COVID-19 Data Dispatch

Tag: Medicaid unwinding

  • Sources and updates, November 5

    • New respiratory virus dashboard for Europe: Residents of about 50 European countries can now follow respiratory virus trends for their nations on a new dashboard developed by the World Health Organization (WHO) and European Centre for Disease Prevention and Control (ECDC). The dashboard compiles data from patient visits to healthcare facilities, laboratory testing, and genetic sequencing of coronavirus variants, according to a press release by the ECDC. Viewers can find summary trends for influenza-like illness as well as specific trends for COVID-19, flu, and RSV. This dashboard is a great step forward for standardizing surveillance data across countries.
    • Medicaid unwinding update from KFF: This week, the Kaiser Family Foundation (KFF) published an update to its Medicaid Enrollment and Unwinding Tracker, which follows the Americans who lost their health insurance following the end of a Medicaid rule tied to the federal public health emergency for COVID-19. At least 10 million people have lost Medicaid coverage as of November 1, KFF reports, though the researchers acknowledge that this number is likely an undercount due to limited data. While disenrollment rates vary by state, overall, 71% of people who lost Medicaid coverage did so for “procedural reasons,” i.e. paperwork issues, according to KFF’s analysis.
    • New Long COVID prevalence estimates: In a new paper, published this week in PLOS ONE, researchers at Dartmouth and University College London estimate Long COVID prevalence in the U.S. based on six months of data from the U.S. Census and CDC’s Household Pulse Survey. (Longtime readers may remember that this survey is one of my personal favorite sources for Long COVID data.) About 14% of respondents surveyed between June and December 2022 reported that they had experienced Long COVID at some point, half of them during the time they were surveyed, the researchers found. Americans with less education and lower incomes were more likely to report Long COVID symptoms, and the condition was correlated with physical and mental difficulties such as trouble dressing and bathing.
    • Vaccine confidence falling in the U.S.: A new study from the Annenberg Public Policy Center at the University of Pennsylvania finds that vaccine confidence is declining for a variety of diseases, not just COVID-19. The researchers compared results from similar surveys conducted in October 2023 and in April 2021, both of which included about 1,600 people selected for a nationally representative sample. Confidence rates in COVID-19 vaccines dropped from 75% to 63%, while confidence rates that all vaccines approved in the U.S. are generally safe fell from 77% to 71%. At the same time, the researchers found that more survey respondents believed incorrect statements, such as that ivermectin was an effective treatment for COVID-19.
    • Reasons for masking in Japan: One more study that caught my attention this week, on a more positive note: a researcher at Osaka University examined Japanese use of masks for COVID-19. Among participants in the researcher’s online surveys, the majority reported still wearing masks in June 2023, even though COVID-19 guidelines in Japan became less strict earlier this year. Social norms in Japan contribute to this behavior, the survey found, as respondents reported that they continued to mask both to avoid infection and to appear “normal” in public spaces. The study provides data behind well-known social norms in Japan, while offering some hope to those of us “lone maskers” in places where the norms are quite different.

  • Sources and updates, September 10

    • Cost details about new treatment from Project Next Gen: The Department of Health and Human Services (HHS) has recently started to share more details about Project Next Gen, a federal initiative to support new vaccines and treatments as the coronavirus continues evolving. This week, HHS announced details about its agreement with Regeneron, a company working on a new monoclonal antibody with federal funding. If a new treatment arises from this research, Regeneron cannot sell it for a higher price in the U.S. than elsewhere in the world, HHS said. This is a relatively small step for treatment access, but still could set a precedent for other products that come out of Project Next Gen.
    • Viral persistence in Long COVID: A new paper from some top Long COVID researchers (including Amy Proal, Michael VanElzakker, and others) reviews evidence about viral reservoirs, or pockets of coronavirus continuing to replicate in people’s bodies. Past studies have found these viral reservoirs throughout the body; Proal and her colleagues explain how they may contribute to different Long COVID symptoms. The review paper also recommends priorities for further research on this topic and potential treatment options. “Many aspects of SARS-CoV-2 reservoir in Long COVID require further study,” Proal wrote in a Twitter thread summarizing the paper. “For example, we need to better understand factors that differentiate SARS-CoV-2 persistence in Long COVID from persistence in asymptomatic individuals.”
    • Genetic factors for COVID-19 risk: In another notable paper from this week, researchers from a global consortium published results about how genetic factors may contribute to COVID-19 risk. The team reviewed genomic data from about 220,000 people who had COVID-19 and three million who had not tested positive. They found 51 areas of the genome that were statistically correlated to a higher risk for infection with SARS-CoV-2 or more severe symptoms. These findings could lead to “identification of the mechanisms involved in the susceptibility and the severe course of the disease,” one of the study’s lead authors said in a press release.
    • Updated Medicaid unwinding data from KFF: The Kaiser Family Foundation has updated its Medicaid Enrollment and Unwinding Tracker, which shares data about people losing their Medicaid coverage thanks to the end of the federal health emergency. As of September 8, at least 5.9 million people across 48 states and Washington, D.C. have lost their coverage, KFF reports. Disenrollment varies widely by state, from 9% in Michigan to 72% in Texas. And the majority of people who lost their Medicaid coverage have done so due to procedural reasons, meaning an error of lost paperwork (rather than an actual change in eligibility, in many cases).

  • COVID source callout: Medicaid unwinding

    The Biden administration has recently boasted that the number of Americans without health insurance hit a “record low” earlier this year. But that statement rings hollow when you consider how millions of people will lose their insurance in the coming months, thanks to the end of the federal COVID-19 emergency.

    Early in the pandemic, the federal government gave states more funding for Medicaid programs, under the condition that they kept people enrolled in insurance rather than reevaluating their eligibility every year. This change led more people to be covered under Medicaid than ever before: about 94 million in total.

    Now, however, the COVID-19 emergency has ended and states are able to reevaluate who qualifies for Medicaid, in a process called “Medicaid unwinding.” Every state has a different evaluation process, many of them involving a lot of bureaucratic hassle (waiting for paperwork in the mail, finding the right forms to fill out online, enrolling in different health insurance if you no longer qualify for Medicaid, etc.).

    The Centers for Medicare & Medicaid Services (CMS) released new data this week about people losing access to Medicaid. About 700,000 people lost their health insurance in April 2023 alone, CMS reports. That accounts for just 18 states that had started their reevaluation process in April; experts estimate that millions more will lose coverage in the coming months.

    Losing health insurance during the ongoing pandemic means losing access to COVID-19 tests, vaccines, treatments, and care for Long COVID, not to mention all the routine health services that people need. Doesn’t really seem like something the Biden administration should be bragging about.

    more source spotlights

  • Sources and updates, June 11

    • Quantifying Long COVID’s impact on day-to-day life: A new study published this week in the BMJ is one of the first I’ve seen to focus not on Long COVID’s symptoms, but on how it impacts quality of life for patients. Researchers at University College London assessed life impacts for about 3,700 Long COVID patients using surveys in an online health platform. The surveys found that “Long COVID can leave people with worse fatigue and quality of life than some cancers, yet the support and understanding is not at the same level,” study coauthor Dr. William Henley said in a statement about the research. This study confirms what I’ve heard from many long-haulers in interviews over the last couple of years.
    • Long COVID and ME/CFS similarities: Another notable Long COVID paper: two leading experts on chronic illness, Dr. Anthony Komaroff at Harvard Medical School and W. Ian Lipkin at Columbia University, wrote a detailed review identifying commonalities between Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a debilitating condition with symptoms similar to Long COVID that often occurs after infection. ME/CFS has long been under-recognized and understudied, but there are still lessons from this condition that can inform Long COVID research and lead to answers for both diseases. The review paper points to directions for future study.
    • Metformin for Long COVID: One more Long COVID paper: a study published this week in The Lancet shares results from a Long COVID clinical trial at the University of Minnesota, which found that the diabetes drug metformin reduces the risk of developing long-term symptoms when patients take it early in the course of a COVID-19 case. I shared this study when it was first posted as a preprint in March, and also spoke to one of its authors for my STAT/MuckRock story about the RECOVER initiative. I’m glad to see that the major findings haven’t changed in this peer-reviewed version; metformin appears to be a promising treatment option, though more study is needed.
    • At-home test receives FDA approval: This week, the FDA approved an at-home, rapid COVID-19 test made by the company Cue Health. It’s the first at-home test to receive full approval, as these tests have previously received Emergency Use Authorization under public health emergency rules. With the federal emergency over, the FDA is encouraging test companies to apply for full approval so that at-home COVID-19 tests can be distributed (and marketed) like other commonly-available health products. The emerency authorizations still apply for tests that don’t have full approval yet, though.
    • COVID-19 Medicaid rules led to more coverage for children: For the first three years of the pandemic, federal rules tied to the public health emergency forbid states from kicking their residents off of Medicaid. The policy led to a significant increase in Americans with health insurance—and that includes children, according to a new paper published this week in Health Affairs. For states that changed their Medicaid rules for children due to the pandemic policy, coverage increased by about 5% from 2019 to 2021, representing thousands of kids who were able to get healthcare more easily. Of course, these kids and their family members are now likely to lose their health insurance, as the federal policy ended in April.
    • Animal behaviors changed during 2020 lockdowns: Remember when, in the early days of the pandemic, big cities with more stringent lockdowns saw more wild animals than normal? A new paper from a large coalition of scientists, published this week in Science, finds that this pattern wasn’t just anecdotal: animal behavior really did change. The scientists compiled a large dataset of animals tracked with GPS, representing 2,300 individuals from 43 different mammal species, and compared their behaviors in spring 2020 to the same period in 2019. Animals living in areas under strict lockdowns were more likely to travel outside their normal ranges, the researchers found.

  • Sources and updates, June 4

    • Medicaid coverage losses by state: KFF Health News published a story this week sharing new data on the Americans who lost Medicaid coverage due to the end of a COVID-19 policy that prevented states from kicking people off the insurance during earlier stages of the pandemic. More than 600,000 people in 14 states have lost coverage since April 1, according to reporter Hannah Recht’s analysis. That represents about 36% of the people whose Medicaid eligibility was up for review in these states, though the number is much higher in some states (about 80% in Oklahoma). Recht also published the underlying data from her analysis for other reporters to use.
    • Library of Congress COVID-19 history project: The Library of Congress has announced a new project to collect COVID-19 oral history stories, partnering with the StoryCorps interview archive. Congress has provided funding for the COVID-19 project, which will provide grants to researchers working to document the experiences of specific groups. This project is focusing on frontline workers and the survivors of people who died from COVID-19, but other Americans are welcome to share their stories through the StoryCorps website.
    • Children often cause household COVID-19 spread: Researchers at Boston Children’s Hospital and Kinsa, a health tech company, used data from smart thermometers to track how the coronavirus spreads inside households. Among about 39,000 instances of household transmission, a child was the initial case 70% of the time. The study suggests that children are major drivers of disease spread, especially during the school year; it also demonstrates the potential utility of smart thermometer data. (For more about Kinsa, see this post from last fall.)
    • Disproportionate COVID-19 impacts within a city: Another study that caught my attention this week: researchers at the University of Texas at Austin and collaborators evaluated how severe COVID-19 impacts differed by ZIP code within the city of Austin. Their analysis found that ZIP codes with more vulnerable populations (based on the CDC’s Social Vulnerability Index) had higher rates of COVID-19 cases, but were less likely to have their cases reported. When limited surveillance data are available, the researchers suggest, health agencies should direct resources to more vulnerable communities.
    • Assessing who’s not connected to public sewers: One commonly-cited limitation of wastewater surveillance data is that about one in five U.S. households aren’t connected to public sewers. A new preprint from scientists at Harvard University and Biobot Analytics looks at this issue in more detail, using publicly available datasets describing sewer connectivity. The researchers found that, overall, some demographic groups (such as Native Americans, wealthier people in rural areas, etc.) are less likely to be connected to public sewers, as are some regions (such as Alaska and Navajo Nation). But public datasets have many gaps and biases, making it challenging to thoroughly assess this problem. Lead author QinQin Yu has a Twitter thread with more details.