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About This TrackerThis tracker provides the number of confirmed cases and deaths from novel antibiotics important site by country, the trend in confirmed case and death counts by country, and a global map showing which countries have confirmed cases and deaths get cipro. The data are drawn from the Johns Hopkins University (JHU) antibiotics Resource Center’s buy antibiotics Map and the World Health Organization’s (WHO) antibiotics Disease (buy antibiotics-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About buy antibiotics antibioticsIn late 2019, a get cipro new antibiotics emerged in central China to cause disease in humans. Cases of this disease, known as buy antibiotics, have since been reported across around the globe.

On January 30, 2020, the World Health Organization (WHO) declared the cipro represents a public health emergency of international concern, and on January get cipro 31, 2020, the U.S. Department of Health and Human Services declared it to be a health emergency for the United States.Key PointsOn January 23, 2017, President Donald Trump reinstated and expanded the Mexico City Policy via presidential memorandum, renaming it “Protecting Life in Global Health Assistance.” This explainer provides an overview of the policy, including its history, changes over time, and current application.First announced in 1984 by the Reagan administration, the policy has been rescinded and reinstated by subsequent administrations along party lines and has now been in effect for 19 of the past 34 years.The policy requires foreign non-governmental organizations (NGOs) to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S. Funds) as a get cipro condition of receiving U.S. Government global family planning assistance and, as of Jan.

23, 2017, most other U.S get cipro. Global health assistance.The Trump administration’s application of the policy extends to the vast majority of U.S. Bilateral global health assistance, including funding for HIV under PEPFAR, maternal and get cipro child health, malaria, nutrition, and other programs. This marks a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounts for approximately $600 million of that total).Additionally, as a result of a March 2019 policy announcement and subsequent information released in June 2019, the policy, for the first time, prohibits foreign NGOs who accept the policy from providing any financial support using any source of funds and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning.

This greatly extends its reach get cipro to other areas of U.S. Development assistance beyond global health and to other non-U.S. Funding streams.More recently, in September 2020, a proposed rule to extend the policy get cipro to contracts was published. If finalized, it would greatly extend the reach of the policy beyond grants and cooperative agreements to also include contracts.KFF analyses have found that:more than half of the countries in which the U.S.

Provides bilateral global get cipro health assistance allow for legal abortion in at least one case not permitted by the policy (analysis). Andhad the expanded policy been in effect during the FY 2013 – FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy (analysis).What is the Mexico City Policy?. The Mexico City Policy is a U.S get cipro. Government policy that – when in effect – has required foreign NGOs to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S.

Funds) as a condition of receiving U.S get cipro. Global family planning assistance and, as of Jan. 23, 2017, get cipro most other U.S. Global health assistance.The policy was first announced by the Reagan administration at the 2nd International Conference on Population, which was held in Mexico City, Mexico, on August 6-14, 1984 (hence its name.

See Box get cipro 1). Under the Trump administration, the policy has been renamed “Protecting Life in Global Health Assistance” (PLGHA). Among opponents, it is also known as get cipro the “Global Gag Rule,” because among other activities, it prohibits foreign NGOs from using any funds (including non-U.S. Funds) to provide information about abortion as a method of family planning and to lobby a foreign government to legalize abortion.

€œ[T]he United States does not consider abortion an acceptable element of family planning programs and will get cipro no longer contribute to those of which it is a part. €¦[T]he United States will no longer contribute to separate nongovernmental organizations which perform or actively promote abortion as a method of family planning in other nations.”When first instituted in 1984, the Mexico City Policy marked an expansion of existing legislative restrictions that already prohibited U.S. Funding for abortion internationally, get cipro with some exceptions (see below). Prior to the policy, foreign NGOs could use non-U.S.

Funds to engage in certain voluntary get cipro abortion-related activities as long as they maintained segregated accounts for any U.S. Money received, but after the Mexico City Policy was in place, they were no longer permitted to do so if they wanted to receive U.S. Family planning assistance.The Trump administration’s get cipro application of the policy to the vast majority of U.S. Bilateral global health assistance, including funding for HIV under the U.S.

President’s Emergency Plan for AIDS Relief (PEPFAR), maternal and child health, malaria, nutrition, and other programs, marks a significant expansion of get cipro its scope, potentially encompassing $7.3 billion in FY 2020, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounted for approximately $600 million of that total). The Administration’s more recent extension of the policy to include any financial support (health or otherwise) provided by foreign NGOs for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning is likely to encompass significant additional funding.When has it been in effect?. The Mexico City Policy has been in effect for 19 of the past 34 years, primarily through executive action, and has been instated, rescinded, and reinstated by presidential administrations along party lines (see Table 1).The policy was first instituted in 1984 (taking effect in 1985) by President Ronald Reagan and continued to be in effect through President George H.W. Bush’s administration get cipro.

It was rescinded by President Bill Clinton in 1993 (although it was reinstated legislatively for one year during his second term. See below) get cipro. The policy was reinstated by President George W. Bush in 2001 and then rescinded get cipro by President Barack Obama in 2009.

It is currently in effect, having been reinstated by President Trump in 2017. YearsIn Effect? get cipro. Presidential Administration (Party Affiliation)Executive (E) or Congressional (C) Action?. 1985-1989YesReagan (R)E1989-1993YesBush (R)E1993-1999 Sept.NoClinton (D)E1999 Oct.-2000 Sept.Yes*Clinton (D)C2000 Oct.-2001NoClinton (D)E2001-2009YesBush get cipro (R)E2009-2017NoObama (D)E2017-presentYesTrump (R)ENOTES.

Shaded blue indicate periods when policy was in effect. * There was a temporary, one-year legislative imposition of the policy, which included a portion of get cipro the restrictions in effect in other years and an option for the president to waive these restrictions in part. However, if the waiver option was exercised (for no more than $15 million in family planning assistance), then $12.5 million of this funding would be transferred to maternal and child health assistance. The president get cipro did exercise the waiver option.SOURCES.

€œPolicy Statement of the United States of America at the United Nations International Conference on Population (Second Session), Mexico City, Mexico, August 6-14, 1984,” undated. Bill Clinton get cipro Administration, “Subject. AID Family Planning Grants/Mexico City Policy,” Memorandum for the Acting Administrator of the Agency for International Development, January 22, 1993, Clinton White House Archives, https://clintonwhitehouse6.archives.gov/1993/01/1993-01-22-aid-family-planning-grants-mexico-city-policy.html. FY 2000 Consolidated Appropriations Act, P.L get cipro.

106-113. George W get cipro. Bush Administration, “Subject. Restoration of the Mexico City Policy,” Memorandum for the Administrator of the United States Agency for International get cipro Development, January 22, 2001, Bush Administration White House Archives, https://georgewbush-whitehouse.archives.gov/news/releases/20010123-5.html.

€œSubject. Restoration of the Mexico City Policy,” Memorandum for the Administrator of the United get cipro States Agency for International Development, March 28, 2001, Federal Register, https://www.federalregister.gov/documents/2001/03/29/01-8011/restoration-of-the-mexico-city-policy. George W. Bush Administration, “Subject get cipro.

Assistance for Voluntary Population Planning,” Memorandum for the Secretary of State, August 29, 2003, Bush Administration White House Archives, http://georgewbush-whitehouse.archives.gov/news/releases/2003/08/20030829-3.html. Barack Obama Administration, “Mexico City Policy and Assistance for Voluntary Population Planning,” get cipro Memorandum for the Secretary of State, the Administrator of the United States Agency for International Development, January 23, 2009, Obama White House Archives, https://obamawhitehouse.archives.gov/the-press-office/mexico-city-policy-and-assistance-voluntary-population-planning. White House, “The Mexico City Policy,” Memorandum for the Secretary of State, the Secretary of Health and Human Services, the Administrator of the Agency for International Development, Jan. 23, 2017, https://www.whitehouse.gov/the-press-office/2017/01/23/presidential-memorandum-regarding-mexico-city-policy.How is it instituted (and rescinded)? get cipro.

The Mexico City Policy has, for the most part, been instituted or rescinded through executive branch action (typically via presidential memoranda). While Congress has the ability to institute the policy through legislation, this has happened only get cipro once in the past. A modified version of the policy was briefly applied by Congress during President Clinton’s last year in office as part of a broader arrangement to pay the U.S. Debt to get cipro the United Nations.

(At that time, President Clinton was able to partially waive the policy’s restrictions.) Other attempts to institute the policy through legislation have not been enacted into law, nor have legislative attempts to overturn the policy. See Table 1.Who does the policy apply get cipro to?. The policy, when in effect, applies to foreign NGOs as a condition for receiving U.S. Family planning support and, now, other global health assistance, either directly (as the main – or prime – recipient of U.S.

Funding) or indirectly (as a recipient get cipro of U.S. Funding through an agreement with the prime recipient. Referred to as a get cipro sub-recipient). Specifically, a foreign NGO “recipient agrees that it will not, during the term of this award, perform or actively promote abortion as a method of family planning in foreign countries or provide financial support to any other foreign non-governmental organization that conducts such activities.”Foreign NGOs include:international NGOs that are based outside the U.S.,regional NGOs that are based outside the U.S., andlocal NGOs in assisted countries.U.S.

NGOs, while not directly subject get cipro to the Mexico City Policy, must also agree to ensure that they do not provide funding to any foreign NGO sub-recipients unless those sub-recipients have first certified adherence to the policy. Specifically, a U.S. NGO “recipient get cipro (A) agrees that it will not furnish health assistance under this award to any foreign non-governmental organization that performs or actively promotes abortion as a method of family planning in foreign countries. And (B) further agrees to require that such sub-recipients do not provide financial support to any other foreign non-governmental organization that conducts such activities.”As in the past, the current policy does not apply to funding provided by the U.S.

Government to foreign governments (national or sub-national), public international organizations, and other multilateral entities, such as the Global Fund to Fight AIDS, Tuberculosis get cipro and Malaria and Gavi, the treatment Alliance. However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy. See “What get cipro is ‘financial support’?. € below.To what assistance does it apply?.

In the past, foreign NGOs have been required to adhere to the Mexico City Policy – when it was in effect – as a condition of receiving support through get cipro certain U.S. International funding streams. Family planning assistance through the get cipro U.S. Agency for International Development (USAID) and, beginning in 2003, family planning assistance through the U.S.

Department of get cipro State. In the 2003 memorandum announcing the policy’s expansion to include the Department of State, President Bush stated that the policy did not apply to funding for global HIV/AIDS programs and that multilateral organizations that are associations of governments are not included among “foreign NGOs.”The current policy, reinstated in 2017, applies to the vast majority of U.S. Bilateral global get cipro health assistance furnished by all agencies and departments. “Assistance” includes “the provision of funds, commodities, equipment, or other in-kind global health assistance.” Specifically, the expanded policy applies to nearly all bilateral global health assistance, including.

family planning and reproductive healthfor the first time:maternal and child health (including household-level water, sanitation, and hygiene (WASH))nutritionHIV under PEPFARtuberculosismalaria under the President’s Malaria Initiative (PMI)neglected tropical diseasesglobal health securitycertain get cipro types of research activitiesThe policy applies to the assistance described above that is appropriated directly to three agencies and departments. USAID. The Department of State, including the Office of the Global get cipro AIDS Coordinator, which oversees and coordinates U.S. Global HIV funding under PEPFAR.

And for the first time, the Department of Defense (DoD) get cipro. When such funding is transferred to another agency, including the Centers for Disease Control (CDC) and the National Institutes of Health (NIH), it remains subject to the policy, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly.The policy applies to three types of funding agreements for such assistance. Grants. Cooperative agreements.

And, for the first time, contracts, pending necessary rule-making that would be needed to do so (a proposed rule to accomplish this was published in September 2020).The policy does not apply to U.S. Assistance for. Water supply and sanitation activities, which is usually focused on infrastructure and systems. Humanitarian assistance, including activities related to migration and refugee assistance activities as well as disaster and humanitarian relief activities.

The American Schools and Hospitals Abroad (ASHA) program. And Food for Peace (FFP). However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy. See “What is ‘financial support’?.

€ below.What activities are prohibited?. The policy prohibits foreign NGOs that receive U.S. Family planning assistance and, now, most other U.S. Bilateral global health assistance from using funds from any source (including non-U.S.

Funds) to “perform or actively promote abortion as a method of family planning.” In addition to providing abortions with non-U.S. Funds, restricted activities also include the following:providing advice and information about and offering referral for abortion – where legal – as part of the full range of family planning options,promoting changes in a country’s laws or policies related to abortion as a method of family planning (i.e., engaging in lobbying), andconducting public information campaigns about abortion as a method of family planning.The prohibition of these activities are why the policy has been referred to by its critics as the “Global Gag Rule.”Additionally, for the first time, the policy prohibits foreign NGOs from providing any financial support with any source of funds (including non-U.S. Funding) and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning. See “What is “financial support?.

€ below.The policy, however, does not prohibit foreign NGOs from:providing advice and information about, performing, or offering referral for abortion in cases where the pregnancy has either posed a risk to the life of the mother or resulted from incest or rape. Andresponding to a question about where a safe, legal abortion may be obtained when a woman who is already pregnant clearly states that she has already decided to have a legal abortion (passively providing information, versus actively providing medically-appropriate information).In addition, the expanded policy does not apply to healthcare providers who have an affirmative duty required under local law to provide counseling about and referrals for abortion as a method of family planning.Does it restrict direct U.S. Funding for abortion overseas?. U.S.

Funding for abortion is already restricted under several provisions of the law. Specifically, before the Mexico City Policy was first announced in 1984, U.S. Law already prohibited the use of U.S. Aid:to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortion (the Helms Amendment, 1973, to the Foreign Assistance Act);for biomedical research related to methods of or the performance of abortion as a means of family planning (the Biden Amendment, 1981, to the Foreign Assistance Act).

Andto lobby for or against abortion (the Siljander Amendment, first included in annual appropriations in 1981 and included each year thereafter).Then, shortly after the policy was announced in 1984, the Kemp-Kasten Amendment was passed in 1985, prohibiting the use of U.S. Aid to fund any organization or program, as determined by the president, that supports or participates in the management of a program of coercive abortion or involuntary sterilization (it is now included in annual appropriations).Before the Mexico City Policy, U.S. Aid recipients could use non-U.S. Funds to engage in certain abortion-related activities but were required to maintain segregated accounts for U.S.

Assistance. The Mexico City Policy reversed this practice. No longer were foreign NGOs allowed to use non-U.S. Funds, maintained in segregated accounts, for voluntary abortion-related activities if they wished to continue to receive or be able to receive U.S.

Family planning funds.Does the policy prohibit post-abortion care?. The Mexico City Policy does not restrict the provision of post-abortion care, which is a supported activity of U.S. Family planning assistance. Whether or not the Mexico City Policy is in effect, recipients of U.S.

Family planning assistance are allowed to use U.S. And non-U.S. Funding to support post-abortion care, no matter the circumstances of the abortion (whether it was legal or illegal).What has been the impact of the policy?. Several studies have looked at the impact of the policy.

A 2011 quantitative analysis by Bendavid, et. Al, found a strong association between the Mexico City Policy and abortion rates in sub-Saharan Africa. This study was recently updated to include several more years of data, again identifying a strong association. Specifically, the updated study found that during periods when the policy was in place, abortion rates rose by 40% in countries with high exposure to the Mexico City Policy compared to those with low exposure, while the use of modern contraceptives declined by 14% and pregnancies increased by 12% in high exposure compared to low exposure countries.

In other words, it found patterns that “strengthen the case for the role played by the policy” in “a substantial increase in abortions across sub-Saharan Africa among women affected by the U.S. Mexico City Policy … [and] a corresponding decline in the use of modern contraception and increase in pregnancies,” likely because foreign NGOs that declined U.S. Funding as a result of the Mexico City Policy – often key providers of women’s health services in these areas – had fewer resources to support family planning services, particularly contraceptives. Increased access to and use of contraception have been shown to be key to preventing unintended pregnancies and thereby reducing abortion, including unsafe abortion.

The study also found patterns that “suggest that the effects of the policy are reversible” when the policy is not in place.Additionally, there has been anecdotal evidence and qualitative data on the impact of the policy, when it has been in force in the past, on the work of organizations that have chosen not to agree to the policy and, therefore, forgo U.S. Funding that had previously supported their activities. For example, they have reported that they have fewer resources to support family planning and reproductive health services, including family planning counseling, contraceptive commodities, condoms, and reproductive cancer screenings.While it is likely too early to assess the full effects of the current policy on NGOs and the individuals they serve, as the policy is applied on a rolling basis as new funding agreements or modifications to existing agreements are made, some early data are available. Several early qualitative and quantitative studies have been released, and at least one long-term, quantitative assessment is underway.

Additionally, an official assessment by the U.S. Department of State on implementation during the first six months of the policy has been released (see below). This review acknowledged that it took “place early in the policy’s implementation, when affected U.S. Government departments and agencies have added a significant portion of the funding affected by the policy to grants and cooperative agreements only recently [i.e., after the period the review examined].

A follow-on analysis would allow an opportunity to address one of the primary concerns presented in feedback from third-party stakeholder organizations, namely that six months is insufficient time to gauge the impacts of” the policy.Nonetheless, it is already clear that the reinstated and expanded version of the policy applies to a much greater amount of U.S. Global health assistance, and greater number of foreign NGOs, across many program areas. KFF has found that more than half (37) of the 64 countries that received U.S. Bilateral global health assistance in FY 2016 allow for legal abortion in at least one case not permitted by the policy and that had the expanded Mexico City Policy been in effect during the FY 2013 – FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy.

In addition, at least 469 U.S. NGOs that received U.S. Global health assistance during this period would have been required to ensure that their foreign NGO sub-recipients were in compliance. Additional foreign NGOs are likely to be impacted by the policy due to the revised interpretation of “financial support” announced in March 2019 and implemented beginning June 2019.

See “What is ‘financial support’?. € below.A report released in March 2020 by the U.S. Government Accountability Office (GAO) provided new information on the number of projects (awards) and NGOs affected. It found that from May 2017 through FY 2018:the policy had been applied to over 1,300 global health projects, with the vast majority of these through USAID and CDC, andNGOs declined to accept the policy in 54 instances, totaling $153 million in declined funding – specifically, seven prime awards amounting to $102 million and 47 sub-awards amounting to $51 million (more than two-thirds of sub-awards were intended for Africa) – across USAID and CDC.

The Department of State and DoD did not identify any instances where NGOs declined to accept the policy conditions.What have the U.S. Government’s reviews of the policy found?. The U.S. Government has published two reviews of the policy to date, with the first examining the initial six months of the policy released in February 2018 and the second examining the first 18 months of the policy released in August 2020.First ReviewIn February 2018, the Department of State announced the findings of an initial six-month review of implementation of the policy through the end of FY 2017 (September 2017).

The report directed agencies to provide greater support for improving understanding of implementation among affected organizations and provided guidance to clarify terms included in standard provisions of grants and cooperative agreements. In the six-month review report, the Department of State report identified a number of “actions” for implementing agencies, such as a need for:more central and field-based training and implementation tools,a clearer explanation of termination of awards for NGOs found to be in violation of the policy, anda clarification of “financial support,” which was not defined in the standard provisions (see “What is financial support?. € below).The six month review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2017 (see Table 2). U.S.

Agency or DepartmentPolicy Implementation DateOverall # of Grants and Cooperative Agreements with Global Health Assistance FundingOf Overall #:(From the Policy Implementation Date through 9/30/2017)# That Received New Funding and Accepted Policy# That Received New Funding and Declined to Accept Policy^# That Had Not Received New Funding YetUSAIDMay 15, 20175804193158State*May 15, 2017142108034HHS+May 31, 20174991600339DoDMay 15, 20177742134TOTAL12987294565NOTES. * reflects PEPFAR funding implemented through the Department of State. Other departments and agencies implement the majority of PEPFAR funding. + At HHS agencies, only certain assistance funding transferred from USAID, State, and DoD are subject to the policy.

^ As of September 30, 2017, USAID reported it was aware of three centrally funded prime partners, and 12 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards. DoD reported that one DoD partner, a U.S. NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries. And HHS reported that no HHS partners declined to agree.SOURCES.

KFF analysis of data from Department of State, “Protecting Life in Global Health Assistance Six-Month Review,” report, Feb. 6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Second ReviewOn August 17, 2020, the Department of State released its second review of the policy, updating its initial six-month review (as an action item in the six-month review report, the department stated it would “conduct a further review of implementation of the policy by December 15, 2018, when more extensive experience will enable a more thorough examination of the benefits and challenges”). The long-anticipated review, which examines the period from May 2017 through September 2018, found:the awards declined spanned a variety of program areas, including family planning and reproductive health (FP/RH), HIV and AIDS (HIV/AIDS), maternal and child health (MCH), tuberculosis (TB), and nutrition, in addition to cross-cutting awards;the awards declined spanned geographic areas but many were for activities in sub-Saharan Africa;agencies and departments made efforts to transition projects to another implementer in order to minimize disruption. Butnevertheless, among USAID awards involving health service delivery where prime and sub-award recipients declined to accept the policy, gaps or disruptions in service delivery were sometimes reported.The second review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2018 (see Table 3).

U.S. Agency or DepartmentPolicy Implementation Date# of Grants and Cooperative Agreements with Global Health Assistance Funding# of Prime Awardees That Declined to Accept Policy^USAIDMay 15, 20174866State*May 15, 20173350HHS+May 31, 20174661DoDMay 15, 2017531TOTAL13408NOTES. * reflects PEPFAR funding implemented through the Department of State. Other departments and agencies implement the majority of PEPFAR funding.

+ At HHS agencies, only certain assistance funding transferred from USAID, State, and DoD are subject to the policy. ^ As of September 30, 2018, USAID reported it was aware of six centrally funded prime partners, and 47 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards. DoD reported that one DoD partner, a U.S. NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries.

And HHS reported that one HHS partner declined to agree.SOURCES. KFF analysis of data from Department of State, “Review of the Implementation of the Protecting Life in Global Health Assistance Policy ,” report, Aug. 17, 2020, https://www.state.gov/wp-content/uploads/2020/08/PLGHA-2019-Review-Final-8.17.2020-508.pdf, and Department of State, “Protecting Life in Global Health Assistance Six-Month Review,” report, Feb. 6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Additionally, the review reports that 47 sub-awardees, all under USAID awards, declined to accept the policy.

It is important to note that the review also states that information on sub-awards is not systematically collected by departments and agencies and that DoD was not able to collect information on sub-awards.What is “financial support”?. In February 2018, in the initial six-month review issued when Secretary of State Tillerson led the department, the Department of State report included an “action” statement to clarify the definition of “financial support” as used in the standard provisions for grants and cooperative agreements. At issue was whether it applied more narrowly to certain funding provided by foreign NGOs (i.e., funding other than U.S. Global health funding) to other foreign NGOs specifically for the purpose of performing or actively promoting abortion as a method of family planning or if it applied more broadly to certain funding provided by foreign NGOs to other foreign NGOs for any purpose, if that foreign NGO happened to perform or actively promote abortion as a method of family planning.

The State Department clarified that it was the more narrow interpretation.However, on March 26, 2019, Secretary of State Pompeo reversed this interpretation, announcing further “refinements” to the policy to clarify that it applied to the broader definition of financial support. Specifically, under the policy, U.S.-supported foreign NGOs agree to not provide any financial support (global health-related as well as other support), no matter the source of funds, to any other foreign NGO that performs or actively promotes abortion as a method of family planning. In June 2019, USAID provided additional information to reflect this broader interpretation of the standard provisions.This marks the first time the policy has been applied this broadly, as it can now affect funding provided by other donors (such as other governments and foundations) and non-global health funding provided by the U.S. Government for a wide range of purposes if this funding is first provided to foreign NGOs who have accepted the policy (as recipients of U.S.

Global health assistance) that then in turn provide that donor or U.S. Non global health funding for any purpose to foreign NGOs that perform or actively promote abortion as a method of family planning. For example, under the prior interpretation, a foreign NGO recipient of U.S. Global health funding could not provide any non-U.S.

Funding to another foreign NGO to perform or actively promote abortion as a method of family planning but could provide funding for other activities, such as education, even if the foreign NGO carried out prohibited activities. Under the broader interpretation, a foreign NGO could not provide any non-U.S. Funding for any activity to a foreign NGO that carried out prohibited activities. Similarly, while under the prior interpretation a foreign NGO recipient of U.S.

Global health funding could provide other U.S. Funding (such as humanitarian assistance) to another foreign NGO for non-prohibited activities, even if the foreign NGO carried out prohibited activities, now under the broader interpretation, it could not do so.What are the next steps in implementing the expanded policy?. The policy went into effect in May 2017 (see Table 2), although it is applied on a rolling basis, as new funding agreements and modifications to existing agreements occur. While it applies to all grants and cooperative agreements, the Trump administration has indicated that it intends the policy to apply to contracts, which would require a rule-making process (it began this process by publishing a proposed rule in September 2020)..

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Transgender patients undergoing gender-affirming surgery were not at significant risk for perioperative venous thromboembolism (VTE) whether or not hormone therapy was stopped before surgery, researchers reported.In a retrospective study that included 407 transgender patients undergoing vaginoplasty, no VTE events occurred in those who continued hormone therapy through surgery, said John Pang, MD, of the Mount Sinai Center for Transgender Medicine and Surgery in New York City, and colleagues.Reporting online in the how can i get cipro Journal of Clinical Endocrinology and Metabolism, the team said the only VTE event in the study Cheap amoxil pills occurred in the group that stopped hormone therapy prior to surgery.Pang told MedPage Today that because both estrogen therapy and surgery can increase the risk of blood clots, experts have suggested that transgender women stop taking estrogen when undergoing gender-affirming surgery. However, prior to this study, there was no published data on blood clot risk specific to these patients."Hormone how can i get cipro therapy is not as unsafe as the general community and the greater medical community has feared it to be," Pang said. "A study with a large patient cohort like ours should lead people to carefully reconsider what we put our patients through as far as stopping hormone therapy before surgery in an attempt to protect them from a harm that may not actually be present. This should give healthcare providers some pause to consider what guidelines they have in place."Because of a lack of standardization and evidence-based guidelines, it is more how can i get cipro common than not that providers stop hormone therapy before surgery, he noted. "The discomfort that it causes in trans women is how can i get cipro not insignificant.

In addition to the emotional and psychological impact, patients can go through estrogen withdrawal if they have been on hormone therapy for a long period of time."For the study, Pang's group performed a retrospective chart review of all transgender patients who underwent gender-affirming surgery at their center from November 2015 to August 2019. This included how can i get cipro 919 patients who underwent 1,858 surgical procedures. However, the researchers focused especially on 407 trans women who underwent vaginoplasty. Of these, approximately half (190) had their hormone therapy suspended 1 week how can i get cipro prior to surgery, and this is the group in which the study's single VTE event occurred. The remaining 212 patients continued hormone therapy how can i get cipro through surgery.

Mean postoperative follow-up was 313 days.The VTE incidence in the study was significantly lower than the expected incidence of 1.16% to 1.35%, which has been reported among hospitalized patients with a Caprini score of 3 or more, the study authors noted. "This association would have estimated more than 2.5 VTE events from our cohort of transfeminine patients who remained on estrogen hormone therapy, and a total of 4.5 VTE events among our 407 primary how can i get cipro vaginoplasty cases."Pang told MedPage Today that one likely reason for the low VTE rate in the study is his center's careful blood clot prevention program. "What we should be doing is focusing on directly correlated risk factors. So some things that we do here are patients undergoing surgery have chemoprophylaxis that includes receiving heparin or Lovenox [enoxaparin] after surgery," he said.Getting patients walking early after surgery is also how can i get cipro important, he continued. "We have our patients at the hospital get up out of bed on day 1 how can i get cipro after surgery.

The nursing staff helps them walk around. What we want is those modifiable and known risk factors to be what we concentrate on decreasing in patients so that their risk for blood clots decreases and be less focused on things how can i get cipro we don't have the evidence to prove."Limitations of the study, the authors said, included its retrospective design, with patients not randomly assigned to one group or the other but separated according to their institution's preoperative hormone therapy protocol at that time."More large-scale multicenter studies are needed to further elucidate the association, if any, of patient demographics and hormone therapy regimen with postoperative VTE risk," the team wrote. "Additionally, the data reflect the experience of a single academic institution and may not be generalizable to other institutions with variations within the patient population and different VTE prophylaxis protocols." Last Updated January 15, 2021 Disclosures No funding sources were reported for this study and no authors disclosed conflicts of interest..

Transgender patients undergoing gender-affirming surgery were not at significant risk for perioperative venous thromboembolism (VTE) whether or not hormone therapy was stopped before surgery, researchers reported.In a retrospective study that included 407 transgender patients undergoing get cipro vaginoplasty, no VTE events occurred in those who continued hormone therapy through Cheap amoxil pills surgery, said John Pang, MD, of the Mount Sinai Center for Transgender Medicine and Surgery in New York City, and colleagues.Reporting online in the Journal of Clinical Endocrinology and Metabolism, the team said the only VTE event in the study occurred in the group that stopped hormone therapy prior to surgery.Pang told MedPage Today that because both estrogen therapy and surgery can increase the risk of blood clots, experts have suggested that transgender women stop taking estrogen when undergoing gender-affirming surgery. However, prior get cipro to this study, there was no published data on blood clot risk specific to these patients."Hormone therapy is not as unsafe as the general community and the greater medical community has feared it to be," Pang said. "A study with a large patient cohort like ours should lead people to carefully reconsider what we put our patients through as far as stopping hormone therapy before surgery in an attempt to protect them from a harm that may not actually be present. This should give healthcare providers some pause to consider what guidelines they have in place."Because of a lack of standardization and evidence-based guidelines, it is more common than not that providers stop hormone get cipro therapy before surgery, he noted. "The discomfort get cipro that it causes in trans women is not insignificant.

In addition to the emotional and psychological impact, patients can go through estrogen withdrawal if they have been on hormone therapy for a long period of time."For the study, Pang's group performed a retrospective chart review of all transgender patients who underwent gender-affirming surgery at their center from November 2015 to August 2019. This included 919 patients who underwent 1,858 get cipro surgical procedures. However, the researchers focused especially on 407 trans women who underwent vaginoplasty. Of these, approximately half (190) had their hormone therapy suspended 1 week prior get cipro to surgery, and this is the group in which the study's single VTE event occurred. The remaining 212 patients get cipro continued hormone therapy through surgery.

Mean postoperative follow-up was 313 days.The VTE incidence in the study was significantly lower than the expected incidence of 1.16% to 1.35%, which has been reported among hospitalized patients with a Caprini score of 3 or more, the study authors noted. "This association would have estimated more than 2.5 VTE events from our cohort of transfeminine patients who remained on estrogen hormone therapy, and a total of 4.5 VTE get cipro events among our 407 primary vaginoplasty cases."Pang told MedPage Today that one likely reason for the low VTE rate in the study is his center's careful blood clot prevention program. "What we should be doing is focusing on directly correlated risk factors. So some things that we do here are patients undergoing get cipro surgery have chemoprophylaxis that includes receiving heparin or Lovenox [enoxaparin] after surgery," he said.Getting patients walking early after surgery is also important, he continued. "We have our patients at get cipro the hospital get up out of bed on day 1 after surgery.

The nursing staff helps them walk around. What we want is those modifiable and known risk factors to be what we concentrate on decreasing in patients so that their risk for blood clots decreases and be less focused on things we don't have the evidence to prove."Limitations of the study, the authors said, included get cipro its retrospective design, with patients not randomly assigned to one group or the other but separated according to their institution's preoperative hormone therapy protocol at that time."More large-scale multicenter studies are needed to further elucidate the association, if any, of patient demographics and hormone therapy regimen with postoperative VTE risk," the team wrote. "Additionally, the data reflect the experience of a single academic institution and may not be generalizable to other institutions with variations within the patient population and different VTE prophylaxis protocols." Last Updated January 15, 2021 Disclosures No funding sources were reported for this study and no authors disclosed conflicts of interest..

What should I watch for while taking Cipro?

Tell your doctor or health care professional if your symptoms do not improve.

Do not treat diarrhea with over the counter products. Contact your doctor if you have diarrhea that lasts more than 2 days or if it is severe and watery.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how Cipro affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

Cipro can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

Avoid antacids, aluminum, calcium, iron, magnesium, and zinc products for 6 hours before and 2 hours after taking a dose of Cipro.

Kansas cipro settlement

WASHINGTON, DC how much does cipro cost per pill – The kansas cipro settlement U.S. Department of Labor today announced a final rule that modernizes the H-2A Temporary Agricultural Labor Certification Program. Furthering the Trump Administration’s agenda to kansas cipro settlement help American farmers, the Department’s Employment and Training Administration, and Wage and Hour Division are issuing this final rule in response to the extensive public comments received from farmers, farmworkers, as well as advocates and associations for both groups from across the country.

This rule will modernize the Department’s H-2A regulations in response to stakeholder concerns and enhance employer access to a legal source of agricultural labor, while maintaining the program’s protections for the U.S. Workforce and enhancing enforcement against fraud and abuse. “This final rule will streamline and simplify the H-2A application process, strengthen kansas cipro settlement protections for U.S.

And foreign workers, and ease unnecessary burdens on employers,” said Assistant Secretary for Employment and Training John Pallasch. €œIt is a victory for farmers, agricultural workers, and the American people, who rely on a vibrant agricultural sector to supply food for our families.” The rule mandates electronic filing of job orders and applications, bringing the H-2A application process into the digital era and harnessing the power of electronic filing through the Foreign Labor Application Gateway system to share information with federal agencies like the Department of Homeland Security, and with State Workforce Systems and domestic farmworkers. It also provides small employers that cannot kansas cipro settlement offer full-time work for their H-2A employees with an opportunity to participate in the H-2A program by establishing new standards that permit individual employers possessing the same need for agricultural services or labor to file a single application and job order to employ workers jointly in full-time employment.

Additionally, the rule will provide additional flexibilities that will reduce unnecessary burdens on the agricultural employers that use the program. These flexibilities include the ability to stagger the entry of workers into the country over a 120-day period, allowing agricultural employers the flexibility to file a single application for different start dates of need within a certified employment period instead of multiple applications. The rule will kansas cipro settlement strengthen protections for U.S.

And foreign workers by enhancing standards applicable to rental housing and public accommodations, strengthening surety bond requirements, and expanding the Department’s authority to use enforcement tools like program debarment for substantial violations of program rules. Learn more about H-2A Temporary Agricultural Labor Certification Program. The Department will publish the final rule in kansas cipro settlement the Federal Register at a later date.

Read the final rule. The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States. Improve working conditions.

Advance opportunities for profitable employment. And assure work-related benefits and rights..

WASHINGTON, DC get cipro best place to buy cipro – The U.S. Department of Labor today announced a final rule that modernizes the H-2A Temporary Agricultural Labor Certification Program. Furthering the Trump Administration’s agenda to help American farmers, the Department’s Employment and Training Administration, and Wage and Hour Division are issuing this final rule in response to the extensive public comments received from farmers, farmworkers, as get cipro well as advocates and associations for both groups from across the country. This rule will modernize the Department’s H-2A regulations in response to stakeholder concerns and enhance employer access to a legal source of agricultural labor, while maintaining the program’s protections for the U.S.

Workforce and enhancing enforcement against fraud and abuse. “This final rule get cipro will streamline and simplify the H-2A application process, strengthen protections for U.S. And foreign workers, and ease unnecessary burdens on employers,” said Assistant Secretary for Employment and Training John Pallasch. €œIt is a victory for farmers, agricultural workers, and the American people, who rely on a vibrant agricultural sector to supply food for our families.” The rule mandates electronic filing of job orders and applications, bringing the H-2A application process into the digital era and harnessing the power of electronic filing through the Foreign Labor Application Gateway system to share information with federal agencies like the Department of Homeland Security, and with State Workforce Systems and domestic farmworkers.

It also provides small employers that cannot offer full-time work for their H-2A employees with an opportunity to participate in the H-2A program by establishing new standards that permit individual employers possessing the same need for agricultural services or labor to file a single application and get cipro job order to employ workers jointly in full-time employment. Additionally, the rule will provide additional flexibilities that will reduce unnecessary burdens on the agricultural employers that use the program. These flexibilities include the ability to stagger the entry of workers into the country over a 120-day period, allowing agricultural employers the flexibility to file a single application for different start dates of need within a certified employment period instead of multiple applications. The get cipro rule will strengthen protections for U.S.

And foreign workers by enhancing standards applicable to rental housing and public accommodations, strengthening surety bond requirements, and expanding the Department’s authority to use enforcement tools like program debarment for substantial violations of program rules. Learn more about H-2A Temporary Agricultural Labor Certification Program. The Department will publish the final get cipro rule in the Federal Register at a later date. Read the final rule.

The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States. Improve working get cipro conditions. Advance opportunities for profitable employment. And assure work-related benefits and rights..

Can cipro cause shortness of breath

#masthead-section-label, #masthead-bar-one http://www.col-twinger-strasbourg.ac-strasbourg.fr/aides/ { display can cipro cause shortness of breath. None }The antibiotics ciprobuy antibiotics Updatesantibiotics Map and CasesBooster ShotsDelta Variant F.A.Q.Delta Variant MapAdvertisementContinue reading the main storySupported byContinue reading the main storyThose Anti-buy antibiotics Plastic Barriers Probably Don’t Help and May Make Things WorseClear barriers have sprung up at restaurants, nail salons and school classrooms, but most of the time, they do little to stop the can cipro cause shortness of breath spread of the antibiotics.Shields at a restaurant in Placerville, Calif., in May 2020. Research suggests that can cipro cause shortness of breath transparent barriers can interfere with normal ventilation.Credit...Rich Pedroncelli/File, via Associated PressAug.

19, 2021Leer en españolbuy antibiotics precautions have turned many parts of our world into a giant salad bar, with plastic barriers separating sales clerks from shoppers, dividing customers at nail salons and shielding students from their classmates.Intuition tells us a plastic shield would be protective against germs. But scientists who study aerosols, air flow and ventilation say that much of the time, the barriers can cipro cause shortness of breath don’t help and probably give people a false sense of security. And sometimes the barriers can make things worse.Research suggests that in some instances, a barrier protecting a clerk behind a checkout counter may redirect the germs to another worker or can cipro cause shortness of breath customer.

Rows of clear plastic shields, like those you might find in a nail salon or classroom, can also impede normal can cipro cause shortness of breath air flow and ventilation.Under normal conditions in stores, classrooms and offices, exhaled breath particles disperse, carried by air currents and, depending on the ventilation system, are replaced by fresh air roughly every 15 to 30 minutes. But erecting plastic barriers can change air flow in a room, disrupt normal ventilation and create “dead zones,” where viral aerosol particles can build up and become highly concentrated.“If you have a forest of barriers in a classroom, it’s going to interfere with proper ventilation of that room,” said Linsey Marr, professor of civil and environmental engineering at Virginia Tech and one of the world’s leading experts on viral transmission. €œEverybody’s aerosols are going can cipro cause shortness of breath to be trapped and stuck there and building up, and they will end up spreading beyond your own desk.”There are some situations in which the clear shields might be protective, but it depends on a number of variables.

The barriers can stop big droplets ejected during coughs and sneezes from splattering on others, which is why buffets and can cipro cause shortness of breath salad bars often are equipped with transparent sneeze guards above the food.But buy antibiotics spreads largely through unseen aerosol particles. While there isn’t much real-world research on the impact of transparent barriers and the risk of disease, scientists in the United States and Britain have begun to study the issue, and the findings are not reassuring.A study published in June can cipro cause shortness of breath and led by researchers from Johns Hopkins, for example, showed that desk screens in classrooms were associated with an increased risk of antibiotics . In a Massachusetts school district, researchers found that plexiglass dividers with side walls in the main office were impeding air flow.

A study looking at schools in Georgia found that desk barriers had little effect on the spread of the antibiotics compared can cipro cause shortness of breath with ventilation improvements and masking.Before the cipro, a study published in 2014 found that office cubicle dividers were among the factors that may have contributed to disease transmission during a tuberculosis outbreak in Australia.British researchers have conducted modeling studies simulating what happens when a person on one side of a barrier — like a customer in a store — exhales particles while speaking or coughing under various ventilation conditions. The screen is more can cipro cause shortness of breath effective when the person coughs, because the larger particles have greater momentum and hit the barrier. But when a person speaks, the screen doesn’t trap the exhaled particles — can cipro cause shortness of breath which just float around it.

While the store clerk may avoid an immediate and direct hit, the particles are still in the room, posing a risk to the clerk and others who may inhale the contaminated air.“We have shown this effect of blocking larger particles, but also that the smaller aerosols travel over the screen and become mixed in the room air within about five minutes,” said Catherine Noakes, professor of environmental engineering for buildings at the University of Leeds in England. €œThis means if people are interacting for more than a few minutes, they would likely be exposed to the cipro can cipro cause shortness of breath regardless of the screen.”The antibiotics cipro ›Latest UpdatesUpdated Aug. 21, 2021, 10:11 can cipro cause shortness of breath p.m.

ETJesse Jackson and his wife, Jacqueline, are hospitalized with buy antibiotics.A can cipro cause shortness of breath radio host who scoffed at buy antibiotics, then urged his followers to get vaccinated, dies.The British government is starting an antibody surveillance program.Dr. Noakes said erecting barriers may seem like a good idea but can have unintended consequences. She conducted can cipro cause shortness of breath a study published in 2013 that looked at the effect of partitions between beds in hospitals.

The study showed that while some people were protected from can cipro cause shortness of breath germs, the partitions funneled the air in the room toward others.So while a worker behind a transparent barrier might be spared some of the customer’s germs, a worker nearby or customers in line could still be exposed. Dr. Noakes said most screens she has seen are “poorly positioned and are unlikely to be of much benefit.”“I think this may be a particular problem in places like classrooms where people are present for longer periods of time,” Dr.

Noakes said. €œLarge numbers of individual screens impede the airflow and create pockets of higher and lower risk that are hard to identify.”To understand why screens often have little effect on protecting people from aerosol particles, it helps to think about exhaled breath like a plume of cigarette smoke, Dr. Marr said.“One way to think about plastic barriers is that they are good for blocking things like spitballs but ineffective for things like cigarette smoke,” Dr.

Marr said. €œThe smoke simply drifts around them, so they will give the person on the other side a little more time before being exposed to the smoke. Meanwhile, people on the same side with the smoker will be exposed to more smoke, since the barriers trap it on that side until it has a chance to mix throughout the space.”Most researchers say the screens most likely help in very specific situations.

A bus driver, for instance, shielded from the public by a floor-to-ceiling barrier is probably protected from inhaling much of what passengers are exhaling. A bank cashier behind a wall of glass or a clerk checking in patients in a doctor’s office may be at least partly protected by a barrier.A study by researchers with the National Institute for Occupational Safety and Health in Cincinnati tested different sized transparent barriers in an isolation room using a cough simulator. The study, which hasn’t yet been peer-reviewed, found that under the right conditions, taller shields, above “cough height,” stopped about 70 percent of the particles from reaching the particle counter on the other side, which is where the store or salon worker would be sitting or standing.But the study’s authors noted the limitations of the research, particularly that the experiment was conducted under highly controlled conditions.

The experiment took place in an isolation room with consistent ventilation rates that didn’t “accurately reflect all real-world situations,” the report said.The study didn’t consider that workers and customers move around, that other people could be in the room breathing the redirected particles and that many stores and classrooms have several stations with acrylic barriers, not just one, that impede normal air flow.While further research is needed to determine the effect of adding transparent shields around school or office desks, all the aerosol experts interviewed agreed that desk shields were unlikely to help and were likely to interfere with the normal ventilation of the room. Depending on the conditions, the plastic shields could cause viral particles to accumulate in the room.“If there are aerosol particles in the classroom air, those shields around students won’t protect them,” said Richard Corsi, the incoming dean of engineering at the University of California, Davis. €œDepending on the air flow conditions in the room, you can get a downdraft into those little spaces that you’re now confined in and cause particles to concentrate in your space.”Aerosol scientists say schools and workplaces should focus on encouraging workers and eligible students to be vaccinated, improving ventilation, adding HEPA air filtering machines when needed and imposing mask requirements — all of which are proven ways to reduce cipro transmission.The problem, experts say, is that most people in charge of erecting barriers in offices, restaurants, nail salons and schools are not doing so with the assistance of engineering experts who can evaluate air flow and ventilation for each room.People shouldn’t panic when they see transparent barriers, but they shouldn’t view them as fully protective, either.

Workers and students who have transparent shields around them should continue to wear a mask to lower risk, Dr. Corsi said.“Air flow in rooms is pretty complicated,” Dr. Corsi said.

€œEvery room is different in terms of the arrangement of the furniture, the height of the walls and ceilings, the vents, where the book shelves are. All of these things have a huge impact on the actual flow and air distribution in a room because every classroom or office space is different.”AdvertisementContinue reading the main story#masthead-section-label, #masthead-bar-one { display. None }The antibiotics ciprobuy antibiotics Updatesantibiotics Map and CasesBooster ShotsDelta Variant F.A.Q.Delta Variant MapAdvertisementContinue reading the main storySupported byContinue reading the main storyCan the Vaccinated Develop Long buy antibiotics After a Breakthrough ?.

While the treatments are effective at preventing serious illness and death, the risk of developing post-buy antibiotics health problems after a breakthrough isn’t known.Credit...Saul Martinez for The New York TimesPublished Aug. 16, 2021Updated Aug. 17, 2021Leer en españolWhile some breakthrough cases among those who are fully vaccinated against buy antibiotics are inevitable, they are unlikely to result in hospitalization or death.

But one important question about breakthrough that remains unanswered is. Can the vaccinated develop so-called long buy antibiotics?. Long buy antibiotics refers to a set of symptoms — such as severe fatigue, brain fog, headache, muscle pain and sleep problems — that can persist for weeks or months after the active has ended.

The syndrome is poorly understood, but studies suggest that between 10 and 30 percent of adults who catch the cipro may experience long buy antibiotics, including those who experienced only mild illness or no symptoms at all.But the vast majority of data collected about long buy antibiotics has been in the unvaccinated population. The risk of developing long buy antibiotics for the fully vaccinated who get infected after vaccination hasn’t been studied.While preliminary research suggests that it is, in fact, possible for a breakthrough case to lead to symptoms that can persist for weeks to months, there are still more questions than answers. What percent of breakthrough cases result in lingering symptoms?.

How many of those people recover?. Are the persistent symptoms after breakthrough as severe as those that occur in the unvaccinated?. €œI just don’t think there is enough data,” said Dr.

Zijian Chen, medical director at the Center for Post-buy antibiotics Care at Mount Sinai Health System in New York. €œIt’s too early to tell. The population of people getting sick post vaccination isn’t that high right now, and there’s no good tracking mechanism for these patients.”One recent study of Israeli health care workers published in the New England Journal of Medicine offers a glimpse of the risk of long buy antibiotics after a breakthrough .

Among 1,497 fully vaccinated health care workers, 39 of them — about 2.6 percent — developed breakthrough s. (All of the workers were believed to be infected after contact with an unvaccinated person, and the study was conducted before the Delta variant became dominant.)While most of the breakthrough cases were mild or asymptomatic, seven out of 36 workers tracked at six weeks (19 percent) still had persistent symptoms. These long buy antibiotics symptoms included a mix of prolonged loss of smell, persistent cough, fatigue, weakness, labored breathing or muscle pain.But the study’s authors caution against drawing too many conclusions from the research.

The sample size — just seven patients — is small. And the research was designed to study antibody levels in the infected, said Dr. Gili Regev-Yochay, director of the infectious disease epidemiology unit at Sheba Medical Center.

It was not designed to study the risk of long buy antibiotics after a breakthrough .“It was not the scope of this paper,” Dr. Regev-Yochay said. €œI don’t think we have an answer to that.”Even so, the fact that one in five of the health care workers who had breakthrough s still had lingering symptoms after six weeks appears to be the first indication from a peer-reviewed study that long buy antibiotics is possible after a breakthrough .The antibiotics cipro ›Latest UpdatesUpdated Aug.

21, 2021, 10:11 p.m. ETJesse Jackson and his wife, Jacqueline, are hospitalized with buy antibiotics.A radio host who scoffed at buy antibiotics, then urged his followers to get vaccinated, dies.The British government is starting an antibody surveillance program.“People have said to me, ‘You’re fully vaccinated. Why are you being so careful?.

€™â€ said Dr. Robert M. Wachter, professor and chair of the department of medicine at the University of California, San Francisco.

€œI’m still in the camp of I don’t want to get buy antibiotics. I don’t want to get a breakthrough .”Dr. Wachter said that despite the many limitations of the Israeli study, the data offer more evidence that the vaccinated should keep taking reasonable precautions to avoid the cipro.“I’m going to take it at face value that one in five people, six weeks after a breakthrough case, continued to feel crummy,” Dr.

Wachter said. €œThat’s enough to make me want to wear two masks when I go into the grocery store, which is not that burdensome anyway.”.css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,'times new roman',times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-9s9ecg{margin-bottom:15px;}.css-16ed7iq{width:100%;display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;-webkit-box-pack:center;-webkit-justify-content:center;-ms-flex-pack:center;justify-content:center;padding:10px 0;background-color:white;}.css-pmm6ed{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;}.css-pmm6ed > :not(:first-child){margin-left:5px;}.css-5gimkt{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.8125rem;font-weight:700;-webkit-letter-spacing:0.03em;-moz-letter-spacing:0.03em;-ms-letter-spacing:0.03em;letter-spacing:0.03em;text-transform:uppercase;color:#333;}.css-5gimkt:after{content:'Collapse';}.css-rdoyk0{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;-webkit-transform:rotate(180deg);-ms-transform:rotate(180deg);transform:rotate(180deg);}.css-eb027h{max-height:5000px;-webkit-transition:max-height 0.5s ease;transition:max-height 0.5s ease;}.css-6mllg9{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;position:relative;opacity:0;}.css-6mllg9:before{content:'';background-image:linear-gradient(180deg,transparent,#ffffff);background-image:-webkit-linear-gradient(270deg,rgba(255,255,255,0),#ffffff);height:80px;width:100%;position:absolute;bottom:0px;pointer-events:none;}.css-uf1ume{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;}.css-wxi1cx{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;-webkit-align-self:flex-end;-ms-flex-item-align:end;align-self:flex-end;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% - 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:'See more';}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 .css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}Understand the State of treatment and Mask Mandates in the U.S.Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May.

See where the C.D.C. Guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.treatment rules.

Private companies are increasingly mandating antibiotics treatments for employees, with varying approaches. Such mandates are legally allowed and have been upheld in court challenges.College and universities. More than 400 colleges and universities are requiring students to be vaccinated against buy antibiotics.

Almost all are in states that voted for President Biden.Schools. On Aug. 11, California announced that it would require teachers and staff of both public and private schools to be vaccinated or face regular testing, the first state in the nation to do so.

A survey released in August found that many American parents of school-age children are opposed to mandated treatments for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots. Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a buy antibiotics treatment, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.New York.

On Aug. 3, Mayor Bill de Blasio of New York announced that proof of vaccination would be required of workers and customers for indoor dining, gyms, performances and other indoor situations, becoming the first U.S. City to require treatments for a broad range of activities.

City hospital workers must also get a treatment or be subjected to weekly testing. Similar rules are in place for New York State employees.At the federal level. The Pentagon announced that it would seek to make antibiotics vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September.

President Biden announced that all civilian federal employees would have to be vaccinated against the antibiotics or submit to regular testing, social distancing, mask requirements and restrictions on most travel.Complicating the study of breakthrough s is the fact that the U.S. Centers for Disease Control and Prevention only tracks post-vaccination s that result in hospitalization or death. While the C.D.C.

Does continue to study breakthrough s in several large cohorts, the lack of data on all breakthrough cases remains a source of frustration among scientists and patient advocacy groups.“It’s very frustrating not to have data at this point in the cipro to know what happens to breakthrough cases,” said Akiko Iwasaki, an immunologist at Yale School of Medicine who is conducting studies of long buy antibiotics. €œIf mild breakthrough is turning into long buy antibiotics, we don’t have a grasp of that number.”Diana Berrent, founder of Survivor Corps, a Facebook group for people affected by buy antibiotics that has about 171,000 members, took an informal poll and found 24 people who said they had lingering symptoms after a breakthrough . It’s not a scientific sample, and the cases haven’t been validated, but the poll shows the need for more data on breakthrough cases, Ms.

Berrent said.“You can’t extrapolate it to the general population, but it’s a very strong signal that the C.D.C. Needs to be mandating reporting of every breakthrough case,” Ms. Berrent said.

€œWe can’t know what we’re not counting.”But some experts predict the surge of new cases caused by the spread of the Delta variant will, unfortunately, lead to more breakthrough cases in the coming months. Dr. Chen of Mount Sinai said it will take several months before patients with long buy antibiotics from a breakthrough are enrolled in studies.“We’re waiting for these patients to show up at our doors,” Dr.

Chen said.Despite the lack of data, one thing is clear. Getting vaccinated will reduce the risk of getting infected and getting long buy antibiotics, said Athena Akrami, a neuroscientist at University College London who collected and published data from nearly 4,000 long buy antibiotics patients after developing long buy antibiotics herself after a March 2020 bout with buy antibiotics.“It’s simple math,” said Dr. Akrami.

€œIf you reduce s, then the likelihood of long buy antibiotics will drop automatically.”AdvertisementContinue reading the main story.

#masthead-section-label, #masthead-bar-one { display get cipro. None }The antibiotics ciprobuy antibiotics Updatesantibiotics Map get cipro and CasesBooster ShotsDelta Variant F.A.Q.Delta Variant MapAdvertisementContinue reading the main storySupported byContinue reading the main storyThose Anti-buy antibiotics Plastic Barriers Probably Don’t Help and May Make Things WorseClear barriers have sprung up at restaurants, nail salons and school classrooms, but most of the time, they do little to stop the spread of the antibiotics.Shields at a restaurant in Placerville, Calif., in May 2020. Research suggests that transparent barriers can interfere with get cipro normal ventilation.Credit...Rich Pedroncelli/File, via Associated PressAug. 19, 2021Leer en españolbuy antibiotics precautions have turned many parts of our world into a giant salad bar, with plastic barriers separating sales clerks from shoppers, dividing customers at nail salons and shielding students from their classmates.Intuition tells us a plastic shield would be protective against germs. But scientists who study aerosols, air get cipro flow and ventilation say that much of the time, the barriers don’t help and probably give people a false sense of security.

And sometimes the barriers can make things worse.Research suggests that in some instances, get cipro a barrier protecting a clerk behind a checkout counter may redirect the germs to another worker or customer. Rows of get cipro clear plastic shields, like those you might find in a nail salon or classroom, can also impede normal air flow and ventilation.Under normal conditions in stores, classrooms and offices, exhaled breath particles disperse, carried by air currents and, depending on the ventilation system, are replaced by fresh air roughly every 15 to 30 minutes. But erecting plastic barriers can change air flow in a room, disrupt normal ventilation and create “dead zones,” where viral aerosol particles can build up and become highly concentrated.“If you have a forest of barriers in a classroom, it’s going to interfere with proper ventilation of that room,” said Linsey Marr, professor of civil and environmental engineering at Virginia Tech and one of the world’s leading experts on viral transmission. €œEverybody’s aerosols are going to be trapped and stuck there get cipro and building up, and they will end up spreading beyond your own desk.”There are some situations in which the clear shields might be protective, but it depends on a number of variables. The barriers can stop big droplets ejected during coughs and sneezes from splattering on others, which get cipro is why buffets and salad bars often are equipped with transparent sneeze guards above the food.But buy antibiotics spreads largely through unseen aerosol particles.

While there isn’t much real-world research on the get cipro impact of transparent barriers and the risk of disease, scientists in the United States and Britain have begun to study the issue, and the findings are not reassuring.A study published in June and led by researchers from Johns Hopkins, for example, showed that desk screens in classrooms were associated with an increased risk of antibiotics . In a Massachusetts school district, researchers found that plexiglass dividers with side walls in the main office were impeding air flow. A study looking at schools in Georgia found that desk barriers had little effect on the spread of the antibiotics compared with ventilation improvements and masking.Before the cipro, a study published in 2014 found that office cubicle dividers were among the factors that may have contributed to disease transmission during a tuberculosis outbreak in Australia.British researchers have conducted modeling studies simulating what happens when a person on one side of a barrier — like a customer in a store — exhales particles while speaking or get cipro coughing under various ventilation conditions. The screen is get cipro more effective when the person coughs, because the larger particles have greater momentum and hit the barrier. But when a person speaks, the screen doesn’t trap the exhaled particles — which just float around get cipro it.

While the store clerk may avoid an immediate and direct hit, the particles are still in the room, posing a risk to the clerk and others who may inhale the contaminated air.“We have shown this effect of blocking larger particles, but also that the smaller aerosols travel over the screen and become mixed in the room air within about five minutes,” said Catherine Noakes, professor of environmental engineering for buildings at the University of Leeds in England. €œThis means if people are interacting for more than a few minutes, they would likely be exposed to the get cipro cipro regardless of the screen.”The antibiotics cipro ›Latest UpdatesUpdated Aug. 21, 2021, 10:11 p.m get cipro. ETJesse Jackson and his wife, Jacqueline, are hospitalized with buy antibiotics.A radio host who scoffed at buy antibiotics, then urged his get cipro followers to get vaccinated, dies.The British government is starting an antibody surveillance program.Dr. Noakes said erecting barriers may seem like a good idea but can have unintended consequences.

She conducted a study published in get cipro 2013 that looked at the effect of partitions between beds in hospitals. The study showed that while some people were protected from germs, the partitions funneled the air in the room toward others.So while a worker behind get cipro a transparent barrier might be spared some of the customer’s germs, a worker nearby or customers in line could still be exposed. Dr. Noakes said most screens she has seen are “poorly positioned and are unlikely to be of much benefit.”“I think this may be a particular problem in places like classrooms where people are present for longer periods of time,” Dr. Noakes said.

€œLarge numbers of individual screens impede the airflow and create pockets of higher and lower risk that are hard to identify.”To understand why screens often have little effect on protecting people from aerosol particles, it helps to think about exhaled breath like a plume of cigarette smoke, Dr. Marr said.“One way to think about plastic barriers is that they are good for blocking things like spitballs but ineffective for things like cigarette smoke,” Dr. Marr said. €œThe smoke simply drifts around them, so they will give the person on the other side a little more time before being exposed to the smoke. Meanwhile, people on the same side with the smoker will be exposed to more smoke, since the barriers trap it on that side until it has a chance to mix throughout the space.”Most researchers say the screens most likely help in very specific situations.

A bus driver, for instance, shielded from the public by a floor-to-ceiling barrier is probably protected from inhaling much of what passengers are exhaling. A bank cashier behind a wall of glass or a clerk checking in patients in a doctor’s office may be at least partly protected by a barrier.A study by researchers with the National Institute for Occupational Safety and Health in Cincinnati tested different sized transparent barriers in an isolation room using a cough simulator. The study, which hasn’t yet been peer-reviewed, found that under the right conditions, taller shields, above “cough height,” stopped about 70 percent of the particles from reaching the particle counter on the other side, which is where the store or salon worker would be sitting or standing.But the study’s authors noted the limitations of the research, particularly that the experiment was conducted under highly controlled conditions. The experiment took place in an isolation room with consistent ventilation rates that didn’t “accurately reflect all real-world situations,” the report said.The study didn’t consider that workers and customers move around, that other people could be in the room breathing the redirected particles and that many stores and classrooms have several stations with acrylic barriers, not just one, that impede normal air flow.While further research is needed to determine the effect of adding transparent shields around school or office desks, all the aerosol experts interviewed agreed that desk shields were unlikely to help and were likely to interfere with the normal ventilation of the room. Depending on the conditions, the plastic shields could cause viral particles to accumulate in the room.“If there are aerosol particles in the classroom air, those shields around students won’t protect them,” said Richard Corsi, the incoming dean of engineering at the University of California, Davis.

€œDepending on the air flow conditions in the room, you can get a downdraft into those little spaces that you’re now confined in and cause particles to concentrate in your space.”Aerosol scientists say schools and workplaces should focus on encouraging workers and eligible students to be vaccinated, improving ventilation, adding HEPA air filtering machines when needed and imposing mask requirements — all of which are proven ways to reduce cipro transmission.The problem, experts say, is that most people in charge of erecting barriers in offices, restaurants, nail salons and schools are not doing so with the assistance of engineering experts who can evaluate air flow and ventilation for each room.People shouldn’t panic when they see transparent barriers, but they shouldn’t view them as fully protective, either. Workers and students who have transparent shields around them should continue to wear a mask to lower risk, Dr. Corsi said.“Air flow in rooms is pretty complicated,” Dr. Corsi said. €œEvery room is different in terms of the arrangement of the furniture, the height of the walls and ceilings, the vents, where the book shelves are.

All of these things have a huge impact on the actual flow and air distribution in a room because every classroom or office space is different.”AdvertisementContinue reading the main story#masthead-section-label, #masthead-bar-one { display. None }The antibiotics ciprobuy antibiotics Updatesantibiotics Map and CasesBooster ShotsDelta Variant F.A.Q.Delta Variant MapAdvertisementContinue reading the main storySupported byContinue reading the main storyCan the Vaccinated Develop Long buy antibiotics After a Breakthrough ?. While the treatments are effective at preventing serious illness and death, the risk of developing post-buy antibiotics health problems after a breakthrough isn’t known.Credit...Saul Martinez for The New York TimesPublished Aug. 16, 2021Updated Aug. 17, 2021Leer en españolWhile some breakthrough cases among those who are fully vaccinated against buy antibiotics are inevitable, they are unlikely to result in hospitalization or death.

But one important question about breakthrough that remains unanswered is. Can the vaccinated develop so-called long buy antibiotics?. Long buy antibiotics refers to a set of symptoms — such as severe fatigue, brain fog, headache, muscle pain and sleep problems — that can persist for weeks or months after the active has ended. The syndrome is poorly understood, but studies suggest that between 10 and 30 percent of adults who catch the cipro may experience long buy antibiotics, including those who experienced only mild illness or no symptoms at all.But the vast majority of data collected about long buy antibiotics has been in the unvaccinated population. The risk of developing long buy antibiotics for the fully vaccinated who get infected after vaccination hasn’t been studied.While preliminary research suggests that it is, in fact, possible for a breakthrough case to lead to symptoms that can persist for weeks to months, there are still more questions than answers.

What percent of breakthrough cases result in lingering symptoms?. How many of those people recover?. Are the persistent symptoms after breakthrough as severe as those that occur in the unvaccinated?. €œI just don’t think there is enough data,” said Dr. Zijian Chen, medical director at the Center for Post-buy antibiotics Care at Mount Sinai Health System in New York.

€œIt’s too early to tell. The population of people getting sick post vaccination isn’t that high right now, and there’s no good tracking mechanism for these patients.”One recent study of Israeli health care workers published in the New England Journal of Medicine offers a glimpse of the risk of long buy antibiotics after a breakthrough . Among 1,497 fully vaccinated health care workers, 39 of them — about 2.6 percent — developed breakthrough s. (All of the workers were believed to be infected after contact with an unvaccinated person, and the study was conducted before the Delta variant became dominant.)While most of the breakthrough cases were mild or asymptomatic, seven out of 36 workers tracked at six weeks (19 percent) still had persistent symptoms. These long buy antibiotics symptoms included a mix of prolonged loss of smell, persistent cough, fatigue, weakness, labored breathing or muscle pain.But the study’s authors caution against drawing too many conclusions from the research.

The sample size — just seven patients — is small. And the research was designed to study antibody levels in the infected, said Dr. Gili Regev-Yochay, director of the infectious disease epidemiology unit at Sheba Medical Center. It was not designed to study the risk of long buy antibiotics after a breakthrough .“It was not the scope of this paper,” Dr. Regev-Yochay said.

€œI don’t think we have an answer to that.”Even so, the fact that one in five of the health care workers who had breakthrough s still had lingering symptoms after six weeks appears to be the first indication from a peer-reviewed study that long buy antibiotics is possible after a breakthrough .The antibiotics cipro ›Latest UpdatesUpdated Aug. 21, 2021, 10:11 p.m. ETJesse Jackson and his wife, Jacqueline, are hospitalized with buy antibiotics.A radio host who scoffed at buy antibiotics, then urged his followers to get vaccinated, dies.The British government is starting an antibody surveillance program.“People have said to me, ‘You’re fully vaccinated. Why are you being so careful?. €™â€ said Dr.

Robert M. Wachter, professor and chair of the department of medicine at the University of California, San Francisco. €œI’m still in the camp of I don’t want to get buy antibiotics. I don’t want to get a breakthrough .”Dr. Wachter said that despite the many limitations of the Israeli study, the data offer more evidence that the vaccinated should keep taking reasonable precautions to avoid the cipro.“I’m going to take it at face value that one in five people, six weeks after a breakthrough case, continued to feel crummy,” Dr.

Wachter said. €œThat’s enough to make me want to wear two masks when I go into the grocery store, which is not that burdensome anyway.”.css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,'times new roman',times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-9s9ecg{margin-bottom:15px;}.css-16ed7iq{width:100%;display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;-webkit-box-pack:center;-webkit-justify-content:center;-ms-flex-pack:center;justify-content:center;padding:10px 0;background-color:white;}.css-pmm6ed{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;}.css-pmm6ed > :not(:first-child){margin-left:5px;}.css-5gimkt{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.8125rem;font-weight:700;-webkit-letter-spacing:0.03em;-moz-letter-spacing:0.03em;-ms-letter-spacing:0.03em;letter-spacing:0.03em;text-transform:uppercase;color:#333;}.css-5gimkt:after{content:'Collapse';}.css-rdoyk0{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;-webkit-transform:rotate(180deg);-ms-transform:rotate(180deg);transform:rotate(180deg);}.css-eb027h{max-height:5000px;-webkit-transition:max-height 0.5s ease;transition:max-height 0.5s ease;}.css-6mllg9{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;position:relative;opacity:0;}.css-6mllg9:before{content:'';background-image:linear-gradient(180deg,transparent,#ffffff);background-image:-webkit-linear-gradient(270deg,rgba(255,255,255,0),#ffffff);height:80px;width:100%;position:absolute;bottom:0px;pointer-events:none;}.css-uf1ume{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;}.css-wxi1cx{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;-webkit-align-self:flex-end;-ms-flex-item-align:end;align-self:flex-end;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% - 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:'See more';}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 .css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}Understand the State of treatment and Mask Mandates in the U.S.Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. Guidance would apply, and where states have instituted their own mask policies.

The battle over masks has become contentious in some states, with some local leaders defying state bans.treatment rules. . . And businesses. Private companies are increasingly mandating antibiotics treatments for employees, with varying approaches.

Such mandates are legally allowed and have been upheld in court challenges.College and universities. More than 400 colleges and universities are requiring students to be vaccinated against buy antibiotics. Almost all are in states that voted for President Biden.Schools. On Aug. 11, California announced that it would require teachers and staff of both public and private schools to be vaccinated or face regular testing, the first state in the nation to do so.

A survey released in August found that many American parents of school-age children are opposed to mandated treatments for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots. Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a buy antibiotics treatment, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.New York. On Aug. 3, Mayor Bill de Blasio of New York announced that proof of vaccination would be required of workers and customers for indoor dining, gyms, performances and other indoor situations, becoming the first U.S.

City to require treatments for a broad range of activities. City hospital workers must also get a treatment or be subjected to weekly testing. Similar rules are in place for New York State employees.At the federal level. The Pentagon announced that it would seek to make antibiotics vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the antibiotics or submit to regular testing, social distancing, mask requirements and restrictions on most travel.Complicating the study of breakthrough s is the fact that the U.S.

Centers for Disease Control and Prevention only tracks post-vaccination s that result in hospitalization or death. While the C.D.C. Does continue to study breakthrough s in several large cohorts, the lack of data on all breakthrough cases remains a source of frustration among scientists and patient advocacy groups.“It’s very frustrating not to have data at this point in the cipro to know what happens to breakthrough cases,” said Akiko Iwasaki, an immunologist at Yale School of Medicine who is conducting studies of long buy antibiotics. €œIf mild breakthrough is turning into long buy antibiotics, we don’t have a grasp of that number.”Diana Berrent, founder of Survivor Corps, a Facebook group for people affected by buy antibiotics that has about 171,000 members, took an informal poll and found 24 people who said they had lingering symptoms after a breakthrough . It’s not a scientific sample, and the cases haven’t been validated, but the poll shows the need for more data on breakthrough cases, Ms.

Berrent said.“You can’t extrapolate it to the general population, but it’s a very strong signal that the C.D.C. Needs to be mandating reporting of every breakthrough case,” Ms. Berrent said. €œWe can’t know what we’re not counting.”But some experts predict the surge of new cases caused by the spread of the Delta variant will, unfortunately, lead to more breakthrough cases in the coming months. Dr.

Chen of Mount Sinai said it will take several months before patients with long buy antibiotics from a breakthrough are enrolled in studies.“We’re waiting for these patients to show up at our doors,” Dr. Chen said.Despite the lack of data, one thing is clear. Getting vaccinated will reduce the risk of getting infected and getting long buy antibiotics, said Athena Akrami, a neuroscientist at University College London who collected and published data from nearly 4,000 long buy antibiotics patients after developing long buy antibiotics herself after a March 2020 bout with buy antibiotics.“It’s simple math,” said Dr. Akrami. €œIf you reduce s, then the likelihood of long buy antibiotics will drop automatically.”AdvertisementContinue reading the main story.

Buy cipro online usa

When Ashlee Wisdom launched an early version of buy cipro online usa her health and wellness website, have a peek at this web-site more than 34,000 users — most of them Black — visited the platform in the first two weeks. “It wasn’t the most fully functioning platform,” recalled Wisdom, 31. €œIt was buy cipro online usa not sexy.” But the launch was successful.

Now, more than a year later, Wisdom’s company, Health in Her Hue, connects Black women and other women of color to culturally sensitive doctors, doulas, nurses and therapists nationally. As more patients seek culturally competent care — the acknowledgment of a patient’s heritage, beliefs and values during treatment — a new wave of Black tech founders like Wisdom want to help. In the same way Uber Eats and Grubhub revolutionized food delivery, Black tech health startups across the United States want buy cipro online usa to change how people exercise, how they eat and how they communicate with doctors.

Inspired by their own experiences, plus those of their parents and grandparents, Black entrepreneurs are launching startups that aim to close the cultural gap in health care with technology — and create profitable businesses at the same time. €œOne of the most exciting growth opportunities across health innovation is to back underrepresented founders building health companies focusing on underserved markets,” said Unity Stoakes, president and co-founder of StartUp Health, a company headquartered in San Francisco that has invested in a number of health companies led by people of color. He said those leaders have buy cipro online usa “an essential and powerful understanding of how to solve some of the biggest challenges in health care.” Platforms created by Black founders for Black people and communities of color continue to blossom because those entrepreneurs often see problems and solutions others might miss.

Without diverse voices, entire categories and products simply would not exist in critical areas like health care, business experts say. €œWe’re really speaking to a need,” said Kevin Dedner, 45, founder of the mental health startup Hurdle. €œMission alone buy cipro online usa is not enough.

You have to solve a problem.” Dedner’s company, headquartered in Washington, D.C., pairs patients with therapists who “honor culture instead of ignoring it,” he said. He started the company three years ago, but more people turned to Hurdle after the killing of George Floyd. In Memphis, buy cipro online usa Tennessee, Erica Plybeah, 33, is focused on providing transportation.

Her company, MedHaul, works with providers and patients to secure low-cost rides to get people to and from their medical appointments. Caregivers, patients or providers fill out a form on MedHaul’s website, then Plybeah’s team helps them schedule a ride. While MedHaul is for everyone, Plybeah knows people of color, anyone with a low income and residents of rural areas are more likely to face transportation hurdles buy cipro online usa.

She founded the company in 2017 after years of watching her mother take care of her grandmother, who had lost two limbs to Type 2 diabetes. They lived in the Mississippi Delta, where transportation buy cipro online usa options were scarce. €œFor years, my family struggled with our transportation because my mom was her primary transporter,” Plybeah said.

€œTrying to schedule all of her doctor’s appointments around her work schedule was just a nightmare.” Plybeah’s company recently received funding from Citi, the banking giant. €œI’m more buy cipro online usa than proud of her,” said Plybeah’s mother, Annie Steele. €œEvery step amazes me.

What she is doing is going to help people for many years to come.” Mission alone is not enough. You have to solve a problem.Kevin Dedner Health in Her Hue launched in 2018 with just six doctors on the buy cipro online usa roster. Two years later, users can download the app at no cost and then scroll through roughly 1,000 providers.

€œPeople are constantly talking about Black women’s poor health outcomes, and that’s where the conversation stops,” said Wisdom, who lives in New York City. €œI didn’t see anyone building anything to empower us.” As her business continues to grow, Wisdom draws buy cipro online usa inspiration from friends such as Nathan Pelzer, 37, another Black tech founder, who has launched a company in Chicago. Clinify Health works with community health centers and independent clinics in underserved communities.

The company analyzes medical and social data to help doctors identify their most at-risk patients and those they haven’t seen in awhile. By focusing on getting those patients preventive care, the medical providers can buy cipro online usa help them improve their health and avoid trips to the emergency room. €œYou can think of Clinify Health as a company that supports triage outside of the emergency room,” Pelzer said.

Pelzer said he started the company by printing out online slideshows he’d made and throwing them in the trunk of his car. €œI was driving around the South Side of Chicago, knocking on doors, saying, ‘Hey, this is my idea,’” he said buy cipro online usa. Wisdom got her app idea from being so stressed while working a job during grad school that she broke out in hives.

€œIt was really buy cipro online usa bad,” Wisdom recalled. €œMy hand would just swell up, and I couldn’t figure out what it was.” The breakouts also baffled her allergist, a white woman, who told Wisdom to take two Allegra every day to manage the discomfort. €œI remember thinking if she was a Black woman, I might have shared a bit more about what was going on in my life,” Wisdom said.

The moment inspired her to buy cipro online usa build an online community. Her idea started off small. She found health content in academic journals, searched for eye-catching photos that would complement the text and then posted the information on Instagram.

I didn’t see anyone buy cipro online usa building anything to empower us.Ashlee Wisdom Things took off from there. This fall, Health in Her Hue launched “care squads” for users who want to discuss their health with doctors or with other women interested in the same topics. €œThe last thing you want to do when you go into the doctor’s office is feel like you have to put on an armor and feel like you have to fight the person or, like, you know, be at odds with the person who’s supposed to be helping you on your health journey,” Wisdom said.

€œAnd that’s oftentimes the position that Black buy cipro online usa people, and largely also Black women, are having to deal with as they’re navigating health care. And it just should not be the case.” As Black tech founders, Wisdom, Dedner, Pelzer and Plybeah look for ways to support one another by trading advice, chatting about funding and looking for ways to come together. Pelzer and Wisdom met a few years ago as participants in a competition sponsored by Johnson &.

Johnson. They reconnected at a different event for Black founders of technology companies and decided to help each other. €œWe’re each other’s therapists,” Pelzer said.

€œIt can get lonely out here as a Black founder.” In the future, Plybeah wants to offer transportation services and additional assistance to people caring for aging family members. She also hopes to expand the service to include dropping off customers for grocery and pharmacy runs, workouts at gyms and other basic errands. Pelzer wants Clinify Health to make tracking health care more fun — possibly with incentives to keep users engaged.

He is developing plans and wants to tap into the same competitive energy that fitness companies do. Wisdom wants to support physicians who seek to improve their relationships with patients of color. The company plans to build a library of resources that professionals could use as a guide.

€œWe’re not the first people to try to solve these problems,” Dedner said. Yet he and the other three feel the pressure to succeed for more than just themselves and those who came before them. €œI feel like, if I fail, that’s potentially going to shut the door for other Black women who are trying to build in this space,” Wisdom said.

€œBut I try not to think about that too much.” Cara Anthony. canthony@kff.org, @CaraRAnthony Related Topics Contact Us Submit a Story TipCan’t see the audio player?. Click here to listen.

Click here for a transcript of the episode. This episode kicks off with a wild ride. How one journalist nearly got roped into a scam.

While hunting for a new health insurance plan, award-winning journalist Mitra Kaboli got an offer that seemed too good to be true — and seemed to be coming from her current insurer. She was skeptical and, it turns out, had every reason to be. Dania Palanker of Georgetown University’s Center on Health Insurance Reforms unpacks this sketchy scheme and gives us the key to avoiding it.

When you’re searching for health insurance, skip Google. Seriously. Then, top health insurance nerds teach us the right way to shop for health insurance.

Where to find the fine print and how to read it. They also deliver some good news (for once). The subsidies in the American Rescue Plan ensure that some deals this year are actually … deals!.

Meaning. Health insurance has become more affordable for lots of people. To read all of those tips in one place, check out “First Aid Kit,” a newsletter in which we sum up all the practical stuff we’ve been learning since “An Arm and a Leg” podcast launched.

“An Arm and a Leg” is a co-production of KHN and Public Road Productions. To keep in touch with “An Arm and a Leg,” subscribe to the newsletter. You can also follow the show on Facebook and Twitter.

And if you’ve got stories to tell about the health care system, the producers would love to hear from you. To hear all KHN podcasts, click here. And subscribe to “An Arm and a Leg” on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts.

Related Topics Contact Us Submit a Story TipWhen Greta Christina fell into a deep depression five years ago, she called up her therapist in San Francisco. She’d had a great connection with the provider when she needed therapy in the past. She was delighted to learn that he was now “in network” with her insurance company, meaning she wouldn’t have to pay out-of-pocket anymore to see him.

But her excitement was short-lived. Over time, Christina’s appointments with the therapist went from every two weeks, to every four weeks, to every five or six. €œTo tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks,” she said.

€œIt’s not enough. It’s not even close to enough.” Then, this summer, Christina was diagnosed with breast cancer. Everything related to her cancer care — her mammogram, biopsy, surgery appointments — happened promptly (like a “well-oiled machine,” she said), while her depression care stumbled along.

€œIt is a hot mess,” she said. €œI need to be in therapy — I have cancer!. And still nothing has changed.” A new law signed by Gov.

Gavin Newsom in October aims to fix this problem for Californians. Senate Bill 221, which passed the state legislature with a nearly unanimous vote, requires health insurers across the state to reduce wait times for mental health care to no more than 10 business days. Six other states — including Colorado, Maryland and Texas — have similar laws limiting wait times.

Long waits for mental health treatment are a nationwide problem, with reports of patients waiting an average of five or six weeks for care in community clinics, at Department of Veterans Affairs facilities and in private offices from Maryland to Los Angeles County. Across California, half of residents surveyed by the California Health Care Foundation in late 2019 said they had to wait too long to see a mental health care provider when they needed one. At Kaiser Permanente, the state’s largest insurance company, 87% of therapists said weekly appointments were not available to patients who needed them, according to a 2020 survey by the National Union of Healthcare Workers, which represents KP therapists — and was the main sponsor of the California wait times legislation.

€œIt just feels so unethical,” said triage therapist Brandi Plumley, referring to the typical two-month wait time she sees at Kaiser Permanente’s mental health clinic in Vallejo, east of San Francisco. Every day, she takes multiple crisis calls from patients who have therapists assigned to them but can’t get in to see them, she said, describing the providers’ caseloads as “enormous.” “It’s heartbreaking. And it eats on me day after day after day,” Plumley said.

€œWhat Kaiser simply needs to do is hire more clinicians.” Kaiser Permanente says there just aren’t enough therapists out there to hire. KP is an integrated system — it is a health provider and insurance company under one umbrella — and has struggled to fill 300 job vacancies in clinical behavioral health, according to a statement from Yener Balan, the insurer’s Northern California vice president of behavioral health. Hiring more clinicians won’t solve the problem, said Balan, who suggested that sustaining one-on-one therapy for all who want it in the future wouldn’t be possible in the current system.

€œWe all must reimagine our approach to the existing national model of care.” Kaiser Permanente lodged concerns about the wait times bill when it was introduced. And the trade group representing insurers in the state, the California Association of Health Plans, opposed it, saying the shortage of therapists would make meeting the two-week mandate too difficult. €œThe buy antibiotics cipro has only exacerbated this workforce shortage, and demand for these services significantly increased,” said Jedd Hampton, a lobbyist for the California Association of Health Plans, in testimony during a state Senate hearing for the bill in the spring.

Hampton referred to a University of California-San Francisco study that predicted California would have nearly 30% fewer therapists than needed to meet demand by 2028. €œSimply put, mandating increased frequency of appointments without addressing the underlying workforce shortage will not lead to increased quality of care,” Hampton said. Lawmakers pushed back.

State Sen. Scott Wiener (D-San Francisco), who authored the bill, accused insurers of overstating the shortage. State Sen.

Connie Leyva (D-Chino) said that the therapeutic providers are out there but that insurers are responsible for recruiting them into their networks by paying higher rates and reducing administrative burdens. If insurers want more young people to enter the mental health care profession, they must improve salaries and working conditions now, said state Sen. Richard Pan (D-Sacramento).

(A 2016 KQED investigation uncovered multiple ways that insurers save money by keeping provider networks artificially small.) As bipartisan support for the bill grew in Sacramento, insurers withdrew their formal opposition. But whether other states have the political will, or the resources, to legislate a similar solution is unclear, said Hemi Tewarson, executive director of the nonpartisan National Academy for State Health Policy in Washington, D.C. Although California may be able to force insurers to hire more therapists, she said, places like New Mexico, Montana, Wyoming, and parts of the South don’t have enough therapists at any price.

€œThey don’t have the providers, so you could fine the insurers as much as you want, you’re not going to be able to, in the short term, make up those wait times if they already exist,” she said. The new California law is a solid step toward improving access to mental health care, with communities of color standing to benefit the most, said Lonnie Snowden, a professor of health policy and management at the University of California-Berkeley. African Americans, Asian Americans and Latinos face the most barriers getting into care, Snowden said, and when people of color do come in for treatment, they are more likely to drop out.

Oversight and enforcement are needed for the new rules to work, said Keith Humphreys, a psychiatry professor at Stanford University. Kaiser Permanente has data systems that can track the time between appointments, but other insurers set up contracts with therapists in private practice, who manage their own caseloads and schedules. €œWho would keep track of whether people who’ve been seen once were seen again in 10 days, when it’s hard enough just to keep track of how many providers we have and who they are seeing?.

€ he asked. Questions like that one will fall to state regulators, primarily the California Department of Managed Health Care. The department has fined insurers $6.9 million since 2013 for violating state standards, including a $4 million penalty against Kaiser Permanente for excessive wait times for mental health care.

Previous state law required insurers to provide initial mental health care appointments within 10 days, and the new law clarifies that they must do the same for follow-up appointments. Greta Christina, who gets her care at a Kaiser Permanente facility, said she is desperate for the new law to start working. It takes effect on July 1, 2022.

Christina thought about paying out-of-pocket in the meantime, to find a therapist she could see more often. But in a cancer crisis, she said, starting over with someone new would be too hard. So she’s waiting.

€œKnowing that this bill is on the horizon has been helping me hang on,” she said. This story is part of a partnership that includes KQED, NPR and KHN. April Dembosky, KQED.

@adembosky Related Topics Contact Us Submit a Story Tip.

When Ashlee Wisdom launched an early version of her health and wellness website, more than 34,000 users get cipro — most of them Black — visited the platform in the first two weeks. “It wasn’t the most fully functioning platform,” recalled Wisdom, 31. €œIt was not sexy.” But the launch was successful get cipro. Now, more than a year later, Wisdom’s company, Health in Her Hue, connects Black women and other women of color to culturally sensitive doctors, doulas, nurses and therapists nationally. As more patients seek culturally competent care — the acknowledgment of a patient’s heritage, beliefs and values during treatment — a new wave of Black tech founders like Wisdom want to help.

In the same way Uber Eats and Grubhub revolutionized food delivery, Black tech health startups across the United States want get cipro to change how people exercise, how they eat and how they communicate with doctors. Inspired by their own experiences, plus those of their parents and grandparents, Black entrepreneurs are launching startups that aim to close the cultural gap in health care with technology — and create profitable businesses at the same time. €œOne of the most exciting growth opportunities across health innovation is to back underrepresented founders building health companies focusing on underserved markets,” said Unity Stoakes, president and co-founder of StartUp Health, a company headquartered in San Francisco that has invested in a number of health companies led by people of color. He said those get cipro leaders have “an essential and powerful understanding of how to solve some of the biggest challenges in health care.” Platforms created by Black founders for Black people and communities of color continue to blossom because those entrepreneurs often see problems and solutions others might miss. Without diverse voices, entire categories and products simply would not exist in critical areas like health care, business experts say.

€œWe’re really speaking to a need,” said Kevin Dedner, 45, founder of the mental health startup Hurdle. €œMission alone get cipro is not enough. You have to solve a problem.” Dedner’s company, headquartered in Washington, D.C., pairs patients with therapists who “honor culture instead of ignoring it,” he said. He started the company three years ago, but more people turned to Hurdle after the killing of George Floyd. In Memphis, get cipro Tennessee, Erica Plybeah, 33, is focused on providing transportation.

Her company, MedHaul, works with providers and patients to secure low-cost rides to get people to and from their medical appointments. Caregivers, patients or providers fill out a form on MedHaul’s website, then Plybeah’s team helps them schedule a ride. While MedHaul get cipro is for everyone, Plybeah knows people of color, anyone with a low income and residents of rural areas are more likely to face transportation hurdles. She founded the company in 2017 after years of watching her mother take care of her grandmother, who had lost two limbs to Type 2 diabetes. They lived in the Mississippi Delta, where transportation options were scarce get cipro.

€œFor years, my family struggled with our transportation because my mom was her primary transporter,” Plybeah said. €œTrying to schedule all of her doctor’s appointments around her work schedule was just a nightmare.” Plybeah’s company recently received funding from Citi, the banking giant. €œI’m more than proud get cipro of her,” said Plybeah’s mother, Annie Steele. €œEvery step amazes me. What she is doing is going to help people for many years to come.” Mission alone is not enough.

You have to solve a problem.Kevin Dedner Health in Her Hue launched in 2018 with just six doctors on get cipro the roster. Two years later, users can download the app at no cost and then scroll through roughly 1,000 providers. €œPeople are constantly talking about Black women’s poor health outcomes, and that’s where the conversation stops,” said Wisdom, who lives in New York City. €œI didn’t see anyone building anything to empower get cipro us.” As her business continues to grow, Wisdom draws inspiration from friends such as Nathan Pelzer, 37, another Black tech founder, who has launched a company in Chicago. Clinify Health works with community health centers and independent clinics in underserved communities.

The company analyzes medical and social data to help doctors identify their most at-risk patients and those they haven’t seen in awhile. By focusing on getting those get cipro patients preventive care, the medical providers can help them improve their health and avoid trips to the emergency room. €œYou can think of Clinify Health as a company that supports triage outside of the emergency room,” Pelzer said. Pelzer said he started the company by printing out online slideshows he’d made and throwing them in the trunk of his car. €œI was driving around the South Side of Chicago, knocking on doors, saying, ‘Hey, this is my idea,’” get cipro he said.

Wisdom got her app idea from being so stressed while working a job during grad school that she broke out in hives. €œIt was really bad,” get cipro Wisdom recalled. €œMy hand would just swell up, and I couldn’t figure out what it was.” The breakouts also baffled her allergist, a white woman, who told Wisdom to take two Allegra every day to manage the discomfort. €œI remember thinking if she was a Black woman, I might have shared a bit more about what was going on in my life,” Wisdom said. The moment inspired her to get cipro build an online community.

Her idea started off small. She found health content in academic journals, searched for eye-catching photos that would complement the text and then posted the information on Instagram. I didn’t see anyone building anything to get cipro empower us.Ashlee Wisdom Things took off from there. This fall, Health in Her Hue launched “care squads” for users who want to discuss their health with doctors or with other women interested in the same topics. €œThe last thing you want to do when you go into the doctor’s office is feel like you have to put on an armor and feel like you have to fight the person or, like, you know, be at odds with the person who’s supposed to be helping you on your health journey,” Wisdom said.

€œAnd that’s oftentimes get cipro the position that Black people, and largely also Black women, are having to deal with as they’re navigating health care. And it just should not be the case.” As Black tech founders, Wisdom, Dedner, Pelzer and Plybeah look for ways to support one another by trading advice, chatting about funding and looking for ways to come together. Pelzer and Wisdom met a few years ago as participants in a competition sponsored by Johnson &. Johnson. They reconnected at a different event for Black founders of technology companies and decided to help each other.

€œWe’re each other’s therapists,” Pelzer said. €œIt can get lonely out here as a Black founder.” In the future, Plybeah wants to offer transportation services and additional assistance to people caring for aging family members. She also hopes to expand the service to include dropping off customers for grocery and pharmacy runs, workouts at gyms and other basic errands. Pelzer wants Clinify Health to make tracking health care more fun — possibly with incentives to keep users engaged. He is developing plans and wants to tap into the same competitive energy that fitness companies do.

Wisdom wants to support physicians who seek to improve their relationships with patients of color. The company plans to build a library of resources that professionals could use as a guide. €œWe’re not the first people to try to solve these problems,” Dedner said. Yet he and the other three feel the pressure to succeed for more than just themselves and those who came before them. €œI feel like, if I fail, that’s potentially going to shut the door for other Black women who are trying to build in this space,” Wisdom said.

€œBut I try not to think about that too much.” Cara Anthony. canthony@kff.org, @CaraRAnthony Related Topics Contact Us Submit a Story TipCan’t see the audio player?. Click here to listen. Click here for a transcript of the episode. This episode kicks off with a wild ride.

How one journalist nearly got roped into a scam. While hunting for a new health insurance plan, award-winning journalist Mitra Kaboli got an offer that seemed too good to be true — and seemed to be coming from her current insurer. She was skeptical and, it turns out, had every reason to be. Dania Palanker of Georgetown University’s Center on Health Insurance Reforms unpacks this sketchy scheme and gives us the key to avoiding it. When you’re searching for health insurance, skip Google.

Seriously. Then, top health insurance nerds teach us the right way to shop for health insurance. Where to find the fine print and how to read it. They also deliver some good news (for once). The subsidies in the American Rescue Plan ensure that some deals this year are actually … deals!.

Meaning. Health insurance has become more affordable for lots of people. To read all of those tips in one place, check out “First Aid Kit,” a newsletter in which we sum up all the practical stuff we’ve been learning since “An Arm and a Leg” podcast launched. “An Arm and a Leg” is a co-production of KHN and Public Road Productions. To keep in touch with “An Arm and a Leg,” subscribe to the newsletter.

You can also follow the show on Facebook and Twitter. And if you’ve got stories to tell about the health care system, the producers would love to hear from you. To hear all KHN podcasts, click here. And subscribe to “An Arm and a Leg” on Spotify, Apple Podcasts, Stitcher, Pocket Casts, or wherever you listen to podcasts. Related Topics Contact Us Submit a Story TipWhen Greta Christina fell into a deep depression five years ago, she called up her therapist in San Francisco.

She’d had a great connection with the provider when she needed therapy in the past. She was delighted to learn that he was now “in network” with her insurance company, meaning she wouldn’t have to pay out-of-pocket anymore to see him. But her excitement was short-lived. Over time, Christina’s appointments with the therapist went from every two weeks, to every four weeks, to every five or six. €œTo tell somebody with serious, chronic, disabling depression that they can only see their therapist every five or six weeks is like telling somebody with a broken leg that they can only see their physical therapist every five or six weeks,” she said.

€œIt’s not enough. It’s not even close to enough.” Then, this summer, Christina was diagnosed with breast cancer. Everything related to her cancer care — her mammogram, biopsy, surgery appointments — happened promptly (like a “well-oiled machine,” she said), while her depression care stumbled along. €œIt is a hot mess,” she said. €œI need to be in therapy — I have cancer!.

And still nothing has changed.” A new law signed by Gov. Gavin Newsom in October aims to fix this problem for Californians. Senate Bill 221, which passed the state legislature with a nearly unanimous vote, requires health insurers across the state to reduce wait times for mental health care to no more than 10 business days. Six other states — including Colorado, Maryland and Texas — have similar laws limiting wait times. Long waits for mental health treatment are a nationwide problem, with reports of patients waiting an average of five or six weeks for care in community clinics, at Department of Veterans Affairs facilities and in private offices from Maryland to Los Angeles County.

Across California, half of residents surveyed by the California Health Care Foundation in late 2019 said they had to wait too long to see a mental health care provider when they needed one. At Kaiser Permanente, the state’s largest insurance company, 87% of therapists said weekly appointments were not available to patients who needed them, according to a 2020 survey by the National Union of Healthcare Workers, which represents KP therapists — and was the main sponsor of the California wait times legislation. €œIt just feels so unethical,” said triage therapist Brandi Plumley, referring to the typical two-month wait time she sees at Kaiser Permanente’s mental health clinic in Vallejo, east of San Francisco. Every day, she takes multiple crisis calls from patients who have therapists assigned to them but can’t get in to see them, she said, describing the providers’ caseloads as “enormous.” “It’s heartbreaking. And it eats on me day after day after day,” Plumley said.

€œWhat Kaiser simply needs to do is hire more clinicians.” Kaiser Permanente says there just aren’t enough therapists out there to hire. KP is an integrated system — it is a health provider and insurance company under one umbrella — and has struggled to fill 300 job vacancies in clinical behavioral health, according to a statement from Yener Balan, the insurer’s Northern California vice president of behavioral health. Hiring more clinicians won’t solve the problem, said Balan, who suggested that sustaining one-on-one therapy for all who want it in the future wouldn’t be possible in the current system. €œWe all must reimagine our approach to the existing national model of care.” Kaiser Permanente lodged concerns about the wait times bill when it was introduced. And the trade group representing insurers in the state, the California Association of Health Plans, opposed it, saying the shortage of therapists would make meeting the two-week mandate too difficult.

€œThe buy antibiotics cipro has only exacerbated this workforce shortage, and demand for these services significantly increased,” said Jedd Hampton, a lobbyist for the California Association of Health Plans, in testimony during a state Senate hearing for the bill in the spring. Hampton referred to a University of California-San Francisco study that predicted California would have nearly 30% fewer therapists than needed to meet demand by 2028. €œSimply put, mandating increased frequency of appointments without addressing the underlying workforce shortage will not lead to increased quality of care,” Hampton said. Lawmakers pushed back. State Sen.

Scott Wiener (D-San Francisco), who authored the bill, accused insurers of overstating the shortage. State Sen. Connie Leyva (D-Chino) said that the therapeutic providers are out there but that insurers are responsible for recruiting them into their networks by paying higher rates and reducing administrative burdens. If insurers want more young people to enter the mental health care profession, they must improve salaries and working conditions now, said state Sen. Richard Pan (D-Sacramento).

(A 2016 KQED investigation uncovered multiple ways that insurers save money by keeping provider networks artificially small.) As bipartisan support for the bill grew in Sacramento, insurers withdrew their formal opposition. But whether other states have the political will, or the resources, to legislate a similar solution is unclear, said Hemi Tewarson, executive director of the nonpartisan National Academy for State Health Policy in Washington, D.C. Although California may be able to force insurers to hire more therapists, she said, places like New Mexico, Montana, Wyoming, and parts of the South don’t have enough therapists at any price. €œThey don’t have the providers, so you could fine the insurers as much as you want, you’re not going to be able to, in the short term, make up those wait times if they already exist,” she said. The new California law is a solid step toward improving access to mental health care, with communities of color standing to benefit the most, said Lonnie Snowden, a professor of health policy and management at the University of California-Berkeley.

African Americans, Asian Americans and Latinos face the most barriers getting into care, Snowden said, and when people of color do come in for treatment, they are more likely to drop out. Oversight and enforcement are needed for the new rules to work, said Keith Humphreys, a psychiatry professor at Stanford University. Kaiser Permanente has data systems that can track the time between appointments, but other insurers set up contracts with therapists in private practice, who manage their own caseloads and schedules. €œWho would keep track of whether people who’ve been seen once were seen again in 10 days, when it’s hard enough just to keep track of how many providers we have and who they are seeing?. € he asked.

Questions like that one will fall to state regulators, primarily the California Department of Managed Health Care. The department has fined insurers $6.9 million since 2013 for violating state standards, including a $4 million penalty against Kaiser Permanente for excessive wait times for mental health care. Previous state law required insurers to provide initial mental health care appointments within 10 days, and the new law clarifies that they must do the same for follow-up appointments. Greta Christina, who gets her care at a Kaiser Permanente facility, said she is desperate for the new law to start working. It takes effect on July 1, 2022.

Christina thought about paying out-of-pocket in the meantime, to find a therapist she could see more often. But in a cancer crisis, she said, starting over with someone new would be too hard. So she’s waiting. €œKnowing that this bill is on the horizon has been helping me hang on,” she said. This story is part of a partnership that includes KQED, NPR and KHN.

April Dembosky, KQED. @adembosky Related Topics Contact Us Submit a Story Tip.

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