery.

“There is no evidence to support either watchful waiting or unnecessary delay of appropriate treatment of children with obesity,” the guidance explains, instead setting the tone that early and aggressive drug and surgical treatment is warranted.4

Coauthor Dr. Sandra Hassink, medical director for the AAP Institute for Healthy Childhood Weight, told The Associated Press that the guidelines are meant to change the view that obesity is “a personal problem, maybe a failure of the person’s diligence. This is not different than you have asthma and now we have an inhaler for you.”5 According to the guideline’s executive summary:6

“Obesity has long been stigmatized as a reversible consequence of personal choices but has, in reality, complex genetic, physiologic, socioeconomic, and environmental contributors.

An increased understanding of the impact of social determinants of health (SDoHs) on the chronic disease of obesity — along with heightened appreciation of the impact of the chronicity and severity of obesity-related comorbidities — has enabled broader and deeper understanding of the complexity of both obesity risk and treatment.”

Further, the guidelines specifically state:7

  • Pediatricians and other primary health care providers should offer adolescents 12 years and older with obesity (BMI ≥95th percentile) weight loss pharmacotherapy … as an adjunct to health behavior and lifestyle treatment
  • Pediatricians and other primary health care providers should offer referral for adolescents 13 years and older with severe obesity (BMI ≥120% of the 95th percentile for age and sex) for evaluation for metabolic and bariatric surgery

Risky Weight Loss Drugs for Children?

Obesity-related diseases like cancer, Type 2 diabetes, high blood pressure and osteoarthritis are significant. But while maintaining a healthy weight is essential for optimal health, resorting to drugs and surgery to get there can be dangerous, especially for children.

The AAP recommends the weight loss pill orlistat, Novo Nordisk’s semaglutide (Wegovy) — a diabetes drug given by injection — and the diabetes medicine metformin as potential obesity treatments in 12-year-olds and up.8 Each comes with its own set of risks. Orlistat can cause kidney and liver injury, along with gastrointestinal adverse effects, such as oily stools, diarrhea and abdominal pain, for instance.9

Wegovy, meanwhile, also caused gastrointestinal side effects, including nausea and vomiting, as well as concerns of pancreatitis, pancreatic cancer and retinopathy complications, including hemorrhage and blindness.10 Metformin’s side effects include a metabolic condition called lactic acidosis, which can be life-threatening.11

Weight Loss Surgery Can Be Deadly

Subjecting children to surgery for weight loss is also egregious, as it can lead to permanent complications and even death. Two primary types of weight loss surgery include:12

  • Gastric sleeve — This surgery involves removing most of your stomach, leaving only a banana-shaped portion that’s closed with staples. In addition to physically reducing the amount of food you can eat, the removal of part of your stomach alters your gut hormones and gut bacteria, which play a role in appetite and metabolism.
  • Gastric bypass — In addition to stapling your stomach so only a small pouch remains in the upper section, gastric bypass involves cutting your small intestine and attaching it to the stomach pouch. By bypassing most of your stomach and upper part of your small intestine, your body absorbs fewer calories when you eat, but the surgery will also alter your gut hormones and bacteria.

In a review of 164 studies, bariatric surgery was found to be effective in helping people lose weight and keep it off as well as reduce rates of obesity-related health problems.13 However, “risks of complication, reoperation and death exist,” the researchers noted. The study found a complication rate of 17%, whereas another 7% required a second surgery.

In addition to the risk of infection or leaking from the areas of the stomach that have been stapled, bariatric surgery can make it difficult for you to absorb nutrients from the food you eat, leading to related health problems like anemia and osteoporosis, which could be even more severe when the disruptions to nutrient absorption begin in adolescence.

Gallstones can also develop, and many patients are prescribed gallstone prevention medication after surgery, whereas gastric bands can also erode into your stomach — a complication that requires removal. Strictures are another potential problem, which refer to narrowing of the newly shaped stomach or connection between the small intestine and stomach.

The narrowing can cause nausea, vomiting and trouble swallowing when you try to eat or swallow food, and must be fixed with additional medical procedures. The way your body processes alcohol may also be affected, so patients must be aware that drinking alcohol could be problematic after bariatric surgery.14

Mary Lou Singleton, midwife and family nurse practitioner, told Children’s Health Defense, “While children are less likely to experience serious surgical complications than adults, the mortality rate for children undergoing weight loss-surgery is 1 in 500. Most parents would not consider this an insignificant risk.”15 Further, the procedures involve removing a part of the body, which cannot be undone:16

“These body parts are not redundant. They serve important purposes in the digestive process. ‘Bypassing’ them means children will permanently be left without the use of these organs. They can never be reintegrated into the digestive system.

… The AAP is recommending these surgeries for children too young to understand the long-term risks. While removing the majority of the stomach will lead to drastic initial weight loss in nearly all patients, we know that 25% to 50% of adults who undergo weight loss surgery eventually regain all or most of this weight.

Treating obesity in a patient who has already lost the function of most of their stomach may be the next brave new frontier in the profitable field of weight loss medicine.”

No Mention of What’s Driving Childhood Obesity

Obesity is a complex problem, but there are nearly always environmental contributors. Obesogens in the environment, such as endocrine-disrupting chemicals, are among them, and it’s believed that dietary exposure — via contaminated foods and food packaging — is a major contributor. Researchers explained in Biomolecules:17

“These chemicals are probably able to contribute not only to the development of obesity and metabolic disturbances in individuals, but also in their progeny, having the capability to epigenetically reprogram genetically inherited set-up points for body weight and body composition control during critical periods of development, such as fetal, early life, and puberty.”

Yet, the AAP guidelines make no mention of controlling exposure to obesogens. “What has not been addressed are the obesogens in American children’s meals, substances that produce obesity, lurking in their food at home as well as school, caused mostly by pesticides and plastics. The cause of the metabolic disorder of obesity is that it is an environmental disease,” pediatrician Dr. Michelle Perro told Children’s Health Defense.

“Unless we remove the pesticides and other toxicants, the promotion of drugs and surgery are panaceas, Band-Aids and foster the ‘pill for ill’ model, rather than root-cause real solutions,” she said. Singleton added:18

“I found no mention of the massive changes in the U.S. food supply that correlate with the skyrocketing rates of obesity among children and adults alike … The document fails to address the school lunch program, which is providing a significant amount of the calories U.S. schoolchildren are eating weekly.

Most schoolchildren in the U.S. are fed plastic-wrapped, chemically-preserved, pesticide-laden food made in factories months or years earlier. In addition to the sugar, the chemicals in these foods have endocrine-disrupting obesogenic properties.”

It’s Not About Calorie Counting and Low-Fat Diets

Part of the problem with the conventional model for treating childhood obesity is that children receive flawed nutritional guidance focused on reducing saturated fats and other whole foods, while promoting vegetable oils and low-fat diets.19 Further, leading kids to focus on calorie counting doesn’t work, as it ignores the complexity of the human body.

When on a starvation-type diet, for instance, your body will tend to shut down various processes in order to survive. For example, by reducing thyroid function, your body will not burn as many calories. In short, it alters the thermodynamics of your body.

Also, the recommendation to reduce fat and eat more carbs is without a doubt a major contributor to the obesity epidemic. This compels people to consume processed junk foods, but when you consume an abundance of ultraprocessed foods, it’s not only a matter of taking in “empty calories” or too many calories that cause weight gain. It actually triggers a catastrophic cascade of health declines rooted in mitochondrial dysfunction and insulin resistance.

Meanwhile, conventional nutritionists typically do not advise that increased intake of toxic industrially processed seed oils, often referred to as “vegetable oils,” are also driving obesity.

Examples of seed oils high in omega-6 PUFAs include soybean, cottonseed, sunflower, rapeseed (canola), corn and safflower.20 Omega-6 is considered to be proinflammatory because of the most common variety, linoleic acid, which will radically increase oxidative free radicals and cause mitochondrial dysfunction.21

As researchers noted in the journal Nutrients, “In addition, a few studies suggested that omega-6 PUFA is related to chronic inflammatory diseases such as obesity, nonalcoholic fatty liver disease and cardiovascular disease.”22 Reducing your intake of seed oils while increasing your intake of healthy fats is a powerful way to support a healthy weight.

Then there’s the timing of your food (i.e., time restricted eating (TRE)) — another important factor in helping to optimize weight. Our ancient ancestors did not have access to food 24/7, so our genetics are optimized to having food at variable intervals, not every few hours. When you eat every few hours for months, years or decades, never missing a meal, your body forgets how to burn fat as a fuel.

In most cases, children will be able to lose weight by eating real food — not ultraprocessed ones — and embracing TRE by limiting food intake to a certain number of hours per day.23 Engaging in nonexercise movement throughout the day, and getting regular exercise, will provide further benefits. Exercise will not produce significant weight loss without addressing diet, but when done in combination it can be significantly beneficial.

Ideally, families should work with a holistic practitioner who understands the underlying drivers of obesity and can provide a comprehensive strategy for weight loss — one that doesn’t involve drugs and surgery.



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The Future of At-Home Testing: Flu, RSV Rapid Tests Are Coming

Feb. 2, 2023 – It’s easy these days to take an at-home COVID test when you have symptoms like a fever and sore throat. But when the test is negative, the next step toward diagnosis usually means leaving the comforts of home.

But that could soon change. The FDA says it is confident that at-home rapid tests like those for COVID-19 are forthcoming for the flu and respiratory syncytial virus, or RSV. 

The division of the National Institutes of Health that helped create rapid COVID tests confirmed it is partnering with developers on combination tests that can look for multiple respiratory illnesses.

Combination tests that can look for the markers of more than one disease are called multi-analyte. Europe and Australia already have over-the-counter tests that look for flu and RSV along with COVID-19.

“We will be authorizing at-home flu and/or RSV tests that are multi-analyte with COVID,” an FDA official told WebMD. “I can’t tell you exactly when that would happen, but we are eager to do that.”

Making such an at-home test possible would be in line with  the FDA’s goals to expand  health care equity and affordability, the official said. 

Right now, the process for developing and applying for FDA approval of combination tests is less complicated and  expensive for developers under special pandemic rules. Developers get extensive assistance from the National Institute of Biomedical Imaging and Bioengineering at the NIH, particularly in the area of validation studies.

The institute has already helped develop combination tests that can be used in health care settings, says  its director, Bruce Tromberg, PhD.

“A couple of those have form factors that look like they should be fully at-home and over-the-counter,” he says “I’m optimistic that these will ultimately meet the performance bars that the FDA has.”

Tromberg calls the current environment for at-home testing a “paradigm shift.” His institute estimates that more than 6.5 billion COVID tests that his organization helped create have been produced.

“We’re actually going to probably stop counting, the numbers are just so big,” he says of the now universal  COVID test.

From Test Tubes to Disposable Ubiquity

With millions or even billions of COVID tests used, home testing is now commonplace in American life. 

“The public’s expectations for medical testing are clearly being shaped differently due to the convenience, privacy, and speed of obtaining these results at home, which is a good thing,” Shannon Haymond, PhD, president of the American Association for Clinical Chemistry, wrote in an email. She is also the director of clinical mass spectrometry at the Ann & Robert H. Lurie Children’s Hospital of Chicago and an associate professor of pathology at Northwestern University Feinberg School of Medicine.

With pandemic culture propelling demand for at-home testing, many are recalling the 1970s era known as the sexual revolution, which centered on women’s autonomy over their own bodies. During that time, pregnancy testing moved from the clinical setting to the privacy of women’s homes.

“I really liked the term from, I think it was an EPT ad, from the ’70s that it was ‘a private little revolution,’” says historian Sarah Leavitt, PhD, a former historian at the NIH whose pregnancy test timeline, “The Thin Blue Line,” is one of the NIH’s most popular historical publications. “It brings the pregnancy test into your own private sphere, you have power over it again, and it’s your story and your body, and you can tell people when you want to.”

Fifty years ago, the thin blue line wasn’t a 15-minute wait, which is about the time it takes these days to see the result of a pregnancy test or COVID test.

“One big difference is that, when the first at-home pregnancy test hit the market in the 1970s, testing technology was a lot less advanced than it is today,” explained Haymond. “This means that the first home pregnancy test was very complicated to perform – it involved 10 steps and equipment like test tubes, and users had to keep the test tubes in a place free from vibrations for two hours. The easy-to-use stick tests that we’re familiar with today weren’t developed until 1988.”

Both at-home COVID and pregnancy tests drew early concern from the medical community regarding test accuracy and potential for user error.

“In retrospect, these concerns might seem overly cautious, but this push-pull between innovation and caution is integral to ensuring that medical advancements are made with patient safety foremost in mind,” Haymond said.

The best approach is one that leverages the benefits of home testing with the expertise available from health care providers, who can advise when to test, how to interpret results, and determine if any extra medical care is needed, she said.

The Future of At-Home Diagnostics

Television can be a mirror for how science finds its place in our culture, Leavitt says. 

“I was trying to envision when COVID tests will show up as a cultural marker in television shows,” she says, noting that beyond pregnancy tests, HIV tests and paternity tests have found their way into plots. “I don’t know what the plot point would be – maybe the test that’s found in the garbage and whose test was it?”

By the time COVID tests show up in television, the pace of technology may have already brought a new forefront for at-home testing. Haymond foresees artificial intelligence on the horizon for at-home diagnostics.

“Of course, like almost all areas of healthcare, we in laboratory medicine are anticipating data analytics as another major area of innovation and transformation,” she said. “This involves using technology such as artificial intelligence to find patterns and trends in healthcare datasets, and then using these findings to identify vulnerable patients before they become ill, better personalize testing and treatments, and augment human workflows in clinical testing and result interpretation.”

In the more near-term, Tromberg at the National Institute of Biomedical Imaging and Bioengineering can envision a program that would help people in rural areas – sometimes called “health care deserts” – test at home and then easily be connected to care. The institute is already helping pilot such a program involving at-home COVID testing and connection to treatment in Pennsylvania. He could see a program like that easily using at-home flu and RSV tests.

“People clearly would like to test at home if they could,” Tromberg says. “It’s not such a stretch, given that many people are already having telemedicine visits anyway.”

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Norflox 400mg Tablet – Uses, Side effects, Dosage, Pricing – Health & Healthier

Norflox 400 is a type of antibiotic medication that falls under the group of quinolones and is used for treating bacterial infections. It treats urinary tract infections, prostatitis (prostate inflammation), and gonorrhea (sexually transmitted disease). Norflox 400mg Tablet is also used to treat stomach and intestine infections such as traveler’s diarrhea.

Norflox 400mg tablet is manufactured and marketed by “Cipla Limited“, which is considered one of the top pharmaceutical companies in India.

Composition of Norflox 400mg tablet 

Norflox 400mg is composed of two types of medications namely

  • Norfloxacin (400mg)
  • Lactobacillus spores

How does Norflox 400mg Tablet work?

Norflox 400 accomplishes its purpose by inhibiting the synthesis of bacterial DNA gyrase, which stops the bacteria from repairing themselves and allowing them to reproduce. In this way, it treats infections while also killing the bacteria. Norflox 400 is a broad-spectrum antibiotic that is effective against a wide variety of gram-positive and gram-negative bacteria.

The combination of Norfloxacin and Lactobacillus makes this medication extremely powerful and efficient. The antibiotic norfloxacin works by eliminating the bacteria that are the source of the infection. On the other hand, Lactobacillus helps to restore the natural balance of beneficial bacteria that are normally found in the intestine, which in turn helps to prevent the growth of pathogenic bacteria.

Uses of Norflox 400 tablet

Norflox 400 tablet is prescribed by doctors under certain medical conditions. The various uses of Norflox 400 tablet are as follows.

Treats bacterial infections

Norflox 400 Tablet is a type of antibiotic medication that can be utilized in the treatment of a wide variety of infections that are brought on by bacteria. It does this by inhibiting the growth of the bacteria that are responsible for the infection, which in turn eradicates the infection. Additionally, it assists in the treatment of diarrhea as well as the prevention of diarrhea that may be brought on by the use of this medicine or by infections of the stomach or gut. This medication is also recommended by doctors when you have a urinary tract infection.

Treats Traveller’s diarrhea

 Norflox 400mg tablets are also recommended by doctors to treat traveller’s disease. This condition is generally caused when you are traveling. It is caused due to various bacteria, viruses and parasites. So, Norflox 400 under such conditions works perfectly.

Dosage 

You should always follow the exact dosage mentioned by your doctor when it comes to Norflox 400. This is because the dosage exactly depends on what you are being treated for. There is a separate dosage for urinary tract infection and a different dosage for treating traveller’s disease. So, in this case, your doctor’s recommendation is the final word.

For educational purposes, Norflox 400mg tablets can be taken once every day one hour before consuming any food. But again, you need your doctor’s advice regarding the exact dosage as the dosage is entirely dependent on the type of condition you are in. Also, make sure to follow the entire course as suggested by your doctor for the proper treatment of your condition.

Side effects of Norflox 400 tablet

There are some minor side effects of Norflox 400mg tablet. The side effects are rare and if you do witness any side effects after having this tablet do not forget to consult your doctor almost immediately. The various side effects that you witness after having Norflox 400mg tablets are as follows

  • Minor headache
  • Vomiting
  • Stomach issues
  • Nausea
  • Heartburn
  • Gas problems and constipation

Precautions

Follow exactly your doctor’s advice regarding the dosage of Norflox 400 tablets

  • If you are pregnant, you can consume Norflox 400 but only after consulting your doctor
  • If you have kidney problems, consult your doctor before consuming the medication
  • If you are under any sort of medication, don’t forget to mention it to your doctor as Norflox 400 tend to react with other medications as well.
  • If you are into drinking, consult your doctor for the accurate dosage and how to consume it

Pricing 

Norflox 400mg Tablet 10’S costs you around Rs 80. Always make sure to buy any type of medicine from your nearby registered pharmacy or online stores.

FAQ’s

Is Norflox 400 good for urine infection?

Urinary tract infections are often treated with Norflox 400. It works well to treat bacterial infections of the urinary tract and eases symptoms like pain, a burning feeling when urinating, and the need to go to the bathroom often. Norflox 400 can be taken by mouth or through an IV, depending on how bad the infection is. It works by stopping bacteria from growing in the kidneys or bladder. It also helps to stop infections from happening again in the future. But it’s important to know that even though Norflox 400 can help treat a urinary tract infection, it won’t completely cure it. Other treatments may be needed to get rid of the infection completely.

What is Norflox 400 used for?

Norflox 400 is an antibiotic that is used to treat infections that are caused by bacteria. It is an antibiotic that is part of a group called fluoroquinolones. It stops bacteria from growing by stopping their growth. Norflox 400 is mostly used to treat urinary tract infections, but it can also be used to treat certain bacterial infections in the stomach, intestines, skin, and bones. It’s important to remember that you shouldn’t use this medicine for viral or fungal infections because it won’t work. People who take Norflox 400 should make sure to finish the full course of treatment, even if their symptoms get better. If they don’t, the infection could come back or get worse.

Is Norflox 400 safe?

Norflox 400 is a drug that can be used to treat a wide range of bacterial infections. It is safe and works well. It is part of a group of antibiotics called quinolones, which kill bacteria very well. The FDA has given permission for adults and children older than 18 months to use Norflox 400. Even though it is usually safe to take, it might make you feel sick or make you throw up or have diarrhea. If any of these symptoms start to happen, you should see a doctor right away. Before starting any new medicine, it’s best to talk to a doctor to make sure it’s right for you and that you know how to take it correctly and safely.

Can Norflox 400 be used for loose motion?

Usually, Norflox 400 is used to treat urinary tract infections, but it can also be given for skin or stomach infections that are caused by bacteria. But it’s not usually recommended as a treatment for loose motion because it doesn’t deal with the problem’s root cause. Instead, it might only help relieve stomach pain and cramps that come with loose stools. Norflox 400 may also interact badly with other drugs and cause problems if taken with them. So, it’s best to talk to a doctor before taking Norflox 400 for loose stools to avoid any risks or side effects that could happen.

Can I take Norflox 400 twice a day?

It is important to follow the dosage and length of treatment exactly as your doctor or pharmacist tells you to. Most of the time, Norflox 400 should only be taken once a day. However, it may be necessary to take it twice a day in some cases. Before taking this medicine twice a day, you should talk to your doctor to see if this is the best way to handle your situation. Before deciding if Norflox 400 can be taken twice a day, your doctor will need to know what kind of infection you are trying to treat, how bad the infection is, and what other medicines you may be taking.

Is Norflox 400 safe during breastfeeding?

Norflox 400 is generally safe to use while breastfeeding, but there are some risks that you should be aware of. Even though the amount of medicine that gets into breast milk is usually too small to hurt the baby, it is still important for mothers to talk to their doctor before taking any medicine while breastfeeding. Also, the long-term safety of Norflox 400 while breastfeeding hasn’t been proven, so it’s best to stay away from it if you can. If you have to take Norflox 400 while breastfeeding, your doctor will probably tell you to keep an eye on your baby for any signs of side effects or changes in behavior and talk to you about any possible risks.

Can I consume dairy products while taking Norflox 400 Tablet 10’s?

If you are taking Norflox 400 Tablet 10’s, you should talk to your doctor before deciding whether or not you can eat dairy products. Some medicines can react badly with dairy products, so it’s best to talk about the situation before making a choice. It is also important to read the information about Norflox 400 Tablet 10’s that your doctor and the company that makes it give you. This will give you a lot of information about possible side effects and drug interactions. Also, if you’re not sure how dairy products might interact with your medication, it’s best to talk to a doctor or nurse who can give you better advice.

Also Read

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Mpox is almost gone in the US, leaving lessons and mysteries in its wake | CNN



CNN
— 

The US public health emergency declaration for mpox, formerly known as monkeypox, ends Tuesday.

The outbreak, which once seemed to be spiraling out of control, has quietly wound down. The virus isn’t completely gone, but for more than a month, the average number of daily new cases reported to the US Centers for Disease Control and Prevention has hovered in the single digits, plummeting from an August peak of about 450 cases a day.

Still, the US led the world in cases during the 2022-23 outbreak. More than 30,000 people in the US have been diagnosed with mpox, including 23 who died.

Cases are also down across Europe, the Western Pacific and Asia but still rising in some South American countries, according to the latest data from the World Health Organization.

It wasn’t always a given that we’d get here. When mpox went global in 2022, doctors had too few doses of a new and unproven vaccine, an untested treatment, a dearth of diagnostic testing and a difficult line to walk in their messaging, which needed to be geared to an at-risk population that has been stigmatized and ignored in public health crises before.

Experts say the outbreak has taught the world a lot about this infection, which had only occasionally been seen outside Africa.

But even with so much learned, there are lingering mysteries too – like where this virus comes from and why it suddenly began to spread from the Central and West African countries where it’s usually found to more than 100 other nations.

Before May 2022, when clusters of people with unusual rashes began appearing in clinics in the UK and Europe, the country reporting the most cases of mpox was the Democratic Republic of Congo, or DRC.

There, cases have been steadily building since the 1970s, according to a study in the CDC’s Morbidity and Mortality Weekly Report.

In the DRC, people in rural villages depend on wild animals for meat. Many mpox infections there are thought to be the result of contact with an animal to which the virus has adapted; this animal host is not known but is assumed to be a rodent.

For years, experts who studied African outbreaks observed a phenomenon known as stuttering chains of transmission: “infections that managed to transmit themselves or be transmitted from person to person to a limited degree, a certain number of links in that chain of transmission, and then suddenly just aren’t able to sustain themselves in humans,” said Stephen Morse, an epidemiologist at Columbia University’s Mailman School of Public Health.

Informally, scientists kept track, and Morse says that for years, the record for links in a mpox chain was about four.

“Traditionally, it always burned itself out,” he said.

Then the chains started getting longer.

In 2017, Nigeria – which hadn’t had a confirmed case of mpox in more than four decades – suddenly saw a resurgence of the virus, with more than 200 cases reported that year.

“People have speculated maybe it was a change in the virus that allowed it to be made better-adapted to humans,” Morse said.

From 2018 through 2021, eight cases of mpox were reported outside Africa. All were in men ages 30 to 50, and all had traveled from Nigeria. Three reported that the rashes had started in their groin area. One went on to infect a health care provider. Another infected two family members.

This Nigerian outbreak helped experts realize that mpox could efficiently spread between people.

It also hinted that the infection could be sexually transmitted, but investigators couldn’t confirm this route of spread, possibly because of the stigma involved in sharing information about sexual contact.

In early May 2022, health officials in the UK began reporting confirmed cases of mpox. One of the people had recently traveled to Nigeria, but others had not, indicating that it was spreading in the community.

Later, other countries would report cases that had started even earlier, in April.

Investigators concluded that mpox had been silently spreading before they caught up to it.

In early summer, as US case numbers began to grow, the public health response bore some uncomfortable similarities to the early days of Covid-19. People with suspicious rashes complained that it was too hard to get tested because a limited supply was being rationed. Because the virus had so rarely appeared outside certain countries in Africa, most doctors weren’t sure how to recognize mpox or how to test for it and didn’t understand all its routes of spread.

A new vaccine was available, and the government had placed orders for it, but most of those doses weren’t in the United States. Beyond that, its efficacy against mpox had been studied only in animals, so no one knew whether it would actually work in humans.

There was an experimental treatment, Tpoxx, but it too was unproven, and doctors could get it only after filling out reams of paperwork required by the government for compassionate use.

Some just gave up.

“Tpoxx was hard to get,” said Dr. Jeffrey Klausner, a clinical professor of public health at the University of Southern California’s Keck School of Medicine.

“I was scrambling to find places that could prescribe it because my own institution just became a bureaucratic nightmare. So I basically would be referring people for treatment outside my own institution to be able to get monkeypox treatment,” he said.

Finally, in August, the federal government declared a public health emergency. This allowed federal agencies to access pots of money set aside for emergencies. It also allows the government to shift funds from one purpose to another to help cover costs of the response – and it helped raise awareness among doctors that mpox was something to watch for.

The government also set up a task force led by Robert Fenton, a logistics expert from the Federal Emergency Management Agency, and Dr. Demetre Daskalakis, director of the CDC’s Division of HIV and AIDS Research.

Daskalakis is openly gay and sex-positive, right down to his Instagram account, which mixes suit-and-tie shots from White House briefings with photos revealing his many tattoos.

“Dr. Daskalakis … really walks on water in most of the gay community, and then [Fenton is] a logistics expert, and I think that combination of leadership was the right answer,” Klausner said.

Early on, after the CDC identified men who have sex with men as being at highest risk of infection, officials warned of close physical contact, the kind that often happens with sexual activity. They also noted that people could be infected through contact with contaminated surfaces like sheets or towels.

But they stopped short of calling it a sexually transmitted infection, a move that some saw as calculated.

“In this outbreak, in this time and context to Europe, United States and Australia, was definitely sexually transmitted,” said Klausner, who points out that many men got rashes on their genitals and that infectious virus was cultured in semen.

Klausner believes vague descriptions about how the virus spread were intentional, in order to garner resources needed for the response.

“People felt that if they called it an STD from the get-go, it was going to create stigma, and because of the stigma of the type of sex that was occurring – oral sex, anal sex, anal sex between same-sex male partners – there may not have been the same kind of federal response,” Klausner said. “So it was actually a political calculation to garner the resources necessary to have a substantial response to be vague about how it spread.”

This ambiguity created room for misinformation and confusion, said Tony Hoang, executive director of Equality California, a nonprofit advocacy group for LGBTQ civil rights.

“I think there was a balancing dance of not wanting to create stigma, in terms of who is actually the highest rates of transmission without being forthright,” Hoang said.

Hoang’s group launched its own public information campaign, combining information from the CDC on HIV and mpox. The messaging stressed that sex was the risky behavior and made sure to explain that light brushes or touches weren’t likely to pass the infection, he said.

Klausner thinks the CDC could have done better on messaging.

“By giving vague, nonspecific information and making comments like ‘everyone’s potentially at risk’ or ‘there’s possible spread through sharing a bed, clothing or close dancing’ … that kind of dilutes the message, and people who engage in risk behavior that does put them at risk get confused, and they say ‘well, maybe this isn’t really a route of spread,’ ” he said.

In July and August, when the US was reporting hundreds of new mpox cases each day, health officials were worried that the virus might be here to stay.

“There were concerns that there would be ongoing transmission and that ongoing transmission would become endemic in the United States like other STIs: gonorrhea, chlamydia, syphilis. We have not seen that occur,” said Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention.

“We are now seeing three to four cases a day in the United States, and it continues to decline. And we see the possibility of getting to zero as real,” he said.

At the peak of the outbreak, officials scrambled to vaccinate the population at highest risk – men who have sex with men – in the hopes of limiting both severity of infections and transmission. But no one was sure whether this strategy would work.

The Jynneos vaccine was approved by the US Food and Drug Administration in 2019 to prevent monkeypox and smallpox in people at high risk of those infections.

At that time, the plan was to bank it in the Strategic National Stockpile as a countermeasure in case smallpox was weaponized. The approval for mpox, a virus closely related to smallpox, was tacked on because the US had seen a limited outbreak of these infections in 2003, tied to the importation of exotic rodents as pets.

Jynneos had passed safety tests in humans. In lab studies, it protected primates and mice from mpox infections. But researchers only learn how effective vaccines are during infectious disease outbreaks, and Jynneos has never been put through its paces during an outbreak.

“We were left, when this started, with that great unknown: Does this vaccine work? And is it safe in large numbers?” Mermin said.

Beyond those uncertainties, there wasn’t enough to go around, and infectious disease experts feared that a shortage of the vaccine might thwart any effort to stop the outbreak.

So public health officials announced a change in strategy: Instead of injecting a full dose under the skin, or subcutaneously, they would inject just one-fifth of that dose between the skin’s upper layers, or intradermally.

An early study in the trials of the vaccine had suggested that intradermal dosing could be effective, but it was a risk. Again, no one was sure this dose-sparing strategy would work.

Ultimately, all of these gambles appear to have paid off.

Early studies of vaccine effectiveness show that the Jynneos vaccine protected men from mpox infections. According to CDC data, people who were unvaccinated were almost 10 times as likely to be diagnosed with the infection as those who got the recommended two doses.

Men who had two doses were about 69% less likely, and men with a single dose were about 37% less likely, to have an mpox infection that needed medical attention compared with those who were unvaccinated, according to the CDC.

Mermin says studies have since showed that the vaccine worked well no matter if was given into the skin or under the skin – another win.

Still, the vaccine is almost certainly not the entire reason cases have plunged, simply because not enough people have gotten it. The CDC estimates that 2 million people in the United States are eligible for mpox vaccination. Mermin says that about 700,000 have had a first dose – about 36% of the eligible population.

So it’s unlikely that vaccination was the only reason for the steep decline in cases. CDC modeling suggests that behavior change may have played a substantial role, too.

In an online survey of men who have sex with men conducted in August, half of participants indicated that they had reduced their number of partners and one-time sexual encounters, behaviors that could cut the growth of new infections by 20% to 30%.

If that’s the case, some experts worry that the US could see monkeypox flare up again as the weather warms.

“The party season was during the summer, during the height of the outbreak, and we’re in the dead of winter. So there’s a possibility that behavior change may not able to be sustained,” said Gregg Gonsalves, an epidemiologist at the Yale School of Public Health.

Although we’re clearly in a much better position than we were last summer, he says, public health officials shouldn’t make this a “mission accomplished” moment.

“Now, put your foot on the accelerator. Let’s get the rest of these cases,” Gonsalves said.

Mermin says that’s exactly what the CDC intends to do. It isn’t finished with the response but intends to switch to “a ground game.”

“So much of our work in the next few months will be setting up structures so that getting vaccinated is easy,” he said.

Nearly 40% of mpox cases in the United States were diagnosed in people who also had HIV, Mermin said. So the CDC is going to make sure Jynneos vaccines are available as a routine part of care at HIV clinics and STI clinics that offer pre-exposure prophylaxis, or PrEP, for HIV.

Mermin said officials are also going to continue to go to LGBTQ festivals and events to offer on-site vaccinations.

Additionally, they’re going to study people who’ve been vaccinated and infected to see whether they remain immune – something else that’s still a big unknown.

Experts say that’s just one of many questions that need a closer look. Another is just how long the virus had been spreading outside Africa before the world noticed.

“We’re starting to see some data that suggests that asymptomatic infection and transmission is possible, and that certainly will change how we how we think about this virus and and risk,” said Anne Rimoin, an epidemiologist at the Fielding School of Public Health at UCLA.

When researchers at a sexual health clinic in Belgium rescreened more than 200 nasal and oral swabs they had taken in May 2022 to test for the STIs chlamydia and gonorrhea, they found positive mpox cases that had gone undiagnosed. Three of the people reported no symptoms, while another reported a painful rash, which was misdiagnosed as herpes. Their study was published in the journal Nature Medicine.

“Mild and asymptomatic infections may have indeed delayed the detection of the outbreak,” study author Christophe Van Dijck of the Laboratory of Medical Microbiology at the University of Antwerp in Belgium said in an email to CNN.

While researchers tackle those pursuits, advocacy groups say they aren’t ready to relax.

Hoang says Equality California is pushing the CDC to address continuing racial disparities in mpox vaccination and treatment, particularly in rural areas.

He’s not worried that gay men will drop their guard now that the emergency has expired..

“We’ve learned that we have to take health into our own hands, and I do think that we will remain vigilant as a community for this outbreak and future outbreaks,” Hoang said.



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Children’s mental health tops list of parent worries, survey finds | CNN



CNN
— 

Forty percent of US parents are “extremely” or “very” worried that their children will struggle with anxiety or depression at some point, a new survey finds.

The Pew Research Center report said mental health was the greatest concern among parents, followed by bullying, which worries 35% of parents. These concerns trumped fears of kidnapping, dangers of drugs and alcohol, teen pregnancy and getting into trouble with the police.

Concerns varied by race, ethnicity and income level, with roughly 4 in 10 Latino and low-income parents and 3 in 10 Black parents saying they are extremely or very worried that their children could be shot, compared with about 1 in 10 high-income or White parents.

Nearly two-thirds of the respondents said that being a parent has been at least somewhat harder than they expected, about 41% say that being a parent is tiring, and 29% say it is stressful all or most of the time.

The report captured the perceptions of a nationally representative sample of 3,757 US parents whose children were younger than 18 in 2022.

Experts say mental health issues among children and adolescents have skyrocketed in recent years.

“I would say over the last 10 years, since I’ve been practicing as a general pediatrician, I have seen a shift both in the amount of patients and of all ages dealing with anxiety and depression. And their parents being concerned about this is a key issue,” said Dr. Katherine Williamson, a pediatrician and spokesperson for the American Academy of Pediatrics. “Even before the pandemic, we were seeing skyrocketing numbers of kids and adolescents dealing with mental health issues, and that has increased exponentially since the pandemic.”

Suicide became the second leading cause of death among children 10 to 14 during the Covid-19 pandemic, according to the US Centers for Disease Control and Prevention. Mental health-related emergency room visits among adolescents 5 to 11 and 12 to 17 also jumped 24% and 31%, respectively.

Many parents feel helpless when their children have mental health issues because they don’t feel equipped to offer support in this area.

“They are unable to relieve [mental health issues] and address that as they could if they were struggling with their grades or other things that seem more traditional to for kids to struggle with,” said Allen Sabey, a family therapist at the Family Institute at Northwestern University.

Parents trying to “work out and look at and connect with their own feelings will give them important information about what feels off or OK for their kid,” he said.

When it comes to anxiety and depression in children, pediatricians say, parents can watch for signs like decreased interest or pleasure in things they previously enjoyed, poor self-esteem and changes in mood, appetite or sleep.

Experts also say parents should consider the amount and content of social media their child consumes, as research has found that it can have negative effects on their mental health.

But, they say, having more parents recognize the importance of mental health in children is a step in the right direction.

“I have always felt there’s been so much resistance to seeking care for mental health among the population that I serve. And I am actually happy that since the Covid pandemic, at least people now are recognizing this as a very key and important health need,” said Dr. Maggi Smeal, a pediatrician at Stanford Medicine Children’s Health.

Smeal hopes that “all people that are interacting with children can be aware of these issues and feel empowered to identify and advocate for these children, to tell them to go to their primary care provider and have an assessment just like you do if your kid has a cough or a fever or ear infection.”

The number of parents concerned about gun violence reflects the fact that guns are the leading cause of death among children in the US, research has showed. From 2019 to 2020, the rate of firearm-related deaths increased 29.5% – more than twice the increase as in the general population.

“Gun violence is a real risk to our kids today. And that is both being killed by somebody else as well as suicide in the face of the mental health issues that we’re seeing today,” Williamson said.

The survey found that Black, Hispanic and lower-income parents were most likely to be concerned about gun violence, a finding that’s consistent with the communities most affected. Research has shown that from 2018 to 2021, the rate of firearm-related deaths doubled among Black youth and increased 50% among Hispanic youth. Another study found that children living in low-income areas are at higher risk of firearm-related death.

Direct and indirect exposure to gun violence can contribute to mental health problems.

“Even if they hear gunshots in their community, they hear adults talking, there’s all different ways that children are traumatized and victimized by gun violence. And what we see is all the symptoms of anxiety in even the youngest of children. We see children with somatic complaints – stomachaches, headaches. They have post-traumatic stress disorder,” Smeal said.

Most of the parents in the survey said parenting is harder than they expected, and that they feel judgment from various sources.

“The findings of this of this report were, as a pediatrician and a parent, just exactly what you would expect. Parenting is the hardest thing you’ll ever do, and there are very high levels of stress and fatigue, especially in the parents of young children,” Smeal said.

One of the best things parents can do is lean on fellow parents, experts say.

“The main challenge for parents is our siloed independent nature sometimes, and so we want to find people who we trust and kind of work towards being more vulnerable and open with,” Sabey said. “To where it’s like not just you and your kid, but it’s a kind of a group of people caring and working together.”

Pediatricians emphasize that no parent is perfect and that the most important thing you can do is to just be there for your child.

“We know that the best chance for a child to be successful and happy is for them to have at least one person in their life who believes in them and advocates for them. So I think it’s important for parents to know that there’s no such thing as a perfect parent, because we are all human, and humans are imperfect by nature, but that is OK,” Williamson said.

A parent’s job is to “really make sure that they know how important they are and they have a voice in this world,” she said. “Every child will have their own unique struggles, whether it is academically, emotionally, physically. Our job is to help them with the areas [where] they struggle, but even more, help them recognize their strengths.”

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COVID Emergency Orders Ending: What’s Next?

Feb. 1, 2023 – It’s the end of an era. The Biden administration announced Monday that it will be ending the twin COVID-19 emergency declarations, marking a major change in the 3-year-old pandemic.  .

The orders spanned two presidencies. The Trump administration’s Health and Human Services Secretary Alex Azar issued a public health emergency in January 2020. Then-President Donald Trump declared the COVID-19 pandemic a national emergency 2 months later. Both emergency declarations – which remained in effect under President Joe Biden – are set to expire May 11. 

Read on for an overview of how the end of the public health emergency will trigger multiple federal policy changes. 

Changes That Affect Everyone

  • There will be cost-sharing changes for COVID-19 vaccines, testing, and certain treatments. One hundred-percent coverage for COVID testing, including free at-home tests, will expire May 11. 
  • Telemedicine cannot be used to prescribe controlled substances after May 11, 2023.
  • Enhanced federal funding will be phased down through Dec. 31, 2023. This extends the time states must receive federally matched funds for COVID-related services and products, through the Consolidated Appropriations Act of 2023Otherwise, this would have expired June 30, 2023.
  • Emergency use authorizations  for COVID-19 treatments and vaccinations will not be affected and/or end on May 11.

Changes That Affect People With Private Health Insurance

  • Many will likely see higher costs for COVID-19 tests, as free testing expires and cost-sharing begins in the coming months.
  • COVID-19 vaccinations and boosters will continue to be covered until the federal government’s vaccination supply is depleted. If that happens, you will need an in-network provider.
  • You will still have access to COVID-19 treatments – but that could change when the federal supply dwindles.

Changes That Affect Medicare Recipients

  • Medicare telehealth flexibilities will be extended  through Dec. 31, 2024, regardless of public health emergency status. This means people can access telehealth services from anywhere, not just rural areas; can use a smartphone for telehealth; and can access telehealth in their homes. 
  • Medicare cost-sharing for testing and treatments will expire May 11, except for oral antivirals. 

Changes That Affect Medicaid/CHIP Recipients

  • Medicaid and Children’s Health Insurance Program (CHIP) recipients will continue to receive approved vaccinations free of charge, but testing and treatment without cost-sharing will expire during the third quarter of 2024.
  • The Medicaid continuous enrollment provision will be separated from the public health emergency, and continuous enrollment will end March 31, 2023.

Changes That Affect Uninsured People

  • The uninsured will no longer have access to 100% coverage for these products and services (free COVID-19 treatments, vaccines, and testing). 

Changes That Affect Health Care Providers

  • There will be changes to how much providers get paid for diagnosing people with COVID-19, ending the enhanced Inpatient Prospective Payment System reimbursement rate, as of May 11, 2023.
  • Health Insurance Portability and Accountability Act (HIPAA) potential penalty waivers will end. This allows providers to communicate with patients through telehealth on a smartphone, for example, without violating privacy laws and incurring penalties.

What the Experts Are Saying 

WebMD asked several health experts for their thoughts on ending the emergency health declarations for COVID, and what effects this could have. Many expressed concerns about the timing of the ending, saying that the move could limit access to COVID-related treatments. Others said the move was inevitable but raised concerns about federal guidance related to the decision. 

Q: Do you agree with the timing of the end to the emergency order?

A: Robert Atmar, MD, a professor of infectious diseases at Baylor College of Medicine in Houston: “A lead time to prepare and anticipate these consequences may ease the transition, compared to an abrupt declaration that ends the declaration.” 

A: Georges C. Benjamin, MD, executive director of the American Public Health Association: “I think it’s time to do so. It has to be done in a great, thoughtful, and organized way because we’ve attached so many different things to this public health emergency. It’s going to take time for the system to adapt. CDC data collection most likely will continue. People are used to reporting now. The CDC needs to give guidance to the states so that we’re clear about what we’re reporting, what we’re not. If we did that abruptly, it would just be a mess.”

A: Bruce Farber, MD, chief public health and epidemiology officer at Northwell Health in Manhasset, NY:  “I would have hoped to see it delayed.”

A: Steven Newmark, JD, chief legal officer and director of policy at the Global Healthy Living Foundation: “While we understand that an emergency cannot last forever, we hope that expanded services such as free vaccination, promotion of widespread vaccination, increased use of pharmacists to administer vaccines, telehealth availability and reimbursement, flexibility in work-from-home opportunities, and more continues. Access to equitable health care should never backtrack or be reduced.”

Q: What will the end of free COVID vaccinations and free testing mean? 

A: Farber: “There will likely be a decrease in vaccinations and testing.The vaccination rates are very low to begin with, and this will likely lower it further.”

A: Atmar: “I think it will mean that fewer people will get tested and vaccinated,” which “could lead to increased transmission, although wastewater testing suggests that there is a lot of unrecognized infection already occurring.” 

A: Benjamin: “That is a big concern. It means that for people, particularly for people who are uninsured and underinsured, we’ve got to make sure they have access to those. There’s a lot of discussion and debate about what the cost of those tests and vaccines will be, and it looks like the companies are going to impose very steep, increasing costs.”

Q: How will this affect higher-risk populations, like people with weakened immune systems? 

A: Farber: “Without monoclonals [drugs to treat COVID] and free Paxlovid,” people with weakened immune systems  “may be undertreated.”

A: Atmar: “The implications of ongoing widespread virus transmission are that immunocompromised individuals may be more likely to be exposed and infected and to suffer the consequences of such infection, including severe illness. However, to a certain degree, this may already be happening. We are still seeing about 500 deaths/day, primarily in persons at highest risk of severe disease.”

A: Benjamin: “People who have good insurance, can afford to get immunized, and have good relations with practitioners probably will continue to be covered. But lower-income individuals and people who really can’t afford to get tested or get immunized would likely become under-immunized and more infected. 

“So even though the federal emergency declaration will go away, I’m hoping that the federal government will continue to encourage all of us to emphasize those populations at the highest risk – those with chronic disease and those who are immunocompromised.”

A: Newmark: “People who are immunocompromised by their chronic illness or the medicines they take to treat acute or chronic conditions remain at higher risk for COVID-19 and its serious complications. The administration needs to support continued development of effective treatments and updated vaccines to protect the individual and public health. We’re also concerned that increased health care services – such as vaccination or telehealth – may fall back to pre-pandemic levels while the burden of protection, such as masking, may fall to chronic disease patients, alone, which adds to the burden of living with disease.”

Q: What effect will ending Medicaid expansion money have? 

A: Benjamin: Anywhere from 16 to 20 million people are going to lose in coverage. I’m hoping that states will look at their experience over these last 2 years or so and come to the decision that there were improvements in healthier populations.

Q: Will this have any effect on how the public perceives the pandemic? 

A: Farber: “It is likely to give the impression that COVID is gone, which clearly is not the case.”

A: Benjamin: “It’ll be another argument by some that the pandemic is over. People should think about this as kind of like a hurricane. A hurricane comes through and tragically tears up communities, and we have an emergency during that time. But then we have to go through a period of recovery. I’m hoping people will realize that even though the public health emergencies have gone away, that we still need to go through a period of transition … and that means that they still need to protect themselves, get vaccinated, and wear a mask when appropriate.”

A: Atmar: “There needs to be messaging that while we are transitioning away from emergency management of COVID-19, it is still a significant public health concern.”

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