You can stop screening everyone

Remember when you couldn’t take two steps without getting screened for Covid? How the turns have tided. The Society for Healthcare Epidemiology of America now says that healthcare facilities shouldn’t bother testing asymptomatic people.

Wait, what? Yep. At this point, they say, “there was still little data to suggest the routine screening prevents transmission, and substantial data to suggest it comes at a cost.” The cost being that waiting for results bottlenecks the pipeline — eventually we’re talking hours of extra waiting — and “can prevent patients from getting screened and sent to specialized care.”

Georgia insurance news

Prices going up up up

The average cost of health in Georgia will increase more than any other state in 2023 — up more than 20 percent from this year, according to CMS data. Contrast Virginia, where prices are going down by 17 percent.

A silver plan will average $371, $474, and $1007 for people aged 21, 40, and 60, respectively — but that’s not including subsidies, which are available for a lot of folks. (Aetna’s Silver 2 plan is the least expensive, if you were wondering.)

Lots of people are about to lose coverage

Thanks, Congress. If the Big Year-End Spending Bill passes, it includes an end to the Covid-19 public health emergency — and that means millions of people who have been on Medicaid will lose their coverage, especially in the remaining non-expansion states. Some will get insurance through employers, others will use Obamacare exchanges, and the rest, well, they’ll have to be sure not to get sick.

Georgia will be able to stop Medicaid coverage starting April 1, but, per the bill, it will need to find a way to notify them first — and that isn’t always simple.

Oseltamivir shortage

Generic versions of Tamiflu are the latest meds to be in shortage, as five of the eight manufacturers are having trouble meeting demand. That is all.

Doctors know best?

Sure, a doctor might follow the official recommendations when writing a prescription for a patient, but when it comes to herself or her family … “Research shows doctors and their families are less likely to follow guidelines about medicine.”

A big (~6 million people) study out of MIT and Stanford found that doctors, because they know more about why guidelines are in place, are more likely to ignore them. For example, they’ll use broad-spectrum antibiotics for themselves, but start patients on a more targeted drug.

[W]hat is good for the public in the long run — trying more targeted drugs first — may not work well for an individual patient. For this reason, doctors could be more likely to prescribe broader-spectrum antibiotics for themselves and their families.

There are other examples, but the overall question is whether patients aren’t being given all the relevant information about why drugs are chosen — or if guidelines need to be adjusted to reflect what’s actually being used on the front lines.

Celebrex can rot kids’ teeth

Actually, both celecoxib and indomethacin “may be associated with dental enamel defects, currently seen in about 20% of children worldwide.”

Both NSAIDs inhibit cyclooxygenase and prostaglandin, but those are also needed to build dental enamel. Result: Brazilian researchers found that kids who take those drugs can end up with fragile teeth to the point that crowns can’t adhere well; they have dental problems their entire lives.

Paxlovid’s recommended price slashed

Pfizer was planning to charge $4.2 gadzillion for Paxlovid once the feds stop paying for it, but now there’s a bit of a snag: The US Institute for Clinical and Economic Review (ICER) has set its recommended price for Paxlovid at $563 to $906 per treatment course. That’s a big drop from its previous recommendation of $3,600 to $5,800 per course, thanks to Omicron being less deadly.

ICER has no power to set prices, but private insurers use its recommendations when negotiating with drug companies. (Medicare, of course, can’t negotiate, so Pfizer will just have to make up the profit by setting its price higher.)

Good news/bad news when it comes to social media

Aieeee! A third of Generation Z — those born after 1997 — turns to TikTok influencers for medical advice before talking to a physician. And 44% use YouTube. (The numbers are a bit lower for the general population.) 🤦‍♂️

Aieeee! “[O]ne in five Americans [it’s actually 17%] said they trust health influencers more than medical professionals in their community.” 🤦‍♂️

Oh, OK: “The top reasons include accessibility (37%), affordability (33%), and approachability (23%). 👍

Oh, OK: Nearly one in five (17%) said they turn to influencers to avoid judgment from medical professionals or because they don’t have access to a medical professional. 👍

Aieeee! One nurse who wasn’t helped by doctors turned to TikTok suggestions. “I decided that as I come across more of these videos I would just do whatever they said helped cure them or mitigate their symptoms to the best of my ability and see if it helps me.” 🤦‍♂️

Oh, OK: While the vast amount of medical advice from “influencers” is probably wrong, there’s good news: “[C]elebrities were rated as the least trusted for advice on medications.” 👍

When coffee can kill

Drinking three or four cups of coffee a day is great for your health in a lot ways. Unless you have severe hypertension^*. Then it can kill you.

“Drinking two or more cups of coffee a day was associated with twice the risk of death from cardiovascular disease among people with severe hypertension.”

^* 160/100 mmHg or higher

Red dye and the gut

Some of you may remember in the Long Long Ago when there was a kerfuffle about red dye #2 — people were scared enough of it that red M&Ms were pulled from the market even though they used a different red dye.

Red dye rears its ugly head again with FD&C Red 40, aka Allura Red. According to researchers in the Great White North, “[C]ontinual exposure to Allura Red AC harms gut health and promotes inflammation,” and can lead to colitis, and inflammatory bowel diseases including Crohn’s disease.

Oh, and they also think it might also affect “certain allergies, immune disorders, and behavioural problems in children, such as attention deficit hyperactivity disorder.”

Allura Red is used in candies, soft drinks, dairy products, and some cereals — looking at you, Trix.