News, public health

What you need to know about the Republican plan for replacing the Affordable Care Act (Audio)

If you missed it over the weekend, be sure to check out Chris Fitzsimon’s radio interview with health policy analyst Brendan Riley of the NC Justice Center. Riley discusses the Republican plan for replacing the Affordable Care Act, what subsidies could look like, and how many people could lose coverage under the new Republican proposal.

Also take time to read Health Advocacy Project analyst Ciara Zachary’s take on the replacement plan for the ACA over on Policy Watch’s main site.

Environment, public health

Former DHHS deputy Randall Williams nominated to head Missouri health department

Missouri Gov. Eric Greitens (left) has nominated Randall Williams, former NC Deputy Secretary of DHHS, to lead Missouri’s health department. (Photo: Gov. Geitens’s Facebook page)

Randall Williams, among the state officials entangled in the coal ash and drinking water controversy, could be the next leader of the Missouri health and senior services department. The story was reported today by The Kansas City Star.

Williams, who served as the deputy secretary of the the NC Health and Human Services, was nominated by Missouri Gov. Eric Greitens, a Republican. The Missouri Senate still must confirm Williams.

In a Facebook post, Gov. Greitens wrote, “Our new Director of the Department of Health and Senior Services, Dr. Randall Williams, is an exceptional leader who will put the people of Missouri first.”

The post continued:

As the State Health Director and Deputy Secretary for Health Services in North Carolina, Dr. Williams helped lead a 17,000 member agency with a 20 billion dollar budget. But even as he helped lead such a large organization, he never forgot that he was there to serve the people. He visited all 100 counties in North Carolina to understand and listen to the needs of their rural, underserved patients. And after each visit, he took action. And he got results. He’s committed to doing the same here in Missouri. … Now, he’ll serve the people of Missouri with the same commitment and compassion. Together, I know that we can create a health system that ensures that everyone has access to quality care, and nobody is forgotten.”

Williams became central to the coal ash scandal for his role in reversing the do not drink orders to households whose wells may have been contaminated by discharge from Duke Energy coal ash basins. Those letters, which rescinded previous “do not drink” advisories, downplayed the health risks of hexavalent chromium in drinking water.

Shortly before leaving office, Gov. Pat McCrory appointed Williams to the state’s oil and gas commission. Obviously, Williams must resign that position to take the Missouri job. Fun fact: Greitens, a former Navy SEAL and amateur boxer, graduated from Duke University in 1996.

News, public health

WATCH: Governor Cooper explain his plan for Medicaid expansion

Governor Roy Cooper will file the paperwork this week asking the federal government to amend the state’s Medicaid plan, opening door for expansion. While conservative legislators staunchly oppose Medicaid expansion, Cooper told business leaders Wednesday it makes sense fiscally.

North Carolina’s new governor says expansion would bring $2-4 billion in new investment to the state and create between 20,000-40,000 jobs.

Watch Cooper’s remarks below:

Environment, public health

How to become an AirKeeper for your neighborhood

A smog-filled cityscape of Beijing, China.

Become an AirKeeper: Don’t let your neighborhood air get as filthy as Beijing’s. (Photo: Creative Commons)

The power to monitor the air can sit in the palm of your hand.

Clean Air Carolina, a Charlotte-based nonprofit, has launched an AirKeeper program that deploys citizen scientists and sensors into neighborhoods, schools, even private back yards.

Today, NCPW posted a story about how citizens are filling in the monitoring gaps created by a lack of funding and political will on the state and federal level.

The group is soliciting donations for the programs; for $450, an individual, group or even city/county can get an air sensor, a mobile device for uploading the data, plus training and technical expertise. The AirKeeper program uses sensors that measure particulate matter, PM 2.5, microscopic pollution, which can damage the lungs and heart. Next year, Clean Air Carolina plans to expand the monitoring to include ozone.

Terry Lansdell, program director for Clean Air Carolina, said citizens can use what’s known as fixed monitoring: Placing a sensor outside a home, school or community center, for a span of time, usually a month, where the air can be constantly monitored. All the information collected is uploaded online as part of a crowd-sourcing data management. “We can look at data in real time,” Lansdell said. “It’s a powerful tool.”

People can also use a sensor for mobile monitoring. They can walk around their neighborhood or in suspected pollution hotspots to get real-time data. Or a person with asthma could carry a sensor for a day to determine if they should avoid certain areas. The data could also be useful in looking back to see if an asthma attack might have been triggered by pollution.

To contact Clean Air Carolina about the program, call Terry Lansdell at 980-213-6446 or email him at terry@cleanaircarolina.org. More info is also available from Medical Advocates for Healthy Air, which is part of Clean Air Carolina. Laura Wenzel of Chapel Hill is the manager of that program: Laura@CleanAirCarolina.org

Environment, public health

Superbug alert: Mutant gene found in U.S. swine farm makes bacteria resistant to antibiotics

A photo of enterobacteria, which are rod-like and can cause serious infections in humans. A new gene found in swine could make it resistant to even the strongest drugs.

Enterobacteria cause serious infections, and a new gene found in swine could make it resistant to even the strongest drugs. (Photo: Google images)

This post has been updated with a statement from the National Pork Board.

A wayward gene has wandered onto a U.S. swine farm, inserted itself into sows and piglets and created a bacteria that is resistant to drugs of last resort.

The study, conducted by Ohio State University, did not name the swine farm, nor did it identify the location. Update 5:53 p.m.: Andy Curliss of the NC Pork Council told NCPW that the farm is not in North Carolina.

However, we do know that the farm had about 1,500 swine and that “the sows give birth in tight pens” — aka gestation crates (a favorite “production method” of state Rep. Jimmy Dixon) — and the piglets are taken to separate pens of 25 each after they are weaned. Researchers theorize that the pigs, which are housed in tight quarters, passed the gene around.

From the story:

“No pigs scheduled for slaughter carried the mutant gene, the researchers stressed, and they haven’t found any threat to people yet. And none of the pigs were sick. But the mutant should not have been on the farm at all and they have no idea how it got there.”

Researchers are now worried that the altered bacteria could enter the food supply through raw meat. Humans infected with the bacteria could then become resistant to a class of antibiotics known as carbapenems. These antibiotics are deployed when other drugs fail. They are used to treat serious bacterial infections such as bronchitis, meningitis, septicemia and kidney infections — all potentially fatal, especially in people with depressed immune systems.

A type of antibiotic-resistant germ called carbapenem-resistant Enterobacteriaceae, or CRE, are especially dangerous, the story reported. If they get into the bloodstream and cause an infection, CRE germs kill half their victims.

North Carolina researchers announced in October that they had discovered antibiotic-resistant staph bacteria in young children whose parent or parents worked at industrialized hog farms in the eastern part of the state.

Crowded conditions make hogs, chickens, cattle and other livestock prone to infections, which in turn, compels farmers to dose them with antibiotics. (The situation is similar to human health outbreaks in jails, nursing homes, day cares and schools, all the equivalent of giant petri dishes.) Public health and environmental advocates have both called for farmers to use fewer antibiotics in their hogs, especially to boost growth. Pasture-raised and free-range animals also require fewer antibiotics.

Representatives from the NC Department of Agriculture could not be reached this morning for comment. The National Pork Board released a statement today.

 “The National Pork Board today reacted to the recent research paper from the Ohio State University research study detailing the researchers’ discovery of an antibiotic-resistant gene in one farrowing barn.
According to the National Pork Board, an important takeaway from the study is that the U.S. pork supply is safe. The resistant gene identified in the study was not found in a market hog, and there was no threat to food safety.
As experts in swine production, the Pork Checkoff is eager to analyze the initial findings, alongside its authors, and better understand results of this report from this farm. Specifically, resistant gene samples were found in one barn, on one site without any confirmed indication of how the resistant gene got there.
Ohio State University researchers acknowledge that it is unknown how the Carbapenem-Resistant Enterobacteriaceae (CRE) bacteria was introduced to the facility and that it could have been introduced by an outside source. The conclusions drawn without further validation, replication and research demonstrate this issue requires additional study.
The fact that CRE was found in one area of the farm indicates that current internal biosecurity measures are effective. The U.S. pork industry supports efforts to monitor for the occurrence of this type of isolated incident. However, consistent with FDA and Pork Quality Assurance® Plus requirements, Ceftiofur [a type of antibiotic] should only be used in the treatment and control of disease with veterinarian oversight and direction.
Pig farmers in many states voluntarily participate in the Ohio State University’s Public Health Preparedness for Infectious Diseases Program. These producers take part in this research to better understand emerging disease issues. The National Pork Board agrees that more studies be performed to validate and attempt to replicate the finding. The National Pork Board looks forward to learning more about ongoing surveillance efforts that protect human and animal health.”