Supreme Court takes up bid to defund Planned Parenthood
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(WASHINGTON) — The battle over taxpayer funding for Planned Parenthood takes center stage at the U.S. Supreme Court on Wednesday in a dispute over South Carolina’s exclusion of the group from the state Medicaid program because it provides abortions.
On the line is the ability of Medicaid beneficiaries to freely choose a healthcare provider, including physicians at Planned Parenthood who provide services other than abortion, like contraception treatments and cancer screenings.
South Carolina’s two Planned Parenthood clinics have served mostly low-income, minority women for more than 40 years. Hundreds of their patients are Medicaid recipients.
The case also implicates the millions of federal dollars Planned Parenthood receives in the form of reimbursements for treating Medicaid patients each year.
According to Planned Parenthood, 34% of its overall revenue, or $699 million, comes from government grants, contracts, and Medicaid funds.
In 2018, South Carolina’s Republican governor Henry McMaster issued executive orders disqualifying Planned Parenthood from receiving Medicaid reimbursements for non-abortion services.
Julie Edwards, a Medicaid beneficiary and type-1 diabetic who sought medical care at a Planned Parenthood clinic in Columbia, SC, sued the state alleging a violation of the Medicaid Act, which guarantees a “free choice of provider” that is willing and qualified.
“Medicaid beneficiaries often face significant barriers to obtaining care, particularly in South Carolina. Twenty-five percent of state residents live in medically underserved areas,” the plaintiffs wrote in their brief to the high court.
“[Congress] enacted the free-choice-of-provider provision to ensure that Medicaid patients, like everyone else, can choose their own doctor,” they wrote. “Congress specifically enacted this provision in response to some States’ efforts to restrict Medicaid patients’ choice of provider.”
The state argues that Congress never intended to give individuals the right to sue over access to a particular provider and that there are plenty of other clinics available to serve Medicaid recipients.
“Congress wanted states to have substantial discretion to innovate with their Medicaid programs,” the state wrote in its brief to the high court. Allowing individuals to sue over access to specific providers would “subject the state to unanticipated (and expensive) lawsuits.”
While federal law already prohibits any government funding of abortions, South Carolina contends it has the right to target non-abortion funding to abortion providers. “Because money is fungible, giving Medicaid dollars to abortion facilities frees up their other funds to provide more abortions,” the state told the court.
“[Planned Parenthood] can restore Medicaid funding if it stops performing abortions— but it has chosen not to do so,” South Carolina wrote.
If the justices allow the suit to go forward, Edwards and Planned Parenthood can continue to challenge the clinics’ exclusion from the state’s Medicaid program in a lower court.
If the justices side with the state, they would bolster efforts to cut off Planned Parenthood from sources of government funding and effectively limit the number of providers available to Medicaid recipients.
A decision in the case is expected by the end of the Court’s term in June.
(NEW YORK) — More measles cases are being confirmed across the United States as health officials work to treat patients in an ongoing outbreak in Texas.
The Kentucky Department for Public Health (KDPH) and the Franklin County Health Department announced on Wednesday a confirmed case of measles in an adult resident, the first in the state in two years.
The departments said the resident recently traveled internationally to an area where measles is spreading.
Meanwhile, in New Jersey, health officials confirmed two new measles cases in Bergen County linked to a patient whose case was confirmed earlier this month.
Officials haven’t found any links between the cases in Kentucky and New Jersey, and there’s no evidence the cases in Kentucky or New Jersey are connected to the outbreak in Texas, which has so far sickened 124 people and led to one death in an unvaccinated school-aged child.
Kentucky health officials are now attempting to contact anyone the infected resident may have come into contact with. The resident attended a Planet Fitness in Frankfort on Feb. 17 while contagious, officials said.
“Measles is one of the most contagious viruses in the world,” KDPH Commissioner Dr. Steven Stack said in a statement. “Fortunately, measles can be prevented with the measles, mumps and rubella (MMR) vaccine, which is safe and effective. Vaccines are an essential tool to keep children and adults safe and healthy.”
An official briefed on the situation told ABC News on Thursday that the new cases in New Jersey are members of the same family and were not vaccinated. Because they are in the same family, public health officials are hopeful public spread will have been limited.
The original case tested positive after traveling internationally. The New Jersey Department of Health said people may have been exposed to measles if they visited Englewood Hospital’s Emergency Department on Feb. 5.
Health officials said people who were exposed could develop symptoms until as late as March 6.
Measles is one of the most contagious diseases known to humans. Just one infected patient can spread measles to up to nine out of 10 susceptible close contacts, according to the Centers for Disease Control and Prevention.
Health officials have been urging anyone who isn’t vaccinated to receive the measles, mumps, rubella (MMR) vaccine.
The CDC currently recommends that people receive two vaccine doses, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective, and two doses are 97% effective. Most vaccinated adults don’t need a booster.
Measles was declared eliminated from the U.S. in 2000 due to the highly effective vaccination program, according to the CDC. However, CDC data shows vaccination rates have been lagging in recent years.
(NEW YORK) — A personalized mRNA vaccine may reduce the risks of pancreatic cancer returning after surgery, according to a preliminary study published Wednesday in the journal Nature.
Pancreatic cancer is one of the most aggressive cancers, with a typical survival rate of only about a year after the diagnosis according to the study.
While the findings are encouraging, the vaccine is still in early testing and will likely take years before it becomes widely available — assuming ongoing trials continue to show success, according to Dr. Vinod P. Balachandran, lead investigator of the trial and senior author of the study.
In this small, preliminary trial of 16 patients, half had a strong immune response to the vaccine. Most of these responders remained cancer-free for more than three years, much longer than those who didn’t respond.
The vaccine works by training specialized immune system cells, known as T cells, to recognize and attack the cancer.
Researchers couldn’t track tumor shrinkage because all patients had surgery to remove visible cancer before vaccination. However, they found that the vaccine produced long-lasting T cells that may keep fighting cancer for years.
“This is one way through which you can make lots of T cells, and you can make these T cells such that they can persist for a long time in patients and retain their function,” Balachandran said.
Balachandran said “to be able to get an immune response has been very challenging,” especially when an illness like pancreatic cancer typically does not respond to vaccines, which highlights the significance of these findings.
A larger trial is now underway to confirm the results. If successful, this approach could lead to new ways to treat or even prevent pancreatic and other advanced cancers.
Overall, Balachandran said this study can “provide some important clues on how you would be able to develop vaccines more broadly for other cancers.”
“Hopefully this information that we will learn from these clinical trials will give us information to know apply vaccines in other settings, such as primary prevention, meaning preventing cancers from occurring even before they occur, with vaccines or perhaps also using it to treat patients who have more advanced disease,” Balachandran said.
(NEW YORK) — Dr. Kimberly Shriner remembers the first COVID-19 patient who came into Huntington Hospital in Pasadena, California, in March 2020.
He was a 35-year-old man who arrived at the hospital short of breath.
“He went straight to our intensive care unit. We were very suspicious that he had COVID,” Shriner, an infectious disease specialist and the hospital’s medical director of infectious disease and infection prevention, told ABC News.
Testing was minimal at the time, but eventually the results came back and confirmed that he had COVID. The patient was eventually sedated and intubated, and he died 24 hours later. Shriner said the next few patients admitted to the hospital for COVID-19 followed similar trajectories, becoming more and more short of breath before eventually dying of their illness.
“As physicians, we understand death,” Shriner said. “We understand that we can’t save every patient, but when you’re having 100% mortality with your first experience with this thing, it was pretty overwhelming and daunting. That first week [was] particularly surreal.”
Tuesday, March 11, marked five years since the World Health Organization (WHO) declared the global outbreak of COVID-19 to be a pandemic. The U.S. is in a much better situation now, with fewer hospitalizations and deaths — and vaccines to prevent severe illness from COVID, frontline health care workers say.
However, they add that, as Americans become more removed from the early days of COVID, it may be hard to remember what it was like — especially for those who were treating patients.
“Everybody was worried, doctors, nurses,” Dr. Matthew Sims, director of infectious disease research for Corewell Health, a non-profit health care system located in Michigan, told ABC News. “It was absolutely crazy, and I think that people have forgotten. I think people have forgotten the horror of what COVID was like in the beginning and, I mean, it was a horror situation.”
Quickly changing world
Shriner said one of the indicators of how quickly the world was changing was the evolution of her hospital’s meetings about the virus and how to prepare as information was starting to come out of China.
“Meetings were held in a very tiny, little meeting room. Nobody was wearing masks or anything,” she said. “And then as things began to evolve, and we saw it was happening, that the rooms got started getting bigger, and then we started meeting with masks on, and then, eventually, went virtual.”
Shriver recalled that the situation was “very terrifying” on a personal and professional level.
“If we’d known how difficult it was going to be, I think we would have been even more disturbed,” she said.
Sims said it became clear how quickly patients could get infected in March 2020. Not long after the WHO declared a global pandemic, he came on shift that week to be the infectious disease doctor rotating in the hospital.
“We had two confirmed cases admitted at that point. By the end of the week I spent on, we had over 100 confirmed cases admitted,” he told ABC News. “It was absolutely devastating to the hospital, to the health care system as a whole … It was a crazy time.”
The state of hospitals
Both Sims and Shriner said the lack of early testing at the time was a source of frustration. Since routine testing wasn’t available, results often took days — or even weeks — to return.
Additionally, hospital labs often had to confirm results with state departments of health.
Sim said as the hospitals became full, it sometimes became a race against the clock to try and treat patients.
“I remember one of the most devastating cases I saw was a young man, relatively young, young kids at home,” he said. “A little overweight, I think he was a diabetic, but he just got super sick, and we were trying to get remdesivir, which was compassionate use at the time,” referencing an antiviral drug later approved to treat COVID-19.
Sims said the hospital had to call up the company manufacturing the drug, tell them about the patient and then get approval from the U.S. Food and Drug Administration (FDA) to use doses on the patient.
“And we got approval, and then they have to ship it to us,” Sims said. “It was all being shipped as fast as possible, but before it could even get here, that patient got too sick to even use it, and the patient died. A week before, he was home with his kids, his wife, et cetera, in normal state of health, and then, all of a sudden, got this terrible virus and died.”
As it became clear how contagious the virus was, hospital staff were required to always wear masks. Shriner said she still has a scar or imprint on her nose from having to wear a mask for 18 hours a day.
One of things she remembers most was the lack of sound, other than machines, whenever she visited ICUs.
“As the months progressed, we ended up having six different intensive care units because the patients were so sick,” she said. “We had many, many patients that were on ventilators. You’d walk into these areas, and it was just silence. All you heard were the ventilators going and seeing people in full protective gear all the time.”
To handle the influx of patients, both hospitalized and in emergency departments, Shriner said her hospital stopped all non-emergency surgeries to be able to have extra physicians available.
COVID-19 vaccines arrive
On Dec. 11, 2020, the FDA granted Pfizer-BioNTech the first emergency use authorization for a COVID-19 vaccine for those aged 16 and older. Three days later, nurse Sandra Lindsay became the first person to receive a COVID-19 vaccine in the U.S. as distribution began.
Both Shriner and Sims felt a sense of relief that a tool was finally available to help stem the spread of disease.
Shriner said she was the first person in her hospital to receive the COVID-19 vaccine, even though she didn’t want to be.
“I didn’t want to be the first person. I was perfectly fine with letting other people go ahead of me,” she said. “And [the CEO] said to me, ‘You have to be.’ She said, ‘If you don’t get vaccinated, nobody else is going to do it.'”
Shriner said the distribution of the vaccine “was a sign of the way out. It was very hopeful.”
Lessons learned
Both Sims and Shriner say COVID-19 taught health care workers many lessons, including how to share information quickly, how to diligently monitor diseases and how to scale up health care capacity.
Sims said another valuable discovery was better communicating to the public that information during a public health crisis can change rapidly.
One example is that early studies would come out suggesting certain drugs might help treat patients. Eventually additional information would be published proving the opposite.
“We were learning, and we were learning in such a rapid [way], it was hard to communicate,” he said. “I think if we had any failure, it was that in that rapid push to communicate.”
Sims noted how that created some uncertainty.
“We didn’t get the message across enough that some of what we’re learning may be wrong, and we will tell you that as we learn,” Sims said. “We’re going to tell you what we know now that may not be the same thing we know tomorrow.”
Shriner added that stay-at home orders and lockdowns were hard on people and, if another pandemic happens, she is hopeful there would be different decisions on what should be locked down.
“Maybe we don’t have such stringent lockdown rules and isolation rules,” she said. “You know, the outdoor restaurant became a great thing. You know, think of all the home delivery services really took off. And so, a lot of good things came out of it, but they were hard won.”
