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By Alexander Freund
Sepsis is a life-threatening organ dysfunction caused by the body's immune system overreacting in response to an infection. This overactive, toxic response can lead to tissue damage, multiple organ failure and death.
EcoWatch Daily Newsletter
A deadly fungal disease responsible for the deaths of millions of bats across the U.S. has been confirmed in Texas for the first time.
By Rebecca S.B. Fischer
The coronavirus is on everyone's minds. As an epidemiologist, I find it interesting to hear people using technical terms – like quarantine or super spreader or reproductive number – that my colleagues and I use in our work every day.
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Editor's note: The coronavirus that started in Wuhan has sickened more than 4,000 people and killed at least 100 in China as of Jan. 27, 2020. Thailand and Hong Kong each have reported eight confirmed cases, and five people in the U.S. have been diagnosed with the illness. People are hoping for a vaccine to slow the spread of the disease.
Is there a vaccine under development for the coronavirus?<p>Work has begun at <a href="https://www.niaid.nih.gov/diseases-conditions/mers-sars-therapeutics-vaccines" target="_blank">multiple organizations</a>, including the National Institutes of Health, to develop a <a href="https://www.ecowatch.com/tag/vaccines" rel="noopener noreferrer">vaccine</a> for this new strain of coronavirus, known among scientists as <a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html" target="_blank">2019-nCoV</a>.</p><p>Scientists are just getting started working, but their vaccine development strategy will benefit both from work that has been done on closely related viruses, such as <a href="https://www.niaid.nih.gov/news-events/niaid-officials-discuss-novel-coronavirus-recently-emerged-china" target="_blank">SARS and MERS</a>, as well as advances that have been made in vaccine technologies, such as <a href="https://doi.org/10.2147/IJN.S39810" target="_blank">nucleic acid vaccines</a>, which are DNA- and RNA-based vaccines that produce the vaccine antigen in your own body.</p>
Was work underway on this particular strain?<p>No, but work was ongoing for other closely related coronaviruses that have caused severe disease in humans, namely MERS and SARS. Scientists had not been concerned about this particular strain, as we did not know that it existed and could cause disease in humans until it started causing this outbreak.</p>
How do scientists know when to work on a vaccine for a coronavirus?<p>Work on vaccines for severe coronaviruses has historically begun once the viruses start infecting humans.</p><p>Given that this is the third major outbreak of a new coronavirus that we have had in the past two decades and also given the severity of disease caused by these viruses, we should consider investing in the development of a vaccine that would be broadly protective against these viruses.</p>
What does this work involve, and when might we actually have a vaccine?<p>This work involves designing the vaccine constructs – for example, producing the right target <a href="https://www.britannica.com/science/antigen" target="_blank">antigens</a>, viral proteins that are targeted by the immune system, followed by testing in animal models to show that they are protective and safe.</p><p>Once safety and efficacy are established, vaccines can advance into clinical trials in humans. If the vaccines induce the expected immune response and protection and are found safe, they can be mass produced for vaccination of the population.</p><p>Currently, we lack virus isolates – or samples of the virus – to test the vaccines against. We also lack antibodies to make sure the vaccine is in good shape. We need the virus in order to test if the immune response induced by the vaccine works. Also, we need to establish what animals to test the vaccine on. That potentially could include mice and nonhuman primates.</p><p>Vaccine development will likely take months.</p>
Can humans ever be safe from these types of outbreaks?<p>We expect that these types of outbreaks will occur for the foreseeable future in irregular intervals.</p><p>To try to prevent large outbreaks and pandemics, we need to improve surveillance in both humans and animals worldwide as well as invest in risk assessment, allowing scientists to evaluate the potential threat to human health from the virus, for detected viruses.</p><p>We believe that global action is needed to invest in novel vaccine approaches that can be employed quickly whenever a new virus like the current coronavirus – and also viruses similar to Zika, Ebola or influenza – emerges. Currently, responses to emerging pathogens are mostly reactive, meaning they start after the outbreak happens. We need a more proactive approach supported by continuous funding.</p>
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By Roz Plater
It's 2020 and another year of health-related topics awaits us.
Medicare<p>Medicare is front and center as we kick off 2020.</p><p>That's in part because "<a href="https://www.healthline.com/health/what-medicare-for-all-would-look-like-in-america" target="_blank">Medicare for All</a>" is the single payer option health plan being touted by two of the top Democratic presidential candidates.</p><p><a href="https://www.forrester.com/Jeff-Becker" target="_blank">Jeff Becker</a>, the senior analyst for healthcare strategy at Forrester Research says there are also a number of bills in Congress looking to expand access to Medicare as a public option.</p><p>"When you look at the polling numbers, our call is that Medicare for All will die in the court of public opinion and become Medicare Advantage for more," Becker told Healthline.</p>
Affordable Care Act<p>The <a href="https://www.healthline.com/health/consumer-healthcare-guide/pros-and-cons-obamacare" target="_blank">Affordable Care Act (ACA)</a>, often referred to as Obamacare, will be in the courts again this year.</p><p>In December, a federal appeals court <a href="https://www.cnbc.com/2019/12/18/-.html" target="_blank">ruled</a> that the health insurance law's individual mandate provision was unconstitutional.</p><p>However, the justices sent back to a federal district court in Texas the issue of whether other parts of the law could continue to exist without the mandate that requires everyone to have health insurance.</p><p>Look for some sort of Obamacare case to wind up in the U.S. Supreme Court this year.</p><p>"Our call is whether or not it goes to the Supreme Court, the ACA will survive because the individual mandate is severable," Becker told Healthline.</p>
Price Transparency<p>Experts say you'll hear a lot of debate about price transparency, a move designed to increase competition and lower costs.</p><p>President Trump <a href="https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html?amp" target="_blank">signed an executive order</a> in November that requires hospitals and insurers to publish their confidential, negotiated rates for treatments.</p><p>"The reason this would be important is you'd be able to figure out what your out-of-pocket expenses would be" said Becker.</p><p>But a coalition of hospital groups has <a href="https://www.reuters.com/article/us-us-hospitals/hospital-groups-file-lawsuit-to-block-trumps-price-transparency-rule-idUSKBN1Y81YY" target="_blank">filed a lawsuit</a> to block the rule. They argue that the public disclosure of negotiated charges would create confusion about consumers' out-of-pocket costs.</p><p>The order is scheduled to go into effect January 1, 2021.</p>
Lower Prescription Drug Prices<p>"The thing about pharmaceuticals is, if you can't afford them, they don't work," Mosley said.</p><p>He predicts the move to lower the costs of prescription drugs will again be on the front burner of the healthcare debate in 2020.</p><p>"The problem is Medicare and Medicaid can't negotiate prices with these drug companies," Mosley told Healthline.</p><p>The House of Representatives has <a href="https://www.aarp.org/politics-society/advocacy/info-2019/house-passes-drug-price-bill.html" target="_blank">approved a bill</a> that would do just that. The legislation also caps out-of-pocket expenses for people enrolled in Medicare Part D.</p><p>However, the prognosis for this bill becoming law isn't good.</p><p>Political observers say the legislation won't go anywhere in the Senate, and the White House has indicated the president would veto it.</p><p>Republicans in the Senate have <a href="https://www.usatoday.com/story/news/health/2019/11/11/mcconnell-pelosi-clash-over-drug-price-bill-congress-act/2558426001/" target="_blank">crafted</a> their own prescription drug price plan. The president has indicated he would sign this bill, but it would need to be approved by the Democrat-controlled House.</p>
Access to Health Services<p>"One of the cross-cutting issues we see as a priority in 2020 is the social determinants in health disparities in our patients," said <a href="https://www.aafp.org/media-center/releases-statements/all/2013/amy-mullins-medical-director.html" target="_blank">Amy Mullins</a>, MD, FAAFP, medical director for quality improvement for the American Academy of Family Physicians.</p><p>"Patients need more than just access to a physician," she told Healthline. "They need access to good food, safe places to live, to exercise, transportation, community resources, access to medication."</p><p>"If you don't address those, it's really difficult to treat your patients effectively," she added.</p><p>Mullins says her group has an internal division called the Center for Diversity and Health Equity whose mission is to look at healthcare through that lens.</p>
Vaccine Hesitancy<p>Mullins also says the issue of vaccine myths is one you'll continue to hear about in 2020.</p><p>"We want to do more to counter the misinformation that's out there around vaccines that may be holding some people back from getting what they need," said Mullins.</p><p>A <a href="https://www.sciencedirect.com/science/article/pii/S0264410X1931446X?via%3Dihub" target="_blank">recent study</a> concluded that a lot of the false information is being spread on social media by a handful of anti-vaccine ad buyers.</p><p>"We're promoting vaccine education to physicians, their healthcare teams, patients, and communities" Mullins said.</p><p>A <a href="https://www.healthaffairs.org/do/10.1377/hblog20191212.484779/full/" target="_blank">2020 National Vaccine Plan</a> is currently being developed by the Department of Health and Human Services' Office of Infectious Disease and HIV/AIDS Policy.</p>
Vaping<p>"Another of the big priorities for health providers in 2020 is vaping and e-cigarettes," Mullins said.</p><p>"We really applaud and support the work the Centers for Disease Control and Prevention and the Food and Drug Administration is doing to try and get a handle on this crisis," she said. "But these products target adolescents and we think the marketing needs more regulation."</p><p>A <a href="https://www.drugabuse.gov/news-events/news-releases/2019/12/vaping-marijuana-rise-among-teens" target="_blank">study</a> released last month from the National Institute on Drug Abuse reported that more teens are vaping marijuana.</p><p>That's despite a lung illness linked to vaping that's killed <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html" target="_blank">more than 50 people</a> nationwide.</p>
Virtual Care Visits<p>On the digital front, Becker predicts there will be aggressive growth in virtual care visits.</p><p>That's where you interact with your doctor via text, video, or phone call.</p><p>Becker's group crunched the numbers after looking at outpatient visit data as well as talking to virtual vendors and tracking healthcare investments.</p><p>"The result was 36 million net new virtual care visits in 2020," he said.</p><p>He points to how employers and insurers are already embracing the concept. Amazon recently launched a pilot program called "<a href="https://www.cnbc.com/amp/2019/09/24/amazon-launches-employee-health-clinic-amazon-care.html" target="_blank">Amazon Care</a>," a virtual clinic for its employees in Seattle.</p><p>Walmart recently expanded its <a href="https://mhealthintelligence.com/news/walmart-expands-telehealth-services-for-employees-in-3-states" target="_blank">telehealth services</a> to workers in Colorado, Minnesota, and Wisconsin with $4 online or video care visits.</p><p>Humana has <a href="https://medcitynews.com/2019/04/humana-and-doctor-on-demand-launch-new-virtual-primary-care-health-plan/" target="_blank">teamed up</a> with "Doctor on Demand" to offer a virtual primary care plan at significantly lower monthly premiums.</p><p>"Everybody is moving toward a model where we're not using high-cost care centers like emergency rooms," Becker said.</p><p>"And consumers are demanding more cost effective services, too," he added. "In 2018, consumers took out <a href="http://nymag.com/intelligencer/2019/04/americans-borrowed-usd88-billion-for-health-expenses-in-2018.html" target="_blank">$88 billion</a> in personal loans just to pay for out-of-pocket medical costs."</p>
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Ebola virus seen under a microscope. Studio_3321 / iStock / Getty Images Plus
The U.S. Food and Drug Administration (FDA) announced Thursday that it has approved a vaccine for Ebola manufactured by Merck, according to Reuters.
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Measles infected nearly 10 million people in 2018 and killed more than 140,000, according to new estimates from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). Most of the people who died were children under five years old.
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The government of Samoa will shut down its offices for two days this week so civil servants can focus on a nationwide immunization drive after almost 4,000 confirmed cases of measles have swept across the small Pacific nation of just 200,000 people, as NPR reported. So far 55 people have died, 50 of them are children under four, according to The Guardian.
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(R) The measles virus pictured under a microscope. PHIL / CDC
The Pacific Island nation of Samoa declared a state of emergency this week, closed all of its schools and limited the number of public gatherings allowed after a measles outbreak has swept across the country of just 200,000 people, according to Reuters.
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By Julia Ries
- The measles virus was declared eliminated in the United States in 2000.
- But if more cases of the measles virus are detected next month, it could mean an end of that elimination status.
- There have been more than 1,200 measles cases this year so far. That's the largest number of cases since 1992.