Happy Tuesday. Today, health reporter Lena H. Sun has a scoop for The Washington Post that you can read just below. As many loyal Health 202 readers probably know, Lena focuses on covering public health and infectious disease. Send her tips at [email protected]. Not a subscriber? Sign up here.

Today’s edition: Health policy experts aren’t happy about policy changes announced by the Centers for Medicare & Medicaid Services on Monday. Also Monday, a federal judge dismissed a lawsuit over Medicare pricing. But first …

CDC plans to drop five-day covid isolation guidelines

Americans who test positive for the coronavirus would no longer need to stay home from work and school for five days under new guidance planned by the Centers for Disease Control and Prevention, The Post’s Lena H. Sun reports.

For the first time since 2021, the CDC plans to loosen its covid isolation recommendations to align with guidance on how to avoid transmitting flu and RSV, according to four agency officials and two experts familiar with the discussions.

CDC officials acknowledged in internal discussions and in a briefing last week with state health officials how much the covid-19 landscape has changed since the virus emerged four years ago, killing nearly 1.2 million people in the United States and shuttering businesses and schools. The new reality — with most people having developed a level of immunity to the virus because of prior infection or vaccination — warrants a shift to a more practical approach, experts and health officials say.

Under the proposed approach, people would no longer need to stay home if they have been fever-free for at least 24 hours without the aid of medication and their symptoms are mild and improving, according to three agency officials who spoke on the condition of anonymity to share internal discussions. It would base isolation decisions on clinical symptoms, rather than specifying that you need to isolate for a set number of days.

The federal recommendation follows similar moves by Oregon and California. The White House has yet to sign off on the guidance, which the agency plans to release in April for public feedback, officials said.

The plan to further loosen of isolation guidance when the science around infectiousness has not changed is likely to prompt strong negative reaction from vulnerable groups, including people older than 65, those with weak immune systems and long covid patients, CDC officials and experts said.

Doing so “sweeps this serious illness under the rug,” said Lara Jirmanus, a clinical instructor at Harvard Medical School and a member of the People’s CDC, a coalition of health-care workers, scientists and advocates focused on reducing the harmful impacts of covid-19.

Public health officials should treat covid differently from other respiratory viruses, she said, because it’s deadlier than the flu and increases the risk of developing long-term complications.

The new isolation recommendations would not apply to hospitals and other health-care settings with more vulnerable populations, the officials said. 

It’s not clear whether the updated CDC guidance will continue to recommend masking for 10 days.

Health officials from other states told the CDC last week that they are already moving toward isolation guidelines that would treat the coronavirus the same as flu and RSV, with additional precautions for people at high risk, said Anne Zink, an emergency room physician and Alaska’s chief medical officer. Read Lena’s full report here

Researchers incensed over CMS data access change

Health policy experts exploded with frustration on Monday at an announcement by the Centers for Medicare & Medicaid Services that it will begin steering researchers to its Virtual Research Data Center, or VRDC, which requires pricey licenses to access and prevents institutions from building their own data sets. 

CMS also announced it would be creating new fees for researchers who had already obtained data from the agency and wanted to continue working with it.

In announcing the plan on Monday, CMS asked for comments but also said the changes would be phased in starting in August.

  • The VRDC is a powerful tool that gives researchers access to decades of federal health data. For instance, the National Association of ACOs just used to it analyze Medicare claims and discover what it suspects is massive Medicare fraud.

But the VRDC has historically been too expensive for many researchers, who bristled at its start-up fees like $15,000 per year and ongoing user fees like $25,000 per year per user. Columbia University’s Adam Sacarny told our colleague Dan Diamond that he estimated his recent project would have cost $115,000 or more over two years, fees that would have been unworkable under the NIH grant he received.

Under the new plan, health research teams at major institutions would likely need to budget hundreds of thousands of dollars, or more, for their staff to keep accessing Medicare and Medicaid data as they have been, Sacarny estimated. Currently, many institutions have spent far less to build their own data sets from CMS over the years.

  • The experts warned the move would backfire for CMS. Health policy researchers said they currently play an essential role as CMS watchdogs — citing examples of uncovering worrisome trends and other problems the agency ended up addressing — and said that would become much more difficult without easy access to data.

“This is really bad,” Penn health policy professor Aaron Schwartz wrote on social media, saying his doctorate was dependent on physical access to Medicare and Medicaid records. “Incredibly expensive VRDC access cannot be the only way to access CMS data.”

Sujith Ramachandran, an associate professor at the University of Mississippi School of Pharmacy, told Dan that he was organizing a letter of researchers in protest. 

  • CMS cited “security and privacy risks” for pursuing the plan. In a statement, the agency said it remains committed to “user-friendly, secure access to CMS data” and invited feedback.

Federal judge dismisses PhRMA lawsuit over Medicare drug price negotiations

A federal district court judge in Texas dismissed a lawsuit by the Pharmaceutical Research and Manufacturers of America (PhRMA) and two other organizations over Medicare drug price negotiations on Monday.

Eight other lawsuits by manufacturers and others are still pending, Axios reported.  

In a 14-page decision, U.S. District Judge David Alan Ezra granted the U.S. Department of Health and Human Services’ motion for summary judgment. The case was heard in the District Court for the Western District of Texas because one of the plaintiffs — the National Infusion Center — is located there. Ezra dismissed the case for “lack of subject matter jurisdiction” and “lack of venue.”

In an emailed statement, PhRMA spokesperson Nicole Longo told the Health 202 last night: “We are disappointed with the court’s decision, which does not address the merits of our lawsuit, and we are weighing our next legal steps.”

Last year, the Health 202’s Rachel Roubein wrote about the lawsuit that was dismissed Monday as well as others: 

  • The lawsuit filed by PhRMA and two other plaintiffs alleges the drug negotiation program is unconstitutional for three main reasons. The groups contend Congress shouldn’t have delegated such broad authority to the federal health department, the program denies manufacturers their due process rights and imposes a “staggering” tax for noncompliance. 
  • Another lawsuit from the U.S. Chamber of Commerce and local business groups made similar arguments, though they also included other claims in their quest to bring down the program.

In a data brief released today, the National Center for Health Statistics says the rate of maternal syphilis increased 222 percent from 2016 through 2022, from 87.2 to 280.4 per 100,000 births. Maternal syphilis rates rose for all race and Hispanic-origin groups over the same period, the NCHS said.

NCHS reported that the largest increases were for mothers younger than 20 (290 percent, from 107.3 to 418.6 per 100,000 births), followed by mothers 30-34 (277 percent, from 60.9 to 229.6). The maternal syphilis rate rose for every age group from 2016 through 2022, according to the NCHS.

Read the full data brief here. 

  • Defense Secretary Lloyd Austin underwent new medical procedures under general anesthesia on Monday to address a bladder problem that landed him back in the hospital over the weekend, the Pentagon said, The Post’s Missy Ryan and Fenit Nirappil reported. A Pentagon spokesman said Austin was expected to resume his duties on Tuesday.
  • As pickleball’s popularity climbs, serious injuries among players have skyrocketed, Linda Carroll writes for NBC News.
  • Medical debt is associated with financial vulnerability in many areas, and those with more medical debt are also more likely to use payday loans or other high-cost funding sources, according to research from the Peterson-KFF Health System Tracker. 

GoFundMe Has Become a Health Care Utility – KFF Health News (By Elisabeth Rosenthal | KFF Health News)

Southeastern Pennsylvania is getting its first micro-hospitals ( By Harold Brubaker | The Philadelphia Inquirer)

Post-Roe v. Wade, more patients rely on early prenatal testing as states toughen abortion laws (By Laura Ungar and Amanda Seitz | Associated Press)

Thanks for reading! See y’all tomorrow.


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