From the COVID-19 front:

• Beckers Hospital Review reports that

Of the more than 123 million people fully vaccinated as of May 17, just 1,949 breakthrough cases involving hospitalizations or death had been reported to the CDC. 

Three more [CDC] findings:

• Ninety-three percent of cases involved hospitalizations. Of these, 25 percent involved people who were asymptomatic and hospitalized for reasons not related to COVID-19.
  
• Eighteen percent of all reported cases were fatal. Of these deaths, 18 percent involved people who were asymptomatic and died for reasons unrelated to the virus. 
  
• In total, 79 percent of all reported cases involved people aged 65 or older.

The new data comes after the CDC changed how it tracks breakthrough COVID-19 cases among fully vaccinated Americans. As of early May, the agency only monitors the most severe cases.

• The New York Times’ Upshot column discusses opinions on how vaccinated parents can do in terms of socializing activities with children under 12 years of age, the minimum age threshold for COVID-19 vaccination,

As vaccinated Americans return to many parts of their prepandemic lives this summer, one group will be left out: children under 12, who cannot yet be vaccinated. So what should families with young children do when everyone else starts socializing again?

We asked experts as part of an informal New York Times survey. The group of 828 who responded included epidemiologists, who study public health, and pediatric infectious disease physicians, who research and treat children sick with diseases like Covid-19.

They noted that this phase was temporary. Pfizer has said vaccines for children ages 2 and up could come as soon as September. Of the survey respondents with young children, 92 percent said they would vaccinate their own children as soon as a shot was approved. (Only five said no; some were undecided.) In the meantime, families with young children may need to retain more precautions, like masking and distancing, than their childless friends do. But they said some minimally risky activities could help counteract the mental health effects of pandemic living.

• David Leonhardt also in the New York Times believes that vaccination hesitancy is affecting the working class.

Public health experts believe that there are specific strategies that can narrow the vaccination divide [between classes].

One is information. About 25 percent of unvaccinated people remain unsure whether somebody who previously had Covid should still get the vaccine, according to Kaiser. The answer is yes: Almost everybody 12 and older should.

Another promising strategy is making shots even more convenient. Employers can help by hosting on-site vaccinations and giving workers paid time off — including the day after the shot for people who experience side effects. Drugstores and supermarkets can accept walk-ins, as some already do. Government officials can send mobile, walk-in clinics into more communities. (Text your ZIP code to 438829 — or text “VACUNA” for Spanish — and you’ll find your local options.)

“We’ve just got to remove all the barriers,” Brodie said.

Finally, friends and relatives can turn a vaccination into something more than just a shot. “Say, ‘Let’s do this together. Let’s do something, so if you get vaccinated, let’s grab dinner after. Let’s celebrate together,’” Dr. Edith Bracho-Sanchez, a New York pediatrician, told CNN.

• A friend of the FEHBlog called attention to this American Psychology Association “Stress in America survey conducted in late February 2021 found 42% of U.S. adults reported undesired weight gain since the start of the pandemic, with an average gain of 29 pounds.” Whoa Nelly!
• The FEHBlog’s dogs pointed out this American Hospital Association report that “a new study from researchers at the London School of Hygiene & Tropical Medicine and others suggests that people infected with COVID-19 have a distinct body odor that specially trained dogs can rapidly detect with up to 94.3% sensitivity and up to 92% specificity. The study found dogs could detect the odor on clothing samples from individuals, including those who were asymptomatic, had low viral loads and two different strains. The study has yet to be peer reviewed and replicated in real-world settings, but shows promise as a way to screen individuals for COVID-19 testing at airports and other public places, the authors said.” Man’s best friend indeed.

In a Monday mishmosh of other healthcare news

• A Wall Street Journal reporter discusses her own postpartum illness that nearly resulted in another maternal death.

The U.S. has a maternal mortality rate double that of most other high-income countries, including Britain, Canada and Australia, according to the New York City-based Commonwealth Fund, a healthcare research foundation. The CDC says that about two-thirds of pregnancy-related deaths are preventable; factors include lack of access to care, delayed diagnoses and missed warning signs. Black women and those on Medicaid are disproportionately affected.

To help address this, the American College of Obstetricians and Gynecologists recommended in 2018 that women have contact with their providers much sooner than six weeks—within three weeks after birth for low-risk women and sooner for women at higher risk of complications. (The roughly 30% of women who have cesarean sections sometimes already have a follow-up appointment after two weeks.)

The doctors who authored the 2018 recommendations said such a major change is challenging. “It is old habits. This is a huge culture shift,” said Tamika Auguste, chairwoman of Women’s and Infants’ services at MedStar Washington Hospital Center, who co-wrote the recommendations. My midwife said that in her two decades of practice, she has seen most women after about six weeks and found it effective.

Wouldn’t telehealth provide a Goldilocks solution here?

The American College of Obstetricians and Gynecologists also supports in-home visits by a nurse in the days after birth, which is a standard practice in other high-income countries but isn’t always covered by insurance in the U.S. * * * Even doctors who support adding more care say it’s hard to find the right balance. “We don’t know how much contact or care that we need that would be beneficial,” said Mark Clapp, a maternal-fetal medicine specialist at Massachusetts General Hospital.

See above telehealth suggestion.

• UPMC’s Health Plan has a created a virtual concierge for its members using Amazon’s Alexa and the Google Home Assistant.
• The Pew Charitable Trust has released an interesting report on the impact of state No Surprise billing laws on healthcare costs.

Eighteen states have passed surprise billing laws since 2014, most of them in the past three years. Last year, former President Donald Trump signed a federal version that covers self-funded health plans, including those offered by many employers, as opposed to the individual and commercial health plans regulated by states.

The concerns stem from guidelines states have established to help impartial arbitrators resolve disputes between providers and insurance carriers over how much should be paid for surprise, out-of-network bills.

“An upward trend in payments for out-of-network care could push rates higher in in-network contracts,” health policy researchers at Georgetown University wrote in a blog post last month. “These costs, in turn, could push premium costs higher for employers and consumers.”

• The UPI reports that

A healthy lifestyle can lower dementia risk, even among those with a family history of cognitive decline, according to a study presented Thursday during an American Heart Association conference held virtually because of the COVID-19 pandemic.

This includes eating a healthy diet, exercising regularly, not smoking or drinking alcohol to excess and maintaining good sleep habits and a healthy body weight, the researchers said during the Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Conference.

Adults ages 50 to 73 who embrace at least three of the behaviors can reduce their dementia risk by 30%, the data showed.

Those with a family history of dementia who followed at least three of the behaviors had a 25% to 35% reduced risk for the condition compared to those who followed two or fewer.

• The National Committee for Quality Assurance issued an illuminating blog post describing the digital changes taking place with its HEDIS healthcare quality measures which play an important role in OPM’s FEHB Plan Performance Assessment system.