Health experts say that at least 70 percent of the country needs to be vaccinated

Health experts say that at least 70 percent of the country needs to be vaccinated to ensure herd immunity and completely eradicate the epidemic that killed more than 300,000 Americans. National polls show a growing number of Americans are willing to get a coronavirus vaccine, but some populations, especially Black and Latinos, are reticent. Federal officials are releasing a 95 percent effective vaccine from Pfizer and BioNTech, and on Friday the Food and Drug Administration cleared a second vaccine from Moderna that was almost equally effective in preventing COVID-19 cases. Some people have quoted what the Trump administration calls politicizing a vaccine, despite officials’ denial that policy plays a role in rapid development.

These groups have been reinforced by the coronavirus epidemic, which both eroded trust in traditional institutions and left millions of people with few options for social interaction beyond the internet. Paul Barrett, deputy director of the Stern Center for Business and Human Rights at New York University, told The Hill that the biggest source of coronavirus vaccine disinformation is “the transformation of long-standing anti-vaccine activists. “There is a considerable foundation that existed before anyone heard of COVID-19,” he explained. The same mistrust in institutions that have revived anti-vaccination communities has also led thousands to conspiracy theories.

QAnon, whose followers believe President Trump is trying to expose a dark elite group running child sex trafficking gangs in the media and government, has had a clear benefit of shifting towards this conspiratorial notion. The growth of QAnon may make it difficult to achieve herd immunity as its supporters increase the lies about COVID-19 vaccines, as it is applied with a microchip to control and monitor citizens or Bill Gates is responsible for the coronavirus. “These conspiracy theories are wrong, but I am very concerned that they could enter the mainstream. And if we have people who will not be vaccinated, this makes it much more difficult for us to achieve herd immunity through vaccination and therefore end the epidemic, ”said Leana Wen.

A recent Kaiser Family Foundation survey revealed that 42 percent of Republicans would likely not be or definitely would not be vaccinated against the coronavirus. Vice President Pence and his wife Karen were vaccinated live on television Friday in an attempt to bridge the partisan gap. “Today there are millions of Americans whose most trusted envoy is President Trump. And that’s why it’s really important for President Trump to speak to correct misinformation, ”Wen said.

Trump has repeatedly raised doubts about the seriousness of the epidemic and mocked his use of masks to limit its spread. According to a report from Cornell University, 38 percent of all articles published in January that contained misinformation about the coronavirus outbreak, lawmakers in Congress supporting Trump also said things that could deter vaccine use. Ken Buck said in a Fox Business interview Friday morning that he would not receive the vaccine because he was “more concerned with the illness about the side effects of the vaccine”.

His office later announced that Buck believes people at risk should “get the vaccine immediately”. Right-wing media has also been the driving force of coronavirus misinformation. Beyond restricting current coronavirus misinformation, Barrett said platforms should work to increase information about vaccines from trusted sources. Still, healthcare professionals said tech companies can only go so far.

Reference

Health officials, social media scramble to fight vaccine misinformation. https://thehill.com/policy/technology/530943-health-officials-social-media-scramble-to-fight-vaccine-misinformation

CDC Report: Drug Costs Linking to Nonadherence in People With HIV

As stated by the US Centers for Disease Control and Prevention (CDC), Americans pay 14% of their prescription drug costs away from pocket each year, as well as having the United States spends more per capita on pharmaceuticals compared to any high-income country in the world. High expenses help contribute to some magnitude of nonadherence among patients generally. Little information exists about the impact of financial barriers on adherence for those living with HIV specifically.

A study presented in the CDC’s Morbidity and Mortality Weekly Report indicates from 2016 to 17, 14% of individuals coping with HIV have used a drug-cost saving strategy, and 7% have found cost saving-related nonadherence.

The CDC’s Medical Monitoring Project analyzed national representative surveillance data on medical care, behaviors, and clinical outcomes among adults with HIV infection. Data were collected through medical record abstraction and also in-person and telephone interviews between June 2016-May 2017. Investigators weighted data for unequal selection probabilities and nonresponse.

Assembling data from 3948 people taking pharmaceuticals, the prevalence of prescription drug cost-saving strategies among those existing with HIV was estimated overall and with sociodemographic characteristics. Investigators also assessed differences in clinical outcomes between those that did and did not need cost-saving related nonadherence.

Questions pertained to 6 different kinds of cost-saving strategies. Patients reported whether they had asked a clinician for getting a lower-cost medication, used alternative therapies, bought over-the-counter drugs from another country, skipped doses, taken less medication, or delayed filling a prescription owing to cost. Those interviewed were asked concerning over-the-counter drugs, not solely antiretrovirals.

Cost-saving nonadherence was qualified by having used the cost-saving strategies of skipping doses, taking less medication, or delaying a prescription as a consequence of cost.

Care engagement and viral suppression were abstracted from medical records. Individuals interviewed were also asked if they needed but had not received medication beginning with the Ryan White AIDS Drug Assistance Program (ADAP) to enquire unmet needs.

Considering the approximately 14% of USA citizens with HIV who had used a medication cost-saving strategy, 4% had skipped doses, 4% took less medicine, and 6% had delayed a prescription. Within the categories found with him not considered directly nonadherent, 9% had asked clinicians for lower-cost medicine, 1% had bought medication from another country, and 2% used alternative medicine.

Household income above the poverty line was associated with nonadherence simply because of prescription drug costs, with 8.3% reporting nonadherence above the poverty line ($12,490 since 2019), concerning 5.3% below the poverty line.

“Persons with incomes above the poverty level might not apply for the Ryan White HIV/AIDS Program as well as assistance programs which can reduce medication costs,” the authors of one’s report wrote.

Those that reported unmet requirement for medication through ADAP were around five times in a better position to be nonadherent as a consequence of cost than individuals who received ADAP.

People existing with HIV who reported cost-saving related nonadherence were more unlikely to get virally suppressed over at their newest viral load test (64%) than individuals that didn’t report cost-saving related nonadherence (76%). Nonadherence related to drug cost was also associated with lower HIV care engagement rates and even more emergency department visits.

The more occurrence of costly hospitalizations and lower viral suppression rates (increasing likelihood of HIV transmission) among those who were nonadherent due to prescription drug costs demonstrate that cost-related nonadherence presents a broad social need with most stakeholders.

Inside a recent interview concerning upcoming long-acting antiretroviral therapies, Carlos del Rio, MD, FIDSA, Co-director for the Emory Center for AIDS research, claimed that clinicians must take cost seriously when treating HIV.

Author Resource Box:

CDC Report: Drug Costs Leading to Nonadherence in People …. https://www.contagionlive.com/news/cdc-report-drug-costs-leading-to-nonadherence-in-people-with-hiv

Has kratom become the new choice of drug these days?

What is kratom?

Kratom is a tropical tree (Mitragyna speciosa)native to Southeast Asia, with leaves that contain compounds that can have psychotropic (mind-altering) effects.

A kratom tree.

Kratom is not currently an illegal substance and has been easy to order on the internet. It is sometimes sold as a green powder in packets labeled “not for human consumption.” It is also sometimes sold as an extract or gum.

Kratom sometimes goes by the following names:

  • Biak
  • Ketum
  • Kakuam
  • Ithang
  • Thom

How do people use kratom?

Most people take kratom as a pill, capsule, or extract. Some people chew kratom leaves or brew the dried or powdered leaves as a tea. Sometimes the leaves are smoked or eaten in food.

How does kratom affect the brain?

Kratom can cause effects similar to both opioids and stimulants. Two compounds in kratom leaves, mitragynine and 7-α-hydroxymitragynine, interact with opioid receptors in the brain, producing sedation, pleasure, and decreased pain, especially when users consume large amounts of the plant. Mitragynine also interacts with other receptor systems in the brain to produce stimulant effects. When kratom is taken in small amounts, users report increased energy, sociability, and alertness instead of sedation. However, kratom can also cause uncomfortable and sometimes dangerous side effects.

What are the health effects of kratom?

Reported health effects of kratom use include:

  • nausea
  • itching
  • sweating
  • dry mouth
  • constipation
  • increased urination
  • loss of appetite
  • seizures
  • hallucinations

Symptoms of psychosis have been reported in some users.

Can a person overdose on kratom?

There have been multiple reports of deaths in people who had ingested kratom, but most have involved other substances. A 2019 paper analyzing data from the National Poison Data System found that between 2011-2017 there were 11 deaths associated with kratom exposure. Nine of the 11 deaths reported in this study involved kratom plus other drugs and medicines, such as diphenhydramine (an antihistamine), alcohol, caffeine, benzodiazepines, fentanyl, and cocaine. Two deaths were reported following exposure from kratom alone with no other reported substances.* In 2017, the FDA identified at least 44 deaths related to kratom, with at least one case investigated as possible use of pure kratom. The FDA reports note that many of the kratom-associated deaths appeared to have resulted from adulterated products or taking kratom with other potent substances, including illicit drugs, opioids, benzodiazepines, alcohol, gabapentin, and over-the-counter medications, such as cough syrup. Also, there have been some reports of kratom packaged as dietary supplements or dietary ingredients that were laced with other compounds that caused deaths. People should check with their health care providers about the safety of mixing kratom with other medicines.

*(Post et al, 2019. Clinical Toxicology).

Is kratom addictive?

Like other drugs with opioid-like effects, kratom might cause dependence, which means users will feel physical withdrawal symptoms when they stop taking the drug. Some users have reported becoming addicted to kratom. Withdrawal symptoms include:

  • muscle aches
  • insomnia
  • irritability
  • hostility
  • aggression
  • emotional changes
  • runny nose
  • jerky movements

How is kratom addiction treated?

There are no specific medical treatments for kratom addiction. Some people seeking treatment have found behavioral therapy to be helpful. Scientists need more research to determine how effective this treatment option is.

Does kratom have value as a medicine?

In recent years, some people have used kratom as an herbal alternative to medical treatment in attempts to control withdrawal symptoms and cravings caused by addiction to opioids or to other addictive substances such as alcohol. There is no scientific evidence that kratom is effective or safe for this purpose; further research is needed.