February 14th, 2022
The Out-of-Pocket Health News Digest
Below you will find briefs about recent health policy news stories. Our hope is for students to have an information outlet at their fingertips to keep up-to-date with the most pressing news stories in health policy.
This compilation is produced by the HPSA Education Committee: Brynna Thigpen, Christopher Whitlock, Easheta Shah, Hannah Lane, Hassan Kourani, Jourdan Clements, and Lizzy Peppercorn
CDC Proposes Updates to Opioid Prescription Guidelines
by Easheta Shah
On February 10, the Center for Disease Control and Prevention proposed updates to the 2016 guidelines for opioid treatment which provided recommendations for primary care physicians treating patients with chronic pain. These guidelines recommended non pharmacological or nonopioid therapy as the preferred first line of treatment, while suggesting — if opioids are used — immediate-release opioids be prescribed instead of extended-release/long-acting (ER/LA), avoiding an increase in dosage, and encouraging tapering or discontinuation. As per these older recommendations, patients should also be made aware of the risks of long-term opioid use prior to treatment, and patients and providers should establish pain management goals with regular assessment of clinically meaningful improvement through treatment to assure that the benefits of usage outweigh potential risks. These guidelines were meant to minimize harm from long-term opioid use, promote individualized treatment, and encourage regular reassessment according to the patients’ pain needs. 

Since their release, the 2016 guidelines have been widely misapplied and misinterpreted by insurers, policymakers, and clinicians alike who cited the publication for its strict limits on duration and dosages of opioid prescriptions. The recommendations were viewed as hard prescription ceilings irrespective of patient circumstance. As a result, some patients were unable to get the adequate treatment they needed for their chronic pain because physicians were unsafely tapering or discontinuing patients’ prescriptions.

The updated CDC guidelines are proposed in a published draft currently accepting public comments until April 11, 2022. The new guidelines attempt to emphasize that while tapering or discontinuing opioids could be the goal for some patients when the risks of use outweigh the benefits, clinicians should not precariously reduce dosages except in emergencies. The new draft omits any recommended time limit for acute pain prescriptions and additionally provides explicit recommendations on when and how opioid tapering should be safely carried out according to the patient’s circumstance. The updates provide clearer language that these guidelines are meant to be used as a tool to help providers and patients make safe and effective opioid treatment decisions. 

COVID-19 Impact on Children's Development
by Lizzy Peppercorn
One consequence of the COVID-19 pandemic was increased screen time for children. The move to online school forced many school aged children to stare at screens all day. However, there has been limited research until now on the impact of COVID-19 on screen time and development in toddlers and preschoolers. Two recent studies analyzed data from young children ages 8 to 36 months from around a dozen different countries. 

The studies found that countries with longer lockdowns experienced longer increases in screen time during lockdown for toddlers and young infants. Further, screentime had a negative association socioeconomic status and a positive association with age, caregiver screen time, and caregiver attitudes towards children’s screen time. The countries participating in this study experienced different lengths and severity levels of lockdown. 

Research on the increased screen time impact of children's development demonstrated that children who did increase in screen time also learned fewer words and that children who were read to more frequently learned more words. However, though children were exposed to more screen time due to lockdown, children overall learned more words than the study predicted during lockdown, showing that relatively short isolation periods are not largely detrimental to language development in young infants and toddlers. 

Sources: ScienceDaily, Nature
US COVID-19 Hospitalizations Hit New Record High
by Jourdan Clements
As of this past week, the omicron variant has resulted in tremendously high rates of COVID-19 hospitalizations across the United States, reaching a new maximum for the pandemic with 145,982 patients hospitalized. This surpasses the previous recorded high, which was reported in January of 2021.

Across hospitals in the US, patients with COVID-19 currently fill about 30% of ICU beds. In addition, pediatric COVID-19 hospitalizations are at their highest since the start of the pandemic. These statistics attest to how rapidly the omicron variant has affected the country. Today, infections have reached record levels, with the US reporting more than 700,000 new COVID-19 cases a day.

Record-breaking rates are sending hospitals into crisis conditions and healthcare workers warn that the crowded conditions could be leading to a rise in avoidable deaths, due to overwhelmed clinicians struggling to provide the level of care they would normally. Hospitals are stressed across the country, with the number of people infected with COVID-19 in many hospitals exceeding or nearing previous highs. As such, the medical consequences of this recent surge will likely affect many Americans who need medical care, whether for COVID-19 or unrelated illness or injury. This is supported by research and previous case surges, which have demonstrated that when hospital admissions reach crisis levels, more patients die.

If omicron cases continue to rise and the healthcare workforce continues to fall under stress, many hospitals may be unable to provide the same standard of care for all patients.

Source: NPR, AAC
One-Liners
  • Flawed John Hopkins Lockdown Study: Non peer-reviewed research paper — not endorsed by the university — written by three economists at JHU claims lockdowns had little to no effect on the COVID-19 mortality rate, but researchers criticize the study’s flawed methodology. (MedPage)
  • MA Tells Hospital to Shrink Costs: Massachusetts’ state healthcare regulatory agency has given its largest hospital, Mass General Brigham, 45 days to put together a cost containment plan, citing excessive cost growth relative to competitors that threatens the whole state’s delivery system. (Fierce Healthcare, NASHP) 
  • To Telehealth, or Not?: Health insurance companies are exploring whether or not they should continue paying for telehealth programs. (NASHP)
  • Winding Down Emergency in IA: Iowa’s governor Kim Reynolds has announced plans to end Iowa’s COVID-19 public health emergency and decommission the state’s COVID-19 tracking websites. (Axios)
  • SD Medicaid Expansion Tip Toes Toward Possibility: A bill in South Dakota would lay the groundwork for the state to expand Medicaid to cover potentially more than 42,000 South Dakotans; it is currently one of only twelve that has not yet expanded the program. (Argus Leader)