Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
We saw this play out with President Joe Biden’s bout with COVID-19: It takes longer than you might expect to test negative. Indeed, the CDC found, “Between 5 and 9 days after symptom onset or after initial diagnosis with SARS-CoV-2 infection, 54% of persons had positive SARS-CoV-2 antigen test results.”
The LA Times says the rule of thumb “five days and you are clear” is a misconception:
“If your test turns out to be positive after five days, don’t be upset because the majority of people still test positive until at least Day 7, to Day 10 even,” Dr. Clayton Chau, director of the Orange County Health Care Agency, said during a briefing Thursday. “So that’s the majority. That’s the norm.”
Dr. Robert Kosnik, director of UC San Francisco’s occupational health program, said at a campus town hall in July that there’s an expectation people will test negative on Day 5 and can return to work the next day.
“Don’t get your hopes up,” Kosnik told his colleagues. “Don’t be disappointed if you’re one of the group that continues to test positive.”
In fact, some 60% to 70% of infected people still test positive on a rapid test five days after the onset of symptoms or their first positive test, meaning they should still stay in isolation, Kosnik said.
“It doesn’t significantly fall off until Day 8,” he said.
The California Department of Health gives clear guidance on what to do once you test positive for COVID-19:
If you test positive or have symptoms of COVID-19, you should stay away from others, even at home and even if you have been vaccinated. Isolate for at least 5 full days after your symptoms start, or after your first positive test date if you don’t have symptoms.
Ending isolation: You can end isolation after 5 days if you test negative (use an antigen test) on Day 5 or later – as long as you do not have a fever and your symptoms are getting better. If you still test positive on or after Day 5 or if you don’t test, isolate for 10 full days, and until you don’t have a fever. It is strongly recommended that you wear a well-fitting mask around others – especially when indoors – for 10 days, even if you stop isolating earlier.
For those of you who have been traveling this summer (maybe you attended a journalism conference or other big event) the guidelines say, “If you have been exposed to someone with COVID-19, even if you are vaccinated, test 3-5 days after your exposure. Isolate if you test positive. If you had COVID-19 in the last 90 days, only test if you have new symptoms, using an antigen test.” And let’s face it: If you have been anywhere more than 50 feet from your front door this summer, you have been exposed to someone who has COVID-19.
The fight to limit insulin costs
There are 7 million Americans who need insulin to control their diabetes. That number alone makes the Inflation Reduction Act important to a lot of your viewers/readers/listeners.
Two administrations representing both political parties have promised they would do something to control insulin prices. And once again, the plan is stalled in Congress.
Senate Democrats hoped to include a provision in the Inflation Reduction Act that would cap the cost of insulin at $35 not only for people with private healthcare but also for people who are covered by Medicare.
But because the legislation before the Senate over the weekend was a budget reconciliation bill, it had to comply with rules that the Senate Parliamentarian said made that provision out of line.
Democrats tried to keep the provision in the final legislation anyway, but it failed even with the support of seven GOP senators including Sens. Bill Cassidy (Louisiana), Susan Collins (Maine), Josh Hawley (Missouri), Cindy Hyde-Smith (Mississippi), John Kennedy (Louisiana), Lisa Murkowski (Alaska) and Dan Sullivan (Alaska).
The final vote was 57-43 but under Senate rules it needed 60 votes to pass.
Interestingly, more Republicans supported the proposal when Donald Trumped backed such a plan to limit the cost of insulin.
The Senate votes means that the plan heading for a House vote next caps out-of-pocket costs only for Medicare patients who use insulin, around a quarter of whom pay more than $35 per month right now. Some states have imposed a $30 monthly cap on insulin for some patients with private insurance.
Let me give you an idea of how many people this affects. FierceHealthCare summarized the latest findings:
Kaiser Family Foundation looked at 2018 enrollee data for all individual and small group Affordable Care Act plans sold on and off the exchanges. It also looked at claims data from that year from people who had large employer coverage using IBM MarketScan data.
Overall, the analysis explored 110 million out of 160 million Americans with private insurance. Kaiser added that about 1 million people among those studied got an insulin prescription filled in 2018.
Researchers looked at how many enrollees paid more than $420 a year out-of-pocket on insulin, which is the average of $35 a month.
It found that 26% in the individual market and another 31% in the small group market paid more than $420 a year. The large employer market had only 19% of people who paid more than that figure annually, as this group tends to have lower deductibles and copayments.
People who work for smaller companies or employers and people who do not have employer-sponsored healthcare pay the most, as you would suspect.
The Kaiser Family Foundation says a $35-a-month cap on out-of-pocket insulin costs could benefit more than one in four Americans on the individual and small group markets and one in five in large employer-sponsored plans. Critics say insulin costs a few dollars to produce but for some people has become so expensive they are rationing their care.
Return to office, heel and foot pain
Bloomberg reports that as women return to the office, they also are finding that old shoe-wearing habits are a big pain in the bunion.
Podiatrists are seeing an uptick in injuries brought on by a return to the office, in-person conferences and other professional events that require a return to more formal footwear. Dr. Miguel Cunha of Gotham Footcare in Manhattan said his offices have recently seen an influx of overuse injuries, from shin splints to plantar fasciitis, among patients wearing heels again after ditching them for two years. During the pandemic, lower levels of activity and going barefoot led to weakness and tightness of muscles and tendons
“Once the restrictions of the pandemic were lifted, many women resumed their use of heels for work without giving their body adequate time to transition back to their pre-pandemic activity levels,” Dr. Cunha said. For many, that’s led to intensified foot pain and discomfort.
“The body doesn’t like any kind of abrupt change,” said Dr. James Hanna, former president of the New York State Podiatric Medical Association. “Whenever you’re forced to do something all at once, suddenly you’re going back to the office, and now you’re wearing these shoes you haven’t worn in two years, that’s really like asking for trouble.”
No water, no grass: City tears out sod
During my time in Las Vegas last week for the NABJ/NAHJ convention, every conversation I had with cab drivers centered on the weather and water. As I watched fountains flow and thought of the water the skyscraping hotels must use, I was interested to learn how Vegas, oddly, may be modeling how other cities, desperate for water, may adapt.
CBS News found that the city is so dry that it is ripping up what little grass the city maintains.
A new law, the first of its kind in the nation, bans non-functional grass — defined as grass that is used to make roadways and roundabouts look good while serving no other purpose.
The city’s already pulled up about four million square feet of grass on public property so far this year, because thirsty green parkways are something they just can’t afford anymore. “The grass that you see behind me is not long for this world,” Mack told correspondent Tracy Smith. “In fact, within the next couple of months to a year, this grass will be completely eliminated, and it’ll be replaced with drip-irrigated trees and plants.”
And John Entsminger, the general manager of the Southern Nevada Water Authority said:
“Everything we use indoors is recycled. If it hits a drain in Las Vegas, we clean it. We put it back in Lake Mead,” Entsminger said. “You could literally leave every faucet, every shower running in every hotel room, and it won’t consume any more water.”
In the past two decades, Lake Mead has dropped a startling 180 feet due to a the ongoing megadrought, made worse by climate change and the rapid growth of cities and agriculture in the Southwest. Southern Nevada, though, has beaten the odds by cutting its overall water use by 26% while also adding 750,000 people to its population since 2002.
How is your community thinking about sustainability in parks, along highways and streets? As cities grow, what requirements are the communities placing on developers to keep sustainability in mind for what they plant and how much water the landscaping will require?
The Natural Resources Defense Council warns that even while attempting to save water, it is a bad idea to rip up greenspace. NRDC promotes “green infrastructure”:
Green infrastructure encompasses a variety of water management practices, such as vegetated rooftops, roadside plantings, absorbent gardens, and other measures that capture, filter, and reduce stormwater. In doing so, it cuts down on the amount of flooding and reduces the polluted runoff that reaches sewers, streams, rivers, lakes, and oceans. Green infrastructure captures the rain where it falls. It mimics natural hydrological processes and uses natural elements such as soil and plants to turn rainfall into a resource instead of a waste. It also increases the quality and quantity of local water supplies and provides myriad other environmental, economic, and health benefits—often in nature-starved urban areas.
And NRDC recommends that cities build rain gardens, which are between sidewalks and streets where runoff waters flows rather than flooding streets. NRDC points to porous sidewalks that “allows rainfall to seep through to underlying layers of pollutant-filtering soil before making its way to groundwater aquifers. Once installation costs are factored in, it can cost as much as 20 percent less up front than conventional pavement systems, and it can be cheaper in the long run to maintain.”
Journalists, the summer of 2022 has been jam-packed with floods and storms. The climate experts tell us worse is coming. America is spending billions on new infrastructure. Wouldn’t this be the time to adapt to anticipate our future rather than just react to the past?
Plunge pools: trend or fad?
As summers get hotter, homeowners may be tempted to ask, “Do we need a pool?” Thankfully the answer in my household has always been that our kids had friends who had pools and we lived fairly close to a nice public pool, so we avoided digging up the backyard. But now, this being 2022 and all, let me introduce you to the concept of a “plunge pool”: a shallow, maybe 10 by 20 feet in-ground tub that is enough to wallow in but not big enough to swim in. You avoid the expensive maintenance, and you cause less harm to tree roots for about half the price. The New York Times will show you pictures.
See you soon
I have a heavy week of travel and teaching ahead so I will be away from the newsletter for a bit.
See you soon-ish.
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Al Tompkins is senior faculty at Poynter. He can be reached at atompkins@poynter.org or on Twitter, @atompkins.
