- Starting July 15, hospitals are to redirect their COVID-19 reporting away from the Centers for Disease Control and to the Department of Human and Health Services instead.
- The decision is billed as a way to “streamline” data collection across multiple government agencies.
- However, there are fears that the data won’t be completely transparent and available to the public now that it’s controlled by a Trump administration official.
The Trump administration ordered hospitals to bypass the Centers for Disease Control (CDC) and send information about COVID-19 to a central database controlled by the Department of Health and Human Services (HHS), starting July 15.
The move came as a shock to many health experts as the CDC has long been the agency where pandemic data has been submitted. However, the administration issued the policy change after discussions with hospitals and government task forces highlighted how cumbersome current data-submission processes are.
The government also hopes that by keeping the process streamlined, data will be more easily accessible to agencies other than just the CDC, including groups like the Coronavirus Task Force. That would allow the task force to better handle the pandemic and better allocate scarce resources like ventilators and remdesivir – a drug that is known to help reduce the recovery time of COVID-19.
The move to redirect which agency handles coronavirus information stemmed from a July 10 memo that laid out what Wednesday’s new rules would be. According to that HHS memo, back in late March, Vice-President Mike Pence sent a letter to hospitals across the U.S. asking them to send daily reports about the pandemic. It adds that since then, many government agencies have asked for similar information.
The administration claims that hospitals complained about how many different agencies were asking for information, adding that it was distracting administrators from actual hospital duties. Following these complaints, Dr. Deborah Birx, the White House coronavirus response coordinator, set up a call with hospital administrators and groups that represent hospitals to come up with a new plan.
Ultimately that call and other discussions led to the July 10 memo and Wednesday’s updates to how coronavirus data is collected.
Why Take the Data Away?
The move to switch COVID-19 data collection away from the semi-independent CDC and to the politically appointed HHS was a cause of concern for many. The largest complaint is that it’s moving the information away from experts who specialize in disease management and control.
Moving the information away from the experts has led to accusations that the administration is politicizing the science. Such an accusation was made on Tuesday in an open letter from the past heads of the CDC, both Democrat and Republican.
Dr. Nicole Lurie, former assistant secretary for preparedness and response during President Barack Obama’s administration, told The New York Times, “Centralizing control of all data under the umbrella of an inherently political apparatus is dangerous and breeds distrust,” adding, “It appears to cut off the ability of agencies like C.D.C. to do its basic job.”
This leads to another possible issue: that information won’t be made available. Like Dr. Lurie stated, there are fears the CDC and other groups will be blocked from the information. Jen Kates, Director of Global Health and HIV policy at the Kaiser Family Foundation also raised concerns to The New York Times.
“Historically, C.D.C. has been the place where public health data has been sent, and this raises questions about not just access for researchers but access for reporters, access for the public to try to better understand what is happening with the outbreak,” Kates said.
“How will the data be protected? Will there be transparency, will there be access, and what is the role of the C.D.C. in understanding the data?”
Streamlining the Data
However, despite concerns there are experts who think the decision is a good idea.
The CDC’s system is called the National Healthcare Safety Network and it’s known for being cumbersome and slow. On top of that, the guidelines for what data and how to submit it constantly changes, frustrating hospital administrators who have to report the data over and over again to a ton of different agencies who have shifting guidelines.
The new system, which is managed by TeleTracking, a health data firm in Pittsburgh, is supposed to remove some of those redundancies, partly by using one standardized submission form. Additionally, If hospitals report to their state, and that state then sends the info to HHS, the hospital can get a waiver and skip sending it to HHS themselves. Officials within the administration, like Michael R. Caputo, the Health and Human Services spokesman, explained the problem like this: “Today, the C.D.C. still has at least a week lag in reporting hospital data. America requires it in real time.”
Critics still point to one possible issue with this explanation, both systems use push data. Push data means both databases require hospitals, states, and agencies to actually input the data themselves and send it to the HHS. However, the July 10 memo does state that there are plans to automate the process, something the CDC has struggled to do for years.
Caputo tried to calm fears that the information was going to be locked away from the CDC and the public, saying, “The new, faster and complete data system is what our nation needs to defeat the coronavirus, and the C.D.C., an operating division of H.H.S., will certainly participate in this streamlined all-of-government response. They will simply no longer control it.”
He also went on to specifically say that the data would be available to the public. That information was also backed up by Dr. Birx, who gave assurances to hospital administrators back when this whole system was being set up that the info would be public.
Some doctors took the assurance at face value, like Dr. Janis Orlowski, who told The New York Times, “We are comfortable with [the switch] as long as they continue to work with us, as long as they continue to make the information public, and as long as we’re able to continue to advise them and look at the data.”
She also believes the switch is “a sincere effort to streamline and improve data collection.’’
However, as of Wednesday afternoon, there’s no data coming out at all. The New York Times reports, “the Health and Human Services database that will receive new information is not open to the public, which could affect the work of scores of researchers, modelers and health officials who rely on C.D.C. data to make projections and crucial decisions.”
There’s a key distinction there; the difference between the information being made public down the line, and having direct access to the database itself. The lack of data could be because the HHS system just went online as of July 15 and hospitals have yet to begin submitting their information.
It remains to be seen if HHS will beat the CDC timeline of “at least a week” to get the data about COVID-19 out, and whether or not it’ll be available to the public.
Adderall Shortage Sparks Fears of Opioid-Like Crisis
Experts specifically have expressed concerns that the lack of legal Adderall will force people to turn to black markets as they did when the supply of opioids was cut off.
Public health experts watching the ongoing Adderall shortage in the U.S. have raised concerns about the possibility that it could cause a major health crisis.
In mid-October, the Food and Drug Administration (FDA) announced that there was a nationwide shortage of immediate-release Adderall. The agency specifically noted that Teva Pharmaceuticals, which is the biggest manufacturer of the drug, was “experiencing ongoing intermittent manufacturing delays.”
Since then, the FDA has also reported that there are other manufacturers experiencing similar problems as well. In statements to the media, Teva has explained that the supply disruptions were triggered by a combination of a since-resolved labor shortage on its packing line this summer, as well as increased demand for the drug.
Adderall prescriptions have skyrocketed over the last two decades. From 2006 to 2016, the prescription of stimulants more than doubled in the U.S., and those numbers have grown since the pandemic. According to figures from the data analytics firm IQVIA, from 2019 to 2021, Adderall prescriptions alone rose by about 16%, surging from 35.5 million to 41.2 million.
Experts say the big spike over the last few years has been driven by the fact that more people are seeking these drugs to help cope with stress and distraction. Telehealth regulations that were relaxed during the pandemic also made it much easier for people to get diagnosed and prescribed in shorter periods of time.
A growing number of new start-ups have been taking advantage of lax rules, flooding social media — and specifically TikTok — with advertisements telling people to get ADHD meds if they feel distracted or tired. Many professionals say these apps pose issues because they are designed for such quick diagnosis so it can be hard to tell if ADHD is actually the problem people who present those symptoms are dealing with.
The resulting effect has been renewed speculation that stimulants are being overprescribed — a factor some believe could also be driving this shortage.
Additionally, Adderall is a Schedule II controlled substance, so it is highly regulated by the Drug Enforcement Administration (DEA), meaning there are caps on how much each company can produce so they can’t just ramp up production to make up for the backlog. It is also difficult for pharmacies to just pivot and start carrying new brands because of the regulations on this drug.
Leo Beletsky, a professor of law and health sciences at Northeastern University and faculty director of the Health in Justice Action Lab, worries all these elements could create the perfect storm for a full-blown crisis.
In an interview with Rogue Rocket, he outlined two overarching concerns.
“One is that you have lots of people who had access, sort of regular access to medication that they may not now have access to, and there are individual-level risks that sort of cascade from that,” he said. “Insomnia, depression, in some instances, you could even see suicidal ideation. So all of these are kind of, you know, health risks that result from rapid tapering or discontinuation, discontinuation of taking Adderall.”
“What is an even bigger concern or, an equally important concern, is that lots of people without access to the pharmaceutical supply will turn to the illicit market and counterfeit Adderall is readily available on the illicit market and other forms of unfettered means. Specifically, methamphetamine is available, widely available on the illicit market 24/7. You know, there’s no shortage in that market,” he continued.
Beletsky explained that there are a number of harms that can come as a result of people turning to the black market — and there is first-hand evidence of this from the opioid crisis. As he noted, opioids were also widely criticized as being overprescribed, and so when access was cut for prescription opioids, people turned to illegal markets and there was a massive spike in the use of heroin, counterfeit opioids, and fentanyl contamination.
“The public health, sort of population-level concern is that we might see similar patterns here where lots of folks are being pushed into the market and they’re, you know, it’s the Wild West. Counterfeit Adderall oftentimes does have methamphetamine,” he stated. Counterfeit Adderall can also be cross-contaminated with other dangerous drugs like fentanyl.
“Methamphetamine is even cheaper than counterfeit Adderall pills, and so the concern is that folks might start smoking meth and even injecting meth, which is, you know, increasingly common,” Beletsky continued. “It would be a huge public health disaster if thousands or even millions of people started taking methamphetamine in or trying to replace this pharmaceutical supply.”
Beletsky pointed out a number of tools the FDA has at its disposal to address the possible crisis and clear up the shortage, including encouraging other competitors to create new sources of production, as well as encouraging the importation of Adderall from abroad.
However, while the agency would have the power to fast-track these actions to skirt regulatory hurdles, so far, they have not taken any of these steps. In response to questions as to whether the FDA will intervene and speed up the process, a spokesperson told Rogue Rocket that the agency “evaluates all its tools and determines how best to address each shortage situation based on its cause and the public health risk associated with the shortage.”
When asked when the FDA thinks the shortage will be resolved, the spokesperson said it is “expecting the supply issues to resolve in the next 30-60 days.”
But Beletsky said he does not buy that timeline.
“I’m afraid that they may be over overly optimistic given the scale of the problem,” he told Rogue Rocket. “My guess is it’s going to take months to resolve. And I hope that, you know, most folks are able to kind of make do and not start kind of purchasing alternatives from the illicit market.”
The professor emphasized that the current shortage is a symptom of broader problems with America’s overall system for drug regulation that goes beyond the FDA and centers on the powers granted to the DEA.
Unlike the FDA, the DEA is a law enforcement agency, and Beletsky notes it has a long history of focusing on controlling the supply of these kinds of drugs rather than ensuring there is adequate access for the people who need them.
As a result, the DEA has very little control over both the legal and illegal markets for controlled substances. Because of this, people lack proper access to the prescriptions they need while the massive, unregulated black market is thriving.
Beletsky argued it is imperative that we use this latest shortage as yet another wake-up call to highlight the need for rethinking how drug access is structured in America.
“I think that it’s really important to highlight the failures of the DEA in this context, because the DEA, much more than the FDA, is responsible for finding that balance between access and control,” he said. “I think that we really need to reevaluate the role of the DEA in our drug regulatory system. And the FDA, on the other hand, probably could use additional authority.”
“When it comes to essential medicines, we really need much more authority for governmental regulation to step in and sort of help to stabilize access to these particular medications, as well as many others.”
How to Seek Help
Beletsky noted that there are several steps people who need Adderall can take until the shortage clears up.
“I think it’s important to note that there are other alternatives in the pharmaceutical supply that are not in shortage,” he explained. “And so talk to your provider about what additional tools may be available, you know, other stimulants that you can […] try to kind of bridge the gap.”
“I think it’s also important to note that if you do turn to, you know, folks are turning to buying Adderall or other alternatives on the illicit market, it’s really important to test that supply, especially for fentanyl.”
For more information on obtaining test strips and other harm reduction tools, Beletsky recommended visiting Next Distro or finding your local harm reduction agency, which can be done on the National Harm Reduction Coalition website.
For those suffering the impact of the Adderall shortage, The Washington Post has a guide with helpful tips and ideas from professionals.
See what others are saying: (WIRED) (The New York Times) (Axios)
Senate Approves Respect for Marriage Act, Clearing Path for Finalization
The bill was passed 61-36 with bipartisan support from 12 Republicans and is expected to be approved by the House next week.
Respect for Marriage Act
The Senate passed a landmark bill Tuesday that will codify the right to same-sex and interracial marriage into federal law.
The legislation, called the Respect for Marriage Act, was passed in a bipartisan vote of 61-36 with 12 Republicans bucking pressure from many of their colleagues and powerful conservative groups.
The bill would repeal the 1996 Defense of Marriage Act (DOMA), which defined marriage as a union between one man and one woman. While it will not require all states to allow for same-sex marriage, it does mandate that they recognize out-of-state same-sex marriages performed legally in states that do allow them.
Furthermore, the proposal contains a provision that Republican supporters insisted on, which clarifies that religious nonprofit organizations do not have to provide goods or services for same-sex marriages and that the federal government is not authorized to recognize polygamous marriages, among other measures.
Lawmakers introduced the bill after the Supreme Court reversed Roe v. Wade, stirring concerns that the high court could come after other basic rights. In his decision to overturn Roe, Justice Clarence Thomas said he believes the court should reconsider Obergefell v. Hodges, the 2015 case that established gay marriage.
Many Republicans initially opposed the Respect for Marriage Act, claiming it was not necessary because Obergefell was still in place, and accused Democrats of trying to pull off a political stunt ahead of the midterms.
The accusations prompted the bipartisan group of Senators driving the push to postpone a vote on the matter until after the elections.
“I feel like we were told in pretty clear terms that we would have some people support only if the vote came after the midterms,” Sen. Tammy Baldwin (D-Wi.), who led the effort, told Rogue Rocket after the decision in October.
An earlier version of the bill passed the House this summer, though the changes to the language of the policy require the lower chamber to vote on it again.
That passage is all but assured as Democrats still hold the House and the last version was approved with a broad bipartisan majority that included 47 Republicans. President Joe Biden, for his part, applauded the Senate vote and said he looks forward to signing the bill.
Shift in Opinion
Other proponents of the bill also cheered its passage in the Senate, which just two decades ago would have been unimaginable, and not just because of Republican opposition.
Democrats, too, have only more recently shifted to support same-sex marriage and LGBTQ+ rights more broadly. President Bill Clinton, a Democrat, signed DOMA into law, and President Barack Obama first voiced his support for same-sex marriage while running for his second term in 2012.
The transformation in public opinion has happened relatively fast, especially when compared to other civil rights movements. When Clinton signed DOMA in 1996, gay marriage had the support of just 27% of the public. Now, polling shows seven in ten Americans support legal recognition.
Still, the Republican party appears to lag behind the times, with 70% of senate Republicans having opposed the Respect for Marriage Act.
“This is a great example of politicians following public opinion rather than leading it,” Sasha Issenberg, author of “The Engagement: America’s Quarter-Century Struggle over Same-Sex Marriage,” told Axios.
“Now it’s Republicans who are torn between placating some of their loudest activists and taking a position that aligns with where general-election voters are.”
See what others are saying: (The Washington Post) (The New York Times) (Axios)
Kathy Griffin, Ethan Klein, More Suspended From Twitter Over Elon Musk Impersonations
Many have pretended to be Musk in an attempt to highlight the potential issues paid-for verifications could cause on the platform.
Musk Takes on Impersonations
Comedian Kathy Griffin and internet personality Ethan Klein are among the many Twitter users that have been permanently suspended for impersonating the platform’s new CEO, Elon Musk.
Impersonation has long been against Twitter’s rules, but on Sunday, the billionaire took the policy a step further by announcing that “any Twitter handles engaging in impersonation without clearly specifying ‘parody’ will be permanently suspended.”
“Previously, we issued a warning before suspension, but now that we are rolling out widespread verification, there will be no warning,” Musk explained. “This will be clearly identified as a condition for signing up to Twitter Blue.”
Musk also said that any user who changes their name will temporarily lose their verification check mark.
The announcement came as many verified users began mocking Musk by changing their name and photo to match his, then tweeting jokes that were either absurd or out of character for the business mogul. Many did this to protest Musk’s plan to charge an $8 monthly subscription fee that would allow any Twitter user to become verified.
Klein was one of many who changed his name to “Elon Musk” and made a photo of the CEO his profile image. The podcast host sent out several jokes, including one referencing the increased use of the N-word on the platform since Musk’s takeover, and another referencing Jeffrey Epstein.
“Even though Jeffrey Epstein committed horrible crimes, I do still miss him on nights like this for his warmth and camaraderie. Rest In Peace old Friend,” he wrote.
His account was quickly banned, but Klein defended himself on TikTok, arguing that both his cover photo and bio labeled his account as “parody” and therefore should be acceptable under Musk’s guidelines.
“What more do you want from me?” he asked. “Comedy is dead. And Elon Musk dug the grave.”
Protests of Musk’s Twitter Control
For her part, Griffin likewise tweeted while masquerading as Musk, writing that after “spirited discussion with the females in my life, I’ve decided that voting blue for their choice is only right.”
Musk joked that she was actually “suspended for impersonating a comedian” and added that she can have her account back if she pays for the $8 subscription. Griffin, however, found another way around the ban.
The comedian logged into her late mother’s Twitter account and began using the hashtag #FreeKathy while calling out Musk.
“Mad Men” actor Rich Sommer and podcaster Griffin Newman have also had their accounts suspended for tweeting as Musk. Other celebrities, including TV producer Shonda Rhimes, musician Sara Bareilles, and model Gigi Hadid have protested Musk’s Twitter reign by leaving the platform altogether.
“For a long time, but especially with its new leadership, it’s becoming more and more of a cesspool of hate & bigotry, and it’s not a place I want to be a part of,” Hadid wrote on Instagram over the weekend.