Friday, June 21, 2024

Bird flu continues to infect cattle, but national testing for humans is stymied; only about 45 people have been tested

So far, H5N1 has not spread from human to human.

Despite studies showing Americans have little to zero immunity to H5N1, the strain of bird flu that has infected more than 100 herds of dairy cows and at least three farm employees, the Centers for Disease Control and the Food and Drug Administration are distributing bird flu tests at a snail's pace. "The U.S. has tested only about 45 people across the country," reports Amy Maxmen of KFF Health News. Without more testing, knowing how many dairy workers are infected is impossible. "A lack of testing means the country might not notice if the virus begins to spread between people — the gateway to another pandemic."

The CDC has around 1 million tests available, but the channels for getting the tests aren't the norm. Nirav Shah, principal deputy director of the CDC, "is concerned because the CDC and public health labs aren't generally where doctors order tests from. That job tends to be done by major clinical laboratories run by companies and universities, which lack authorization for bird flu testing," Maxmen explains. "Researchers cite testing failures as a key reason the U.S. fared so poorly with Covid."

Testing is critical to stemming a pandemic, but the U.S. needs to include clinical laboratories in the testing supply chain. Alex Greninger, assistant director of the University of Washington Medicine Clinical Virology Laboratory, told KFF News, "Clinical labs are part of the nation's public health system. . . . Pull us into the game. We're stuck on the bench."

Meanwhile, H5N1 will continue to evolve, and the virus could begin to spread from person to person vs. cow to person, which is yet another reason "to involve clinical laboratories. . . so the nation can ramp up testing," Maxmen writes. "The fastest way to get clinical labs involved, Greninger said, is to allow them to use a test the FDA has already authorized: the CDC's bird flu test. . . . The CDC opened up that possibility by offering royalty-free licenses for components of its bird flu tests to accredited labs."

While several commercial labs requested those licenses, getting FDA approval has hampered progress. "The CDC has given seven companies licenses for its tests — although none have been cleared to use them by the FDA," Maxmen reports. "Greninger said the delays and confusion are reminiscent of the early months of Covid, when federal agencies prioritized caution over speed. Test accuracy is important, he said, but excessive vetting can cause harm in a fast-moving outbreak like this one."

To learn more about the evolution and transfer of viral zoonotic diseases, click here

Drinking raw milk might have a cult following, but it contains harmful pathogens that make people sick

Pasteurized cow's milk is safe and nutritious
to consume. (Photo by Suvrajit, Unsplash)

Advocates may tout raw milk as nutritionally superior to pasteurized milk, but little research supports their claim. The risks involved in raw milk consumption outweigh any possible benefits, write Juan Silva, Joel Komakech and Mandy Conrad for The Conversation, a journalistic platform for academics. "Despite an ongoing outbreak of bird flu in dairy cows, the popularity of raw milk has only risen. . . . Since cattle can shed viral material into their milk, not only can pathogens end up in milk, but at least three farmworkers reportedly contracted H5N1. . . . Farmworkers can get sick by handling infected animals or their byproducts, such as raw milk." 

Below are the authors' slightly edited answers to questions about pasteurized and raw milk. 

What is pasteurization? Does it destroy nutrients?
Pasteurization uses heat to kill harmful microorganisms, including bacteria, viruses and parasites. The process "reduces the total number of microorganisms in the product and also inactivates enzymes that could contribute to spoilage. . . . The taste, nutritional value and quality of pasteurized products aren’t significantly affected by the process."

Is raw milk healthier? No. There is little science behind this idea:Can consuming raw milk make someone sick? Yes. Unpasteurized milk can contain harmful microorganisms: "Raw milk has been associated with hundreds of foodborne disease outbreaks. . . . A number of outbreaks and recalls related to pathogens in raw milk have already occurred in 2024. In all cases, pathogens in the raw milk that cause human diseases were directly responsible for these illnesses. . . . Some illnesses from the pathogens in raw milk can have serious long-term effects, including paralysis, kidney failure and death."

Is eating products such as cheese or yogurt made with raw milk safe?
No. "Only products that undergo a process to inhibit or kill harmful microorganisms may be safe enough to be made from unpasteurized milk. However, the potential for cross-contamination of raw and cooked food as well as the survival of pathogens from inadequate processing is high when products are made with raw milk."

Can pasteurized milk cause illness? "The few reported outbreaks associated with pasteurized milk can be traced to contamination after pasteurization. When handled properly, pasteurized milk is a very safe product."

Final thoughts? Drinking raw milk that contains H5N1 can make a person sick and help the virus evolve into something more dangerous. "People who contract bird flu from raw milk run the risk of transmitting it to other people or animals by giving the virus a chance to adapt and improve its ability to spread between people. This increases the risk of more widespread disease outbreaks."

An EMS system in Letcher County, Kentucky, could serve as a warning for other struggling rural emergency services

When rural fire departments struggle to make ends meet, taking out a loan to cover costs may make sense. But as emergency services in Letcher County, Kentucky, discovered, that can lead to serious problems.

"Letcher Emergency Medical Service is deep in debt and hemorrhaging money, with some employees saying they have missed paydays and a Chicago area lender with a history of lawsuits against it threatening to repossess everything the service owns," reports Sam Adams of The Mountain Eagle in Whitesburg, Kentucky. "Employees say most if not all of those who missed checks have now been paid, but some have left the ambulance service for other pursuits, worried there won't be any money to pay them."

A natural disaster followed by missteps that hurt Medicaid reimbursements is partly blamed for Letcher EMS's financial woes. "After the 2022 flood, Letcher EMS changed its mailing address from the destroyed firehouse and ambulance station to a board member's home," Adams explains. "When Medicaid figured out it was a residential address, it stopped sending checks. That problem ballooned into another one. No checks from Medicaid, no checks to employees and no money to pay debts."

Shawn Gilley, executive director of the service, agreed that the "service has had financial difficulties, but said he has partnered with an unnamed financial backer to pay off debts and try to keep the service open," Adams reports. "Beginning earlier this year, a man identifying himself as Paul Graver of First Government Lease in Northfield, Illinois, began calling The Mountain Eagle asking for information about Letcher Volunteer Fire Department and Kingscreek Volunteer Fire Department and trying to get the newspaper to write a story saying Letcher owed him money."

Grave "listed 11 ambulances and fire trucks as being subject to repossession in a phone call with the newspaper."

While Letcher EMS leadership admitted to borrowing from First Government Lease, it's difficult to say how much is owed or what equipment could be repossessed. "Gilley acknowledges that he borrowed the money. . .. Both [Gilley and Fire Chief Wallace Bolling] have said that First Government has no claim on the fire trucks," Adams reports. 

Letcher EMS is one of several EMS organizations that are financially entangled with First Government Lease. "Court records show fire departments from Warfield, Ky., Pigeon Roost, Ky., Pinecrest, Tenn., Clinton, La., Alexander, Ark., Scott County, Ark., and Illinois" are involved with the company, Adams writes. 

East Palestine's controlled chemical burn in 2023 spread pollutants to at least 16 states, new study shows

Norfolk Southern's controlled burn spread chemicals
to surrounding states. (Adobe Stock photo)
In February 2023, a Norfolk Southern train derailed in East Palestine, Ohio, leading to an explosion and a toxic vinyl chloride spill. The subsequent controlled burn, which was intended to prevent further explosions, created a plume that spread air pollutants to at least 16 states, according to research published in the journal Environmental Research Letters, Zack Budryk of The Hill reports. The cloud "reached as far north as New England . . . according to researchers from the University of Wisconsin. They found the overall radius spanned more than 540,000 square miles."

Researchers studied soil samples before and immediately after the spill to evaluate the burn's reach. "They found evidence of high chloride concentration in states including Virginia, South Carolina and Wisconsin, as well as particularly high concentrations near Canada's border with New York, an area downwind of the crash site," Budryk explains. 

The chemical plume may have also changed precipitation pH levels in surrounding areas. "Researchers found unprecedentedly high, or more basic, pH values across a broad belt in the Midwest and Northeast," Budryk reports. "They also found elevated alkaline and earth metals levels, in some cases within the 99th percentile of measurements for the last decade."

The study's lead researcher, David Gay, said, "All of these pollutants are important in the environment because their accumulation has an impact on the Earth's aquatic and terrestrial environments in many ways."

In March 2024, the chair of the National Transportation Safety Board, Jennifer Homendy, testified at a Senate hearing that the deliberate burn was not necessary because there was no risk of additional explosions.

A simple tool can help identify and treat addiction while creating data for future programs and policies

Using evidence-based addiction screening tools can help
current and future patients. (Adobe Stock photo)
Treating opioid addiction requires practitioners to use multifaceted approaches, and adding process for regularly screening for Opioid Use Disorder is a small tool that can make big difference in patient intervention and data-driven policy, reports Kaitlyn Levinso of Route Fifty. "An under-utilized 'starting point for evaluating care is measuring what portion of the population is diagnosed with OUD. Knowing this information will help policymakers understand how well treatment systems identify people with OUD, which is the first step in getting them needed care,' said Alexandra Duncan, project director of Pew Charitable Trust's substance use prevention and treatment initiative."

Only two states are measuring for OUD as a part of their regular assessment tools for Medicaid patients. "Indiana and West Virginia have leveraged the Screening, Brief Intervention and Referral to Treatment, or SBIRT, model, an evidence-based approach for talking with patients about the use and misuse of drugs and alcohol," Levinso writes. "It helps health care providers flag concerning substance use behaviors in Medicaid patients and intervene with necessary resources and services to aid patient prevention or treatment and recovery of SUDs."

The Indiana SBIRT program provides practitioners with alcohol and drug abuse screening tools, Levinso reports. They also use "the CRAFFT tool, which helps identify substance use and associated behaviors in youth and adolescents, among others. The SBIRT model has been expanded for use at community health centers, federally qualified health centers and rural health centers in Indiana."

As states receive opioid settlement funds distributions, it could be an opportune time to focus on screening as a relatively inexpensive way to combat OUD. Duncan told Levinso: "These data will provide states with crucial information on allocating scarce resources more effectively, whether through increasing SUD screening or other data-driven treatment system improvements."

Tuesday, June 18, 2024

Where tornadoes develop has shifted more to the East; Southern and Midwestern states are now at greater risk.

With the right elements, tornadoes are possible
in all 50 states. (Adobe Stock photo)
Over the past 50 years, where tornadoes develop has shifted from the Great Plain's infamous "Tornado Alley" to Midwestern and Southeastern states, a new study published in the Journal of Applied Meteorology and Climatology finds. The recent research "confirms the legitimacy of this shift and highlights a change in when tornadoes are likely to occur," reports Matthew Cappucci of The Washington Post. "The results spell problems for residents of the Midwest and Southeast, where a higher population density and a greater prevalence of mobile homes lead to a more serious vulnerability to tornadoes."

Researchers don't know why tornado prevalence has shifted East, but their findings show an increased tornado risk across the South, with lower risk in the Plains. "Researchers not involved in the study said the reported trends are convincing but pointed out some limitations in the analysis," Cappucci explains. Karen Kosiba, a tornado researcher at the Center for Severe Weather Research, said "the greater population density in the Southeast compared with that in the Plains exposes it to more damage. That may be part of why twisters in Alabama and Mississippi appear to be on the ground for longer compared with their Plains counterparts."

The study confirms what many social scientists and meteorologists had feared. "The South, where tornado vulnerability is particularly high because of its dense population and concentration of mobile homes, may now be subject to an even greater risk," Cappucci reports. "It remains unclear whether this apparent eastward shift in tornado incidence is something that will reverse or become more pronounced. . . . Researchers hesitate to say what will happen next."

Victor Gensini, a leading researcher on tornado trends in the United States, "isn't persuaded that the shift is enduring," Cappucci adds. "Because twister hot spots jump around so much, Gensini and other researchers have expressed a general dislike for the term, 'Tornado Alley.'" Gensini told him: "We need to stop using tornado alley to describe a specific region. The reality is that tornadoes can occur in all 50 states on any calendar day if the ingredients are present."

Reporting on tornado protocols and resources can help your community be safer should a twister touch down

Tornadoes in Pender, Nebraska, pop. 1,100, on June 16, 2014.
(Photo by Brent Koops/NOAA, Flickr CC via SEJ)
More than 100 tornadoes touched down across the Great Plains and Midwest in April, leaving swaths of wreckage and some fatalities in their wake.

With continued severe weather still possible, journalists can help keep their communities informed on tornado protocols and what to do if a touchdown is imminent. "With preparedness, many fatalities and injuries can be prevented or minimized," reports Joseph A. Davis for the Society of Environmental Journalists. "Public awareness of how to improve safety can be made better with media coverage." The best time for journalists to ask themselves what they can do to ensure their community is ready should disaster strike is before an emergency. Below are some edited story tips from Davis:

  • What is the historical record of tornadoes in your state? What are the most recent trends? Ask researchers at local universities.
  • Does your community have Doppler radar coverage? Researchers have found "radar gaps," which leave some communities less protected.
  • Ask local meteorologists how they get their tornado information.
  • How (and how well) does the emergency notification system work in your area? Who runs it? Who cooperates? What technology platform does it use? Is it effective at warning people? Is there a big siren? How does it work in remote areas?
  • Is your community hooked into the federal Emergency Alert System? Does it have "reverse 911"? Do people know how to get alerts on their phones?
  • Do people in your community have tornado-safe shelters such as storm cellars? Do people typically have basements?
  • Does your community have mobile home parks, nursing homes, schools or daycare facilities? Talk to the managers and residents of these especially vulnerable facilities about whether/how they are prepared to handle tornado emergencies.

Weather reporting tools:

Standard tornado-preparedness advice: The Federal Emergency Management Agency, National Weather Service, and the American Red Cross provide many easy-to-use summaries of good advice on safety in tornadoes.

The U.S. is in the middle of a 'silver tsunami' as the country is becoming 'the land of the senior citizen'

As America ages, more citizens will require unique
care from multiple sectors. (Adobe Stock photo)
As millions of Americans enter their mid-60s, the country is fast becoming "the land of the senior citizen," where government agencies and systems are busy working to accommodate an aging population. "More Americans are about to be 65 years old than ever before. A record number will hit the milestone this year—about 4.1 million. But it's just one of many waves in the 'silver tsunami,' a metaphor often used to describe the aging of America," reports Susan Miller of Route Fifty. "Since 2011, 10,000 Americans have been turning 65 every day, a trend that the Pew Research Center says will continue through 2030." The need for aging accommodations for rural residents may be particularly needed since its population already skews older.

As the number of older residents increases throughout the United States, health care, housing and transportation systems will need additional resources to meet senior needs. To help states support the transition, the Department of Health and Human Services issued a report outlining supportive measures for aging Americans. Miller explains, "It details the web of services an aging society will need beyond financial security, safe housing and adequate health care. . . . The framework comes as several states have also started planning for their aging populations."

Some states have already created programs aimed at helping aging Americans. "New Jersey released its 'age-friendly blueprint,' which provides strategies and best practices to improve the state’s communities for older adults and enable people to remain in their homes and communities as they age," Miller reports. "The state is also putting some funding behind its plan. . . . [Its] Human Services Department is dedicating $5.5 million to launch an age-friendly community grant program later this year."

Other states are developing 10-year plans, also known as "multisector plans for aging," which outline "restructuring state and local government to address the needs of older adult populations," Miller writes. "According to the federal strategic framework, four states have legislation or an executive order to develop an MPA, and seven are in varying stages of implementing plans."

When relatives want to age at home, family caretakers struggle with two jobs. It's more difficult for rural residents.

Responsibility for aging family members can take a toll
on home caretakers. (Adobe Stock photo)
A growing number of Americans are working two jobs: one to pay the bills and a second unpaid job caring for an aging family member. "The double shift can come at a career cost. Caregivers who are also working full-time report turning down promotions or seeking less-demanding assignments," reports Clare Ansberry of The Wall Street Journal. "Some switch companies or say they've had to choose care duties over their careers." Even if the older relative still lives independently, the juggling still can be taxing.

In rural communities, aging residents prefer to have family members care for them, but they have additional challenges. "Like older adults across the country, rural seniors tend to want to age in their communities, amid familiar people and places," report Martha Hostetter and Sarah Klein for The Commonwealth Fund. "But with fewer health care providers, fewer professional caregivers, and fewer young people than in urban areas, rural communities struggle to care for aging residents."

Both rural and urban families struggle to balance elderly care with life's other duties. "An estimated 29 million workers, from senior managers to retail clerks, work while also caring for an adult family member, according to research by AARP and the National Alliance for Caregiving," Ansberry writes. "Care demands on workers are growing because people are living longer with chronic illness. . . . A large share of people want to age at home but need lots of help from family members to do so."

Many companies don't offer eldercare options, so employees often have to sandwich in a loved one's medical appointments during breaks and use vacation time. "Some working caregivers have been called in to talk with their bosses about performance. Others say they haven't used a vacation day for an actual vacation in years," Ansberry reports. "Tensions can run high between employees and employers over caregiving."

Rural communities are working on ways to help residents get to appointments and social events without solely relying on family members. "St. John's United, a member of the Rural Aging Action Network, provides senior housing in and around Billings, Montana," Hostetter and Klein report. "In 2019, St. John's launched 'At Home' services for clients living in their own homes. This monthly subscription service is offered on a sliding scale and provides seniors with rides to medical appointments, help with household tasks, social outings, and other supports."

For information on aging in place and what creative solutions and resources exist or can be cultivated, click here

Exploring and celebrating rural America with The Rural Assembly's "Rural Everywhere" event on Aug. 1

Amid election tensions, negative news and an inflationary economy, it can be important to focus on the good things America has going — especially in rural places.

To that end, The Rural Assembly is hosting a free virtual gathering, Rural Assembly Everywhere 2024: Nurturing Thriving Communities, on Thursday, Aug. 1, from 1 to 3 p.m., E.T. While the session is open to anyone, it is specially designed for rural advocates and the rural-curious listeners and leaders.

To register, click here.

The event will unpack the essence of rural life and examine how rural people can enrich their communities. 

To help others join the conversation, The Rural Assembly is seeking rural stories or video submissions that showcase the nurturing and thriving spirit within rural individuals, communities or organizations. The Assembly also will host a community chat with questions and discussions before the event.

For more information on submissions or joining the conversation, click here.