February 9, 2016

Record number of Nebraskans get insurance through federal marketplace

(photo from HealthCare.gov)

(photo from HealthCare.gov)

The number of Nebraskans who have healthcare coverage through the Affordable Care Act for the coming year totals 87,835.

The U.S. Department of Health and Human Services reports the state’s enrollment grew by about 14,000 from last year.

James Goddard, Nebraska Appleseed healthcare director, calls that good news, but says more needs to be done to cover low-income residents still without insurance.

State senators are considering a bill called the Transitional Health Insurance Program Act (LB1032) that would use Medicaid funds to buy private insurance for that group.

“Those individuals would either be able to go into the marketplace and get coverage or if they had access to employer-sponsored insurance but couldn’t cover it, then Medicaid dollars could be used for that,” Goddard says. “So it would provide coverage to that group of nearly 80,000 people that have really no other way to get it now.”

Goddard says if that group in the so-called coverage gap earned a little bit more than 100% of the poverty level, then they would be able to get subsidies on the healthcare marketplace.

“So, if it seems counterintuitive, it’s because it is,” Goddard says, “and it’s because it’s not the way the Affordable Care Act was originally designed.”

Opponents of the Medicaid expansion bill say the federal funding is unreliable and the plan would cost the state too much in the long-run.

A hearing on the bill is planned for Wednesday afternoon in the Unicameral’s Health and Human Service Committee.


UNMC physician takes part in recent HIV study

The result of a recent study suggests there is pathway to a possible cure for HIV-1 infection. University of Nebraska Medical Center’s Dr. Courtney Fletcher is dean of the College of Pharmacy and took part in this study that questioned why powerful drugs administered to patients didn’t wipe out the infection.  Dr. Fletcher says the study showed that the levels of drugs that make it to reservoirs of HIV in some tissues are too weak to wipe it out.

Dr. Fletcher says, “There’s still evidence for ongoing viral replication in tissue reservoirs. This work points us to a way to try to address that by increasing drug delivery into those tissues.  What is important about this work is that it provides us with another pathway towards a cure.  We don’t know that enhancing drug delivery into these tissues alone will cure HIV.  So, this is an important effort on this whole pathway to trying to cure HIV infection.”

The good news is that the virus has not developed a resistance to those drugs likely because the levels of the drugs are so low. There is no reason for the virus to develop resistance.

Dr. Fletcher has a significant grant application in with the National Institutes of Health and he is optimistic that UNMC will be tasked with finding a way to deliver enough drugs to hard-to-reach places where the last remaining bits of HIV hide out.

The study was recently published in the science journal, Nature.

Two cases of Zika virus in Nebraska, health experts have been expecting it

Countries and territories with active Zika virus transmission as for Feb. 3. (from CDC website)

Countries and territories with active Zika virus transmission as for Feb. 3. (from CDC website)

A mosquito-borne virus affecting Central and South American countries has appeared in Nebraska.

The state Department of Health and Human Services reports two confirmed cases of travel-related Zika virus. Both are women in their 20s – one in Douglas County, the other in Sarpy County.

“They have not been hospitalized,” Douglas County Health Department Director Dr. Adi Pour says. “They had symptoms. They went to their healthcare provider and that’s where they got tested.”

Dr. Tom Safranek, the state epidemiologist, says the women recently traveled overseas.

“This was not unexpected,” Safranek says. “We know that virus is out there. When we first heard about it infecting persons, we knew we would have American citizens traveling to high-risk areas and coming back with it.”

Safranek says it doesn’t appear that the virus can be transmitted by casual contact, but sexual contact is a possibility as well as via a blood transfusion.

“And I’m sure the Red Cross and other blood donation agencies are rapidly developing a test to incorporate in their screening of any donated unit of blood to make sure that they’re not transmitting Zika-positive blood to sick patients,” Safranek says.

The American Red Cross is asking anyone who has gone to a country with a Zika virus outbreak to delay donating blood for 28 days.

The virus in pregnant women can cause birth defects, but in most cases, experts say the symptoms, which include fever, joint pain, a rash and conjunctivitis (red eye), are generally mild and last about a week.

There is no vaccine or medicine to fight Zika, so preventing mosquito bites is the best defense, according to health officials.

UNMC keeping close watch on Zika virus

Health organizations are carefully monitoring the spread of the Zika virus after a large outbreak in May of last year in Brazil.

The virus is typically spread by mosquito but there have been cases of infection through blood transfusion and sexual contact.  Beth Conover is a genetic counselor at the University of Nebraska Medical Center’s Munroe Meyer Institute and says the CDC is keeping close tabs on the virus as it continues to spread.

The outbreak started in Brazil almost a year ago and is spread by mosquitos, similar to the West Nile virus. Conover says that isn’t a concern in Nebraska right now due to the cold weather but come spring that will change.  She says health organizations are now focusing prevention of mosquito borne infections.  Conover says there have also been a couple of cases where the virus was spread through sexual contact.

The the Zika virus is associated with microcephaly, babies born with incomplete brain development and smaller heads. The outbreak is spreading through South American and the Caribbean so pregnant women are asked to avoid those areas. Just this week four counties in Florida have been declared a health emergency due to the virus.  There have been cases in the U-S but most of those infected traveled to areas where the virus is spreading.  Conover in general the virus causes flu-like symptoms or a rash and is typically not life threatening.  She says unfortunately there is no vaccine or cure for the Zika virus.

Nebraskans warned of health risks digging out from the blizzard

Nebraskans are digging out after two days of blizzard conditions in some areas. For many that means working with a shovel.  University of Nebraska Medical Center Associate Professor Gib Willett is a physical therapist and says many people are not used to this kind of physical activity and can easily get into trouble.

First, Willett says many people are not used to this kind of physical activity that can increase the risk of a heart attack. He says it is important to know the symptoms.

Willett says, “If you are starting to have some chest pains, intense shortness of breath that isn’t going away, pain down the left arm, sometimes even in the back.  Women are more known to have atypical heart symptoms so pain in the jaw and in the arm more so than in the chest.”   He says if you have any of these symptoms seek medical help immediately.  Those with previous heart problems should only shovel if they have their doctor’s approval.

Willett says shoveling can also cause other health problems like back injuries. He says using a small shovel will take you longer but smaller loads mean less stress to the back and heart.  He recommends using your legs more while shoveling, avoid twisting because that also stresses the back and heart.  If possible, pushing the snow instead of shoveling it is easier on the body.

There is an increase in the number of emergency room visits during and after snowfalls. CHI Health in the Omaha metro area treated 23 patients for weather related injuries on Tuesday.  Those included exposure to the cold, cardiac events, slips and falls and snow blower injuries.