Reopening the economy prematurely has dire consequences for states

By NCL Health Policy intern Talia Zitner

The past month has seen a serious surge in reported coronavirus cases in the United States. It seems the virus is going to be with us for a while. Of states where COVID is spiking, the majority are in the South, many of which had ambitious reopening plans that are now being reconsidered.

Three of these states—Texas, Florida, and Arizona—have current surges. All three pushed to reopen their economies early in an attempt to “return to normal.” The current deluge in cases that resulted was due to a lack of continuing stay-at-home order and a failure to require masks.

Texas officially started Phase 1 of its reopening plan on May 1, but—as of June 26—had to retract much of the opening that it had started. In total, Texas was only able to reopen the state for 55 days. As of July 27, Texas has seen an average of 8,089 new cases of the coronavirus over a seven-day period. Compared to cases in April, when there were 814, this is astounding. Texas Governor Greg Abbott (R) has since ordered everyone to start wearing face masks and has limited the size of public gatherings.

It does not appear that Texas will shut down again, however. As the governor said, “we need to refocus on slowing the spread, but this time we want to do it without closing down Texas again.” Although it is an issue of public health, the issuance of a statewide masking policy and the staggered re-opening of the economy has become a matter of contention across party lines. Some residents find the Governor’s actions to be inadequate, and others feel as if the newly implemented precautions impede their personal liberties.

Florida and Arizona are not faring much better. As of April, Florida had 1,027 cases reported. In July, it was 6,563. Florida started its reopening plan on May 4 and entered into Phase 2 on June 5. Clearly, cases have surged.

Earlier this week, Florida reported 8,892 new COVID-19 cases. Like Texas, there seems to be a mixed reaction among Florida representatives to slow the spread of the virus. Senator Rick Scott (R) has been vocal about his intentions for Florida, and it appears the state will not roll back any of its reopening course. As Senator Scott put it a couple of months ago, “wearing a mask is a choice you get to make.”

Like Texas and Florida, Arizona is hurting badly, with only 115 in April surging to 4,753 cases in July. Arizona’s stay-at-home order lasted until May 15, and was replaced by the new Stay Healthy, Return Smarter, Return Stronger Executive Order, on May 16. When Arizona first reopened, Governor Doug Ducey did not require residents to wear face masks, but as the case numbers increased, he allowed local governments to set their own masking policies. As of July 1, officials said that Arizona saw the highest rate of new cases in the entire country.

Many public officials are starting to realize opening too soon was foolhardy and has spread the virus. New revelations by scientists show the virus can actually be airborne, urging those to take indoor transmission more seriously. The virus is also proving to be more of a blood vessel disease than solely a respiratory one, which may lead to long-term impacts that doctors are still learning about.

There’s one takeaway here: following the example of states like Texas, Florida, and Arizona is not recommended. The more seriously states take this crisis the better, and the sooner the entire country will be able to move towards a newer, safer “normal”.

Talia is a Washington, DC native and a rising sophomore at Wesleyan University, where she is studying English. Beyond health policy, Talia’s interests are in journalism, law, and social justice.

Meet the winners of this year’s Script Your Future Medication Adherence Team Challenge

The 2020 Medication Adherence Team Challenge is part of the national Script Your Future public awareness campaign coordinated by NCL with support from its partners and the Challenge sponsors—the American Association of Colleges of Pharmacy (AACP), the National Association of Chain Drug Stores (NACDS) Foundation, the National Community Pharmacists Association (NCPA) and the American Pharmacists Association (APhA).

Medication non-adherence can lead to devastating health outcomes. Research shows that nearly one in five prescriptions go unfilled and half of all patients with chronic illnesses do not take their medication as prescribed. Improved medication adherence leads to better health outcomes and reduced total healthcare costs, and it was for these reasons that NCL launched the Script Your Future awareness campaign in 2011.

The Team Challenge was established to extend campaign messages into medical and other schools of health professions, and to nurture adherence-minded values in future generations of professionals entering the workplace. Each year, top performing teams are honored with a National Award for overall outstanding team achievement, or a Focused Award, which recognizes outstanding team achievement in the specific areas of health disparity/under-represented community outreach, media/communications outreach, or creative interprofessional team event. This year, we introduced a new focused award category, with the inclusion of a Technology Innovation Focused Award – a category that evaluates creative outreach with a focus on technology-based interventions.

In 2020, our Team Challenge student health professionals were met with unique challenges as they navigated the historic COVID-19 pandemic, which resulted in school closures, event cancelations, and a host of other obstacles. To adhere to social distancing guidelines, our dedicated teams pivoted their campaigns and made an impact in other ways. This year, the Team Challenge observed engagement from nearly 2,900 future healthcare professionals and volunteers, who all together hosted over 250 events in 14 states. Collectively, the teams directly counseled close to 12,000 patients and introduced Script Your Future messaging to over 430,000 consumers, nationwide.  Since the Team Challenge began in 2011, more than 21, 000 future healthcare professionals have directly counseled nearly 87,000 patients and nearly 26 million consumers.

The recognized schools, selected from dozens of applications and 82 participating educational institutions, are listed below.

National Award | University of the Sciences: Philadelphia College of Pharmacy, PA

University of the Sciences (USciences) interdisciplinary medication adherence outreach centered around individuals across all ages, from children to older adults. USciences’ team structure included students of pharmacy, occupational and physical therapies, medicine, and social work. Throughout the Team Challenge, USciences directly counseled 455 patients, reaching a total of 805 people. During their outreach, USciences introduced a new campaign theme – “A future of ______ begins with me”, to personalize medication adherence through each patient interaction. USciences’ campaign also placed a great emphasis on addressing racial disparities, reducing stigma surrounding mental health, and tangential issues like vaccine confidence and proper nutrition.

National Award Finalists

The following schools were named Finalists under the National Award category:
Pacific University School of Pharmacy, West Virginia University School of Pharmacy, Western University College of Pharmacy, Northeast Ohio Medical University (NEOMED), University of Charleston School of Pharmacy, Touro University College of Pharmacy, St. Louis College of Pharmacy.

Rookie Award | Howard University College of Pharmacy – Washington, DC

NCL is thrilled to announce that DC HBCU, Howard University College of Pharmacy, was the recipient of the 2020 Rookie Award. Howard University’s team included students of pharmacy, medicine, social work, and dentistry. Howard University’s target population included homeless or displaced minorities, children and parents, and adults with behavioral issues. The team tailored its disease focus to diabetes and heart disease, as they are chronic conditions that plague the region. Throughout the Challenge, Howard University directly counseled close to 400 patients and reached over 1,000 people with the help of 169 students and volunteers and distributed nearly 1,000 Script Your Future medication adherence resources.

Rookie Award Finalist: University of Arizona College of Pharmacy– AZ

The University of Arizona College of Pharmacy in Tucson, AZ also made a strong showing in the Team Challenge as a first-time competitor.

Focused Awards

Health Disparities Community Outreach Award | St. Louis College of Pharmacy – MO

Pharmacy students from St. Louis College of Pharmacy and nursing students from St. Louis University, joined forces to strategically and intentionally identify their target population – residents of a region of St. Louis known as the “Delmar Divide.” St. Louis College of Pharmacy chose this target population due to the stark disparities observed in the residents directly north and south of the Delmar Divide. For their outreach, St. Louis College of Pharmacy focused their interventions on communities north of the Delmar Divide, which predominantly consists of people of color of lower socioeconomic means. The team chose to focus on chronic conditions like diabetes and hypertension. Together, 60 students and volunteers directly counseled 350 patients and reached nearly 400 people. Through numerous events and newly fostered community partnerships, St. Louis College of Pharmacy disseminated nearly 400 Script Your Future medication adherence resources within the community.

Communication and Media Outreach Award | Lake Erie College of Osteopathic Medicine School of Pharmacy (LECOM) – PA & FL

To illustrate the diversity of their team, LECOM pharmacy and medical students from campuses based in PA and FL produced a public service announcement (PSA) spoken in eight languages, to help amplify the value of medication adherence to numerous populations. The PSA garnered over 2,800 views. LECOM employed social media platforms like Facebook, Instagram, Twitter, and LECOM’s Pulse Newsletter, to help disseminate Script Your Future medication adherence messaging. LECOM students also wrote an original book to present heart health information to the children entitled “Mr. Pumper and the Heart Valves”, which was read to third grade elementary students. Throughout the Challenge, 293 students and volunteers directly counseled over 500 patients, reaching over 1,200 patients, and disseminated over 730 Script Your Future resources in their community.

Creative Inter-Professional Team Event Award | University of Pittsburgh School of Pharmacy – PA

The University of Pittsburgh School of Pharmacy partnered with the Schools of medicine, dentistry, social work, nursing, dietetics, and rehabilitation sciences, to organize a team of over 300 students and volunteers to execute their medication adherence outreach. University of Pittsburgh harnessed the interdisciplinary nature of their team to build a campaign serving older adults in their community, from a holistic treatment perspective. The team addressed issues like hypertension, social isolation, and food insecurity. Throughout the Challenge, University of Pittsburgh directly counseled over 130 patients and reached over 2,200 patients.

Technology Innovation Award| Western University College of Pharmacy – CA

Western University College of Pharmacy made an impressive debut for the inaugural inclusion of the Technology Innovation Award. To foster medication adherence, the team created a dedicated website that directed patients to resources relating to disease areas like COPD, pneumonia, heart failure, and diabetes. The website was geared towards patients recently discharged following a hospital stay and contained features like medication and post-discharge appointment reminders and medication adherence-related infographics in multiple languages.

At-home vision assessments no replacement for in-office visits

With COVID-19 keeping many of us at home, companies claiming to offer at-home vision tests are ramping up their marketing, despite the fact that there is no U.S. Food and Drug Administration-approved at-home device that people can use to self-conduct a vision assessment, let alone a full eye examination. These devices aren’t even proven to provide an accurate vision prescription. NCL has long recommended an annual, in-person eye exam as part of consumers’ annual health and wellness routines.

“Consumers need to be wary of products that mistakenly claim that their at-home devices can provide an eye exam or a vision prescription and should instead consult their eye doctors who are available to help provide safe solutions,” said NCL Associate Director of Health Policy Nissa Shaffi.

NCL leads advocates in urging FDA to protect patient access to critical therapy for preterm birth

By Sally Greenberg, NCL Executive Director

The National Consumers League and 14 leading health organizations and individual providers have collaborated in sending a letter to the Food and Drug Administration (FDA) as the agency considers whether to withdraw the only FDA-approved therapy that reduces the risk of preterm birth in women with a history of preterm birth.

Why did we and our fellow advocates decide to send this letter in the midst of the COVID-19 pandemic? Several important reasons.

First, preventing preterm birth is always a vital cause—during or without a pandemic. The leading cause of infant death in the United States, premature birth has devastating effects on families and is very costly to our health care system. For babies who do survive, short and long-term complications can accompany preterm birth. For mothers, a history of spontaneous preterm birth is a leading risk factor for recurrent preterm birth, yet providers have only one therapeutic option – hydroxyprogesterone caproate or “17P,” in one branded and five generic forms – to prevent recurrent preterm birth for these at-risk mothers.

Taking away these options—especially in the midst of a pandemic—would be concerning for pregnant women who are at high-risk for preterm birth, including those that reduce their risk of being admitted to the hospital for early delivery.

Secondly, as recent events surrounding both COVID-19 and continued fundamental rights injustices have reminded us, a profound and systemic inequity exists in the United States where institutional racism contributes to health disparities—including preterm birth and infant mortality. COVID-19 has disproportionally impacted African American women, the same population that is most likely to experience preterm birth. The preterm birth rate among U.S. black women is 49 percent higher than the rate among all other women, according to the March of Dimes.

Thirdly, 17P is the only FDA-approved therapy that reduces the risk of preterm birth and has been used for nearly a decade. We are concerned that removing access to the only FDA-approved therapy may deepen maternal and infant health inequities that exist within the U.S.

It is also troubling that if providers cannot access FDA-approved forms of 17P, this may expose pregnant women to compounded medications, which have no labeling to provide guidance on administration, contraindications, or potential side effects.

Removing 17P products in the absence of suitable alternatives would leave patients and providers significantly disadvantaged in the fight against prematurity. While we recognize the FDA is encountering tremendous challenges in addressing the COVID-19 pandemic, it is important to underscore the public health need for continued access to approved treatment options, and we trust that the agency will consider the patient impact as they evaluate this issue.

To add your voice to the letter to FDA, urging the agency to preserve patient access to the only FDA-approved therapy to reduce the risk of preterm birth, you can sign on here.

Vaccine hesitancy and the unique challenge of COVID-19

headshot of NCL Health Policy intern Talia

By NCL Health Policy intern Talia Zitner

Around the globe, researchers and scientists are racing to find a vaccine for the COVID-19 virus. Developing a safe, effective, and affordable vaccine is already a challenging feat, but vaccine hesitancy presents another unique challenge to scientists, government researchers, and community leaders.

“Vaccine hesitancy” refers to the reluctance or refusal to be vaccinated or have one’s children vaccinated against a disease, even if a vaccine is proven to be safe and effective. Vaccine hesitancy poses dangers to both the individual and their community, since exposure to a contagious disease puts the person at risk, and they are far more likely to spread the disease to others if they won’t get vaccinated. Ironically, these communities may be the most vulnerable to COVID-19, and a serious effort must be made to create a sense of comfort around the COVID-19 vaccine once it’s available to the public.

Not to be confused with the vaccine-hesitant, “anti-vaxxers” represent a movement of people who dispute the safety of vaccinations and challenge laws that mandate vaccinations. This is a more insidious movement funded by dubious sources (reportedly, one New York couple has donated millions of dollars to the movement) that deceptively politicize public health measures under the guise of protecting personal liberties.

Public health agencies are trying to get vaccination levels to 95 percent to guarantee herd immunity. Some concerns that are top of mind for consumers include knowing the timeframe for a vaccine, who will have access to it, what it will cost consumers, if anything, and how states will determine methods of enforcing vaccination. The possibility of a COVID-19 vaccine also begs the question of whether vaccination will be mandatory for public schools and government workers.

Perhaps one of the most important projects right now surrounding vaccine hesitancy is the Vaccine Confidence Project (VCP), which is dedicated to “conducting a global study to track public sentiment and emotions around current and potential measures to contain and treat COVID-19.” Using a mix of population surveys and social media tracking, VCP “will investigate perception and sentiment of COVID-19 social distancing measures and potential medical tools globally.” This project will be essential moving forward, as it will continue to inform understanding on how the global population perceives the eventual vaccine.

As of now, VCP reports that only 25 percent of African Americans—a population that has been disproportionately hit by the virus—plan to get the COVID-19 vaccine. Why is this the case? Due to lack of access to hospitals, pharmacies, doctors and clinics in Black communities, failure to expand Medicaid, and other root causes; the COVID-19 pandemic has laid bare the disparities in our health care system.

To ensure herd immunity—which is somewhere north of 90 percent immunity—much work needs to be done, especially with the Black community, to increase confidence when a COVID-19 vaccine is released. At this time, Black leaders such as former U.S. Surgeon General, Dr. Regina Benjamin, and current U.S. Surgeon General Dr. Jerome Adams, are among those leading the charge to encourage public health efforts such as advocating for face-mask usage and collaborating with the National Newspaper Publishers Association (NNPA) Coronavirus Task Force and Resource Center, which provides expertise on the virus and its impact on the Black community.

Another community that will be crucial to prioritize surrounding vaccine hesitancy is the older Americans. The New York Times reported that of the “241 interventional COVID-19 studies undertaken in the United States and listed on clinicaltrials.gov…37 of these trials—testing drugs, vaccines and devices—set specific age limits and would not enroll participants older than 75, 80 or 85 years old. A few even excluded those over 65.” Why would older Americans trust a vaccine not tested for their age groups? Clinical trials will need to include people across all ages, otherwise, this will only increase vaccine hesitation. The vaccine must be safe and effective, and ample outreach must be conducted to ensure vaccine confidence across all demographics.

There are many questions left to be addressed. As we continue to navigate preventive measures for COVID-19, independent researchers and organizations will become increasingly more important to guiding decision making before and after a vaccine is developed.

Vaccine hesitancy is a global problem that will only be compounded by the COVID-19 pandemic. Fostering vaccine confidence will be imperative when the second wave of the virus sweeps the globe, as it inevitably will.

Talia is a Washington, D.C. native, and a rising sophomore at Wesleyan University, where she majors in English. Beyond health, Talia’s interests are in journalism, law, and social justice.

Observing World Food Safety Day: Food safety, foodborne illnesses, and the pandemic.

By Nailah John, Linda Golodner Food Safety and Nutrition Fellow

Happy World Food Safety Day! June 7 is a special day designated by the United Nations to draw global attention to the health consequences of contaminated food and water.

The concept of food safety encompasses all practices that are used to keep our food safe and relies on the joint efforts of everyone involved in our food supply. “Everyone” refers to all actors in the food chain, farmers, manufacturers, wholesalers, retailers, restaurants, caterers, and many more. Laws and regulations are in place to reduce the risk of contamination under the Food Safety Modernization Act, which is transforming the nation’s food safety system by shifting the focus from responding to foodborne illness to preventing it.

In the United States, the Centers for Disease Control and Prevention CDC estimates that each year 48 million people get sick from a foodborne illness, 128,000 are hospitalized, and 3,000 die. There are more than 250 types of foodborne diseases, caused by bacteria, viruses, and parasites. Some common foodborne illnesses that are found in our country include:

Norovirus: a contagious virus that causes vomiting and diarrhea. You can get norovirus from:

  • Direct contact with an infected person
  • Consuming contaminated food or water
  • Touching contaminated surfaces, then putting unwashed hands in your mouth

Salmonella: lives in the intestines of people and animals. can come from infection from a variety of sources, including:

  • Eating contaminated food or drinking contaminated water
  • Touching infected animals, their feces, or their environment.
  • The bacteria cause about 1.35 million infections, 26,500 hospitalizations, and 240 deaths in the United States every year.

Clostridium perfringens: a spore-forming bacterium that is found in the environment as well as in the intestines of humans and animals. It is also commonly found in raw meat and poultry, beef, poultry, gravies and dried of pre-cooked foods

  • Infections often occur when foods are prepared in large quantities and kept warm for a long time before serving. Outbreaks often happen in institutions, such as hospitals, school cafeterias, prisons, and nursing homes, or at events with catered food.

Campylobacter: the most common bacterial cause of diarrheal illness in the United States.

  • Causes 1.5 million illnesses each year.
  • caused by eating raw or undercooked poultry or consuming something that has come into contact with raw or undercooked poultry, seafood and untreated drinking water.

Staphylococcus (Staph): a gastrointestinal illness caused by eating foods contaminated with these toxins.

  • symptoms include sudden nausea, vomiting and stomach cramps, diarrhea.
  • Not washing hands if food is contaminated with Staph, the bacteria can multiply in the food
  • Foods that are not cooked after handling, such as sliced meats, puddings, pastries and sandwiches are especially risky if contaminated with Staph.

As we note efforts worldwide to ensure that our human food supply is safe, we would be remiss in 2020 if we did not note the increased food safety concerns during the COVID-19 pandemic.

According to the CDC, there is currently no evidence to support transmission of COVID associated with food. It is important that consumers wash hands with soap and water for 20 seconds when handling food. The CDC highlights that, because of poor survivability of these coronaviruses on many surfaces, there is likely low risk of spread from food products or packaging. The CDC also reinforces the need to avoid cross-contamination of foods in preparing food safely by keeping raw meat separate from other foods, cooking meat to the recommended temperature, which kills harmful bacteria and ensuring that perishable foods are refrigerated.

It is also important to always rinse fresh fruits and vegetables under running water, including melons and other produce with skins and rinds. Scrub the produce firmly with a clean brush, also remember to clean the lids of canned goods before opening them, says the FDA. Washing produce and cooking meats, fish, and poultry thoroughly is key during this pandemic, especially with so many people preparing their meals at home. Our message to consumers and restaurants and anyone who handles food: as we mark World Food Safety Day, follow these important food safety practices to help prevent foodborne illness and stay healthy and safe during these uncertain times.

An old threat to public health is resurfacing amidst COVID-19 worries

By Sally Greenberg, NCL Executive Director

While all of us have learned to adapt to the ‘new’ ways to stay healthy we can’t let our need to avoid contact with others get in the way of the important steps we have always taken to keep disease at bay; staying up to date on vaccinations.

Since the COVID-19 pandemic hit, most of us have dutifully complied with stay-at-home orders to avoid contracting the virus. While that is critically important, there are other diseases that we must guard against. While the world awaits a COVID-19 vaccine, we need to keep ourselves and our families safe by protecting overall health. This includes taking steps to diminish the risk of other dangerous outbreaks that would weaken our immune systems and put additional strain on the healthcare system.

Before the coronavirus, low vaccination rates were already a concern for many populations. But in the last several weeks, we have been alarmed to learn that the numbers of people receiving vaccinations—from the very young to the very old—have plummeted. That is extremely worrisome for public health officials.

In fact, prominent organizations like the World Health Organization (WHO) and the National Foundation for Infectious Diseases (NFID) have stressed the importance of maintaining vaccination against illnesses like the flu and pneumonia, which affect lung health during the pandemic. This is even more important for those with underlying conditions and those over the age of 65 who are more vulnerable to these diseases.

Early in the pandemic, we thought children might be spared from much of the outbreak. That turns out not to be true. Children need their vaccinations more than ever! Time has proven that there is still much we don’t know about the Coronavirus and how it affects the vulnerable—so staying up-to-date on pediatric vaccines is equally important.

Hesitation to visit the doctor’s office is completely understandable, but I can speak from personal experience that our health care providers are making doctor visits very safe.

When I visited the doctor on a non-coronavirus issue, they staggered patient appointments so patients never had to share a waiting room; everyone wore a mask; we observed 6-foot social distancing; there was an abundance of soap and water and hand sanitizer. The staff at the office was exceptional. They were organized, completely protected with all of the proper PPE, and very focused on making sure that I—the patient—felt safe and secure.

The best advice? Call ahead to ask your health care provider about the precautions they have in place and the best timing for a visit to update your vaccines. Adults, get your shingles, pneumococcal pneumonia, and flu shots. You don’t want those illnesses! And every child needs the array of measles, mumps, tetanus, diphtheria, whooping cough, and other vaccines recommended by the Centers for Disease Control (CDC) for children.

As we continue to live in this new world, we have a responsibility to ourselves, to our families, and our communities to stay as healthy as possible. Modern medicine’s gift to humankind is an array of extremely safe and effective childhood and adult vaccines to prevent diseases that once, collectively, have killed billions globally. As the COVID-19 pandemic has shown, we are lucky to have these vaccines. They keep us safe and healthy. We all have to do our part and get vaccinated from preventable diseases.

NCL: Annual in-office eye exams help diagnose potential problems

May 4, 2020

Contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC–The National Consumers League (NCL) has long recommended an annual, in-person eye exam as part of consumers’ annual health and wellness routines. An eye examination with an eye doctor ensures not only correct eyeglass and contact lens prescriptions, but also the opportunity for important preventive care as the eyes are a window into our overall health. An eye doctor, whether a primary eye care doctor of optometry or an ophthalmologist, can diagnose potentially hundreds of conditions during an exam, including diabetes, cancer, and macular degeneration. Through an eye exam, these doctors can catch an illness or disease early and treat it right away, making this care a critical part of our preventive care toolbox.

But now with COVID-19 keeping many of us at home, companies claiming to offer at-home vision tests are ramping up their marketing, despite the fact that there is no U.S. Food and Drug Administration- (FDA) approved at-home device that people can use to self-conduct a vision assessment, let alone a full eye examination. These devices have not been proven to even provide an accurate vision prescription. Consumers need to be wary of products that mistakenly claim that their at-home devices can provide an eye exam or a vision prescription and should instead consult their eye doctors who are available to help provide safe solutions.

NCL applauds state attorneys general for taking action and the media for publishing articles about the dubious effectiveness and potential dangers that at-home vision tests or devices present. It’s been important to tell consumers to be aware of false marketing promises.

As states begin to reopen health care access, eye doctors across the country are beginning to safely provide routine eye health examinations once again. Patients looking to schedule their annual eye examinations or update their prescriptions should contact their eye doctors, who are employing protocols to protect everyone’s health during this public health emergency.

Although the COVID-19 pandemic is bringing out the best in many companies across our country, there are those few who are taking this opportunity to mislead and misinform the public. NCL wants to remind consumers to be aware and understand that there’s no substitute for an annual, in-person comprehensive eye exam or for the doctor-patient relationship that’s at the heart of healthy outcomes, especially when it concerns our precious eye health and vision. When it comes to your eyes, you don’t fool around!

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneering consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

COVID-19 shows us the extraordinary importance of vaccines

By Sally Greenberg, NCL Executive Director

What a bittersweet moment for advocates like NCL fighting off the lies and falsehoods spread by the anti-vaccine movement, as we start to see some anti-vaxxers changing their tune while still others continue to hold firm to their dangerously misinformed views. The reality is that a vaccine to fight COVID-19 would have prevented the global devastation caused by this disease and prevented the loss of nearly 60,000 lives and 27 million jobs nationwide.

Over the past decade, NCL has become a champion of vaccines and their extraordinary power to protect humans around the globe safely and effectively from many deadly diseases. Illnesses such as polio, tetanus, measles, smallpox, flu, mumps, measles, tuberculosis, human papillomavirus (HPV), that have maimed and killed billions of people, have ebbed or been eradicated, thanks to vaccines.

As a commitment to our advocacy, NCL has twice testified before the Advisory Committee on Immunization Practices (ACIP) in support of the meningitis B and pneumonia vaccine (PCV-13). In our testimonies, NCL called for universal vaccination for children and adults, reaffirming vaccines as one of the greatest gifts modern medicine has provided to the human race.

Our comments also challenged the outrageous falsehoods spread by the small but vocal anti-vaccine movement. Their claims of vaccines causing autism have been debunked over and over, yet their power to scare parents lives on.

I grew up with an uncle who contracted polio a year before the vaccine was introduced. His illness was utterly devastating. Having a quadriplegic member of the family meant that from a very young age I developed an appreciation for vaccines and was comforted in knowing that I didn’t have to worry as my grandparents did about losing my son to a terrible disease.

Now Americans wait anxiously for labs and drug companies to develop a safe and effective COVID-19 vaccine. This could take many months due to our remarkably high standards of safety and efficacy. I certainly hope this calamitous COVID-19 outbreak will be the death knell of the anti-vaccine movement. Sadly, I fear it will not.

COVID-19, what could it cost you?

Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

As the nation continues to navigate the COVID-19 pandemic, another top-of-mind concern is the cost associated with both testing and treatment for the illness. Between the boldness of certain state officials relaxing restrictions and the rapid ascension of cases, exposure to COVID-19 will inevitably rise.

The reassuring news is that the majority of Americans diagnosed will be able to recover from home. But what if you’re among the 15 percent that will need hospitalization? This subset of the population will require the most acute care, including admission into an intensive care unit and use of a ventilator. Between testing and treatment, there are a lot of factors for the consumer and patient to consider—outright costs of care, as well as cost-sharing (co-pays, deductibles, out-of-network costs, and more)—we did some of the research below.

Testing

  • Affordable Care Act (ACA)-compliant Plans: Under the Families First Coronavirus Response Act, all comprehensive health plans (individual, employer-sponsored, or ACA marketplace plans), must cover testing for COVID-19 at 100 percent.
  • Medicare & Medicaid: Testing is covered at 100 percent for Medicare and Medicaid.
  • Uninsured: Testing will be covered at 100 percent by Medicaid, as mandated by the CARES Act.
  • Non-ACA-Compliant Plans: Testing coverage may vary for consumers with non-ACA-compliant plans (i.e., short-term plans), as these plans are not subject to the protections found in the ACA.

Apart from non-ACA plans, there’s testing done in an emergency room, urgent care, or physician’s office, and all that should be covered. In addition, the health plan cannot impose prior authorization or cost-sharing restrictions (i.e., copays, deductibles, coinsurance) on the patient. Of course, access to testing is currently limited to those with symptoms or those working in health care facilities or other consumer-facing businesses. There are still strict criteria established by the Centers for Disease Control and Prevention (CDC).[1]

Treatment

Newly passed emergency bills do not address coverage of treatment. The Kaiser Family Foundation estimates that out-of-pocket costs for COVID-19 treatment for someone insured on an employer-based health plan could run upwards of $10,000, provided that there are no complications. For patients that require more acute care, costs could reach $20,000.

ACA-Compliant Plans: Health plans are not required to fully cover the cost of positive tests. A majority of the treatments for COVID-19 under ACA-compliant plans will qualify as essential health benefits, and as such will be covered. However, every state defines its own criteria for essential health benefits, and it is possible that some treatments will not be covered, based on where you live. Furthermore, coverage may vary depending on the type of group health plan you have (large vs. small).

Cost-sharing will also likely be imposed. Marketplace plans are required to cap maximum out-of-pocket costs for services covered in-network. In 2020, the maximum out-of-pocket cap is $8,150, meaning that if your care is deemed medically necessary, your out-of-pocket costs should not exceed that amount. Some plans have offered to cover patient-cost sharing for out-of-network care for COVID-19 in the absence of in-network availability. As an emergency course of action, several health plans have waived out-of-pocket costs like copays and coinsurance associated with treatment for COVID-19. To see where your health plan stands, click here.

Medicare and Medicaid: Medicare Part A (hospital stays) and Part B (doctor’s visits) will continue to charge copays and deductibles. The deductible for a 60-day hospital stay under Part A is $1,408. For Part B, the annual deductible is approximately $200. Cost-sharing related to Medicare Advantage and Medicaid plans will depend on your individual plan.

Uninsured: The Trump Administration has announced that part of the $100 billion of the $2 trillion appropriated for COVID-19-related relief in the CARES Act will be dedicated to reimbursing providers who treat uninsured patients. Provisions within the law include treatment for primary diagnosis of COVID-19 in a variety of settings, both emergency and non-emergency transportation, and post-acute care. Services that will be excluded from coverage include hospice and outpatient prescription drugs.

While further guidance is pending, Health and Human Services Secretary Alex Azar has clarified the following: “as a condition of receiving funds under this program, providers will be forbidden from balance billing the uninsured for the cost of their care.” This caveat reinforces that providers would get reimbursed at Medicare rates for delivery of uncompensated care and cannot balance bill the difference between Medicare reimbursement and the hospital’s charges.

In addition to the above, the law prohibits hospitals from charging patients beyond what they would pay in-network or what Medicare pays. The mandate against surprise billing serves to protect patients covered by government programs, employer-based plans, and self-purchased insurance.

Also, the growing loss of employer-based health coverage has prompted several states to extend their special enrollment periods to accommodate newly unemployed/uninsured patients during the pandemic. To see if you qualify for a special enrollment period, click here.

Non-ACA-Compliant Plans: Off-marketplace plans are not regulated by the ACA, and this could affect coverage for COVID-19-related treatment, where there is a possibility that treatment may not be covered outright. Examples of non-ACA plans include short-term health, fixed indemnity, and critical illness plans. These plans do not qualify for minimum essential coverage and are insufficient on their own, in our view.

Understanding insurance benefits can be daunting under ideal circumstances, let alone during a global health crisis. Consumers need enhanced accessibility and coverage now more than ever and NCL commends health plans for acting promptly to waive various cost-sharing measures. NCL urges Congress to continue to fortify and provide clear guidance for consumer protections, to ensure that they are not left stranded without vital care. Consumers, please know that there are COVID-19-related resources available to you—for more information, click here.

[1] To find a drive-thru testing site near you, click here.