Army Public Health Weekly Update, 29 April 2022

Date Published: 4/29/2022
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The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link .

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Table of Contents


    2021 Health of the Force Report

    In this changing world, one constant is the requirement for our Soldiers to remain healthy and ready to achieve Force dominance. In its 7th annual installment, the 2021 Health of the Force report documents conditions that influence the health and medical readiness of the U.S. Army Active Component (AC) Soldier population. Leaders can use Health of the Force to optimize health promotion measures and effect culture changes that influence both individual Soldiers and Army institutions. Health of the Force presents Army-wide and installation-level demographics and data for more than 20 health, wellness, and environmental indicators at 41 installations worldwide. Installations included in Health of the Force are those where the AC population exceeds 1,000 Soldiers. Data presented in this report reflect status for the prior year (i.e., the 2021 report reflects calendar year 2020 data). The Coronavirus Disease 2019 (COVID-19) pandemic transformed military operations and healthcare delivery, and much of the global workforce shifted to telework in response. The 2021 Health of the Force report includes a new COVID-19 metric section for a deep dive into surveillance data and methods, the effect of the pandemic on military healthcare utilization, effects on physical and mental health, and local actions focused on Army Public Health Nursing and vaccination efforts. The report also outlines health disparities faced by racial and ethnic minority Soldiers and the unique health needs of female Soldiers. These highlights help to frame conversations and analyses necessary to effect real progress towards health equity. It is important to note that data included in this report were collected during unprecedented times. As certain components of routine healthcare delivery transitioned to telework due to COVID-19, the impact of decreased healthcare utilization in certain areas may represent outliers in rate changes. To access the new report visit APHC


    Army initiatives focus on prevention; caring for victims

    22 April- In an effort to better prevent sexual assault and other harmful behaviors, the Army will form a new, Integrated Prevention Workforce and revamp its Sexual Harassment/Assault Response Program. The SHARP changes include replacing part-time sexual assault response coordinators with full-time ones. A Secretary of Defense Independent Review Commission on sexual assault in the military showed that the department lacked a central sexual assault prevention capability. The study also found that the military services did not direct enough of its efforts toward prevention. “Among their key findings were that our efforts have primarily been focused in the sexual assault response area," said James Helis, Army Resilience Directorate director. “And we needed to move to true prevention." The Integrated Prevention Workforce, or PWF, will be activated at posts throughout the Army beginning in fiscal year 2022 through 2027 to provide the central base for prevention. The entities will be comprised of specialists in fields such as psychology, sociology, and social work, and who have expertise in the prevention of harmful behaviors like suicide and sexual assault. The PWF will provide direct advice and counsel to senior commanders. “The prevention workforce model is going to be an upgrade because it is providing a new capacity and capability for commanders," Helis said. The PWF will examine the social factors that lead to sexual assaults, suicide, domestic violence and substance abuse. External Link

    BACH Squad set to compete in RHC-A Best Leader Competition

    22 April- A squad of Soldiers from Blanchfield Army Community Hospital is headed to Fort Benning, Georgia, where they will compete in the Regional Health Command-Atlantic Best Leader Competition, April 25-29. The Best Leader Competition is designed to promote Esprit De Corps throughout the Army while recognizing Soldiers who demonstrate commitment to the Army Values and embody the Warrior Ethos. Unlike Best Warrior, where a team made up of a non-commissioned officer and a junior enlisted Soldier compete, this competition is made up of a six-member squad. Capt. Joshua Lockwood, Staff Sgt. Terrence Laisin, Sgt. Sangoh Choi, Spc. Ilona Campos, Spc. Angel Galvez and Pfc. Tyrion Smith will represent BACH, competing with 12 other squads from Army military treatment facilities East of the Mississippi River. “We are really excited to have our teams compete. In the past, Army competitions focused on an individual Soldier or a team of two's ability, but this competition takes it a step further and assesses a squad's cohesiveness and teamwork. This is important because Soldiers in our hospitals and on the battlefield work in teams and squads to take care of patients and win on the battlefield in treatment platoons, forward surgical teams, and field hospitals," said Capt. Huy Nguyen, commander, BACH Medical Company. “Our team has been training hard and it benefits our entire unit because we're taking Soldiers from every department of the hospital to train not only our competitors, but our Soldiers and leaders working behind the scenes to help prepare our team." BACH's competitors began training together about two months ago, meeting after work and on weekends. They have worked with various members of the command, ranging from former drill sergeants, a Ranger, marksmanship experts and seasoned combat medics, who have shared their knowledge and experience to help prepare the team as much as possible for any number of events they may face during the competition.  “We don't exactly know what the events will be, but we have been using previous [concept of operations] for better known events, like from Best Medic, to train," said Laisin, the squad's senior enlisted leader and a regional Best Medic winner. DVIDS External Link

    Tricare's autism awareness Facebook post draws ire from parents of autistic kids

    25 April- Cassandra Wheeler said she felt an upswell of anger when she saw a recent social media post by Tricare, the military's health care provider, in support of Autism Acceptance Month. Tricare called for “inclusivity" and “tolerance" for autistic children through “patience, understanding, and education," according to the April 8 post on the provider's official Facebook page. As of Friday, it had received about 800 mostly critical comments, and was shared about 400 times. Wheeler, 34, the wife of a medically retired Army veteran and the mother of two autistic children, said Tricare gutted the care it provides for the autistic children of military families last year. What Tricare is doing “is not OK," she told Stars and Stripes by phone April 13 from her home in Westfield, Ind. “We're hurting as a direct result of decisions you have made. Our kids are suffering." The Defense Health Agency, which oversees Tricare, rolled out a series of “comprehensive" changes to its Autism Care Demonstration program beginning March 23, 2021. The program pays for applied behavior analysis, or ABA, therapy for children diagnosed with autism spectrum disorder, according to a statement on the Military Health System website. The demonstration program will move toward a “beneficiary-centric model" that helps autistic children “reach their maximum potential" and “empower parents" to have a greater role in the care their child receives, according to the health system. Stripes External Link


    Antibiotic resistance is making neonatal sepsis harder to treat

    26 April- A large observational study of newborn babies with sepsis shows the impact that antimicrobial resistance (AMR) is having on this vulnerable population. The study, led by the Global Antibiotic Research & Development Partnership (GARDP), looked at mortality, antibiotic treatments, and resistance among more than 3,200 newborns with suspected neonatal sepsis at hospitals in 11 countries and found that more than 11% died during the study period. The mortality rate ranged from 1% to as high as 27%. The study also found that World Health Organization (WHO)-recommended first-line treatment for neonatal sepsis was used less than 13% of cases, and second-line treatments were used even less frequently. Many hospitals were using combinations of antibiotics, without much underlying data to support their use, because of high levels of resistance and multidrug resistance. Among the antibiotics used were carbapenems and polymyxins—two broad-spectrum, last-resort classes of antibiotic that are needed for the most difficult-to-treat infections. The authors of the study, the findings of which were released in a report today by GARDP and presented at the recent European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2022), say the data could help guide development of antibiotic treatments specifically for newborns. CIDRAP External Link

    CDC issues health advisory for rare liver damage in children—Symptoms and other details

    21 April- CDC issued a new health advisory for the rare liver damage in children. The latest warning against unexplained hepatitis was announced so that public health authorities would be more cautious. A child is vaccinated with a hepatitis B vaccine at the Mixcoac health center in Mexico city, on April 24, 2009. The international health agency released the new Health Alert Network (HAN) Health Advisory on Thursday, Apr. 21. As of writing, CDC identified nine rare liver damage cases in Alabama. On the other hand, dozens of cases were detected in the United States, Netherlands, Spain, the United Kingdom, and the Netherlands. According to NBC News' latest report, the rare liver damage is actually well-known hepatitis. However, the cause of the latest cases is unknown. An Indian boy stands near a replica of the Hepatitis virus, a part of an awareness event in Mumbai on July 28, 2014. World Hepatitis Day is an annual event on July 28 to provide international focus for patient groups and people living with viral hepatitis and an opportunity to raise awareness and influence real change in disease prevention and access to testing and treatment. "This Health Advisory serves to notify US clinicians who may encounter pediatric patients with hepatitis of unknown etiology," said CDC via its official health advisory. The agency also urges health experts to consider adenovirus testing since some of the individuals who have acute liver failure were tested have the disease.  The Centers for Disease Control and Prevention added that medical facilities need to disclose the data they acquire from patients with rare liver damage. Tech Times External Link

    Childhood vaccination rates slipped during pandemic: CDC

    22 April- Many kindergartners fell behind on their childhood vaccinations during the pandemic, U.S. health officials warned Thursday. The drop has not been precipitous: About 94% of kindergarteners had their required vaccines during the 2020-2021 school year, a drop of about one percentage point and just below the 95% vaccination target, the U.S. Centers for Disease Control and Prevention said in a new report. "This means there are 35,000 more children in the United States during this time period without documentation of complete vaccination against common diseases," Dr. Georgina Peacock, acting director of the CDC's immunization services division, said during a media briefing on Thursday, The New York Times reported. "This is further evidence of how pandemic-related disruptions to education and health care could have lingering consequences for children." The numbers of children missing vaccines may even be higher, since there were 400,000 children who had been expected to start school but did not. Why the drop in shots? It could be that families skipped routine pediatrician visits during the pandemic, an easing of immunization requirements for remote school, heavy demands on school nurses, or more evidence of a backlash against the COVID-19 vaccine, CDC scientists suggested. "There's a greater proportion of parents who are questioning routine vaccines," Dr. Jason Terk, a pediatrician practicing in a suburb of Dallas who also acts as a spokesman for the American Academy of Pediatrics, told the Times. External Link

    Genetic sign of aging linked to risk of fatal COVID

    25 April- It's known that certain chronic health conditions up the odds of death from COVID-19. Now, new research identifies another risk factor. Shorter telomeres are associated with an increased likelihood of death from COVID-19, particularly in older women, researchers say. Telomeres are protective caps on the end of chromosomes (DNA) that shorten with age. Previous research has linked shorter telomeres with a number of age-related diseases, including cancer and osteoarthritis, and a higher risk of infections. "Our findings implicate telomere length in COVID-19 mortality and highlight its potential as a predictor of death and severe outcome, particularly in older women," said study co-author Ana Virseda-Berdices, of Health Institute Carlos III in Madrid, Spain. Virseda-Berdices and colleagues examined how telomere length affects COVID-19 severity. The study included more than 600 adults hospitalized with COVID during the first wave of the pandemic, March to September 2020. Telomere length was measured in patient blood samples taken within 20 days of COVID diagnosis or hospitalization. The 533 patients who survived had an average age of 67, compared with an average age of 78 among the 75 patients who died from COVID. Among all patients, shorter telomeres were significantly associated with a higher risk death from COVID-19 at 30 and 90 days after hospital discharge. External Link

    Long COVID-19 may be caused by abnormally suppressed immune system in some people: UCLA-led study

    25 April- A possible contributor of Long COVID -19 may actually be an abnormally suppressed immune system, and not a hyperactive one, according to a UCLA- led research group. The study, recently published in the peer-reviewed journal Clinical Infectious Diseases. It contradicts what scientists previously believed, which was that an overactive immune response to SARS-CoV-2, often referred to as a "cytokine storm," was the root cause of the perplexing syndrome. Health experts told Fox News this "cytokine storm" is an over-reactive inflammatory response in the infected person that can potentially cause damage to lungs and other organs, possibly creating severe illness or even death. Long COVID, which occurs in a subset of patients recovering from COVID-19, is a syndrome where a multitude of symptoms including shortness of breath, muscle aches, fatigue, vocal fatigue, and brain fog persists for several months after the acute infection stage, health experts explained to Fox News. According to the press release about the UCLA study, limited understanding of the causes of long COVID makes treating the condition challenging. "While this was a small pilot study, it does suggest that some people with long COVID may actually have under-active immune systems after recovering from COVID-19, which means that boosting immunity in those individuals could be a treatment," Dr. Otto Yang, a professor of medicine, division of infectious diseases, and of microbiology, immunology and molecular genetics at the David Geffen School of Medicine at UCLA said in a press release. Fox News External Link

    Millions of COVID-19 shots set to go to waste, as vaccine rollout slows

    25 April- While top U.S. health officials are urging some Americans to get yet another coronavirus booster shot, local health departments across the country are grappling with a growing dilemma -- how to address a declining demand for vaccines, while minimizing the waste of unused millions of doses currently in state stockpiles and at risk of expiring. Since the emergency use authorization of the first COVID-19 vaccines in the U.S. last winter, federal data shows that states received a staggering 720 million doses, and more than 570 million of those shots have been administered. However, an ABC News analysis of state-provided data found that millions of those shots have not ended up in arms, largely due to a significant decline in the number of individuals willing to get vaccinated — with many vaccine doses now left unused in refrigerators or discarded in trash cans across the country. ABC News contacted officials from health departments in all 50 states, and in analyzing state provided data, found that millions of COVID-19 vaccine doses have either gone to waste, remain unused, or will expire in the coming weeks and months. "It is a tremendous loss of opportunity for these vaccines to not make it into the shoulders of those who need them," C. Buddy Creech, director of the Vanderbilt Vaccine Research Program and associate professor of pediatric infectious diseases, told ABC News. "Not only is it a financial loss for the purchaser of vaccines -- the U.S. government -- but also a significant health loss for those who are not yet protected from COVID and its complications." ABC News External Link

    Only COVID-19 treatment for pediatric patients approved

    25 April- California-based Gilead Sciences, Inc. today announced that the U.S. Food and Drug Administration (FDA) approved a supplemental new drug application for Veklury (remdesivir). The approval on April 25, 2022, is for the treatment of pediatric patients older than 28 days, weighing at least 3 kg, and are either hospitalized with COVID-19 or have mild-to-moderate COVID-19 and are considered high risk for progression to severe COVID-19, including hospitalization or death. Today's FDA approval follows the recent approval for Veklury for the treatment of non-hospitalized adult and adolescent patients who are at high risk of progression to severe COVID-19. Under the expanded indication, a three-day Veklury treatment regimen is recommended to help prevent hospitalization in non-hospitalized COVID-19 pediatric patients at high risk for COVID-19 disease progression. For hospitalized pediatric patients who do not require invasive mechanical ventilation and/or ECMO, a 5-day treatment course is recommended. “This approval means that remdesivir can potentially provide meaningful clinical improvement by reducing disease progression and helping children recover from COVID-19 more quickly," said Amina Ahmed, M.D., Atrium Health-Levine Children's Hospital in Charlotte, North Carolina, in a related press statement. Precision Vaccinations External Link


    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 15, ending April 16, 2022:

    -Influenza activity varies by region. Activity is highest in the northeast, south-central and mountain regions of the country.

    -The majority of influenza viruses detected are A(H3N2). H3N2 viruses identified so far this season are genetically closely related to the vaccine virus. Antigenic data show that the majority of the H3N2 viruses characterized are antigenically different from the vaccine reference viruses. While the number of B/Victoria viruses circulating this season is small, the majority of the B/Victoria viruses characterized are antigenically similar to the vaccine reference virus.

    -The percentage of outpatient visits due to respiratory illness has steadily increased since mid-February but remains below baseline. Influenza is contributing to levels of respiratory illness, but other respiratory viruses are also circulating. The relative contribution of influenza varies by location.

    -The number of hospital admissions reported to HHS Protect has increased each week for the past 11 weeks.

    -The cumulative hospitalization rate in the FluSurv-NET system is higher than the end-of-seasons rates for the 2020-2021 and 2011-2012 seasons, but lower than the rate seen at this time during the four seasons preceding the COVID-19 pandemic.

    -Three influenza-associated pediatric deaths were reported this week. There have been 22 pediatric deaths reported this season.

    -CDC estimates that, so far this season, there have been at least 4.7 million flu illnesses, 47,000 hospitalizations, and 2,800 deaths from flu.

    -An annual flu vaccine is the best way to protect against flu. Vaccination can prevent serious outcomes in people who get vaccinated but still get sick. CDC continues to recommend that everyone ages 6 months and older get a flu vaccine as long as flu activity continues.

    -There are also prescription flu antiviral drugs that can be used to treat flu illness. CDC External Link


    Beef jerky recalled because it was not inspected

    22 April- Hixson, TN-based Tennessee Brown Bag, LLC, is recalling approximately 4,590 pounds of beef jerky products that were produced without the benefit of federal inspection, according to the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS). The ready-to-eat beef jerky products were produced from January 2020 through April 2022...The products subject to recall do not bear the USDA mark of inspection because Tennessee Brown Bag, LLC is not a federally inspected establishment. The firm produced seven beef jerky varieties and sold the product directly to consumers nationwide through websites and through retail locations in Alabama, Georgia, South Carolina, Tennessee, and Virginia. The problem was discovered when the Tennessee Department of Agriculture notified FSIS about the products. After investigation, FSIS determined that the beef jerky products did not have the USDA mark of inspection and were produced in an establishment that was not inspected by USDA. There have been no confirmed reports of adverse reactions due to the consumption of these products. Anyone concerned about a reaction should contact a healthcare provider. FSIS is concerned that some products may be in consumers' pantries or refrigerators. Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase. Food Safety News External Link

    Ground beef recalled for possible E. coli O13 contamination

    26 April- Ground beef recalled for possible E. coli O103 contamination has been sold at retail locations nationwide. The ground beef was sold under various brand names. No illnesses have been reported to date in connection with the consumption of these products. The recalling firm is Lakeside Refrigerated Services of Swedesboro, New Jersey. The 120,872 pounds of ground beef products were produced from February 1, 2022 though April 8, 2022. You can see the complete list of recalled products at the USDA web site, along with the lot number, package size, and product type. Some of the brand names of the recalled ground beef products include Thomas Farms, Naturally Better, Nature's Reserve, Marketside Butcher, and Weis, among others. Some of the beef does not have a brand name. The products include beef patties, burgers, and raw ground beef. You can also see pictures of product labels. All of these products have the establishment number “EST. 46841" that is stamped inside the USDA mark of inspection. The problem was discovered during routine FSIS testing of imported products. Many labs do not test for non-O157 Shiga toxin-producing E. coli bacteria such as 103 because it is more difficult to identify than STEC O17:H7. The symptoms of illness caused by these pathogens, however, is the same. FSIS is concerned that consumers could have these recalled products in their home freezers. Please check your freezer carefully to see if you purchased any of it. If you did, throw the beef away in a sealed or double bagged package inside a secure trash can. Or you can take it back to the store where you bought it. Wash your hands thoroughly with soap and water after handling these items. Food Poisoning Bulletin External Link


    Time-restricted eating no more beneficial than caloric restriction in obese patients, study says

    24 April- Time-restricted eating limited to 8 a.m. and 4 p.m. did not lead to a greater reduction in body weight, body fat or metabolic risk factors compared to a daily caloric restriction, according to a study published in New England Journal of Medicine this week. The researchers at Southern Medical University in Guangzhou, China randomly assigned 139 obese patients to two groups: one group who participated in a time-restricted eating regimen where they ate only between 8 a.m. and 4 p.m. along with restricting their daily caloric intake and another group of participants who only engaged in daily caloric restriction without a time-restricting regimen. The male participants were instructed to restrict their daily caloric intake to only 1500 -1800 calories while women followed a caloric restriction of 1200 to 1500 calories every day. The primary outcome of the study was the difference in body weight between the two groups from baseline and secondary outcomes were changes in waist circumference, body-mass index, amount of body fat, and measures of metabolic risk factors. Fox News External Link


    Democratic Republic of the Congo kicks off Ebola vaccination

    27 April- The Democratic Republic of the Congo today kicked off Ebola vaccination in Mbandaka, the capital city of Equateur Province in the north-west, to halt the spread of the virus following an outbreak which has claimed two lives since 21 April. Around 200 doses of the rVSV-ZEBOV Ebola vaccine have been shipped to Mbandaka from the eastern city of Goma. More doses will be delivered progressively in the coming days. The vaccination uses the “ring strategy" where the contacts and the contacts of contacts of confirmed Ebola patient are given the vaccine as well as frontline and health workers. So far, 233 contacts have been identified and are being monitored. Three vaccination teams are already on the ground and will work to reach all the people at high risk. To date, two cases, both deceased, have been confirmed since the outbreak began. The disease has currently been reported only in Mbandaka health district. “With effective vaccines at hand and the experience of the Democratic Republic of the Congo health workers in Ebola response, we can quickly change the course of this outbreak for the better," said Dr. Matshidiso Moeti, the World Health Organization (WHO) Regional Director for Africa. “We are supporting the country in all the key aspects of Ebola emergency response to protect and save lives." The national health authorities are stepping up response in addition to the vaccination. A 20-bed Ebola treatment centre has been set up in Mbandaka. Disease surveillance and investigation of suspected cases are underway to detect any new infections, with WHO providing material support as well as six epidemiologists to assist in the response. The country's National Institute for Biomedical Research has completed an analysis of a sample from the first confirmed case, results of which show that the new outbreak indicates a new spill-over event from the host or animal reservoir. Investigations are ongoing to determine the source of the new outbreak and how it came to infect the first confirmed case. The Democratic Republic of the Congo has experienced 14 Ebola outbreaks since 1976, six of which have occurred since 2018 alone. Over the years, with the support of WHO and other partners and donors, the country has developed homegrown expertise capable of mounting effective Ebola response. Investments in local expertise is paying off. Outbreak surveillance, detection and response have improved significantly. AFRO.WHO External Link


    Crimean-Congo hemorrhagic fever in Southern Iraq

    25 April- The Public Health Department in Dhi Qar, southern Iraq, announced Sunday the registration of new cases of hemorrhagic fever (Crimean-Congo hemorrhagic fever), according to a Shafaq News report. The department official, Hussein Riyad, said that “medical tests confirmed the infection of 3 new persons with hemorrhagic fever, out of 5 tests sent to public laboratories." Riyad indicated that “some of the infected patients work as shepherds, and one patient is a neighbor of a butcher," noting that “the total number of cases reached 14, of whom 3 died." Riyadh stressed that “the department is facing difficulty in working on controlling this disease because the supporting government agencies are not working well with his department." In early April 2022, the Public Health Department in Dhi Qar announced recording about 20 cases of hemorrhagic fever in the governorate since the beginning of this year [2022]. On 20 Apr 2022, Al-Najaf governorate (180 km or 112 mi southwest of the capital Baghdad) recorded the 1st laboratory-confirmed death from the hemorrhagic fever of a butcher from Al-Meshkhab district. Crimean-Congo hemorrhagic fever is a widespread disease caused by a tick-borne virus (Nairovirus) of the Bunyaviridae family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10–40%. Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus Hyalomma are the principal vector. Outbreak News Today External Link


    UK officials focus on possible adenovirus link to cases of hepatitis in children

    25 April- Health officials in the UK have released new details in their ongoing investigation of an unusual series of hepatitis cases in children. The new report helps explain why they have zeroed in on a possible link to the adenovirus family, the UK Health Security Agency announced Monday. Since the beginning of the year, at least 111 children have been identified in the UK with acute liver inflammation that does not appear to be caused by the group of hepatitis viruses that would've been a more likely culprit. Many more cases have been announced in the US and other countries around the world. Roughly three-quarters of the 53 children who were tested for adenovirus in the UK came back positive. The virus that causes Covid-19, on the other hand, was found in only a sixth of children who were tested — in line with the levels of community transmission in the UK. Adenoviruses make up a large family of viruses that can spread from person to person, causing a range of illnesses including colds, pinkeye and gastroenteritis. They are only rarely reported as a cause of severe hepatitis in healthy people. CNN External Link


    U.S.: California- Inmate overdoses plummet under drug program

    26 April- The spiraling number of overdose deaths and hospitalizations among California prison inmates fell dramatically during the first two years of a program that uses prescribed drugs to treat more incarcerated addicts than any such program in the country, officials said Tuesday. The rate of overdose deaths dropped 58% after the program began in 2020. Hospitalizations were 48% lower among those receiving the anti-craving drugs than among those waiting to begin treatment. The promising results show the program was effective even after accounting for restrictions during the coronavirus pandemic, according to doctors and researchers with the state corrections system and the federal official who oversees medical care in California prisons. The report says the large scale results “are trending in a positive direction" and officials are “cautiously optimistic." The findings come as Gov. Gavin Newsom's administration seeks $126.6 million in the next fiscal year and $162.5 million annually thereafter to expand treatment. The report said expanding the state's latest expensive attempt to curtail the prisons' pervasive drug problem is “at the highest priority level," given the impact on prisoner health, community safety upon inmates' release, and drug trafficking and violence it brings to prisons. The state's approach includes the once-controversial step of using drugs including buprenorphine, naltrexone and methadone to dampen addicts' cravings and euphoria and relieve withdrawal symptoms while weening them off opioids. It took years of urging by lawmakers and treatment professionals for prison officials to try the program, although the approach is now widely used and has general support from California prosecutors and probation officers. Early critics objected that the treatment substituted one drug for another, and that there could be a black market for some of the substitute drugs. In California, inmates are given the drugs in a sheet that dissolves under the tongue or by injection and are tested to make sure they are taking their medications. US News External Link


    Inequality fuels COVID death rates across Latin America: Report

    27 April- Inequality in Latin America and the Caribbean is the root cause of the region's high COVID-19 mortality rates, a joint report by Amnesty International and the Center for Economic and Social Rights has found. Examining statistics from the start of the pandemic in 2020 until February of this year, the report released on Wednesday revealed that more than 1.6 million people in Latin America died from COVID-19-related causes. That would mean that Latin America accounted for nearly a third (28 percent) of total COVID-19 deaths – despite only 8.4 percent of the world's population living in the region. “The mortality rates from COVID-19 are high across the world, but in Latin America, the numbers are disproportionate compared to the population," Amnesty researcher Diego Vazquez told Al Jazeera. The report cites “staggering inequality" as a core reason behind the death rates, alongside low public health spending, meagre social security and historically low taxes. Among the 17 Latin American and Caribbean countries mentioned, Peru had the highest mortality rates per capita, with poverty and pre-existing health conditions cited as primary reasons. In Brazil, racial discrimination and lack of access to health facilities for minority groups and Indigenous people were singled out as the core factors. Al Jazeera External Link