DANDRIDGE, Tenn. — Rachel Solomon and judges hadn’t been on the best of terms. Then Judge O. Duane Slone “dumbfounded” her.

Solomon was given her first Percocet at age 12 by a family member with a medicine cabinet full. It made her feel numb, she said. “Nothing hurt.” By 17, she was taking 80-milligram OxyContins. A decade later, she was introduced to heroin.

During those years, Solomon was in and out of trouble with the law.

Then, five years ago, at 32, she arrived in Slone’s courtroom, pregnant, fearing the worst. But the state circuit court judge saw promise. He ruled that Solomon would serve jail time for an outstanding warrant for aggravated burglary and then would be placed in a program for pregnant or parenting women recovering from addiction. She would retain custody of her son, Brantley, now 4.

Slone also offered an option that many judges, particularly in rural jurisdictions, at that time were averse to extending: medication for opioid use disorder, or MOUD.

A study conducted a decade ago found that barely half of drug treatment courts offered medication treatment. Those that didn’t cited uncertainty about its efficacy and noted political, judicial, and administrative opposition. But research in the years since has persuaded many of the most insistent abstinence-only advocates.

According to Monica Christofferson, director of treatment court programs at the Center for Justice Innovation, amid an accelerating opioid crisis there has been a “huge shift” among judges, prosecutors, and law enforcement agencies away from the stigma associated with medication treatment. Simply put, “MOUD works,” Christofferson asserted.

By 2022, more than 90% of drug courts located in communities with high opioid mortality rates that responded to a survey said they allow buprenorphine and/or methadone, the medications most commonly used to treat addiction. The study also found that 65% of drug court program staffers have received training in medication for treatment, and a similar share have arranged for clients to continue receiving medications while serving jail time for program violations. Still, almost 1 in 4 programs told researchers they overrule medication decisions.

Federal legislation has lowered the barriers to it. And Bureau of Justice Assistance funding for treatment-court programs now mandates that medication for substance use disorder be provided.

Solomon experienced that shift in real time in Slone’s courtroom as the judge allowed her access to medication to treat her addiction to opioids.

As a young prosecutor in the 1990s in mostly rural eastern Tennessee, Slone was embedded with a drug task force and was well versed in efforts to counteract the supply side of the opioid crisis. Then, as a circuit court judge, he’d put his share of people behind bars on drug-related convictions.

As the crisis deepened, he started to wonder if addressing the demand side would be more effective.

Like so many other prosecutors and judges, Slone believed abstinence was the only path to recovery. But in 2013, after consulting with substance use disorder experts, he relented, introducing medication as an alternative to incarceration for pregnant women. By 2016, he had fully embraced it throughout his recovery courts — even as most judges, he said, “still believed that it was substituting one drug for another.”

Building from evidence-based research, Slone has launched programs that show how a judge, and a region, can trade an abstinence-only, lock-’em-up approach for one that offers a full range of paths to recovery.

Before witnessing medication treatment’s efficacy, Slone said, he would tell a defendant charged with a drug offense, “‘This is your second chance. If you violate the conditions of your probation, I’m going to put you in jail.’”

Often, six months later they’d be back in his courtroom, charged with a low-level crime and having tested positive for drugs. “They’re 19, maybe 20 years old, and I’m executing a five-year sentence. It makes me sick to my stomach now.”

Slone was sure there must be a better way.

A drug recovery court, which he co-founded in his 4th Judicial District in 2009, was a first step. It allows defendants with nonviolent drug-related charges to avoid jail time by entering treatment and counseling. They’re closely monitored by a team that includes a judge, case manager, public defender, prosecutor, and probation officer. If the participant violates the terms of the agreement, the first step is a reassessment of treatment needs. Multiple violations may result in incarceration.

Because this form of drug court is resource-intensive, relatively few people can be enrolled. So in 2013, Slone introduced the Tennessee Recovery Oriented Compliance Strategy, or TN-ROCS, an alternative to jail for those who aren’t considered at high risk of recidivism but are deemed in urgent need of treatment. Many are pregnant women or mothers of young children.

Given the reduced need for supervision, the program can accommodate more participants. So far, more than 1,000 people have been on the district’s TN-ROCS docket.

Both the recovery court and TN-ROCS offer three medication options: buprenorphine, methadone, and naltrexone.

Since TN-ROCS’ launch, Slone said, his community has seen a decrease in property crimes and its jail population. Over its first five years, all 34 pregnant women in the program gave birth to healthy babies and 30 kept custody of their children. TN-ROCS is now being replicated across the state.

One barrier to broader acceptance of medication treatment in both rural and urban communities, Christofferson said, is a lack of education.

Corey Williams agrees. He advocates for educating criminal justice system officials. Williams is an officer with the Lubbock, Texas, Police Department and is a consultant with the Law Enforcement Action Partnership, which promotes drug policy and criminal justice reform. He believes that if more criminal justice officials had personal experience with medication to treat substance use disorder, they’d view it differently.

Williams’ wife, Brianne Williams, became addicted to opioids in medical school. She participated in a series of abstinence-only programs and was free of the drugs for seven years, then relapsed. She was arrested for writing herself a prescription for opioids and placed on probation.

She had entered a Suboxone treatment program, but her probation officer incorrectly informed her she couldn’t remain on Suboxone on probation. Williams relapsed, failed a drug test, and served 30 months in federal prison. After her release, she went back on Suboxone — a brand-name combination of buprenorphine and naloxone — and has maintained her sobriety. “It improved my life drastically,” she said. She now hopes to regain her medical license and specialize in addiction treatment.

The relative unavailability in rural areas of medication treatment is certainly a problem. A shortage, Christofferson noted, is not only an issue in itself, but also a barrier to overcoming stigma. More openings available, more success stories. More success stories, less stigma. Fewer provider options also means one bad actor — a provider who overprescribes or is otherwise negligent — perpetuates the stigma. Strict oversight is essential.

Physician Stephen Loyd influenced Slone’s decision to embrace medication treatment and is now a member of Slone’s recovery court team. Loyd was practicing internal medicine in eastern Tennessee when he developed a 100-pill-a-day addiction to prescription opioids. He was the inspiration for the character Michael Keaton portrayed in the Hulu series “Dopesick.” Loyd overcame his addiction and served as the state’s “opioid czar” under Gov. Bill Haslam from 2016 to 2018.

While in state government, Loyd helped plant the seed for TN-ROCS. He told Slone the first judge to take such an initiative would “be on the cover of Time magazine, because your success rates are gonna go up dramatically; you’re gonna save a bunch of lives.”

“He didn’t get on the cover of Time,” Loyd allowed, “but he did win the William H. Rehnquist Award.” The William H. Rehnquist Award for Judicial Excellence is among the country’s highest judicial honors.

Rachel Solomon contends one of those lives saved was hers.

Today she and her son are together; she’s employed. She remains on Suboxone. She feels good. And she feels fortunate she arrived in Slone’s courtroom when she did.

“He’s the reason I am where I am today,” she said. “He really is.”

The post Once-Resistant Rural Court Officials Begin to Embrace Medications to Treat Addiction appeared first on Medika Life.

Monoclonal antibody therapy reduces the risk of hospitalization and severe disease. Pregnant people qualify for treatment, but they need to get the treatment as early as possible.

Our company, MacArthur Medical Center’s core values include INNOVATION and EXCELLENCE. We stay at the cutting edge to promote the best care possible to our patients.

Our company has started offering monoclonal antibody treatments to any pregnant patient who tests positive for Covid-19. We also refer gynecologic patients who meet the criteria. 

We share this protocol to help other practices learn of this treatment’s value and to provide a roadmap to integrate a similar option inside of their own practice

Here is what all Obgyn practices need to know.

Regneron is a medication approved by the FDA under emergency use authorization for the treatment of Covid-19 for those early in the infection and at high risk of developing severe disease.

All pregnant people diagnosed with Covid-19 are considered high risk. Pregnancy naturally suppresses the immune system which predisposes pregnant people for worse outcomes when they are infected with a viral illness. 

Regeneron is a combination of two medications, Casirivimab and Imdevimab. Regeneronmakes use of monoclonal antibodies to fight the disease. These antibodies are similar to the ones our body would naturally produce in response to infection.

Monoclonal antibodies are mass-produced in a laboratory and are designed to recognize a specific component of the Covid-19 virus — the spike protein on its outer shell. These specific antibodies interfere with the virus’s ability to attach and gain entry into human cells by targeting the spike protein. 

Monoclonal antibodies give the immune system a leg up until it can mount its response.

Most pregnant people who contract Covid-19 do well. But the studies are clear that Covid-19 increases the risk of preterm labor, ICU admission, intubation, and death.

For a practice to successfully integrate monoclonal antibody therapy into practice, we must focus on teamwork. Everyone in the practice should have some basic knowledge of this treatment option to make certain cases are identified and referred early in the infection when the treatment is most effective. 

We must work together to give our patients to best chance possible to stay healthy after being diagnosed with Covid-19. 

Remember: Getting vaccinated against Covid is the best approach. All medical providers and teammates should encourage every patient to protect themself and others. Protect our moms, babies, and children. 

Covid vaccination in pregnancy is safe and effective. There is zero credible evidence linking Covid-19 vaccines to infertility or miscarriage.

Who qualifies for monoclonal antibody therapy? 

Patients must meet at least ONE of the following criteria:

• Pregnancy
• High-risk Ethnicity Groups (Latin X or Black)
• Older age (for example, age ≥ 65)
• Obesity or being overweight (for example, BMI > 25 kg/m2)
• Chronic kidney disease, diabetes, or
• Immunosuppressive disease
• Currently receiving immunosuppressive treatment
• Heart disease 
• High Blood pressure 
• Chronic lung diseases
• Sickle cell disease
• Neurodevelopmental disorders

Additionally, patients must meet ALL the following criteria:

• 12 years of age or older
• The patient is symptomatic (not asymptomatic) and has mild to moderate illness.
• Day 10 or less since symptom onset or testing positive.
• Documented positive COVID test performed
• Not requiring Oxygen therapy 

Where is monoclonal antibody therapy done?

The State of Texas has placed The Regional Infusion Center 8th Avenue in Fort Worth near Cooks Children’s Medical Center. A physician must refer patients. Patients cannot refer themselves, and all treatments must be scheduled in advance.

Monoclonal antibody treatment is free. It is funded by the state of Texas. There is no cost to the patient.

The RIC (Regional infusion Center operates seven days a week from 8:00 AM — 6:00 PM. 

How can a practice refer a patient for monoclonal Antibody Therapy? 

1. Confirm the patient has a positive Covid test. 
2. Confirm the patient meets the eligibility criteria listed above. 
3. Fill out the Statewide RIC Infusion Referral Form. We recommend placing a copy of this required form inside of the practice’s electronic health record to help medical assistants and referral coordinators have easy access. 
4. Fax the RIC Infusion Referral Form to 210–208–5295 or send it by email to InfusionReferral@bcfs.net
5. An Infusion Center Representative will reach out to the patient to schedule an appointment.

The post North Texas Obgyns Need to Know About Monoclonal Antibodies for Covid-19 appeared first on Medika Life.

For several weeks experts warned us of rising Covid-19 Delta Variant cases sweeping across North Texas. The Delta variant, SARS-CoV-2 B.1.617.2 (Delta), was first identified in India in late 2020. This strain rapidly spread worldwide and is now the dominant variant in the United States, including Texas.

The CDC reports that the Delta variant accounts for 93% of current US Cases. The Delta variant is the most contagious so far. It passes easily and quickly from person to person. Children also catch the delta variant at a higher right than the original Covid-19 virus. A mutation in the spike protein makes the virus more “sticky.” It is more contagious and spreads in children faster than the original Covid-19 strain.

All Texans want children back in school, but we disagree on how to do it safely. 

Governor Abbot, who typically advocates for local control, has switched gears and taken a top-down approach. The Governor’s May Executive Order mandated no mask mandates. Abbott took control away from superintendents and consolidated his power in Austin. 

Parents in Dallas and Tarrant County are faced with tough decisions. How do parents send their children to school safely in the middle of a North Texas Covid surge? 

So far, 52,555 Texans have lost their lives to Covid-19. Many people are still in the mindset of “this won’t happen to me.” Now is the time to shift our thinking and face reality in our communities.

The University of Texas Southwestern, located in Dallas, provides updated data to help parents guide their decisions. The medical school publishes publically available projections an epidemiological model. 

Three weeks ago, I had zero patients with Covid-19. This weekend I cared for seven pregnant patients with the virus. The three local hospitals where I work are full of patients in the ICU. 

The UT Southwestern data demonstrates the exact rise that I am seeing working as a local physician. The projections for the next few weeks are alarming. 

UT Southwestern is projecting a substantial increase in the number of hospitalizations over the next few weeks. Hospital admissions are up 99% in two weeks and 346% in the past month. 

Check out the blue line in the chart. The blue line is the estimate of hospitalizations for the next three weeks. If cases continue at this pace, we will be dangerously close to surpassing available hospital capacity in Dallas and Tarrant County. 

In our hospitals, more young people are coming in with severe Covid infections requiring hospitalizations. UT Southwestern data reports that people under 65 represent the largest share of hospitalizations.  

The data also shows the overwhelming majority of patients with severe disease requiring ICU care are unvaccinated people. 

The UT Southwestern projections also show the people of Dallas and Tarrant County have the power to change the course of the virus. 

In this chart, the data scientists show the effect of basic mitigation strategies. If we increase the rate of vaccination locally and keep our masks on, we can save lives. 

The orange line shows what happens if we do nothing different. The green line shows how quickly we can make a substantial difference by covering our faces and getting as many people a life-saving Covid-19 vaccine as possible. 

There are three FDA-approved vaccines for Covid-19. The two messenger RNA vaccines from Moderna and Phizer offer 95% protection against Covid-19. The Covid-19 vaccines from Pfizer and Moderna use messenger RNA (mRNA). A single strand of mRNA delivers instructions to human cells to produce an antibody against the SARS-CoV-2 spike protein.

The Johnson and Johnson’s Janssen vaccine offers 72% protection against infection and 86% against severe disease. The Janssen vaccine uses Adenovirus 26 (AD26) as the vector to deliver DNA material into our cells to provoke an immune response.

The FDA expanded the emergency use authorization for the Pfizer messenger RNA Covid-19 vaccine for kids age 12–15 years old after Phase 3 study data showed the vaccine was 100% effective in preventing Covid-19 in this age group.

None of the vaccines contain a live virus. One can not catch Covid-19 from a vaccine. The vaccines do not enter the nucleus of the cells and do not alter our DNA. 

The Covid vaccines are not linked to miscarriage or Infertility. Research indicates most pregnant people who contract Covid-19 do well but have an increased risk of ICU admission and preterm labor.

The American College of Obgyn and Society for Maternal-Fetal Medicine recommends all pregnant women get a Covid-19 vaccine. The protective antibodies can save women’s lives and help protect the newborn.

Vaccines are available everywhere. They are free. We can help protect children going back to school by increasing vaccination rates.

Children who are 12 years old and older can get their Pfizer vaccine today. Adults can help protect the community by getting any of the three available Covid shots.

Children under age 12 are counting on us to protect them. We can slow the spread of Covid-19 by getting vaccinated. 

Protect yourself. Protect others. Protect the children. 

Get your shot today.

The post Dallas UT Southwestern Paints an Ugly Picture for Covid Projections appeared first on Medika Life.

Every pregnant couple’s worst nightmare is to find out something is wrong with their baby. As an Obgyn, I have seen the anguish on many patients’ faces. They ask the question, “why did this happen to my baby?”

The Texas Department of State Health Services tracks new baby deliveries each year to help parents find answers. Texas received excellent news this week. The Texas Medical Association reported new funding is on the way to track and trend birth defects.

The Center for Disease Control and Prevention will give $300,000 for the next five years to help support the Texas public health efforts. Texas monitors congenital disabilities inside of the Department of State and Health Services.

A robust group of public health experts tracks data through The Texas Birth Defects Epidemiology and Surveillance Branch. The mission is “to identify and describe the patterns and outcomes of children with birth defects in Texas and to collaborate with others in research, prevention, and family outreach services.”

The new funding allows scientists to evaluate environmental and health links that may cause congenital disabilities.

The CDC data shows that “every 4 ½ minutes, a baby is born with a birth defect in the United States.” Of the 3.75 million babies born each year, 120,000 of them will have some form of anomaly.

Birth defects can be minor such as an extra finger, or major such as congenital heart disease. We can break down congenital disabilities into easy-to-understand categories provided by the National Institute of Health.

Structural Birth Defects

Structural birth defects are abnormalities in specific body parts. Common examples are:

• Cleft lip or cleft palate
• Heart defects, such as missing or misshaped valves
• Abnormal limbs, such as a clubfoot
• Neural tube defects, such as spina bifida

Functional or Developmental Birth Defects

Functional or developmental congenital disabilities occur when there is a problem with how a body part or body system works. Examples include:

• Nervous system or brain problems.
• Sensory problems. 
• Metabolic disorders. 
• Degenerative disorders. 

The Texas Birth Defects Registry has a long history and is now celebrating its 25th anniversary. The idea formed after a cluster of fetal brain disorders spiked along the 1200-mile shared border with Mexico in 1990. Doctor’s noticed a high number of babies born with anencephaly, a fatal birth defect where a baby is missing most of the brain and skull.

The data showed a combination of environmental, genetic, and nutritional factors lead to the spike in Latin X women. Responding to this crisis, the Texas State Legislature passed the Texas Birth Defects Act in 1993, which created The Texas Birth Defects Epidemiology and Surveillance (BDES) Branch.

Back in 1990, over 80% of the people were Hispanic, and over 40% of the families had low incomes. BDES studied the health disparities between Texans living along the border with Mexico. Researchers found high rates of obesity, diabetes, and other metabolic disturbances.

The data also revealed high rates of environmental pollutants from the border town of Matamoros, Mexico. The Rio Grande Valley community had high toxic chemicals levels, including heavy metals, pesticides, and polychlorinated biphenyls (PCBs).

But the most critical finding was the low dietary intake of a vitamin called Folic Acid. Scientists now know that taking the daily recommended dose of 0.4 mg of Folic Acid daily can reduce the risk of neural tubes defects like anencephaly by 70%.

The Texas Birth Defects Registry helped identify this link and launched public health campaigns to encourage community clinics to spread the word. A daily prenatal vitamin, including Folic Acid, is now the standard of care for pregnant people.

The new CDC funding for the Texas Birth Defects Registry will allow more accurate reporting. The Department of State and Health Services will include data from Texas Medicaid to improve the accuracy of underreported cases or missing prenatal diagnoses. The registry will also share and collect data from electronic medical record systems.

This new money from the CDC will help Texas track and trend the most accurate data to identify at-risk populations better and increase our States ability to protect pregnant people and babies.

The post New Money From CDC Can Reduce the High Rate of Birth Defects in Texas appeared first on Medika Life.

A bipartisan group of Democratic and Republican representatives from the Dallas Fort Worth area worked hard to prove bipartisanship is not dead in Texas. This coalition fought for prison reform requiring Texas prisons to install air conditioning in all facilities.

HB 357 bill passed the Texas House by a vote of 123-18. In normal times, the bill would have moved to the Texas Senate before heading to Governor Abbott’s desk to sign it into law. Despite bipartisan support for this criminal justice effort, the Texas Senate failed to schedule the bill for a hearing, debate, or vote.

Just in time for Summer, The Texas legislative session is now over, and Texas Prisoners will pay the price. Texas lawmakers killed a bill that would have required air conditioning in prisons and saved lives.

The Dallas Morning News (DMN) reported one out of five lockup facilities has no air conditioning or climate control systems for inmates. Forty-nine prisons only have partial air conditioning. Temperatures can rise well above 100 degrees during the Texas Summers. Inmates confined to their cells no options to keep cool and stay safe.

Some view climate control as a luxury. “[Air conditioning] is seen as a luxury and prison officials don’t want to be seen as running luxurious prisons,” stated David Fathi, director of the ACLU’s National Prison Project. But in Southern states like Texas, regulating temperature can be a matter of life and death.

The lack of air conditioning in Texas prisons places prisoners and staff at risk. Prolonged heat exposure can cause lead to dehydration and heatstroke. Prolonged exposure to extreme temperatures can damage the kidneys, liver, lungs, and brain. Prisoners are at risk of kidney failure and heart attacks.

The DMN published documents showing more than twenty inmates died from the heat inside Texas prisons between 1998 and 2012. Terry Canales, a South Texas Democrat from Edinburg, told the House, “The reality is that we are cooking people in prison in Texas.”

HB 357 provided the Texas prison system with seven years to bring climate control systems to all facilities. The project had a cost cap of $300 million, and the bill is contingent on State or Federal funds approval to assist with cooling costs.

The bill would provide essential climate control and air conditioning to incarcerated people throughout the Texas Penal system. During the vote in House, only 18 members voted against this legislation.

The bill’s sponsors were Democrats and Republicans from the Dallas Fort Worth Metroplex, including Jeff Leach of Plano, Lynn Stuckey of Denton, Speaker Pro Tem Joe Moody, Michelle Beckley of Carrollton, and Carl Sherman of DeSoto.

In 2021, The Texas Winter Storm caused problems in the Texas prisons that do not have climate control. Mother Jones reported Texas prisoners attempted to set fires to try and keep warm during the historic freezing subzero temperatures and failure of the power grid. Inmates used toilet paper, scrap paper, and socks as kindling.

Prison Air conditioning bills have failed over and over again in Texas. Despite being one of the hottest states in the US, lawmakers have failed to provide basic climate control systems for inmates. Many thought 2021 would be different. The bipartisan effort which passed with flying colors in the house seemed destined to succeed in the Senate.

Speaker Pro Tem Joe Moody offered gratitude to the House members for their votes, reminding them, “We dehumanize people who are justice-involved.”

Sadly, The Texas Senate did not bring the bipartisan bill to the floor in the 2021 legislative session.

The post Bipartisan Texas Prison Reform Air Conditioning Bill Dies Without a Vote in Texas Senate appeared first on Medika Life.

Houston Methodist Chief Executive Officer Dr. Marc Boom notified the staff via email of the new vaccine policy back in March. In April, the Methodist system mandated all staff to begin the vaccination series before Jun 7.

Vaccines reached the arms of 99% of the 26,000 employees, but 117 unvaccinated staff members have filed suit against Houston Methodist over the Covid-19 vaccine requirements.

ABCNews reports the lawsuit alleges that Covid-19 vaccine requirements in the hospital setting are illegal because the three US Covid-19 vaccines are FDA approved only under emergency use authorization. The complaint states the hospital violates the Nurenberg Code.

The Nurenberg Code is a set of medical ethics designed to protect human subjects voluntarily participating in clinical trials. The Nurenberg Code was created more than 70 years ago after the Nurenberg trials exposed the horrific truth of Nazi medical experimentation on Jewish prisoners at the Auschwitz concentration camp.

Although Houston Methodist was the first hospital to require vaccinations, The decision is backed up by clinical data. A CDC report showed the messenger RNA vaccines are 90 percent effective at preventing COVID-19 infections in healthcare workers and first responders.

The CDC published updated information on healthcare worker vaccine safety and efficacy in the March 29th Morbidity and Mortality Weekly Report. This update analyzed Covid-19 vaccines in a real-world setting. The findings showed the Pfizer-BioNTech and Moderna were 90 percent effective at preventing COVID-19 infections among healthcare personnel, first responders, and other essential frontline workers.

Improving the number of vaccinated workers reduces the risk of spreading the infection from health providers to patients.

Houston Methodist’s staff Covid-19 vaccine requirements align with the influenza vaccine policy it implemented in 2009. Religious and medical exemptions are allowed. Pregnant women may choose to wait until after delivery to start the Covid-19 vaccine series. Of note, multiple studies now show Covid-19 vaccines in pregnancy are safe for mom and baby.

The hospital considers employee vaccinations to be a patient safety issue. Like other required hospital vaccinations, employees will not be permitted to return to work unless they are vaccinated.

Most hospitals have an employee vaccination policy to help prevent medical professionals from inadvertently spreading infectious diseases to patients. The CDC recommends vaccinations for healthcare workers. The recommendations include physicians, nurses, emergency medical personnel, dental professionals and students, medical and nursing students, laboratory technicians, pharmacists, hospital volunteers, and administrative staff.

These CDC-recommended vaccinations currently include Hepatitis B, Influenza, MMR (Measles, Mumps, and Rubella), Varicella, and Tdap (Tetanus, Diptheria, Pertussis). Most hospitals also require annual tuberculosis risk assessments.

Vaccinating healthcare workers reduces the risk of hospital-acquired infections. Vaccinations protect hospital staff from infectious disease exposure and reduce the risk of a healthcare worker transmitting an infection to a hospitalized patient.

Updated guidance from the Equal Employment Opportunity Commission indicates employers may require vaccination stating “Federal EEO laws do not prevent an employer from requiring all employees physically entering the workplace to be vaccinated for COVID-19, so long as employers comply with the reasonable accommodation provisions of the ADA and Title VII of the Civil Rights Act of 1964 and other EEO considerations.”

There are three FDA-approved vaccines for Covid-19 under emergency use authorization. Full FDA approval is expected as the results of ongoing clinical trials are completed and analyzed.

The two messenger RNA vaccines from Moderna and Pfizer offer 95% protection against Covid-19. The Covid-19 vaccines from Pfizer and Moderna use messenger RNA (mRNA). A single strand of mRNA delivers instructions to human cells to produce an antibody against the SARS-CoV-2 spike protein.

The Johnson and Johnson’s Janssen vaccine offers 72% protection against infection and 86% against severe disease. The Janssen vaccine uses Adenovirus 26 (AD26) as the vector to deliver DNA material into our cells to provoke an immune response.

The Moderna and Janssen vaccines are approved for those 18 years old and up. The Pfizer vaccine is approved starting at age 16.

All three vaccines are highly effective in preventing death.

The post Unvaccinated Hospital Staff Sues Houston Methodist Over Covid-19 Vaccinations appeared first on Medika Life.

After Texas passes the heartbeat bill limiting abortion access, Representative Rose hopes to prove Texans care about women and children after pregnancy ends.

Dallas Representative Toni Rose sponsored House Bill 133. She proposed extending Medicaid benefits to low-income women after they have a baby. Rose told The Austin Statesman, “For the past few years, I’ve heard from families across the state who have lost loved ones due to complications of childbirth. Believe me when I say that this issue knows no political or geographical boundaries.”

Under current guidelines, pregnant people qualify for Medicaid for sixty days after delivery. During the Covid-19 pandemic, Texas extended postpartum Medicaid coverage for one year. Some women qualify for a Healthy Texas Women program that provides contraception access and basic primary care coverage.

House Bill 133 is titled “Relating to the provision of certain benefits under Medicaid and the Healthy Texas Women program, including the transition of case management for children and pregnant women program services and Healthy Texas Women program services to a managed care program.”

The bill would allow pregnant people who qualify for Medicaid to continue their health coverage for twelve months after having a baby. The bill passed the Texas House in bipartisan fashion 121-24. The Texas Senate amended the bill reducing the coverage from twelve to six months. The Texas Medical Association is lobbying to extend health coverage back to one year.

Preexisting medical conditions cause many pregnancy complications. To address preexisting conditions, patients need access to medical providers. Primary care, Obgyn, and specialist care before, during, and after pregnancy reduce the risk of maternal deaths.

Many Americans access the US Health system through the Medicaid program. Medicaid covers almost half of the births in our country. In Texas, 54% of pregnant women qualify for Medicaid. But many states, like Texas, chose not to expand Medicaid under the provisions of the Affordable Care Act.

Federal law dictates states must provide prenatal coverage through the Medicaid program. Pregnant women with family incomes up to 138% of the federal poverty level qualify for mandatory prenatal coverage.

Medicaid coverage does not begin until the pregnant woman completes the pregnancy verification process. For many women, this process is slow and arduous. Federally mandated prenatal coverage also ends sixty days postpartum.

In Texas, we provide Medicaid AFTER patients get pregnant and take it away when they deliver. Women gain temporary access to the US health system once they become pregnant and lose access once they deliver their baby. Health providers lose many opportunities to address health needs and prevent complications.

Pregnant people qualify for free health coverage through Medicaid for Pregnant Women, which makes Medicaid available during pregnancy and for two months after birth if they fall under certain monthly income thresholds based on family size ($2,126 or less for a single woman or $3,624 for a family of three).

But to qualify after the two-month postpartum period, the income threshold is significantly lower: $196 a month for a mother with one child or $230 for a mother with two children ($285 a month for a two-parent household with two children).

The maternal mortality rate in Texas is above the national average. According to 2018 data from the U.S. Centers for Disease Control and Prevention, the estimated maternal mortality rate (women who died while pregnant or within 42 days of delivery) was 17.4 deaths per 100,000 live births. In Texas, the maternal mortality rate was 18.5 deaths — that’s nearly 700 deaths nationally and about 70 in Texas each year.

Black and other women of color are two to three times more likely to die from pregnancy-related causes than white women. This risk increases with age. For women over the age of 30, the risk of dying during or after pregnancy is the risk dying before or after pregnancy is four to five times higher than white women.

The 2010 Affordable Care Act (ACA) increased coverage in our country, but millions of Americans are still without health insurance.

The lack of access to high-quality, affordable healthcare increases poor health outcomes and widens the racial disparities.

Why do pregnant women die?

1. Cardiomyopathy and another cardiac disease
2. Thrombotic pulmonary embolism
3. Preeclampsia and hypertensive disorders of pregnancy
4. Hemorrhage
5. Cerebrovascular accidents (strokes)
6. Infections

Representative Toni Rose proposed House Bill 133 to bridge the gap, ensuring Texas provides care for pregnant people after they give birth. This legislation will save lives.

Representative Toni Rose is serving her fourth term in the Texas House of Representatives. District 10 covers the diverse communities of Oak Cliff, Highland Hills, Pleasant Grove, Balch Springs, and Mesquite.

Representative Rose was born and raised in Dallas. Her passions are mental health, social justice, and criminal justice. Her biography states she works on legislation to help “mental health reform, access to affordable healthcare, improving the quality of life for our aging population and underserved communities.”

Mental health access is a key component of her legislation. One in seven women suffers from postpartum depression. Perinatal mood and anxiety disorders can occur anytime from conception to one year after the delivery of a baby.

Perinatal depression is darker and debilitating. A mom feels unable to function for an extended period. Women need access to mental health care to address their needs when certain symptoms are present.

Postpartum depression symptoms include crying spells, feeling sad, feelings of hopelessness, and feeling guilty. Some may express a lack of happiness or feel the absence of bonding with the baby. Some may have feelings of hurt themselves or their baby. All of these symptoms indicate it is time to seek medical attention.

A study written by Mathematica in collaboration with St. David’s Foundation and Texans Care for Children examined the economic impact on Texas for failing to provide postpartum mental health care. Texas loses 2.2 billion dollars each year by not providing access to care for people after having a baby.

HB 133 is an opportunity for Texas to show we care about pregnant during and after delivery. A bipartisan group of Dallas leaders in the Texas House of representatives is working together on prison reform. Let’s hope more leaders come together to support Representative Rose’s common-sense legislation to save tax-payer money and save the lives of new Texas mothers.

The post Dallas Representative Toni Rose Fighting for Medicaid Extension for Women After Having a Baby appeared first on Medika Life.

One can now legitimately ask the question, “what’s next”. An assault on women’s right to the vote? Ridiculous you say, but wait. Until last week women had a semblance of control over their lives, their health, and their bodies. Greg Abbott has undone that in a move that’s left Texas with the most restrictive abortion laws in the US.

The Texas abortion bill is known as S.B. 8, and is described as a “heartbeat ban” abortion measure. It prohibits abortion the moment a fetal heartbeat has been detected. By banning abortion after the six-week mark, many women in Texas who are not even aware they are pregnant will not be allowed to get the procedure done in the state. The bill, which goes into effect Sept. 1, does not include exceptions for women impregnated as a result of rape or incest but offers a provision for medical emergencies.

Let’s examine a primary point of this bill from a medical perspective. The heartbeat the bill refers to is in fact not an actual heartbeat. This early in the pregnancy there is not a fully formed heart, it hasn’t developed yet (usually at the end of week 7) and what the instruments are detecting is an electrical signal that will be replaced with a heartbeat. It’s a simplified explanation, and the graphic below of a six-week fetus should help you understand this better.

This signal can actually be picked up as early as the 4th week of pregnancy and the fetal heart differs from the heart of the newborn. Our heart adapts to life outside of the womb after we’re born, as the fetus relies on its mother’s lungs rather than its own, so there are fundamental structural differences in a fetal and newborn heart. Which is neither here nor there. It’s just so we are all on the same page relating to actual science.

What is actually at issue here are two things. The health, both mental and physical, of the mother and the right to life of the fetus which we’ll address first. If you are going to view life as sacrosanct and its importance all-consuming, then even allowing a six-week window to terminate that life seems ridiculous. The number of weeks is arbitrary, life is life, whether it’s snuffed out at 6 days, 6 weeks, or 6 months and if you truly believe in its value, you aren’t going to be negotiating time spans.

Which suggests this isn’t really about a right to life. Not really. This is more about politics and Governor Abbott’s conservative view of life and potential aspirations for a presidential run. How? Well, off the back of a Supreme court action contesting S.B. 8. It is crafty, clever, and manipulative politicking at the expense of public health.

The legislation may also simply be a reflection of the sexist views of Abbott and his party. A women’s ability to terminate the progeny of a man makes him vulnerable. The solution is simple. Remove her right to choose.

The S.B. 8 abortion law is going to have a number of dire consequences for women in Texas.

• The bill discriminates against lower-income families, women who enjoy financial resources can travel out of state to abort, not an option for those without the budget to travel freely.
• An upsurge in illegal and dangerous backstreet abortion clinics, placing pregnant mothers’ health in grave jeopardy. Mothers who would need further medical attention may be subject to prosecution.
• Pregnancies resulting from rape and incest that are forced to term by law will place the mother’s mental health at grave risk and lead to unwanted children.
• Genetic abnormalities discovered further into the pregnancy will not entitle the mother to consider an abortion under the current legislation.

Essentially, the message this new legislation sends to women across Texas is a stark one. Governor Greg Abbott and his conservative governance have little regard for your health and for your rights to choice. Your abilities to make an informed decision about your body have been seriously undermined.

The structure of the bill allows for anyone assisting the mother to abort the fetus after the six-week period to be prosecuted. In theory, if you’re driving your wife or partner across state lines for the purposes of obtaining an abortion you could be arrested and prosecuted. If a teenage boy gets his girlfriend pregnant and an abortion is carried out, either set of parents would have cause to file a civil complaint against anyone involved in enabling the abortion.

According to the Washington Post, the Supreme Court announced this week that it will review a similar restrictive Mississippi law that bans most abortions after 15 weeks, potentially providing a clear path to diminishing Roe v. Wade’s guaranteeof a woman’s right to choose an abortion. At a six-week restriction, Texas must surely follow on the heels of the Mississippi review. 

Mississippi and Texas are among many Republican-led states to have passed restrictions conflicting with the Supreme Court’s precedents protecting abortion rights, hoping for a chance to get a case before a Supreme Court they believe is more amenable to their arguments. 

The Supreme Court said on Monday that it would examine whether “all pre-viability prohibitions on elective abortions are unconstitutional.” Women across the country are going to be watching the outcome very closely.

The post Texas’s New Abortion Law Endangers Women and Science appeared first on Medika Life.

The West Nile Virus was detected through PCR testing of Culex quinquefasciatus mosquitoes. No humans have been infected at this time, but typically human cases begin to appear in communities two to three weeks after West Nile Virus appears in mosquito surveillance.

The identification of the first positive trap on May 11 in Grand Praire prompted officials to remind Dallas Fort Worth residents to take mosquito bite precautions.

Mosquitos contract West Nile Virus from biting birds. The infected mosquitos then spread the virus to humans when they bite our skin. The CDC reports West Nile virus is the leading cause of mosquito-borne disease in the continental United States.

West Nile Virus cases increase in communities during the Mosquito season from late Spring to early Fall. Most people who contract West Nile Virus will be asymptomatic. About 20% of people infected will develop signs and symptoms.

Common symptoms included fever, headache, muscle aches, joint pain, weakness, vomiting, diarrhea, or a rash. The fever resolves within a few days, but muscle aches and fatigue can linger for months. As we are learning from Long Covid, any viral illness can lead to long-term problems from the post-viral syndrome.

West Nile Virus cases severe and sometimes fatal disease in about 1 in 150 people. Anyone who contracts the virus is at risk for serious illness, but the risk is higher in those 50 years old and older. People with suppressed immune systems are also at higher risk. Immune suppression occurs from diseases such as cancer, diabetes, hypertension, kidney disease, HIV, and organ transplants.

The CDC lists the symptoms of severe illness, including “high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness, and paralysis.”

West Nile Virus sometimes infects the membranes surrounding the brain or spinal cord, causing encephalitis and meningitis. When West Nile Virus affects the central nervous system, symptoms sometimes become permanent. 10% of people with central nervous system infections do not survive.

There is no vaccine or specific treatment for West Nile Virus. Doctors treat patients with over-the-counter pain relievers such as Acetaminophen or Nonsteroidal anti-inflammatory medication to reduce fever and alleviate symptoms. Physical rehabilitation is helpful for those who develop lingering symptoms after infection.

People who develop viral symptoms after a mosquito bite can undergo specialized testing for West Nile Virus.

Prevention is the best medicine for West Nile Virus.

We can reduce our risk by avoiding mosquito bites. Long sleeve shirts and long pants protect the skin from exposure when in a high-risk area.

Spraying the skin with Environmental Protection Agency (EPA)-registered insect repellents, such as DEET, are safe and effective ways to reduce our risk.

EPA-registered repellants must have at least one of the following ingredients:

• DEET
• Picaridin (known as KBR 3023 and icaridin outside the US)
• IR3535
• Oil of lemon eucalyptus (OLE)
• Para-menthane-diol (PMD)
• 2-undecanone

In our homes, we can take steps to control mosquitos. Screens on windows and doors prevent bugs from entering the house. Air conditions and home cooling systems make rooms less hospitable to mosquitos. Monitoring areas outside for stagnant water can reduce the risk. Old tires, buckets, and children’s toys often contain small amounts of water where mosquitos can lay eggs.

Dallas County Health Service will continue to monitor mosquito traps in the area. Local officials work with State public health services to detect any spike in West Nile cases. Any resident in Dallas County may report mosquito problems by calling 214-819-2115.

People can request a free service request here.

The post Dallas County Reports First West Nile Virus Positive Mosquito Trap appeared first on Medika Life.

HB 357 is a bill “relating to air conditioning requirements at facilities operated by the Texas Department of Criminal Justice.” The legislation seeks to improve the climate control systems lacking in many Texas Correction buildings.

The Dallas Morning News (DMN) reported one out of five lockup facilities has no air conditioning or climate control systems for inmates. Forty-nine prisons only have partial air conditioning.

The DMN published documents showing more than twenty inmates died from the heat inside Texas prisons between 1998 and 2012.

Democrats and Republicans from the Dallas Fort Worth Metroplex are working together to make substantial prison reform changes during the legislative session. Last week, this bill passed the House by a vote of 123-18. Now, the bill moves to the Texas Senate before heading to Governor Abbot’s desk to sign it into law.

This bill provides the State prison system with seven years to bring climate control systems to all locations. The project has a cost cap of $300 million. The bill is contingent on State or Federal funds approval to assist with cooling costs.

The bill would provide essential climate control and air conditioning to incarcerated people throughout the Texas Penal system. The requirements are relatively basic stating:

Let’s meet the Dallas Fort Worth Representatives, who are working together to provide humane treatment to incarcerated Texans.

AIR CONDITIONING REQUIREMENTS AT DEPARTMENT
FACILITIES. The department shall ensure that each cellblock,
dormitory, and common area in a facility operated by the department
is equipped with an air conditioning unit that is operating to
maintain the air temperature at not less than 65 degrees Fahrenheit
or more than 85 degrees Fahrenheit.

Representative Carl O. Sherman District 109

Carl Sherman is the democratic representative for district 109. He was elected in 2010 as the first African-American Mayor of DeSoto, Texas. He served two terms and led efforts to make Desoto one of the first cities in Texas to require police to wear body cameras. District 109 includes Cedar Hill, Dallas, DeSoto, Ferris, Glenn Heights, Hutchins, Lancaster, Ovilla, Seagoville, Wilmer, and other surrounding areas of southern Dallas County.

Representative Jeff Leach District 67

Jeff Leach is the republican representative for District 67. Representative Leach comes from Plano and is serving his fifth term in the Texas house. He is Chairman of the House committee with oversight over the Texas justice system. He also serves on the House Committee on Juvenile Justice and Family Issues. He is also the Chairman of the House committee with oversight over the Texas justice system. House District 67 consists of portions of Plano, Allen, Richardson, and Dallas in Collin County.

Representative Lynne Stuckey

Dr. Lynn Stucky is a veterinarian who now serves as the Republican representative for District 64. Dr. Stucky was raised on a Kansas farm before making Denton, Texas, his home. He spent 15 years on the Sanger ISD Board of Trustees and served on the Sanger Chamber of Commerce Board of Directors. He was elected to Texas House District 64 in 2016. The district includes Denton, Krum, Corinth, Shady Shores, Hickory Creek, and Lake Dallas.

Speaker Pro Tem Joe Moody

Attorney Joe Moody is the Democratic representing District 78, which covers northern El Paso County. Elected at age 27, Moody was the youngest state representative in Texas. He is the Speaker Pro tem and serves as the Vice-Chair of the Calendars Committee. He focuses attention on Judiciary and Civil Jurisprudence as well as redistricting issues. Representative Moody works on veterans issues, mental health, education, and equality, but criminal justice reform is his passion.

Representative Michelle Beckley

Michelle Beckley is the Democratic representative for House District 65 where she serves on the Agriculture and Livestock and the Business and Industry Committees. District 65 covers the major parts of Carrollton and Lewisville. Representative Beckley is a small business owner running the Kookaburra Bird Shop. In between running her company and serving Texans, Beckley is an active bicyclist who has completed two Ironman Triathlons.

Where does the bill stand now?

On Thursday, March 13, the House voted in a truly bipartisan fashion. 123 Representatives voted in favor of the legislation. Only eight were opposed. The bill now heads to the Senate.

Prison reform is a bipartisan issue. Both parties recognize the need to treat the incarcerated with dignity in a safe and healthy environment. Everyone deserves a second chance.

Given the partisan divide throughout our country, let’s celebrate this group of Texas Democrats and Republicans coming together to create a humane environment for incarcerated Texans.

Representative Carl Sherman shows us the importance of House Bill 357 in this April 2021 video from Texas Prisons Air Conditioning Advocates.

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