As the coronavirus pandemic shut down the nation in March of 2020, the U.S. government told methadone clinics they could allow stable patients with opioid addiction to take their medicine at home unsupervised.
Methadone, an opioid itself, can be dangerous in large amounts and most patients are required to take the liquid medicine daily at clinics. It wasn’t clear whether the relaxed take-home policy would cause more harm than good.
Now, a new study of fatal overdoses from January 2019 to August 2021 suggests that easing access was safe. It did not lead to more deaths involving the treatment drug.
The share of overdose deaths involving methadone declined from 4.5% in January 2019 to 3.2% in August 2021, the study found.
The finding may help make the change permanent, wrote the authors, who are U.S. government researchers from the Centers for Disease Control and Prevention and the National Institute on Drug Abuse.
Dr. Neeraj Gandotra, chief medical officer of the federal agency that regulates methadone clinics, called the early analysis “very promising.”
When the government eased restrictions, it said stable patients could receive 28 days of take-home methadone and less stable ones could get 14 days. Clinics were allowed to figure out which patients were eligible; many relied on criteria such as time in treatment and absence of criminal activity.
More than 400,000 people in the United States take methadone as part of their treatment for addiction to opioids such as heroin, fentanyl and painkillers. Methadone, when used correctly, can stop drug cravings without causing a high.
The study, published Wednesday in JAMA Psychiatry, found that overdose deaths overall — including those involving methadone — increased in March 2020. Then, in the months after the policy change, deaths involving methadone held steady while other fatal overdoses continued to climb.
More than 107,000 Americans died of drug overdoses last year, a record in the nation’s overdose epidemic. Increases were driven by deaths involving fentanyl, cocaine and other stimulants.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
Health officials in South Korea are expanding booster shots to adults 50 and over as COVID-19 cases creep up again across the country.
The 40,226 new cases reported Wednesday marked the country’s highest daily jump in more than two months, although hospitalizations and deaths remain stable.
Baek Gyeongran, South Korea’s top infectious disease expert, attributed the rising case counts to people’s waning immunities following vaccinations and prior infections and a major removal of social distancing measures since April as the nation wiggled out of an omicron surge. Health workers are also witnessing a “rapid spread” of BA.5, which is seen as the most transmissible variant of omicron yet, Baek said.
South Korea had previously given second booster shots to people who are 60 or older and those with compromised immune systems. Officials are now expanding the eligibility of those shots to people in their 50s and all adults with pre-existing medical conditions. Weeklong quarantines will be maintained for people who test positive.
Officials say the country may see daily case counts of 200,000 by mid-August or September if infections continue to grow. However, they don’t have immediate plans to meaningfully elevate social distancing restrictions, which have been effectively stripped down to an indoor mask mandate over the past months.
Baek, the commissioner of the Korea Disease Control and Prevention Agency, said the government will focus on expanding booster shots and securing larger supplies of antiviral pills to suppress hospitalizations and deaths. She said a return to stringent social distancing will be considered as a last resort, considering the weak economy, but pleaded for people to cancel unnecessary meetings and travel.
“The need to reduce the social and economic damage from social distancing is greater than ever, and we are also considering the economic situation, including inflation and high interest rates,” Baek said. “We also know that people are in a state of accumulated fatigue following lengthy periods of high-level distancing.”
Officials are also stepping up border controls, newly requiring all incoming travelers to undergo PCR laboratory tests on the day of their arrival and quarantine at home until the results come out.
While incoming travelers are currently required to submit negative results of either rapid antigen tests or PCR tests within 48 hours of departure, officials may change the rules to accept only PCR tests — seen as more accurate — if the virus situation worsens, KDCA official Lim Sook-young said.
The toll of drug-resistant “superbug” infections worsened during the first year of the COVID-19 pandemic, U.S. health officials said Tuesday.
After years of decline, 2020 ushered in a 15% increase in hospital infections and deaths caused by some of the most worrisome bacterial infections, according to a Centers for Disease Control and Prevention report.
Dr. Arjun Srinivasan, a CDC expert, called it “a startling reversal” that he hopes was a one-year blip.
CDC officials think several factors may have caused the rise, including how COVID-19 was treated when it first hit the U.S. in early 2020.
Antimicrobial resistance happens when germs like bacteria and fungi gain the power to fight off the drugs that were designed to kill them. The misuse of antibiotics was a big reason — unfinished or unnecessary prescriptions that didn’t kill the germs made them stronger.
Before the pandemic, health officials said U.S. superbug infections appeared to be going down. Deaths fell 18% between 2012 and 2017, when about 36,000 Americans died from drug-resistant infections. The government credited hospitals for using antibiotics more judiciously, and for isolating patients who might spread the germs.
The CDC doesn’t have 2020 data on all superbugs, partly because health officials had to focus on COVID-19. But it does have data from seven kinds of bacterial and fungal infections that were detected in hospital patients, including MRSA and a bug called CRE that’s known as “the nightmare bacteria.”
The CDC saw increases of 15% or more in infections and deaths from that group of germs.
One possible reason: From March to October 2020, almost 80% of patients hospitalized with COVID-19 received an antibiotic, CDC officials said. Use of certain kinds of antibiotics jumped as doctors aggressively used a variety of drugs to fight not only the coronavirus but also bacterial co-infections that might sweep over their weakened patients.
By 2021, overall use of antibiotics dropped. And Srinivasan noted that the use of catheters, ventilators and other medical devices may also be down. Those devices, which are used on severely ill patients, can become inroads into patient’s bodies for drug-resistant germs.
Still, any uptick in COVID-19 hospitalizations — like the one being seen in the U.S. currently — increases that risk, he said.
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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
The Biden administration is calling on people to exercise renewed caution about COVID-19, emphasizing the importance of getting booster shots for those who are eligible and wearing masks indoors as two new highly transmissible variants are spreading rapidly across the country.
The new variants, labeled BA.4 and BA.5, are offshoots of the omicron strain that has been been responsible for nearly all of the virus spread in the U.S. and are even more contagious than their predecessors. White House doctors stressed the importance of getting booster doses, even if you have recently been infected.
“Currently, many Americans are under vaccinated, meaning they are not up to date on their COVID-19 vaccines,” said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention. “Staying up to date on your COVID-19 vaccines provides the best protection against severe outcomes.”
Walensky said the U.S. has seen a doubling in the number of hospitalizations due to COVID-19 since April, reflecting the spread of the new subvariants, though deaths have remain steady around 300 per day.
Dr. Anthony Fauci, the nation’s top infectious disease expert, said while the new variants are concerning, with boosters, indoor masking and treatments the country has the tools to keep them from being disruptive.
“We should not let it disrupt our lives,” he said, “but we cannot deny that it is a reality that we need to deal with.”
He added that even if someone recently had COVID-19, they should get a booster.
“Immunity wanes, so it is critical to stay up to date with COVID 19 vaccines,” he said.
All Americans age 5 and over should get a booster five months after their initial primary series, according to the CDC, and those aged 50 and over — or who are immunocompromised — should get second booster four months after their first. According to CDC, tens of millions of eligible Americans haven’t received their first booster, and of those over 50 who got their first booster, only 28% have received their second.
“If you’re over 50 and you haven’t gotten the shot this year, you should go get a shot,” said White House COVID-19 coordinator Dr. Ashish Jha. “It’s going to save your life.”
Jha and Fauci said the U.S. is regularly discussing expanding eligibility for a second booster shot to all adults, but that no decision has been made yet.
“It’s a regulatory decision on the part of the FDA,” Fauci said.
Jha pressed said people who are eligible for a booster but haven’t received one shouldn’t wait for forthcoming vaccines targeted at the omicron strain in addition to the original form of the coronavirus. The U.S. has ordered 105 million of those updated shots that studies show provide better protection against omicron variants, but they won’t be available until the fall.
“Let me be clear, if you get vaccinated today, you’re not going to be ineligible to get the variants specific vaccine, as we get into the later part of fall and winter,” Jha said. “So, this is not a trade off, we’ve got plenty. It’s a great way to protect yourself.”
Added Fauci: “The threat to you is now.”
Walensky noted that CDC data shows that about a third of Americans are living in areas the agency classifies as experiencing a high level of COVID spread, where the agency recommends people wear masks in public indoor spaces. Another 41% live in the CDC’s ‘medium’ level, where it recommends that people consider their own individual risk and consider masking.
The European Union said Monday it’s “critical” that authorities in the 27-nation bloc consider giving second coronavirus booster shots to people between the ages of 60 and 79 years and other vulnerable people, as a new wave of the pandemic sweeps over the continent.
“With cases and hospitalizations rising again as we enter the summer period, I urge everybody to get vaccinated and boosted as quickly as possible. There is no time to lose,” European Commissioner for Health and Food Safety Stella Kyriakides said in a statement.
The European Center for Disease Prevention and Control (ECDC) and the European Medicines Agency said that the second boosters can be given at least four months after the first booster.
Monday’s advice comes after the agencies in April recommended that people over age 80 be considered for a second booster.
“As a new wave is currently underway in Europe, with increasing rates of hospital and intensive care unit admissions, it is critical that public health authorities now consider people between 60 and 79 as well as vulnerable persons of any age for a second booster,” the agencies said in a statement.
ECDC Director Andrea Ammon said that the new wave is being driven by the highly transmissible BA.5 mutation of the omicron variant of the coronavirus.
‘This signals the start of a new, widespread COVID-19 wave across the European Union,” she said. “There are still too many individuals at risk of severe COVID-19 infection whom we need to protect as soon as possible. We need to remind people of the importance of vaccination from the very first shot to the second booster. We have to start today.”
The agencies said that at the moment there is “no clear evidence to support giving a second booster dose to people below 60 years of age who are not at higher risk of severe disease.” There also is no immediate need to give second boosters to health care workers or those working in long-term care homes unless they are at high risk, they added.
Monday’s advice from the EU comes as scientists worry about a new omicron mutant — called BA2.75 — that is gaining ground in India and popping up in other countries.
Scientists say the new variant may be able to spread rapidly and get around immunity from vaccines and previous infection. It’s unclear whether it could cause more serious disease than other omicron variants, including the globally prominent BA.5.
Hong Kong authorities are considering implementing a health code system in the city that would restrict the movements of those infected with the coronavirus and overseas arrivals, as infections rise again.
The system is similar to that of mainland China, in which a red code completely restricts a person’s movement, a yellow code is for partial restriction, while a green code means freedom of movement. The colors would appear on Hong Kong’s risk-exposure app LeaveHomeSafe.
Hong Kong’s health chief said Monday that if such a system is implemented, real-name registration would be required and those who test positive for COVID-19 would be given a red code “to identify those who have been infected” and prevent them from interacting with the community.
Authorities are also considering reducing the current seven-day hotel quarantine for incoming travelers, and moving part of it to home isolation and health monitoring.
Such travelers may be issued yellow health codes, and will not be allowed to remove their masks or enter high-risk premises such as hospitals and elderly care homes.
“We hope that we will be able to enforce the home quarantine in a more effective way and try to prevent these people from causing community outbreak,” Lo said.
Starting Friday, all those who are given a home isolation order will also be issued electronic wristbands to ensure that they stay quarantined.
The city’s health code measures are being considered amid an increase of COVID-19 infections after the city battled its fifth and worst outbreak that infected over a million people and killed over 9,000.
Hong Kong recorded over 2,800 cases on Monday, as well as seven deaths.
Lo dismissed concerns that the measures would invade privacy, saying that real-name registration required for the health app is to help law enforcement and not to restrict freedoms of those unaffected.
“I’d like to say that we would make use of technology to put in place a precision strategy,” he said. “This is to reduce our cost in our fight against the epidemic and to maximize effectiveness.”
In mainland China, local media reported that the health code system was used to restrict the movements of people who were planning to join a protest in the Chinese province of Henan last month after they found their bank accounts frozen at a rural bank. The move sparked widespread criticism over its misuse.
