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Yahoo
4 days ago
- Health
- Yahoo
Confusion over maternal care medication plagues politics in Louisiana and beyond
Packages of Mifepristone tablets are displayed at a family planning clinic on April 13, 2023, in Rockville, Maryland. (Photo illustration by) A year ago, Gov. Jeff Landry signed a bill into law that made Louisiana the first state in the country to reclassify pregnancy care drugs as controlled dangerous substances. Since then, the political assault on the medications has continued to ramp up on the state and national level. The Louisiana law to reclassify mifepristone and misoprostol caused controversy, particularly when multiple medical professionals publicly criticized the measure saying the added burdens to accessing the medications could delay medical treatment in times of crisis. Misoprostol and mifepristone have been targeted because they are used in medication abortion, but both have multiple other uses. Misoprostol is used to prevent and treat postpartum hemorrhage. Since the state law went into effect in October, hospitals have changed how they store and dispense the drugs, locking them up in passcode-protected storage containers outside of labor and delivery rooms. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX The New Orleans Health Department has been tracking complaints from health care providers and patients who have struggled with misoprostol access since October. The medical professionals and patients were provided anonymity to encourage feedback. One doctor wrote they had trouble accessing the drug to provide to a patient going through a hysteroscopy, a medical procedure in which the doctor examines a woman's uterus using a thin, lighted tube. 'I was unable to get misoprostol in pre-op for [a] patient undergoing hysteroscope,' the provider wrote. 'Therefore [I] had to manually dilate [the] cervix multiple times causing unnecessary harm to the patient.' Another doctor said they couldn't complete a biopsy, so they prescribed misoprostol to a patient in order to try the procedure again after softening her cervix. The doctor included the patient's diagnosis of abnormal bleeding on the prescription, and that the patient was not pregnant. The pharmacy refused to fill the prescription until the doctor got on the phone to confirm the medication was not being used to end a pregnancy. 'This could lead to a delay in diagnosis of cancer,' the doctor wrote. In another instance, a pharmacist refused to fill a prescription for misoprostol ahead of an IUD insertion, telling the patient 'he thought she was going to use it for an abortion,' wrote the doctor. There were also multiple accounts of misoprostol being prescribed for miscarriages, but pharmacists delayed filling prescriptions until they spoke to the doctor on the phone. In one instance, the mother who miscarried filed a complaint with the city health department. 'I was denied misoprostol, essentially leaving me with my dead baby inside of me even longer because the pharmacist said he couldn't give it to me,' the mother wrote. 'It was more horrific than it needed to be.' Even among state lawmakers who approved the law, confusion reigns. At a Louisiana House committee hearing last month, Rep. Lauren Ventrella, R-Greenwell Springs, said that last year 'we made it illegal to prescribe' mifepristone and misoprostol. However, both can still be legally prescribed by health care providers with the proper licensing for Schedule IV drugs. When the law reclassifying the medication passed, its supporters repeatedly stated they were not restricting access to the medication for people who needed it for reasons outside of abortion. When Ventrella misspoke, she was introducing House Bill 575, which would allow families to sue over suspected abortions. Attorney General Liz Murrill has referred to the law as 'another tool in the toolbox' that could be used against out-of-state doctors who prescribe abortion medication to patients in Louisiana. Murrill is currently prosecuting at least two cases involving a New York doctor who allegedly prescribed medications to pregnant women in Louisiana. So far, New York's shield laws, which protects abortion providers, have held up against states that have tried to prosecute doctors. Ventrella's bill awaits Senate floor action with less than a week remaining in the legislative session. Opponents of the reclassification of mifepristone and misoprostol have worried that, by labeling the drugs as controlled dangerous substances, it would confuse medical providers and the public as well as stigmatize medications that have been proven to be safe and effective. They are challenging the law, Act 246, in state court, and a judge ruled May 15 that the plaintiffs suing the state have a right to pursue their case. 'Specifically, the judge agreed that the plaintiffs have sufficiently demonstrated the harm that the law is causing to their practice, and the patients that they serve, to be able to challenge the constitutionality of this law,' said Ellie Schilling, a New Orleans attorney representing the plaintiffs. The plaintiffs include the reproductive health advocacy group Lift Louisiana, the Birthmark Doula Collective and multiple women's health advocates and Louisiana health care providers, including OB-GYNs, midwives and pharmacists. As the court fight plays out in Louisiana, another clash is occurring on the national stage. U.S. Health Secretary Robert F. Kennedy Jr. has ordered the Food and Drug Administration to conduct a 'complete review' on misoprostol and mifepristone. It comes in the wake of a far-right organization publishing a paper — one that is not peer-reviewed and many critics view as unscientific — claiming the drugs cause adverse medical effects. The far-right think tank, the Ethics and Public Policy Center, claimed almost 11% of women experienced a 'serious adverse event' from the medications, but peer-reviewed clinical studies have shown an overall 0.5% rate of serious adverse events. Other research in the report also doesn't hold up to fact-checking, and its authors did not reveal where they sourced the data that was cited. 'It's deeply troubling that Secretary Kennedy is elevating junk-science to justify reopening mifepristone's safety review, especially at the behest of anti-abortion political operatives,' said Dr. Angel Foster, co-founder of the Massachusetts Abortion Access Project, which provides medication abortion care to all 50 states via telemedicine. 'I know firsthand that mifepristone's safety is backed by decades of rigorous data. Rolling back access to mifepristone would be a disaster.' SUPPORT: YOU MAKE OUR WORK POSSIBLE
New York Times
13-03-2025
- Health
- New York Times
Public Health Survived the Pandemic. Now It Fights Politics.
For months, Dr. Jennifer Avegno, the director of the New Orleans Health Department, has watched the threats come closer: Louisiana led the United States as seasonal flu cases surged to their highest rate in 15 years, and had the nation's first death from bird flu. Then came a deadly measles outbreak in neighboring Texas. The number of Louisiana schoolchildren with exemptions to vaccine requirements doubled in a year. During the Covid pandemic, Dr. Avegno worked with state officials to tame high infection rates and promote vaccines. But after taking office last year, Gov. Jeff Landry began carrying out a promise to remake public health after the state's Covid response, which he thought was a disaster. Mr. Landry, a Republican, created a position for a state surgeon general, appointing Dr. Ralph Abraham, a former congressman who had railed against the state's 'tyrannical' Covid response and argued that the real risk was not the virus itself but the vaccines against it. So it was not entirely a surprise when Dr. Abraham announced last month that Louisiana would 'no longer promote mass vaccination,' calling efforts to do so during Covid 'an offense against personal autonomy that would take years to overcome.' To Dr. Avegno, it was a blunt reminder of how the political aftereffects of the pandemic have left her field worse prepared in many ways to fight the next one. 'We're in a very different world right now,' she said. 'We are now prepared to throw the baby out with the bath water and leave ourselves incredibly vulnerable.' Local public health officials like Dr. Avegno are the front line for responding to any disease outbreak. Five years after the pandemic began, many say that the entrenched politicization of Covid has left them with fewer tools to respond and fresh challenges: Janet Hamilton, the executive director of the Council of State and Territorial Epidemiologists, said that mistrust in public health has made it harder to respond early. She compared fighting outbreaks to battling a blaze, and said lower vaccination rates are providing a path for them to spread. 'The line of gas that's there, that the fire can travel along, exists in ways that it did not exist in 2019,' she said. Local health officials no longer need police protection or to sleep away from home as some did when the public was revolting against mask mandates and other Covid restrictions. In interviews over the last month with two dozen local and state health officials, many acknowledged that public health authorities had made mistakes as they tried to respond to a novel, constantly changing virus — the first outbreak in more than a century that resulted in widespread lockdowns. They say they have learned from those missteps. Many ruled out future lockdowns, closures or other blanket mitigation strategies. 'That ship has completely sailed,' said Dr. Anne Zink, who was Alaska's chief medical officer during the pandemic. 'And maybe for the best.' Instead, she and others said, public health agencies need to be 'really nimble' and respond with targeted interventions like tracking down individuals with an infectious disease, identifying their contacts and working to reduce the risk of further spread. This requires sufficient resources and detailed, up-to-date information about the threat. Yet Dr. Sanmi Areola, director of the Metro Public Health Department in Nashville, worries that laws passed in response to the Covid-19 pandemic are so broad that they would limit the ability to fight a fast-moving threat. Tennessee, like several other states, now has a law stating that only the governor can order infected patients to isolate or exposed people to quarantine during a pandemic. Several states this year have proposed banning mRNA vaccines, the kind used against Covid, based on false assertions that they change recipients' DNA. Absent the powers public health officials once had, Dr. Areola said, 'Public perception, right or wrong, is a very important piece. We have to invest in crafting messages and explaining the benefits.' The biggest lesson, many health officials said, is the importance of clear communication. Many have invested in new outreach campaigns. Erin Ourada, a public health administrator in North Dakota, said each of her agency's roughly 30 staff members travel to at least one community meeting each month to share updates about the department's work. In Clackamas County, Ore., the health department tapped trusted community members to speak to specific groups, including Hispanic and Eastern European immigrants. As Oregon battled its largest measles outbreak in decades last year, they fanned out to address skepticism about vaccines. Still, Dr. Sarah Present, the county's health officer, worries about what she described as the moral injury to the field — the toll taken by the angry public confrontations, the threats, the friends who shied away. Like others, she has stopped telling strangers what she does, after people she met socially took it as an opportunity to debate vaccinations. 'I think that people's exhaustion and the burnout in public health also makes us a little bit less prepared,' she said. In Pima County, Ariz., which includes Tucson, Dr. Theresa Cullen set up the largest free Covid-19 testing program in the state and established mobile vaccination clinics to serve rural residents. But after Gov. Katie Hobbs nominated her to lead the state's health department, she quickly became what one friend called a 'voodoo doll' for public health. At her confirmation hearing in 2023, one state senator blamed her for the depression and suicides of students during school closures; one person testified that Dr. Cullen's agency had 'terrorized' local businesses. 'I was taken aback by the ferociousness,' Dr. Cullen said in an interview. 'Because I know why I wanted to do that job, and it was service.' The governor withdrew her nomination, and Dr. Cullen stayed in Pima County. Others walked away from the stress. With them went a lot of experience: One study found that nearly half of all public health employees who were working at state and local agencies in 2017 had left by 2021. 'People who had been there for 20 years, people who have seen measles before or done a measles outbreak, those who worked through Ebola in the past, a lot of them are gone,' Dr. Zink said. At the same time, public health challenges are increasing. Extreme heat and disasters like hurricanes and wildfires are demanding responses from local departments that are also confronting outbreaks of measles, whooping cough, syphilis, H.I.V. and TB. The federal government sent billions of dollars in pandemic funding to state and local health departments. But that emergency money has all but dried up, leaving local departments with fewer resources to shore up staff, trace new viruses and expand vaccine campaigns. 'People don't question the police and fire budgets — when you dial 911, you're going to have a police officer come,' said Renae Moch, a public health officer in North Dakota. 'Public health is kind of the same, but we don't get the same respect. We're here 24/7 too. Why do we have to keep showing our worth?' Dr. Eric Chow, the interim health officer for Seattle's health department, said the spread of bird flu from farms to humans is a top concern, as Washington has had more cases than most states. Though a vaccine is available, disseminating it would be difficult. 'To be able to stand up the access points, get the information out to people,' he said, 'we're going to require much more federal support.' When the pandemic started, the C.D.C. was not sharing data on the outbreak. It was left to universities and private entities to create public dashboards. In 2023, the C.D.C. created the Center for Forecasting and Outbreak Analytics, a network of centers that collect and distribute data and information. But there are fears that it will be the victim of budget cuts. With the Trump administration reining in communications from health agencies, 'there's this massive gap in communication happening — within the C.D.C., between the C.D.C. and states, between the C.D.C. and academic research partners,' said Dr. Lauren Gardner, an infectious disease expert at Johns Hopkins. In January 2020, Dr. Gardner created an interactive Covid dashboard that members of the public and health officials around the world quickly came to rely on. Local health departments 'all have to be networked into something that's overseeing things at a higher level — that's the C.D.C.,' she said. And given the uncertainty around the agency, she added, 'the C.D.C. is going to struggle to fulfill that role right now.' Local officials say that without coordination with the federal government, it will be hard to act on the lessons they've learned from Covid. 'Public health credibility quickly went out the window when the public could see that we sometimes weren't in the loop either,' said Ms. Ourada, in North Dakota. 'That's kind of what has brought us to where we are today, where we aren't trusted members of the community anymore.'
Axios
25-02-2025
- Health
- Axios
Report: Alarming HIV infection increase in New Orleans teens
New Orleans health officials are urging an expansion in sexually transmitted infection testing, treatment and prevention after a new report says the city saw a sharp increase in HIV cases among 15- to 19-year-olds. The big picture: Louisiana has for years maintained one of the nation's highest HIV infection rates, but New Orleans carries an outsized portion of the state's cases, data shows. In 2023, out of every 100,000 people in Louisiana, 22.3 were living with an HIV diagnosis. But in New Orleans, that rate was 35.2 people out of 100,000. Though a lifelong condition, HIV is treatable, and testing can help to reduce transmissions. Zoom in: The number of New Orleans teens ages 15-19 with HIV diagnoses increased from 3 to 9 people between 2022 and 2023, the New Orleans Health Department said in the report. That "signals an urgent need for targeted interventions to address the rising incidence among adolescents," the report says. One solution is already in the works, thanks to a new sexual health education program the health department plans to roll out to New Orleans schools later this year. By the numbers: The STI report pointed to other alarming trends, including: A chlamydia infection rate that exceeds state and national averages. A 71% increase in gonorrhea cases for a single New Orleans East ZIP code (70129). People of color, young men and pregnant women continue to experience disproportionately high STI rates. Go deeper: Read the full report.
Yahoo
13-02-2025
- Health
- Yahoo
Medical experts warn New Orleans residents of potential flu spike ahead of Mardi Gras season
NEW ORLEANS (WGNO) — It's been one of the worst flu seasons we've seen in about 15 years, with at least 24 million flu illnesses, 310,000 hospitalizations and 13,000 deaths across the country. Unfortunately, Louisiana seems to have played a large part in those numbers. 'Our flu rates led the nation for weeks starting in November. We had some of the highest, if not the highest rates for almost 2 months,' New Orleans Health Department Director Dr. Jennifer Avegno said. Drug overdose death in Washington Parish caused by 'new substance,' sheriff's office says According to the CDC, about 44% of adults got flu shots this winter across the country which is about the same as last year. Only about 45% of children were vaccinated, down from about 50%. 'More people are hesitant and they're not getting their children vaccinated, and again while children are generally healthy, 57 children have already died from the flu; and children are often vectors to spread it, not only to each other, but to their family,' Dr. Avegno said. Just recently thousands of guests from around the country spent time in the city for the Super Bowl, and plenty more will be visiting soon during carnival. Due to this, Avegno says there is a chance the city could see another spike if we're not careful. 'I am hopeful that we in Louisiana because we were so high early and for so long, that we are going to be trending down, and hopefully those visitors who are going to be visiting us are going to be getting through their peak as well,' Dr. Avegno said. Orleans Parish Coroner voices frustration over lack of recognition At around this time of the season, the flu vaccine begins to get more and more scarce, so pharmacists recommend coming as soon as you can to get yours if you haven't already, before it's too late. 'Ideally you would have gotten your flu shot in September, October of last year for this flu season, but if you haven't gotten it, it's not too late because there's still some flu out there. Still good to protect yourself,' Majoria Drugs Pharmacist Brian Guidry threat ending tonight as cold front pushes through NOPD to host mounted unit fundraiser Medical experts warn New Orleans residents of potential flu spike ahead of Mardi Gras season Ellis' 27 points off the bench helps the Kings hold on to beat Williamson and the Pelicans 119-111 Orleans Parish Coroner voices frustration over lack of recognition Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
