HELENA, Mont. — When the Hazelden Betty Ford Foundation began offering telehealth services in Montana in early February, the nation’s largest nonprofit addiction treatment provider promised quality care for far-flung residents without their even having to leave home.

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That promise was what Montana and more than 40 other states had in mind when they temporarily relaxed rules restricting telehealth services and allowed out-of-state providers to hold remote patient visits for the duration of the covid-19 pandemic.

A year into the pandemic, telehealth has become widely accepted. Some states are now looking to make permanent the measures that have fueled its growth. But with it have come some unintended consequences, such as a rise in fraud, potential access problems for vulnerable groups and conflicts between out-of-state and in-state health providers.

In Montana, for example, not everybody cheered the virtual … Read the rest

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President Joe Biden has promised enough covid vaccine to immunize every willing adult by June 1. But right now, the gap between supply and demand is so dramatic that vaccinators are discovering ways to suck the final drops out of each vaccine vial — if federal regulators will let them.

This story also ran on Los Angeles Times. It can be republished for free.

Pharmacists involved in the covid vaccination drive say it’s common to have half a dose left in a Pfizer vial after five or even six doses have been administered — and to have half a dose left after 10 doses have been drawn out of a Moderna vial. Combining two half-doses could increase vaccinations by thousands at a time when 2 million or so doses are being administered every day in the country.

So, they want to use a single hypodermic needle to withdraw leftover vaccine … Read the rest

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Since the start of the pandemic, the most terrifying task in health care was thought to be when a doctor put a breathing tube down the trachea of a critically ill covid patient.

This story also ran on The Guardian. It can be republished for free.

Those performing such “aerosol-generating” procedures, often in an intensive care unit, got the best protective gear even if there wasn’t enough to go around, per Centers for Disease Control and Prevention guidelines. And for anyone else working with covid patients, until a month ago, a surgical mask was considered sufficient.

A new wave of research now shows that several of those procedures were not the most hazardous. Recent studies have determined that a basic cough produces about 20 times more particles than intubation, a procedure one doctor likened to the risk of being next to a nuclear reactor.

Other new studies show that patients … Read the rest

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COLUMBIA, Mo. — The University of Missouri has settled a collection of personal injury and false advertising claims over knee surgeries for $16.2 million, in what appears to be one of its largest public payouts in recent years.

This story also ran on St. Louis Post-Dispatch. It can be republished for free.

The 22 plaintiffs, a handful of whom were minors, filed suits from 2018 through 2020 over “BioJoint” surgeries pioneered by two university employees, orthopedic surgeon Dr. James Stannard and veterinarian Dr. James Cook. The procedure involves a complex operation that the Mizzou BioJoint Center’s website calls a “biological joint restoration,” replacing parts of the knee with cadaver bones or cartilage to treat arthritis or joint damage. Some plaintiffs alleged in court documents that the procedure was sold to them as a way to avoid a traditional artificial knee replacement.

Plaintiffs alleged in court documents that Stannard did not … Read the rest

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For the first time since its enactment in 2010, the Affordable Care Act is slated for major benefit expansions, courtesy of the covid relief bill approved by Congress this week. But the changes are only temporary, so the measure also tees up a fight to make them permanent.

Meanwhile, the uneven distribution of vaccines continues — with some states finding themselves with more shots than takers, while others continue to have too many arms chasing too few shots. And the Centers for Disease Control and Prevention is caught in the middle — trying to issue guidelines that will encourage people to see the vaccine as a ticket to a freer life, while not encouraging dangerous behavior as the coronavirus — and its more transmissible variants — is still spreading widely.

This week’s panelists are Julie Rovner of KHN, Tami … Read the rest

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Rickie Andersen took a brief break from work in March after she fell ill. Her cough, fever and chills were typical covid-19 symptoms, but coronavirus tests were so scarce she could not obtain one to confirm the diagnosis.

After Andersen returned to her job as an information systems project manager in the San Francisco Bay Area, she struggled with profound fatigue, cognitive difficulties and other disabling complaints. For six months, she tried to keep awake during meetings and finish basic tasks that took much longer than before.

Finally, she decided to retain legal help so she could take advantage of the disability insurance coverage offered as an employee benefit. “I realized this is not going to be a short-term thing,” Andersen said.

Hundreds of thousands of people around the world are experiencing what is being called “long covid” — a pattern … Read the rest

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