Helene Relief Efforts Stats-to-Date
As relief efforts continue in Western North Carolina there is a lot of misinformation and untrue statistics being disseminated. Here are some facts you should know.
- 1,440+ air rescues to date
- 515 emergency personnel with 95 fire engines
- 717 EMS personal with 350 ambulances
- 1475 state activated National Guard
- 400 active-duty soldiers in region
- 500 active-duty soldiers enroute to support
- 50 rotary wing assets (21 from EMAC)
- 22 shelters operational with 915 occupants & 102 pets
- FEMA Assistance:
- 83,000 registered
- $27m in disbursements to date
(updated 10/05/24)
Small Business Administration Opens Three Centers to Help Western NC
SBA Opens Three Centers in Aftermath of Helene
WASHINGTON – Low-interest disaster loans from the U.S. Small Business Administration (SBA) are available to businesses and residents in North Carolina following the announcement of a Presidential disaster declaration for Tropical Storm Helene that began on Sept. 25.
“SBA’s mission-driven team stands ready to help small businesses and residents in North Carolina impacted by this disaster in every way possible under President Biden’s disaster declaration for certain affected areas,” said SBA Administrator Isabel Casillas Guzman. “We’re committed to providing federal disaster loans swiftly and efficiently, with a customer-centric approach to help businesses and communities recover and rebuild.”
The disaster declaration covers Alexander, Alleghany, Ashe, Avery, Buncombe, Burke, Caldwell, Catawba, Clay, Cleveland, Gaston, Haywood, Henderson, Jackson, Lincoln, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Transylvania, Watauga, Wilkes and Yancey counties and The Eastern Band of the Cherokee Indians in North Carolina which are eligible for both Physical and Economic Injury Disaster Loans from the SBA. Small businesses and most private nonprofit organizations in the following adjacent counties are eligible to apply only for SBA Economic Injury Disaster Loans (EIDLs): Cherokee, Graham, Iredell, Mecklenburg, Surry, Swain and Yadkin in North Carolina; Rabun, Towns and Union in Georgia; Cherokee, Greenville, Oconee, Pickens, Spartanburg and York in South Carolina; Carter, Cocke, Greene, Johnson, Sevier, and Unicoi in Tennessee; and Grayson in Virginia.
LOCATIONS
- Asheville Business Recovery Center
Asheville Chamber of Commerce
36 Montford Ave.
Asheville, NC 2881
M-F - 9am - 6pm
Sat.- 9am - 3pm
Sun. - Closed - Boone Business Recovery Center
Appalachian Enterprise Center
130 Poplar Grove Connector
Boone, NC 288607
M-F - 8am - 6pm
Sat. - 9am - 3pm
Sun. - Closed - Charlotte Disaster Loan Outreach Center
US Small Business Administration District Office
6302 Fairview Rd., STE 300
Charlotte, NC 28210
M-F - 8am - 5pm
Sat. - Closed
Sun. - Closed
Walk-ins are welcome, but you can schedule an appointment at https://lnkd.in/gCk4SN64 .
Disaster survivors should not wait to settle with their insurance company before applying for a disaster loan. If a survivor does not know how much of their loss will be covered by insurance or other sources, SBA can make a low-interest disaster loan for the total loss up to its loan limits, provided the borrower agrees to use insurance proceeds to reduce or repay the loan.
Businesses and private nonprofit organizations of any size may borrow up to $2 million to repair or replace disaster-damaged or destroyed real estate, machinery and equipment, inventory, and other business assets.
For small businesses, small agricultural cooperatives, small businesses engaged in aquaculture and most private nonprofit organizations, the SBA offers Economic Injury Disaster Loans (EIDLs) to help meet working capital needs caused by the disaster. Economic Injury Disaster Loan assistance is available regardless of whether the business suffered any physical property damage.
Disaster loans up to $500,000 are available to homeowners to repair or replace disaster-damaged or destroyed real estate. Homeowners and renters are eligible for up to $100,000 to repair or replace disaster-damaged or destroyed personal property.
Interest rates are as low as 4% for businesses, 3.25% for nonprofit organizations, and 2.813% for homeowners and renters, with terms up to 30 years. Interest does not begin to accrue, and monthly payments are not due, until 12 months from the date of the initial disbursement. Loan amounts and terms are set by the SBA and are based on each applicant’s financial condition.
Building back smarter and stronger can be an effective recovery tool for future disasters. Applicants may be eligible for a loan amount increase of up to 20% of their physical damages, as verified by the SBA for mitigation purposes. Eligible mitigation improvements may include a safe room or storm shelter, sump pump, French drain or retaining wall to help protect property and occupants from future disasters.
“SBA’s disaster loan program offers an important advantage–the chance to incorporate measures that can reduce the risk of future damage,” said Francisco Sánchez, Jr., associate administrator for the Office of Disaster Recovery and Resilience at the Small Business Administration. “Work with contractors and mitigation professionals to strengthen your property and take advantage of the opportunity to request additional SBA disaster loan funds for these proactive improvements.”
With the changes to FEMA’s Sequence of Delivery, survivors are now encouraged to simultaneously apply for FEMA grants and SBA low-interest disaster loan assistance to fully recover. FEMA grants are intended to cover necessary expenses and serious needs not paid by insurance or other sources. The SBA disaster loan program is designed for your long-term recovery, to make you whole and get you back to your pre-disaster condition. Do not wait on the decision for a FEMA grant; apply online and receive additional disaster assistance information at sba.gov/disaster.
Applicants may also call the SBA’s Customer Service Center at (800) 659-2955 or send an email to [email protected] for more information on SBA disaster assistance. For people who are deaf, hard of hearing, or have a speech disability, please dial 7-1-1 to access telecommunications relay services.
The filing deadline to return applications for physical property damage is Nov. 27, 2024. The deadline to return economic injury applications is June 30, 2025.
NC HealthConnex Helps You Find Clinical Information for Displaced Patients
The NC HealthConnex team is committed to supporting those most in need in western North Carolina impacted by Hurricane Helene. The NC HealthConnex Clinical Portal is a web-based application that allows providers to access critical clinical information such as medical history, medications and treatment plans for displaced patients.
Here are some steps you need to gain access based on your current participation status with the NC HIEA.
If you currently have a Full Participation Agreement:
- A Full Participation Agreement and login credentials are required to utilize this service.
- Current participants can request credentials by contacting the NC HealthConnex Help Desk at [email protected]. For after hours or weekend support, please call 919-531-2700 for immediate assistance.
- Providers with credentials can access the portal from any web browser by visiting https://portal.nchealthconnex.net.
- After searching for a patient, you will need to click “Declare Patient Relationship” to look up patients with whom you do not have a previous treatment relationship. This action will attest that you have a reason to be accessing this patient’s information.
- To get started using the NC HealthConnex Clinical Portal, please see this Quick Start Reference Guide or view this demonstration video.
If you have a Submission Only Participation Agreement:
- You will need a Full Participation Agreement in order to gain access to the NC HealthConnex Clinical Portal. A Submission Only agreement is not sufficient.
- In order to switch to a Full Participation Agreement, please contact the NC HIEA Provider Relations team via email at [email protected] or via phone at 919-754-6912.
- In order to facilitate timely patient care, the provider relations team is prepared to expedite requests for affected providers.
If you do not have an agreement on file with the NC HIEA:
- The NC HIEA can expedite enrollment for new providers in the western part of the state and can provide training on the use of systems, etc. Please contact the NC HIEA Provider Relations team via email at [email protected] or via phone at 919-754-6912.
If you are a user of the NC HealthConnex Clinical Portal and experience any issues over the weekend, you will need to call the Help Desk at 919-531-2700.
NCMS Working to Help You Rebuild. Please Answer a Few Questions about Helene's Impact to Your Practice
Hurricane Helene left a path of destruction across Western North Carolina and now many physicians are without the means to continue their work of healing. The North Carolina Medical Society is collecting information on the impacts of the storm so we can assess where to allocate resources.
Please take a moment and answer a few questions for us about how you are doing and what you need.
Over 150,000 Customers Remain Without Power in Western NC
Over a week after Hurricane Helene tore through western North Carolina, over 150,000 customers remain without power as authorities also work to find missing people, restore water and continue recovery efforts in the devastated region.
In Buncombe County, which includes Asheville and Black Mountain, nearly 43% of customers are still in the dark, along with almost 57% of customers in nearby Henderson County, according to Poweroutage.com.
The small counties of Mitchell, Yancey and Avery, heavily impacted by Helene, also show high percentages of outages, with 64%, 57% and 45% of customers without power, respectively.
To donate to Hurricane Helene Relief click here.
Message from Office of Chief Medical Examiner
- Telephone
- Call NC211 (1-888-892-1162). To report a missing person or request a welfare check, press 1 once you are connected to reach an operator.
- Internet
- Visit www.nc211.org to submit a request for a person to be included in the search and rescue efforts coordinated by United Way – North Carolina.
Important Information for People Enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Impacted by Hurricane Helene
There are more than 250,000 people participating in the WIC program statewide
NCDHHS -- There is widespread damage and devastation following Hurricane Helene, and many participants of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) are impacted. There are more than 250,000 people participating in the WIC program statewide. WIC provides access to healthy food, breastfeeding support, nutrition education and referrals for health care and community services.
Families participating in WIC who may have relocated to a new area can go to any NC WIC agency to have a new eWIC card issued, or to request replacement of breastfeeding supplies, breast pumps, and food purchased with current WIC benefits and lost due to Hurricane Helene. A list of WIC agency closures related to Hurricane Helene can be found on the NC WIC landing page under Special Weather Announcement.
To Replace Your WIC Card:
- If your WIC card is lost, stolen or damaged, call eWIC Customer Service at 1-844-230-0813. WIC cards will be replaced by regular mail. You should receive your replacement card in five to seven days.
- Or visit any local WIC clinic to have your WIC card replaced.
To Check Your WIC Benefit Balance, Purchase History, and Account Information:
- Call eWIC Customer Service toll-free 24/7 at: 1-844-230-0813 OR
- Check your account at www.ebtEDGE.com OR
- Use the FIS ebtEDGE App
To Transfer WIC Benefits from Another State to NC:
- If your family was participating in WIC outside of NC and has relocated to NC as a result of Hurricane Helene, please visit any NC WIC agency to transfer benefits through a Verification of Certification.
Other things you can do at www.ebtEDGE.com or on the ebtEDGE App:
- Set, change or unlock your PIN
- View transaction history
- View future benefits
- Order a replacement card
- Recover password or username
- View a store location where WIC benefits can be used
The North Carolina WIC Program is available statewide through local health departments, community and rural health centers, and community action agencies that provide WIC Program services. To apply for the WIC program, participants must meet eligibility requirements and meet with a nutritionist or other health professional. If you have any questions, you can contact your local WIC clinic or visit our website at www.ncdhhs.gov/ncwic/eWIC. We also have a dedicated page of resources for people impacted by Hurricane Helene at www.ncdhhs.gov.
Replacement Benefits Available for Food and Nutrition Services Recipients Impacted by Hurricane Helene
Replacement Benefits Available for Food and Nutrition Services Recipients Impacted by Hurricane Helene
People in 23 Western North Carolina counties impacted by Hurricane Helene who are enrolled in Food and Nutrition Services now have access to replacement benefits on their Electronic Benefit Transfer (EBT) cards. The United States Department of Agriculture approved North Carolina to allow current FNS participants in the 23 counties to receive 70% of their total monthly September benefit back on their EBT card. The benefit replacement is automatic and does not require action from the FNS participant. This impacts more than 200,000 people in North Carolina and more than $24 million in replacement benefits.
“We’ve worked quickly with the federal government to have $24 million in SNAP benefits restored to 200,000 individuals’ EBT cards, in light of the fact that due to power outages and worse, many families have lost their food,” said NC Health and Human Services Secretary Kody H. Kinsley. “We will creatively use every tool we have to support folks impacted by Hurricane Helene now and for the long-haul.”
The approval is for FNS recipients in the following counties: Alexander, Alleghany, Ashe, Avery, Buncombe, Burke, Caldwell, Cleveland, Gaston, Haywood, Henderson, Jackson, Lincoln, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Transylvania, Watauga, Wilkes, and Yancey counties. The replacement benefits were automatically credited to impacted FNS recipients Electronic Benefits Transfer (EBT) cards Sunday morning and are available now.
There are three ways to check your FNS balance 24 hours a day, seven days a week:
- Visit www.ebtedge.com. Click on More Information under EBT Cardholder. You will be prompted to login and/or register your account.
- Download the ebtEDGE mobile app. The app is available as a free download on the Apple Store and Google Play.
- Call 1-888-622-7328 and follow the prompts to activate your PIN.
NCDHHS recently received approval for FNS participants to temporarily use their benefits to purchase hot food, including food prepared for immediate consumption, from authorized Electronic Benefits Transfer (EBT) retailers using their EBT card. FNS participants statewide will be able to purchase hot food through Nov. 3, 2024, and do not have to apply for the benefit.
Additionally, NCDHHS is actively working with USDA to receive federal authority to operate a Disaster Supplemental Nutrition Assistance Program. D-SNAP allows more people impacted by Hurricane Helene to qualify for food assistance benefits who are not already FNS recipients. More information will be communicated once NCDHHS has approval to implement the D-SNAP program.
NCDHHS recommends people using EBT cards check their balances regularly for unauthorized charges and take the following actions to keep their EBT card and account secure:
- You can check your balance and/or replace a lost or stolen EBT card by visiting www.ebtedge.com, using the EBT Edge mobile app or contacting the North Carolina EBT Call Center at 1-888-622-7328.
- Block out-of-state and online purchases using the EBT Edge website or mobile app.
- If you suspect card skimming, freeze your EBT card when not shopping so fraudulent purchases cannot be made using your card.
- Select a “difficult” PIN (i.e., not 1234 or 1111) for the EBT card and change the PIN regularly.
For information about the FNS program, visit www.ncdhhs.gov/fns or visit epass.nc.gov.
For information regarding Hurricane Helene and additional resources and flexibilities in place, please go to www.ncdps.gov/Helene and www.ncdhhs.gov/helene.
North Carolinians Enrolled in Food and Nutrition Services Can Use Benefits to Buy Hot Food Following Hurricane Helene
Change Remains in Effect Until November 3, 2024
People and families in North Carolina who are enrolled in the Food and Nutrition Services (FNS) program can use their benefits to purchase hot food. This temporary flexibility applies to all 100 counties in North Carolina and the nearly 700,000 households enrolled in the FNS program. The North Carolina Department of Health and Human Services is working closely with the U.S. Department of Agriculture to ensure people impacted by Hurricane Helene receive assistance as soon as possible.
"For people and families in North Carolina whose lives have been turned upside down by Hurricane Helene, a hot meal can provide a small comfort and sense of normalcy to their day," said Governor Roy Cooper. "This flexibility helps us make sure everyone has access to basic necessities while we continue to work to restore services to impacted communities."
"This benefit will support families who are reeling from the effects of Hurricane Helene with hot food they can purchase with their EBT card," said NC Health and Human Services Secretary Kody H. Kinsley. "We are 100% committed to the health and wellbeing of our friends, family, and fellow North Carolinians in every corner of western North Carolina — now and for the long haul."
North Carolinians in the FNS program can purchase hot food, including food prepared for immediate consumption, from authorized Electronic Benefits Transfer (EBT) retailers using their EBT card starting today. All authorized EBT vendors in the state have been notified about this change, which will remain in effect until Nov. 3, 2024.
This will ensure families who are not able to prepare food at home due to displacement or power outages still have access to warm meals. Customers do not have to apply for this benefit but should inquire first with the store to see if they can process hot food purchases with their FNS benefits. It is important to note this is for authorized retailers like gas stations or deli departments, not restaurants or other non-EBT authorized retailers. A map of retailers that accept EBT is available here.
North Carolina has been approved for a waiver that provides additional time for FNS participants residing in the affected disaster areas to report a food loss as a result of Hurricane Helene to their local Department of Social Services office due to displacement, transportation issues or other storm-related hardships through October 26, 2024.
NCDHHS has also applied for a waiver to automatically replace a portion of FNS benefits for individuals and families in the western North Carolina who have lost food purchased with their September FNS benefits. Once NCDHHS receives approval, the department will send out a notification with more details.
Additionally, NCDHHS is actively working with USDA to receive federal authority to operate a Disaster Supplemental Nutrition Assistance Program. D-SNAP allows more people impacted by Hurricane Helene to qualify for food assistance benefits who are not already FNS recipients. More information will be communicated once the department has approval to implement the D-SNAP program.
For information about the FNS program, visit www.ncdhhs.gov/fns or visit epass.nc.gov.
For information regarding Hurricane Helene and additional resources and flexibilities in place, please go to www.ncdps.gov/Helene and www.ncdhhs.gov/helene.
There is no right or wrong way to feel in response to the trauma of a hurricane. If you have been impacted by the storm and need someone to talk to, call or text the Disaster Distress Helpline at 1-800-985-5990. Help is also available to anyone, anytime in English or Spanish through a call, text or chat to 988. Learn more at 988Lifeline.org.
Hurricane Helene by the Numbers
Hurricane Helene Already Ranked in Top 10 Deadliest Hurricanes
(USA Today) -- Helene hit Western North Carolina on the morning of Friday, Sept. 27, dumping inches of rain on communities that had already seen multiple inches of rain that week. By the time it reached the Carolinas, Helene was a tropical storm but less than 12 hours earlier it made landfall as a catastrophic Category 4 hurricane near Perry, Florida, on Thursday, Sept. 26 around 11 p.m. ET.
As it made its way inland, the storm caused millions to lose power, hundreds of homes and scores of roads were damaged or destroyed and has now left a rising death toll.
How many people have died because of Helene?
As of Thursday, Oct. 3, more than 200 people have died due to Hurricane Helene.
In North Carolina, 115 people have died. In addition, South Carolina has reported 41 fatalities, Georgia 33, Florida 19, Tennessee 11 and Virginia two for a total of 214.
Hundreds are still missing in Western North Carolina.
How much rain fell in Western North Carolina due to Tropical Storm Helene?
While Helene dumped rain on the western portion of the Carolinas, the area had already been drenched the week before by storms. Here's how many inches of rain communities saw between Tuesday, Sept. 24 and Saturday, Sept. 28, according to the National Weather Service.
- Busick in Yancey County had the most recorded rain in the period of time at 30.78 inches
- Spruce Pine: 24.12 inches
- Hendersonville: 21.96 inches
- Mountain Home: 17.09 inches
- Candler: 16.18 inches
- Tryon: 15.78 inches
- Grandfather Mountain: 15.42 inches
- Highlands: 14.86 inches
- Banner Elk: 14.85 inches
- Mills River: 13.26 inches
- Swannanoa: 13.21 inches
How high were wind gusts in Asheville, Western North Carolina from Helene?
Mt. Mitchell in Yancey County, which is around 35 miles from Black Mountain and is the highest peak in the United States east of the Mississippi River, had some of the highest gusts for wind in the Carolinas, hitting 106 mph at one point. Here are the top wind gusts in Western North Carolina, the Foothills and into the Piedmont, according to the National Weather Service.
- Frying Pan Mountain, just outside of Waynesville, saw wind gusts of 78 mph.
- Charlotte saw wind gusts of 66 mph
- Kings Mountain saw wind gusts of 56 mph
- Rutherford County, home to Lake Lure and Chimney Rock, saw gusts of 55 mph
- Spruce Pine saw wind gusts as high as 50 mph
- Asheville saw wind gusts of 46 mph
What did the rivers in Western NC crest at during Helene?
Rivers across the region still remain swollen a week after Helene first hit down on the region. On Sept. 27, rivers burst from their banks surpassing major flood stages by more than 10 feet in some areas. Rivers overtook communities across Western North Carolina, almost swallowing whole communities leaving nothing behind but mud and debris.
At its peak, the French Broad River in Fletcher crested at 30.31 feet on Sept. 27 as Helene moved through the area, according to the North Carolina State Climate Office out of North Carolina State University. In Asheville, the French Broad hit 24.67 feet, 1.5 feet above its previous highest crest. Further downstream at Blantyre, the river surpassed its 1916 crest of 27.1 feet to hit 27.38 feet before the gauge stopped reporting on Friday afternoon.
The Swannanoa River at Biltmore crested at 26.1 feet, more than five feet above what it did at its maximum in 1916 and slightly above the apparent 26-foot crest in April 1791, noted the climate office.
How many National Guard members are deployed in Western North Carolina, Asheville?
National Guard members across 16 states in the U.S. have been activated to provide assistance to areas impacted the most by Hurricane Helene. In North Carolina, the National Guard has over 1,100 soldiers and airmen on active duty and is making use of nearly 400 vehicles, including 26 aircraft, according to the U.S. Department of Defense.
President Joe Biden, who visited the area on Wednesday, announced that he has dispatched 1,000 troops to reinforce the North Carolina National Guard with relief efforts.
All together around 6,700 guardsmen are providing support to these different communities, according to the U.S. Department of Defense.
Deadliest hurricanes in the United States
The recent death toll attributed to Hurricane Helene makes it the fifth deadliest hurricane to make landfall in the U.S. mainland since 1950 and the deadliest since Katrina in 2005, according to reports from USA TODAY. Here's a look at some of the deadliest hurricanes to have hit the U.S.
The 10 deadliest hurricanes, based on National Hurricane Center information, are listed below by their rank, name, year and number of deaths.
- Katrina, 2005: 1,392
- Audrey, 1957: 416
- Camille, 1969: 256
- Sandy, 2012: 219
- Helene (preliminary), 2024: 214
- Diane, 1955: 184
- Ian, 2022: 156
- Agnes, 1972: 122
- Harvey, 2017: 103
- Hazel, 1954: 95
Vice President Kamala Harris Visits Western NC in Helene Aftermath
Harris Pledges Ongoing Federal Support
Democratic presidential nominee Kamala Harris pledged ongoing federal support and praised the work of strangers helping strangers as she visited North Carolina on Saturday in the aftermath of Hurricane Helene, her second trip in four days to the disaster zone.
Harris opened her visit by attending a briefing with state and local officials, where she thanked “those who are in the room and those who are out there right now working around the clock.”
She promised federal assistance would continue to flow and added praise for the “strangers who are helping each other out, giving people shelter and food and friendship and fellowship.”
Harris met with North Carolina Gov. Roy Cooper (D), Federal Emergency Management Agency (FEMA) Administrator Deanne Criswell, Charlotte Mayor Vi Lyles (D) and Asheville Mayor Esther Manheimer (D). Democratic gubernatorial candidate Josh Stein was also present for Harris’s visit.
“The work that’s happening here that is so positively impacting so many people is really an example of the best we can do when we bring resources together at the federal, state and local level, and tap into the kind of collegiality that produces results,” Harris said during a briefing with local officials on the response to the storm.
Harris announced the Biden administration had added Mecklenburg County, the second-most populous county in North Carolina, to a major disaster declaration following the hurricane. The move will free up additional resources to help residents get assistance with home repairs, purchasing generators and more.
The vice president praised local officials and residents for “helping each other out, giving people assistance in every way that they need, including shelter, food and friendship and fellowship.”
“I think that these moments of crisis bring out some of the best of who we could be and who we are,” she said.
Cooper said during Saturday’s briefing that at least 68 people died as a result of the storm. The total death toll from Helene, which ripped through Florida, Georgia, South Carolina and North Carolina, has surpassed 200.
(article includes information from the Associated Press and The Hill)
Click here if you would like to make a tax-deductible donation to the NCMS Foundation Relief Fund
Click here if you would like to volunteer
Statement from Baxter International on IV Fluids
Baxter International Facility Sustains Critical Damage From Hurricane Helene
Statement from Baxter International:
As we have previously shared, Baxter International's manufacturing facility located in Marion, NC sustained critical damage from Hurricane Helene and is currently closed for production. As Baxter supplies approximately 60% of IV solutions used in North America, DUHS and hospitals across the U.S. are anticipating significant shortages of Baxter IV fluids.
Clinical and administrative leaders across the health system are working to develop a comprehensive conservation strategy. In an effort to ensure the continuity of patient care is maintained, we have consolidated our inventory of IV fluid for normal saline and lactated ringers to a central distribution point.
Important Points to Note for Duke University Hospital:
- If a patient is hemodynamically decompensating and there is a clinical emergency (including sepsis), proceed as you would normally do in ordering IV fluids to resuscitate the patient. The IV fluid supply will come from your clinical units’ supply and be replenished by restocking from the central distribution room. When a patient has stabilized, please follow previously distributed guidelines on appropriate use of IV fluids.
- If a patient does not have a clinical emergency and you are considering ordering IV fluids (bolus or continuous infusion) then you must contact your responsible covering attending for approval of that fluid order and this approval must be documented in a progress note. There will be an auditing process to confirm compliance with this process.
- Every team must review daily (starting today) their list of ongoing continuous IV fluids to confirm clinical need. We highly encourage all clinicians to add IV Fluids column to their patient lists.
- To order IV fluids, call the Fluid Distribution Center at 919-681-6851. Once confirmed, the fluids will be delivered to you.
As a reminder, the following clinical practices should be implemented immediately:
Maintenance Fluid
- When appropriate, limit maintenance fluids to a specific total volume or time frame.
- Consider oral hydration strategies when possible. We are increasing availability of electrolyte PO fluids in partnership with Food Services (ex. Gatorade and Pedialyte).
- Frequently review and consider elimination of continuous intravenous fluids (IVFs) for patients who are not NPO (or able to take an oral diet).
Procedural/OR
- Consider opportunities to reduce sterile fluid use (intravenous and irrigation) in procedural cases when appropriate.
Nursing Processes
- Extend use of IV and flush bags from 24 to 96 hours when changing tubing.
- Use small-volume bags for low infusion rates.
- Do not use 1L bags when a 100ml bag will do.
- Prime A lines with 500mL bags instead of 1L bags, changed every 4 days
- Eliminate use of Keep Vein Open (KVO) protocols.
- Limit quantities of IV bags placed in warmers to avoid early expiration.
- Verify ongoing fluid needs with providers before a new IV fluid bag is spiked.
- Finish IV bags from the OR or procedure area when going to unit from surgery rather than switching over to a new bag immediately.
Clinical Practice
- Do not empirically start IVF unless clear indications.
Our incident command center remains active and available to assist with any needs. Hours are from 7 a.m. – 7 p.m. To contact the command center, call 919- 684-2222.
We will continue to provide updates as conditions unfold. Our Supply Chain colleagues are working diligently to ensure we are able continue providing quality care to those who need us. Thank you all for your partnership and collaboration, and for your dedication to provide remarkable care to our patients, their loved ones, and each other.
Vice President Kamala Harris to Visit NC After Helene Saturday
Vice President Kamala Harris in NC on Saturday to see Hurricane Helene Damage
(WRAL Staff) -- Vice President Kamala Harris will travel to North Carolina to survey the impacts of Hurricane Helene on Saturday, her office announced.
While in town, Harris will also be briefed on continued recovery efforts that are occurring in communities across the state and provide updates on federal actions that are being taken to support emergency response and recovery efforts in North Carolina and other states throughout the southeast.
It has not been announced what cities Harris will visit while in our state.
Hurricane Helene is now blamed for the deaths of 200 people across the south, and North Carolina has experienced a significant number of power outages, with nearly 245,000 outages reported Friday morning.
As of Thursday, North Carolina data shows at least 105 of those deaths were in North Carolina, including 72 people killed in Buncombe County alone. The ages range from 4 to 89.
NC Rep. David Rouzer gives update on Hurricane Helene
Congressman David Rouzer addresses Hurricane Helene relief efforts
Statement from Congressman David Rouzer:
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The North Carolina Medical Society is also accepting donations to our NCMS Foundation Disaster Relief Fund. Click here for your tax-deducible donation.
Western North Carolina Medical Society Announces Emergency Medical Needs Fund
Urgent Appeal: Help WCMS Support Emergency Medical Needs in the Aftermath of Hurricane Helene
The North Carolina Medical Society is also accepting donations for relief to the people of Western North Carolina. Click here to give your tax-deductible donation.
NCMS Member Dr. Christine Knettel Travels to Western NC to Help After Helene
NCMS wants to hear your story of helping after Helene
NCMS wants to hear your stories too! Please reach out to Randy Aldridge at [email protected] to share how you are helping the needy in North Carolina following Helene.
Hurricane Helene Resources: Open Pharmacies in Western NC
UNC Health System Pharmacy has verified the following pharmacies are open and serving customers
List last updated 10/3/2024
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Sona Pharmacy in Arden
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Publix at Hendersonville Road
Sona Pharmacy in Asheville
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Warrensville Drug Store
Walmart Pharmacy at Ashe County
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Walgreen's Pharmacy at Blowing Rock Blvd
CVS Pharmacy at Blowing Rock Blvd
Walmart Pharmacy at Blowing Rock Blvd
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Boone Drug & Healthcare at Deerfield
Boone Drug at Greenway
Boone Drug at King Street
Boone Drug at New Market
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Avery Pharmacy & Health Care
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CVS Pharmacy at Hendersonville Road
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Walmart Pharmacy at Granite Falls
Granite Drug Center
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Publix at South Market Village
Sam's Club Pharmacy in Hendersonville
Whitley Drugs Hendersonville Pharmacy
Walmart Pharmacy at Hendersonville Supercenter
Blue Ridge Health Pharmacy
Pardee Rx - Fleming
Shelton Compounding Pharmacy
Ingle's Pharmacy at Spartanburg Hwy
Ingle's Pharmacy at Howard Gap
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Publix at Hickory
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East Burke Pharmacy
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CVS Pharmacy at Hudson
Walmart Pharmacy at Hudson
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Regency Village Harris Teeter Pharmacy
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Community Pharmacy at Caldwell Hospital
Medical Arts Pharmacy of Lenoir
Foothill's Pharmacy at Cross Roads
Cajah's Mountain Pharmacy
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Drexel Discount Drug
Walgreens Pharmacy at Fleming Drive
Jay's Hometown Pharmacy
Jones Drugs
Morganton Drug
Table Rock Pharmacy
Walmart Pharmacy at Morganton Heights
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Mountain City Pharmacy
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Halsey Drug Company
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Western NC Assistance for Patient Prescriptions, Vaccines, and Payer Resources
NC AHEC Releases Information on Prescriptions for Physicians in Western NC
Chris Weathington of NC AHEC has released the following information about prescriptions for you and your patients:
Assistance for Your Patients
Several emergency measures have been taken to help patients cope with the aftermath of the storm. The NC Board of Pharmacy have activated Board Rule .1815, which authorizes pharmacists to provide one-time emergency refill of up to a 90-day supply when the pharmacist is unable to obtain refill authorization from the prescriber due to a prescriber’s inability to provide medical services to the patient. This authority was specifically created for emergencies like this one. In addition, if you are trying to send your patient to a pharmacy to pick up needed medication and supplies, the Board of Pharmacy is developing a list of open pharmacies in the impacted area. You can find that list here
Vaccines for Children
If you have lost vaccine stock due to power outages in your practice, for the Vaccines for Children program, you should reach out directly to the VFC Storage and Handling Hotline at 877-873-6247. They can assist with determining viability, wasting doses, and next steps on placing replacement orders. We are in the process of working on solutions for private stock vaccines.
Payer Resources for Practices
NC Medicaid has updated its Medicaid Temporary Flexibilities Due to Hurricane Helene. You can find that information here. This includes information about the expanded ability for hospital swing beds, disaster relief applications available for health care providers, and more.
In addition, please note that many payers across the state have implemented additional flexibilities for practices in the impacted area, including in some instances waiving prior authorizations and allowing early refills, among other things.
UNC Health has released the following list of pharmacies that are open and serving customers:
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Last Update: Oct. 3, 12:30 a.m. |
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Sona Pharmacy in Arden
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Publix at Hendersonville Road
Sona Pharmacy in Asheville
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Warrensville Drug Store
Walmart Pharmacy at Ashe County
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Walgreen's Pharmacy at Blowing Rock Blvd
CVS Pharmacy at Blowing Rock Blvd
Walmart Pharmacy at Blowing Rock Blvd
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Boone Drug & Healthcare at Deerfield
Boone Drug at Greenway
Boone Drug at King Street
Boone Drug at New Market
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Avery Pharmacy & Health Care
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CVS Pharmacy at Hendersonville Road
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Walmart Pharmacy at Granite Falls
Granite Drug Center
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Publix at South Market Village
Sam's Club Pharmacy in Hendersonville
Whitley Drugs Hendersonville Pharmacy
Walmart Pharmacy at Hendersonville Supercenter
Blue Ridge Health Pharmacy
Pardee Rx - Fleming
Shelton Compounding Pharmacy
Ingle's Pharmacy at Spartanburg Hwy
Ingle's Pharmacy at Howard Gap
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Publix at Hickory
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East Burke Pharmacy
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CVS Pharmacy at Hudson
Walmart Pharmacy at Hudson
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Regency Village Harris Teeter Pharmacy
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Community Pharmacy at Caldwell Hospital
Medical Arts Pharmacy of Lenoir
Foothill's Pharmacy at Cross Roads
Cajah's Mountain Pharmacy
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Drexel Discount Drug
Walgreens Pharmacy at Fleming Drive
Jay's Hometown Pharmacy
Jones Drugs
Morganton Drug
Table Rock Pharmacy
Walmart Pharmacy at Morganton Heights
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Mountain City Pharmacy
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Halsey Drug Company
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Don't Have Flood Insurance? You May be Eligible for Federal Disaster Aid
Flood insurance is rare in Western North Carolina
(Axios, Zachery Eanes) -- Just 0.5% of homes in the Western North Carolina counties hit hardest by Hurricane Helene were covered by the National Flood Insurance Program, according to an analysis by Reuters.
- In comparison, more than 40% of homes in Dare County, on the Outer Banks, had flood insurance policies.
Why it matters: A lack of flood insurance will make it more expensive and complicated for many residents of the mountains to recover from the devastation that Helene's massive rainfalls brought.
State of play: Experts say that the FEMA's existing flood maps, which show where people are required to buy flood insurance, underestimate the risks that storms like Helene can bring.
- FEMA's maps, for instance, do not take into account intense rainfall events or sea level rise that is becoming more common due to climate change, according to N.C. State researcher Georgina Sanchez.
- Jeremy Porter, head of climate implications research at the First Street Foundation, told the Washington Post they also don't take into account flooding from smaller water sources, like creeks and streams.
- That leads to many people not on the coast or directly next to a river to be excluded in flood maps, even if the risk could be growing, Reuters said.
Of note: People who have been affected by Helene without flood insurance can apply for up to $30,000 in federal disaster aid, Reuters noted. That, however, is just a fraction of the $250,000 worth of coverage available in the federal flood insurance program.
Click here for more on Federal Disaster Aid
FEMA Activates Transitional Sheltering Assistance for Those Displaced by Helene
Sheltering Assistance Allows for Temporary Hotel Stays
FEMA has activated Transitional Sheltering Assistance (TSA) for North Carolinians displaced by Tropical Storm Helene in Alexander, Alleghany, Ashe, Avery, Buncombe, Burke, Caldwell, Catawba, Clay, Cleveland, Gaston, Haywood, Henderson, Jackson, Lincoln, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Transylvania, Watauga, Wilkes and Yancey counties and for the Eastern Band of Cherokee Indians.
Residents in these counties who have applied for disaster assistance may be eligible to stay temporarily in a hotel or motel paid for by FEMA while they work on their long-term housing plan. People do not need to request this assistance. FEMA will notify them of their eligibility through an automated phone call, text message, and/or email, depending upon the method of communication they selected at the time of application for disaster assistance.
Individuals and households may be eligible if they cannot return to their disaster-damaged home and their housing needs cannot be met by insurance, shelters or rental assistance provided by FEMA or another agency.
Under the TSA program, FEMA pays the cost of room, taxes and non-refundable pet fees directly to participating hotels and motels. Pet fees will only be paid up to the approved limit of assistance for individual rooms. Survivors are responsible for all other costs, including laundry, restaurant/room service, parking, telephone, or movie rental.
Eligible survivors may stay in participating TSA hotels in Georgia, Kentucky, North Carolina, South Carolina, Tennessee, Virginia and West Virginia. To locate participating hotels, visit femaemergencyhotels.com/ and enter your FEMA registration number, obtained when you applied for FEMA assistance.
An initial eligibility review will be conducted 60-days after the check-in date. When eligibility ends, survivors will be notified by FEMA seven days prior to checkout date.
TSA participants may also be eligible for other federal financial help, including Displacement Assistance, Rental Assistance, Home Repair Assistance and other aspects of the Individual Assistance program.
To apply for assistance, homeowners and renters can:
- Go online to DisasterAssistance.gov.
- Download the FEMA App for mobile devices
- Call the FEMA helpline at 800-621-3362. Lines are open every day and help is available in most languages. If you use a relay service, such as Video Relay Service (VRS), captioned telephone or other service, give FEMA your number for that service.
For the latest information on North Carolina’s’ recovery from Hurricane Helene visit fema.gov/disaster/4827. Follow FEMA on X at x.com/femaregion4 or on Facebook at facebook.com/fema.
To view an accessible video about how to apply visit: Three Ways to Register for FEMA Disaster Assistance - YouTube.
For North Carolinians seeking general information, please visit ncdps.gov/helene.
Cancel Your Plans if You Want to See Fall Folliage in NC
Governor Cooper Says Tourists Not Wanted in Western NC Right Now
(Asheville Citizen Times, Will Hofmann) -- As peak leaf season approaches in the mountains, N.C. Gov. Roy Cooper told the Asheville Citizen Times that tourists are not wanted in Western North Carolina in the fallout of the historic, devastating floods that have been confirmed to have taken 97 lives in the state and devastated the region's infrastructure.
Cooper said he only wants people who are dedicated to response efforts coming to the region.
"Whenever you come to Western North Carolina you get emergency notifications that we don't want you here unless you are directly helping with the response," Cooper told the Citizen Times on Oct. 3.
"So we're continuing to ask people not to come. And that's tough for an area that was about to enter its peak season for tourism economy. But I've talked with people in the Chamber of Commerce, they understand that meeting people's immediate needs, saving lives, is first," he continued.
Visit North Carolina, the state's official destination marketing organization, has continued to issue a travel advisory warning to all who intend to visit the region typically known for its strong tourism industry as the leaves turn in the fall. Currently, the message is: Do not travel to the region as cities and towns continue to battle power and water outages.
"State and local officials strongly advise all motorists avoid travel in Western North Carolina due to the continued challenges and risks from riverine flooding, landslides, slope failures, road closures and downed trees," the Visit North Carolina advisory, updated Oct. 3, read. "Power and cell phone service outages are also widespread as are shortages of water, food and gas."
Cooper said the goal is to continue to expand rescue and recovery efforts, which would be hindered and strained by the additional resources and road space required to maintain tourists.
"We want to keep those roads open for utility trucks, for rescue personnel, for medical people, for supplies, for fuel – all of this transportation that is 10 times more than you would normally need roads just to bring in basic necessities for people who don't have them now," Cooper said.
Explore Asheville and the Buncombe County Tourism Development Authority have also put out information regarding resources being provided by the industry at this time. The authority issued an update on the status of the local tourism industry.
"People have always been drawn to Asheville and the mountains of Western North Carolina. We know many people around the country care deeply and want to support our community. It’s not just about what’s happening now, but about planning for the months and years ahead," the BCTDA and Explore Asheville said in a statement to the Citizen Times on Oct. 3.
"Right now, the focus is on taking care of area residents and workers and servicing the many first responders who have answered the call from all over the country — helping those impacted and addressing the economic and emotional toll at hand," the statement said.
The city of Asheville, along with a swath of other cities and towns across WNC, are facing crises after the floods caused by Tropical Storm Helene. Water is out for most of the city, and is not expected to return for weeks. Cell service continues to be spotty, if not unreliable. Whole districts of the town, like the River Arts District — a beloved tourism district near the French Broad — remain in ruins.
Through the storm, VisitNC has been working to address visitor displacement throughout the region, fielding 7,300 calls about the topic, according to the advisory. Many regional attractions are currently closed. The entire Blue Ridge Parkway in North Carolina is closed. The Biltmore is closed. The WNC Nature Center is closed. The Omni Grove Park Inn is closed.
While the leaf season had been expected to be vibrant and bring in thousands to the region, boosting local business, this fall is likely going to hurt as businesses attempt to recover. [Source]
Loss of Life Hits Grim Milestone Following Helene
County Death Toll Update for Western NC
(USA Today, Jacob Wilt) -- The loss of life caused by Hurricane Helene passed a grim milestone Wednesday. Deaths caused by the hurricane nationwide surpassed 160 people, making Helene the second deadliest hurricane in the U.S. this century. That number was surpassed only by Katrina in 2005, which killed 1,392 people.
In North Carolina, officials say 73 people are confirmed dead thus far, with that number expected to rise as rescue crews search for missing persons. The vast majority of those deaths occurred in Buncombe County.
Here's the North Carolina death toll by county as of Thursday morning on Oct. 3. All data is provided by the North Carolina Department of Health and Human Services, unless otherwise noted.
- Yancey: Nine
- Henderson: Six
- Avery: Three
- Madison: Three
- Cleveland: Two
- Rutherford: Two
- Watauga: Two
- Burke: One
- Catawba: One
- Gaston: One
- Macon: One
- Mecklenburg: One
- Polk: One
- Yadkin: One
The NCDHHS confirmed a range of causes of death due to Helene's excessive wind and rainfall. The following are the most common causes of death:
- Unknown circumstances: 17
- Drowning: 15
- Landslide: Ten
- Wind/tree trauma: Five
- Motor vehicle drownings: Four
- Blunt force injuries: Four
- Motor vehicle crash: Three
- Other: Two
NC Justice Center Releases New Information on Tenants Rights After Natural Disaster
Refreshed information includes FEMA benefits for immigrants
Kate Woomer-Deters of the NC Justice Center has updated the information on Tenants Rights and it includes FEMA Benefits for Immigrants and Tenants in English and Spanish at this website: https://www.ncjustice.org/publications/resources-for-natural-disasters/
These materials answer such questions as:
- Can I cancel my lease or stop paying rent if I am a tenant and my home is damaged by a natural disaster?
- Is my landlord responsible for reimbursing me for personal property damaged in a disaster?
- If I am an immigrant or members of my family are immigrants, can we qualify for monetary assistance from FEMA?
- Is it safe to share my personal information with FEMA if I am an immigrant?
- What sort of benefits does FEMA provide to tenants, homeowners and those in “rent to own” contracts?
Other resources: Resources for Natural Disasters – North Carolina Justice Center (ncjustice.org)
'The Nation Has Your Back,' President Biden Makes Pledge to NC
"The nation has your back" promises President Joe Biden
Visits hard-hit North Carolina after Hurricane Helene
(USA Today, John Bacon, Beth Warre, Jorge L. Oritz) -- President Joe Biden traveled to the Carolinas on a Wednesday tour to survey devastation from Hurricane Helene as residents across much of the Southeast press on with the arduous task of rebuilding their shattered communities, homes and lives.
Biden visited Greenville, South Carolina, and later got an aerial view of the extensive damage in Asheville, North Carolina. Vice President Kamala Harris also made a trip to a highly impacted state, meeting with local officials and first responders in Augusta, Georgia.
"I'm here to say the United States – the nation – has your back,'' Biden said at an emergency command center in Raleigh alongside North Carolina Gov. Roy Cooper. "We're not leaving until you're back on your feet completely."
NCDHHS Releases Printable Resource Lists for Your Patients
NCDHHS Releases Printable Resource Lists for Your Patients
The North Carolina Department of Health and Human Services has released two printable versions of Hurricane Helene Resources for you to distribute to your patients and people in the community. Please feel free to share.
President Joe Biden to Visit Storm Ravaged North Carolina Today
Biden Landing in Raleigh to Avoid Complicating Recovery Efforts in Asheville
President Joe Biden will survey Western North Carolina today before landing at Raleigh-Durham International Airport at approximately 3:45. He will receive an Operational Briefing at the Raleigh Emergency Operations Center at 4:15 and remain in North Carolina until almost 7:00pm.
Per the New York Times, President Biden will get an aerial view of the destruction wrought by Hurricane Helene across the mountains of western North Carolina, where many residents are isolated by muddy debris and washed-out roads.
Six days after Helene made landfall on Florida’s Gulf Coast, the extent of the damage across the Southeast is still coming to light. Broken water systems, downed power lines and poor cellphone service are complicating rescue and recovery efforts.
“There’s so much, so much, that has to be done, beyond what we’re even thinking about now,” Mr. Biden said in a call this week to the mayor of Asheville, N.C. She shared a portion of the call on social media ahead of the president’s trip.
Mr. Biden plans to visit the emergency operations center in Raleigh, the state’s capital, and fly over the damaged region to avoid disrupting emergency efforts. He will also meet with emergency workers in South Carolina, and said he planned visits to other states, as well.
As of noon Wednesday, the death toll from Helene in North Carolina had risen to 90 people, a number expected to still climb.
The NCMS is coordinating volunteer efforts and taking tax deductible donations. Click here for how you can help.
NC Death Toll Rises to 90. Make a Tax Deductible Donation to Help Through NCMS
“One of the worst storms in modern history for parts of NC” – Gov. Roy Cooper
Hurricane Helene and its remnants continue to roll across the United States, leaving a wide swath of destruction and death. In the Southeast alone, at least 55 people are dead in five states, communities are leveled, power is out for millions, and many remain stranded by floodwaters. The NC Department of Transportation said Saturday in post on X that “all roads in Western NC should be considered closed.” So far, Buncombe County as received over 5,500 911 calls and conducted more than 130 swift water rescues. Officials are warning residents to stay away from water because of downed power lines and sewage contamination.
Per Cooper’s office, search and rescue operations remain underway as over 700,000 people across the state remain without power. More than 2 feet of rain fell in the state’s mountainous region from Wednesday morning to Friday morning, with Busick recording a total of 29.58 inches in just 48 hours. According to the Associated Press, floodwaters pushed by the remnants of Hurricane Helene left Asheville largely cut off Saturday by damaged roads and a lack of power and cellphone service, About 20 miles southwest of Asheville, overwhelming, torrential rainfall was pushing the Lake Lure Dam into “imminent failure,” according to the National Weather Service, but Rutherford County officials said early Saturday the dam is no longer at risk. Engineers controlled the flow rate, according to Rutherford County Emergency Management, but the town is still experiencing cell and internet service issues along with roadways blocked by trees and fallen power lines.
The North Carolina Medical Society is mobilizing efforts to help
- If you are in Western North Carolina and have been impacted by Hurricane Helene, the NC Department of Public Safety has set up a web page to answer your questions on everything from open shelters, closed roads, welfare checks for family, friends, and coworkers, and what you need to do next. Click here for the latest from NCDPS.
- FEMA and other federal agencies are closely working with governments and communities to respond to Hurricane Helene. Follow directions from local officials to stay safe, as rainfall and flooding continue through multiple states. Click here for the latest from FEMA.
- If you are interested in volunteering, the NCMS is helping facilitate volunteers to help. If you are a member who wants to help, please let us know by e-mail to Rokita Pitts at [email protected].
- Donate to the NCMS Foundation’s Disaster Relief Fund, which will provide grants to healthcare practices damaged or destroyed by Helene. This is a tax deductible donation.
As the floodwaters subside, the North Carolina Medical Society will continue to monitor our members and the healthcare community of North Carolina for additional needs and relief efforts. Please continue to check our website for more information as it becomes available.
NC Department of Public Safety Issues List of FAQs for Hurricane Helene
The North Carolina Department of Public Safety continues to update information for people across North Carolina with the latest on Hurricane Helene disaster recovery. Included is an extensive list of Frequently Asked Questions.
Here is a partial list of topics:
- I have an emergency or need rescue. What can I do?
- Call 911 for any emergencies. While some 911 centers are down in western NC, their calls are being routed to other counties in central and eastern NC.
- I have questions about food, shelter, roadways, or need other general non-emergency information. Who can I call?
- You may call 211 for any non-emergency related questions.
- I have a loved one in Western NC who I cannot contact. How can I get a welfare check?
- You can call 211 to report a missing person or to request a welfare check. Please note that 211 is not an emergency processing resource and any emergencies should be routed to 911.
- Can I get around in Western NC? What are road conditions?
- If you do not need to travel for an emergency reason, stay off the roadways. You can see the current roadway conditions by visiting DriveNC.Gov.
- I cannot stay at home and need shelter. Where can I find out what to do?
- Visit ReadyNC.Gov for sheltering information and follow your local government’s social media and website for more information.
- My home or community has damage. What is next?
- Damage assessments will be scheduled with impacted communities and counties where damage to homes, structures, and public infrastructure. This begins after any flood waters have receded and active response to life-safety hazards are completed.
- How does my local government know what to do in a disaster recovery situation?
- Meetings are promptly scheduled with local jurisdictions by state officials to outline the recovery process and to plan for debris management operations as soon as emergency response efforts are completed.
- What is damage assessment and why is it important to recovery?
- The results of the damage assessments will lead to what disaster recovery avenues are eligible as outlined in state and federal law. Each state and federal disaster program are structured so that certain thresholds have to be met to determine eligibility. Damage assessments determine if those thresholds are met and what the extent on the damages are from the disaster.
For more questions and answers click here.
Helene Latest and Resources For You and Your Patients
The Death Toll Continues to Rise, NC Has Largest Number of Deaths
(CNN) -- The death toll from Helene has risen to at least 166 people across six states, according to CNN’s tally, after four more deaths were announced in Henderson County, North Carolina.
Helene is the second-deadliest hurricane to strike the US mainland in the past 50 years, following Hurricane Katrina, which killed at least 1,833 people in 2005.
Here’s the breakdown of deaths from Helene by state:
- North Carolina: 77
- South Carolina: 36
- Georgia: 25
- Florida: 17
- Tennessee: 9
- Virginia: 2
Power Outages Continue to Hamper Communications in NC
It been five days since Helene roared through parts of the Southeast and mid-Atlantic and more than 1.3 million homes and businesses in the deadly storm’s path are still without power.
A majority of these outages are in the western Carolinas where Helene caused “unprecedented destruction,” according to the region’s power provider Duke Energy.
“Major portions of the power grid… were simply wiped away,” the utility wrote in a Monday statement.
It’s going to be a long road to recovery. About half of the power outages caused by Helene in upstate South Carolina and the mountains of North Carolina, will require “a significant repair or complete rebuild of the electricity infrastructure that powers this region,” a Duke Energy statement said Tuesday.
Hundreds of thousands of people are also still without power in Georgia and outages linger in Florida, Virginia and West Virginia.
Here’s where the outages stand as of 8 a.m.:
- South Carolina: 493,000+
- Georgia: 373,000+
- North Carolina: 347,000+
- Virginia: 44,000+
- Florida: 40,000+
- West Virginia: 10,000+
How Should You Talk to Your Children and Young Patients About What is Happening
Elizabeth Hudgins, Executive Director of the North Carolina Pediatric Society shares some helpful websites with advice for young people:
AAP Parenting Resources – Information providers can share with families
- Hurricanes & Floods: Taking Care of Your Children and Yourself
- AAP Tips on Talking to a Child after a Disaster (featuring NCMS Member Dr. David Hill)
- How to Support Your Child’s Resilience in a Time of Crisis
AAP Provider Resources
- Hurricanes: Disaster Management Resources
- Flash Floods and Flood Recovery: Disaster Management Resources
- Helping Children Cope and Adjust After a Disaster
- Disasters and Children
More from NCMS:
Hurricane Helene and How You Can Help. A Message from CEO Chip Baggett
A Message from NCMS CEO Chip Baggett
Who would have ever thought the perfect storm would hit our mountains? Western North Carolina is reeling from the aftermath of Hurricane Helene. Infrastructure is in shambles. Entire towns have been destroyed. Our physician and PA colleagues are dealing with yet another unprecedented crisis, while many are also dealing with significant damage to their own homes. NCMS has sprung into action doing what we do best; convening, coordinating, and supporting our physicians and PAs in their role as the backbone of our communities.
What is needed right away?
First, we appreciate the immediate response from those of you willing to help in the impacted areas. As NCMS physicians or PAs, you can engage in these activities through two coordinated paths with the Office of Emergency Management.
- Option 1 is working through your hospital if you are an employed physician or PA. Hospital- to-Hospital Credentialing is the most direct way for you to be deployed to an impacted facility to provide force multiplication or relief for frontline teams. The hospitals are coordinating directly on needs and assignments with the Office of Emergency Management.
- Option 2 is for North Carolina licensed physicians and PAs who would like to serve. NCMS can facilitate that process for you by emailing Rokita Pitts at [email protected] . She will respond to you with specific instructions on how to get in the queue with Emergency Management, assist you with managing expectations, and provide a point of contact if you have any questions or are not hearing back from the State.
- A final option is for out-of-state physicians and PAs who want to help but are not licensed in NC. They will first need to apply for a Limited Volunteer License through the NC Medical Board. After receiving approval from the NC Medical Board, they can then complete this document to express interest and request assignment through NC Emergency Management.
Recovery is a long road.
The level of destruction is not yet fully realized, but the NCMS Foundation has already activated its NCMS Disaster Relief Fund. This fund is dedicated to helping community practices recover and remain in place for their communities. We provided direct funding assistance during Hurricane Florence, the COVID-19 Pandemic, and other episodic disasters. We are currently setting up a process for requests that will be published soon. We are actively seeking additional funding for what expect to be significant needs across WNC. Donate today by clicking here.
Finally, NCMS is providing ongoing coordination with our County and Specialty Society partners to assure that we are all informed and coordinated in our response to this disaster. NCMS staff are taking part in daily briefings with the State Operations Center. Volunteer leaders are stepping up to engage in recruitment and fundraising.
We are strongest when we work together in organized medicine. Thank you for trusting us to work along side you through this challenge. NCMS will be with you every step of the way.
Sincerely,
Chip
If Disaster Strikes! What to do if you are Impacted by a Hurricane or Tropical Storm
Is Your Practice Ready to Face a Hurricane?
North Carolina is in the middle of Hurricane Season and the path of hurricane Helene has portions of the state facing strong winds, heavy rains, possible tornadoes, and potential flooding. A disaster can overwhelm an office practice, causing physical damage such as shattered windows, flood debris, power outages, disrupted telephone service, computer and technology system outages, unsafe drinking water, patient record destruction, medication exposure to temperature and humidity extremes, contaminated instruments and supplies, and building structure failure.
Clinicians may be forced to relocate their practices quickly―sometimes permanently―or move scheduled procedures to different facilities. For public safety, practices may be forced to close for days or even weeks. These disruptions can be catastrophic to the delivery of essential healthcare services to patients and, potentially, to the long-term financial well-being of the office and the individual providers.
If Disaster Strikes
Communication
- Stay current on emergency directives from state and local governmental disaster relief and recovery entities. Consider registering for text message, social media, and email alerts.
- Contact staff immediately to determine return-to-work time frames as permitted.
- Implement virtual staff briefings at the beginning and end of each day.
- Create temporary telephone, fax, and answering services if necessary.
- Notify external vendors and business associates about your practice interruption and targeted resumption of operation.
- Establish patient telephone triage. (Find more information in our article “Telephone Triage and Medical Advice Protocols.”)
- Establish telehealth services as capabilities permit. (For more information, see our article “Top Seven Tips for Telehealth.”)
- Implement temporary controls to ensure HIPAA compliance.
Patient records
- Determine and document the extent of damage to, or loss of, electronic and paper patient records and filing systems.
- Attempt to restore all damaged charts and relevant business records, and document inventory findings.
- Check the websites of your state licensing board and federal agencies, such as HHS and CMS, for specific guidance pertaining to lost or damaged records.
- Reconstruct lost charts at the next patient encounter and include a notation that the record is a re-creation.
- Date and initial all late entries and duplicate information in context of recovery efforts.
- Document all efforts to restore and protect existing records.
- Contact your insurance carrier for restorative services and/or claim procedures.
- Reestablish a filing system and temporary storage if necessary.
- Obtain legal guidance for patient notification during recovery efforts.
- Guidelines for maintaining HIPAA compliance. The U.S. Department of Health and Human Services (HHS) provides protected health information guidance for planning and response to emergency situations (see Emergency Situations: Preparedness, Planning, and Response). Although the HIPAA Privacy Rule is not suspended during a natural disaster or other type of emergency, the HHS Secretary may waive certain provisions of the Privacy Rule (see “Is the Privacy Rule suspended during a national or public health emergency?”). The Office of Civil Rights may also issue notifications of temporary enforcement discretion. (For example, see the HHS notifications related to HIPAA and COVID-19.)
- Copies of certificates of insurance for your professional malpractice coverage and all product lines (such as general liability, cybersecurity, and employment practices) or instructions for contacting your agents or insurers directly to obtain proof of coverage and policy terms. These documents will be necessary if you are forced to temporarily relocate your practice or convert your delivery of care to a virtual format.
Computers and systems
- Contact computer service vendors to ensure the integrity and recovery of your systems.
- Inventory and document damage to hardware and software.
- Verify insurance coverage for repair or replacement costs and losses.
- Evaluate applicable warranties and consider contracting with an information technology restoration service.
- Reestablish filing systems and internal programs.
- Ensure data backup and periodically test compliance.
Office building
- Notify the building owner and your property insurance company regarding damage.
- Review inspection reports for identified damage and the schedule for repairs, and determine what impact the findings have on practice operations.
- Take appropriate measures regarding mold growth and removal if the building has suffered water or flood damage.
- Flush hot and cold water lines for 10 minutes if the building has been vacant for a week or more.
- Create an inventory of all equipment and medications that may have been exposed to water, extremes in temperature, or other contaminants. Repair, replace, or discard damaged items appropriately.
Practice and rehearse the plan’s protocols at least twice a year with all professional, administrative, and clerical staff, and participate in a community-based drill, if available. Address any areas that need improvement. An effective disaster preparedness plan will help ensure patient and staff safety and keep your practice focused on delivering care during an emergency.
The North Carolina Department of Public Safety has prepared a NC Hurricane Guide. It has tips for you and your family in the event of imminent tropical impacts. Here is a guide for you to use at home:
NCDPS North Carolina Hurricane Guide
NCDHHS has also put together a list of resources so you can be best prepared for the Atlantic Hurricane Season:
NCDHHS Disaster Preparation and Recovery Guide
To track any tropical disturbance, the NOAA National Hurricane Center has a website to keep you up to date:
National Hurricane Center Tracking Center
Biden-Harris Administration Announces Nearly $9 Million Investment in Rural Health Care in North Carolina
9/23/24: Notice from U.S. Department of Health and Human Services, Health Resources and Services Administration
New funding will launch substance use disorder treatment services in rural communities.
Today, the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS), announced nearly $9 million to support health care services in rural North Carolina. The funding will launch new opioid treatment and recovery services in rural communities. HRSA Administrator Carole Johnson announced the awards at an event in Wilson, North Carolina.
The Biden-Harris Administration has taken numerous actions to support rural communities’ health including by investing in training physicians in rural communities, providing loan repayment to primary care providers in return for practicing in high need rural areas, and supporting health care delivery through rural community health centers.
Today, the Administration is taking another series of vital steps to strengthen health care services in rural communities, with an emphasis on key priorities like behavioral health and expanding access to services.
“The Biden-Harris Administration believes health care should be available to everyone regardless of where they live. That’s why we are investing heavily in rural communities, which have historically lacked resources and access to health services” said HHS Secretary Xavier Becerra. “The awards announced today support rural hospitals and address acute challenges related to substance use and maternal health.”
“At the Health Resources and Services Administration, we know that where you live should not determine your access to or the quality of the care that you receive,” said HRSA Administrator Carole Johnson. “And, we are taking action to deliver for rural families by supporting high-quality substance use disorder treatment and by helping rural hospitals continue to serve their communities.”
Many rural communities face challenges accessing essential health care services. Smaller populations, longer travel distances, and other barriers can make health care services difficult for rural residents to access and hard for facilities like rural hospitals to remain viable.
Today’s announcement includes the following HRSA investments:
- Launching and expanding substance use disorder treatment, recovery, and social support services in rural communities: HRSA is awarding nearly $9 million over four years to three organizations to create new or expand existing access points for treatment and recovery services, support the behavioral health workforce, and collaborate with social services to ensure coordinated care and sustainable impact in rural communities.
Name City State Fiscal Year 2024 Award Amount Total Funding (Years 1-4) Wilson County Substance Abuse Coalition Wilson NC $749,389 $2,999,536 United Way of Rutherford County, Inc. Forest City NC $750,000 $3,000,000 Integrated Care of Greater Hickory Inc. Hickory NC $750,000 $3,000,000
For more information on HRSA’s rural health grants and programs, visit https://www.hrsa.gov/rural-health.
Experts Are Keeping a Close Eye on a New Covid Variant
What to know about XEC.
(KatieCouricMedia, Rachel Uda) -- Yet another strain of Covid-19 has emerged — and experts believe it may soon become the dominant version of the virus here in the U.S. Here’s what you need to know about XEC, its potential to drive a winter wave, and how you can stock up on free coronavirus tests.
What is the XEC variant?
The summer may have belonged to the so-called FLiRT variants, but experts think that XEC is poised to take over. The subvariant is a recombinant or hybrid of two earlier forms of the virus — KS.1.1 and KP.3.3 — which both belong to the Omicron family.
XEC was first detected in June in Berlin, and has since spread throughout Germany, France, Denmark, and Netherlands, according to a data scientist who’s been tracking the variant’s spread. And although it appears to be moving quickly across Europe, the World Health Organization hasn’t yet classified it as a variant.
Where has XEC spread?
Currently, XEC has been detected in at least 25 states, according to data from global virus database GISAID. Those states are: Arizona, California, Colorado, Delaware, Florida, Hawaii, Illinois, Iowa, Maryland, Massachusetts, Michigan, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Virginia, and Washington.
But the number of domestic XEC cases is still quite low — so low it hasn’t even been added to the Centers for Disease Control and Prevention’s Covid-19 tracker. (In order for it to be included, a lineage must make up at least 1 percent of cases nationally.) Currently, the strain causing most Covid cases in the U.S. is KP.3.1.1, which some scientists have called “DeFLuQE.”
Why are experts watching XEC?
Even though it’s not widespread at the moment, scientists have been watching XEC because of its quick rise in Germany. “We often use what happens in Europe as a good indication of what might happen here,” epidemiologist Joëlla W. Adams tells USA Today.
Eric Topol, MD, director of the Scripps Research Translational Institute in La Jolla, tells the Los Angeles Times that he believes “XEC is definitely taking charge.”
“That does appear to be the next variant,” he says. “But it’s months off from getting into high levels.”
However, other experts seem skeptical, and think another strain — one more closely related to KP.3.1.1 that’s spread widely through some countries — is a more likely successor, CBS reports.
Will the vaccines be effective against XEC?
The updated vaccines released earlier this month were designed to protect against the KP.2 strain, which is part of the FLiRT family. That means the shot should be highly effective against the most common strains now — like KP.3.1.1 — but probably less so against XEC, Dr. Topol says.
He tells the Los Angeles Times that the difference between what the new shot is formulated for and XEC is “pretty substantial…and we’ll see how it plays out.”
Still, any booster will help bolster your immunity, he says. And the CDC told CBS that it anticipates the vaccines “will continue to work against all circulating variants.”
How to get free Covid tests
Whether it’s XEC or some other version of Covid, CDC modelers believe the U.S. will experience an uptick this winter, with cases peaking in mid-January. Fortunately, you should soon be able to order free Covid-19 tests. A spokesperson for the U.S. Health and Human Services agency told the Associated Press that Americans will be able to request four free nasal swab tests this month by visiting COVIDTests.gov. However, the online portal is not yet up and running and the agency did not say exactly when ordering will begin.
FDA Approves Nasal Flu Vaccine for At-Home Use
The FluMist vaccine will remain available from prescribers as an in-office treatment. (photo: AstraZeneca)
The F.D.A. authorized AstraZeneca’s treatment to be given outside a health care setting, although it will still need a prescription.
(New York Times, Christina Jewett) -- The Food and Drug Administration on Friday authorized at-home use of FluMist, opening the door for needle-shy people to have easy access to a nasal spray vaccine that is potentially lifesaving.
The approval will allow, for the first time, an alternative to the annual flu shot that parents and caregivers can give to children and that adults can use on their own outside of a health-care setting. It would still require a prescription and is expected to be available from an online pharmacy next fall.
AstraZeneca, which makes the treatment, said it would start a FluMist Home website, where people can fill out a questionnaire that will be reviewed by a pharmacist before the treatment is shipped to a person’s home. The mist will remain available from prescribers as an in-office treatment. The current out-of-pocket cost for a dose is about $35 to $45, but may be less depending on insurance coverage.
“Today’s approval of the first influenza vaccine for self- or caregiver-administration provides a new option for receiving a safe and effective seasonal influenza vaccine potentially with greater convenience, flexibility and accessibility for individuals and families,” said Dr. Peter Marks, director of the F.D.A.’s vaccine center, which authorized the at-home option.
The agency required the company to study whether its instructions were clear and whether at-home administration was feasible. The agency concluded that it was, but advised caregivers to give the spray to those who are 2 to 17 years old.
The flu takes a steep toll that varies greatly from year to year, according to an F.D.A. summary of data from the Centers for Disease Control and Prevention. From 2010 through 2023, hospitalizations have ranged from 100,000 to 700,000 each year, and from about 4,900 to 51,000 people have died.
FluMist was first approved by the F.D.A. in 2003 for people ages 5 to 49; since 2007, it has been authorized for people as young as 2 years old. The spray contains a weakened form of live flu virus that is applied inside the nose.
According to the C.D.C., the nasal spray has largely been found to be as effective as the shot, except for children in 2009, a year of particularly high levels of flu cases. Since then, the formula of the spray has changed, according to the agency, which said studies outside the United States found it to have similar efficacy to the shot.
Dr. Abraar Karan, a Stanford infectious disease doctor, said he saw a lot of flu patients in urgent care. He added that many said they had meant to get a vaccine, but found that the major challenge was basic logistics: making an appointment, missing work and building in time to feel tired or achy after receiving the vaccine.
He said the new approval would ideally go a long way toward preventing more flu cases.
“A lot of it is actually just reducing those logistical barriers,” Dr. Karan said. “And so an at-home platform, I think, will increase uptake, and that will increase uptake quickly, which is really the key before the season starts picking up.”
Lower Cape Fear LifeCare Opening First Free-standing Palliative Medical Clinic in Southeastern NC
Lower Cape Fear LifeCare Will Open Doors in Wilmington on October 1
Lower Cape Fear LifeCare is opening the first free-standing palliative medicine clinic in southeastern North Carolina. LifeCare Center for Palliative Medicine will provide expert support for people with serious illness and be located at 2250 Shipyard Blvd., Wilmington, NC in Barclay Common dining, shopping and office complex at the intersection of Independence and Shipyard Blvd. The clinic will open its doors to patients on Oct. 1, 2024, and will serve patients from local healthcare providers including Novant Health Zimmer Cancer Institute, Novant Health physician clinics as well as patients from other area physicians.
Palliative medicine is specialized medical care for people living with serious illnesses. The goal is to provide patients with relief from the symptoms and the stress of illnesses such as heart disease, COPD, cancer, renal and liver disease, dementia, Parkinson’s, and ALS. Palliative medicine can be provided together with curative treatment for a serious illness.
"As oncologists, we work hand in hand with our palliative care colleagues who provide expertise on pain and symptom management and add an extra layer of support for people living with cancer," Dr. Lindsey Buckingham, a gynecologic oncologist with Novant Health Zimmer Cancer Institute, said. "Both patients and families benefit from the involvement of both oncology and palliative care."
Palliative medicine improves quality of life for patients and their families by managing the pain, symptoms and stresses of the illness while receiving ongoing curative treatments. It also supports and improves coordination of care by working in partnership with a patient’s current doctor. It assists patients and their loved ones with discussions about goals of care and provides information and support on advance care planning. A palliative medicine team works with patients to help with physical and psychosocial needs such as pain, nausea, vomiting, breathing difficulties, fatigue, confusion, and depression.
“We’re proud and delighted to offer our community the first free-standing palliative medicine clinic in southeastern North Carolina,” Gwen Whitley, president and CEO said. “This is truly a significant step in providing life impacting care to people and families living with serious illnesses. We are thankful to be able to make this move with the support of Novant Health, who previously housed the clinic in its Zimmer Cancer Institute. Having outgrown that space and with the increasing demand for such care from other local providers for their patients, we are opening this dedicated space to serve those in our region. We look forward to providing palliative medicine in the clinic as well as appointments through telehealth, in private homes, assisted and skilled nursing facilities, and by continuing our in-patient palliative care partnerships with regional hospitals.”
Lower Cape Fear LifeCare has been providing palliative medicine to people in our region for more than three decades. It is the longest operating nonprofit hospice care provider in southeastern North Carolina and the second largest hospice provider in the state. Each year it provides more than one million dollars in care and services to people in the communities it serves.
Lower Cape Fear LifeCare is a nonprofit organization dedicated to providing access to the highest quality LifeCare, education, and supportive services to our patients, their families, and the communities we serve. For more information, visit lifecare.org.
New Report: US Spends Most, but Ranks Last in Health Compared to Other High-Income Nations
Australia Has Highest Overall Score
(CBS Health Watch, Sara Moniuszko) -- Americans, despite spending the most on healthcare, are the sickest and die the youngest compared with nine other high-income nations, according to a new report.
The report, released Thursday by independent research group The Commonwealth Fund, found the United States has the worst-performing health care system overall despite spending the most of any nation in the study.
Using data from World Health Organization and more since the onset of the pandemic in 2020, the study looked at five key health care measures, including health equity, access to care, care process, administrative efficiency and health outcomes.
Here's how the countries ranked based on overall score:
1. Australia
2. Netherlands
3. United Kingdom
4. New Zealand
5. France
6. Sweden
7. Canada
8. Switzerland
9. Germany
10. United States
"Differences in overall performance between most countries are relatively small, but the only clear outlier is the U.S., where health system performance is dramatically lower," the report states.
In addition to ranking last overall, the U.S. also ranked lowest for specific health measures including access to care to health outcomes. Australia and the Netherlands, the two countries with the highest overall rankings, also have the lowest health care spending while the U.S. spends the most among the group.
"When it comes to life expectancy and avoidable deaths, the U.S. comes in last," the report's news release noted.
But, all countries have strengths and weaknesses despite their overall rankings.
"No country is at the top or bottom on all areas of performance. Even the top-ranked country — Australia — does less well, for example, on measures of access to care and care process. And even the U.S., with the lowest-ranked health system, ranks second in the care process domain," the report states.
US Overdose Deaths Plummet, UNC Dr. Analyzes Data
NPR: Data Shows Overdose Deaths Nationwide are Falling for First Time in Decades
(NPR, Brian Mann) -- For the first time in decades, public health data shows a sudden and hopeful drop in drug overdose deaths across the U.S.
"This is exciting," said Dr. Nora Volkow, head of the National Institute On Drug Abuse [NIDA], the federal laboratory charged with studying addiction. "This looks real. This looks very, very real."
National surveys compiled by the Centers for Disease Control and Prevention already show an unprecedented decline in drug deaths of roughly 10.6 percent. That's a huge reversal from recent years when fatal overdoses regularly increased by double-digit percentages.
Some researchers believe the data will show an even larger decline in drug deaths when federal surveys are updated to reflect improvements being seen at the state level, especially in the eastern U.S.
"In the states that have the most rapid data collection systems, we’re seeing declines of twenty percent, thirty percent," said Dr. Nabarun Dasgupta, an expert on street drugs at the University of North Carolina.
According to Dasgupta's analysis, which has sparked discussion among addiction and drug policy experts, the drop in state-level mortality numbers corresponds with similar steep declines in emergency room visits linked to overdoses.
Dasgupta was one of the first researchers to detect the trend. He believes the national decline in street drug deaths is now at least 15 percent and could mean as many as 20,000 fewer fatalities per year.
"Today, I have so much hope"
After years of wrenching drug deaths that seemed all but unstoppable, some researchers, front-line addiction workers, members of law enforcement, and people using street drugs voiced caution about the apparent trend.
Roughly 100,000 deaths are still occurring per year. Street drug cocktails including fentanyl, methamphetamines, xylazine and other synthetic chemicals are more poisonous than ever.
"I think we have to be careful when we get optimistic and see a slight drop in overdose deaths," said Dan Salter, who heads a federal drug interdiction program in the Atlanta-Carolinas region. "The last thing we want to do is spike the ball."
But most public health experts and some people living with addiction told NPR they believe catastrophic increases in drug deaths, which began in 2019, have ended, at least for now. Many said a widespread, meaningful shift appears underway.
"Some of us have learned to deal with the overdoses a lot better," said Kevin Donaldson, who uses fentanyl and xylazine on the street in Burlington, Vermont.
According to Donaldson, many people using fentanyl now carry naloxone, a medication that reverses most opioid overdoses. He said his friends also use street drugs with others nearby, ready to offer aid and support when overdoses occur.
He believes these changes - a response to the increasingly toxic street drug supply - mean more people like himself are surviving.
Gupta called for more funding for addiction treatment and healthcare services, especially in Black and Native American communities where overdose deaths remain catastrophically high.
"There is no way we're going to beat this epidemic by not focusing on communities that are often marginalized, underserved and communities of color," Gupta said.
But even some researchers who support wider public health and harm reduction programs said it's unlikely those efforts alone are causing such a sudden decline in drug deaths.
"We don't have anything that would predict this magnitude of effect this quickly," said Dasgupta, the researcher at North Carolina University, who described the reversal as hopeful and also mysterious.
Addiction experts pointed to a number of possible factors, other than public health strategies, that could be contributing to the drop in fatal overdoses, including the changing make-up of the street drug supply.
Fentanyl may be harder to find and less pure in some areas because of law enforcement efforts targeting Mexican drug cartels.
The chemical xylazine is also being mixed with fentanyl by drug gangs. While toxic in humans, causing lesions and other serious long-term health problems, xylazine may delay the onset of withdrawal symptoms in some users. Dasgupta said it's possible that means people are taking fewer potentially lethal doses of fentanyl per day.
Other experts pointed to the end of the COVID pandemic, combined with the high number of people who have already died from drug overdoses, as possible causes of the abrupt change.
Dr. Daniel Ciccarone, a physician and addiction researcher at the University of California San Francisco, said a debate is already underway over what triggered the improvement and what might happen next.
"This is where we're all going to differ. Everyone is going to come out and claim that what they did is what caused the decline," he said.
But Ciccarone agreed that for now, the improvements appear real: "What makes it fascinating is the speed at which it's happening."
"Overdose deaths in Ohio are down 31 percent"
Indeed, in many states in the eastern and central U.S. where improvements are largest, the sudden drop in drug deaths stunned some observers who lived through the darkest days of the fentanyl overdose crisis.
"This year overdose deaths [in Ohio] are down 31 percent," said Dennis Couchon, a harm reduction activist. "The deaths were just plummeting. The data has never moved like this."
"While the mortality data for 2024 is incomplete and subject to change, Ohio is now in the ninth consecutive month of a historic and unexpected drop in overdose deaths," said the organization Harm Reduction Ohio in a statement.
Missouri is seeing a similar trend that appears to be accelerating. After dropping by 10 percent last year, preliminary data shows drug deaths in the state have now fallen roughly 34 percent in the second quarter of 2024.
"It absolutely seems things are going in the right direction, and it's something we should feel pleased about," said Dr. Rachel Winograd, director of addiction science at the University of Missouri St. Louis, who also noted that drug deaths remain too high.
"It feels wonderful and great," said Dr. Mark Levine, head of the Vermont Health Department. "We need encouraging data like this and it will help sustain all of us who are actively involved in trying to have an impact here."
Levine, too, said there's still "plenty of work left to do."
Some survivors of the overdose crisis said while the situation on the streets remains grim for many people, they believe the public health response is keeping more people alive.
Eric Breeyear, who lives in a recovery shelter called Good Samaritan Haven in Barre, Vermont, said he was given naloxone repeatedly after experiencing fentanyl overdoses.
In recovery for roughly a year, Breeyear takes a prescription medication called suboxone to reduce opioid-fentanyl cravings.
He told NPR there is "probably a 100 percent chance" he would have died without the medical help that is now far more widely available.
"I'm happy people's lives are being saved, but on every street I see somebody in the middle of an overdose that could potentially be fatal," Breeyear said.
He said being revived after repeated overdoses isn't enough. He wants more done to help people in severe addiction heal and enter recovery, as he has done.
Dasgupta, the researcher at the University of North Carolina, agreed more needs to be done to help people in addiction recover when they're ready.
But he said keeping more people alive is a crucial first step that seemed impossible only a year ago.
"A fifteen or twenty percent [drop in deaths] is a really big number, an enormous impact," he said, calling for more research to determine how to keep the trend going.
"If interventions are what's driving this decline, then let's double down on those interventions."
ADDITIONAL READING
Questions About Opioid Settlement
CDC Guidelines for Prescribing Opioids
Researchers Discover New Blood Group System - MAL
The discovery of a new blood group, MAL, has solved a 50- year-old mystery. Researchers from NHS Blood and Transplant (Bristol), NHSBT’s International Blood Group Reference Laboratory (IBGRL) and the University of Bristol identified the genetic background of the previously known but mysterious AnWj blood group antigen. The findings allow identification and treatment of rare patients lacking this blood group.
Blood is complex and matching across groups can be lifesaving.
(University of Bristol, 9/16/24) -- Some people can lack this blood group due to the effect of illness, but the rare inherited form of the AnWj-negative phenotype has only been found in a handful of individuals – though due to this discovery it will now be easier to find others in the future.
The two best known blood group systems are ABO and Rh but blood is more complex and matching across the other groups can be lifesaving.
If people who are AnWj-negative receive AnWj-positive blood they could have a transfusion reaction, and this research allows development of new genotyping tests for detecting such rare individuals and reducing the risk of transfusion-associated complications.
The AnWj antigen – an antigen is a surface marker - was discovered in 1972 but its genetic background was unknown until now.(3) The new research, to be published by Blood, the journal of the American Society of Hematology, and now available online in pre-print, establishes a new blood group system (MAL), the 47th ever to be discovered, as home to the AnWj antigen.
The research team established that AnWj is carried on the Mal protein. More than 99.9% of people are AnWj-positive, and such individuals were shown to express full-length Mal protein on their red cells, which was not present on the cells of AnWj-negative individuals. The team identified homozygous deletions in the MAL gene associated with the inherited AnWj-negative phenotype.
The most common reason for being AnWj-negative is due to suffering from a hematological disorder or some types of cancer which suppress antigen expression (4). Only a very small number of people are AnWj-negative due to a genetic cause. There were five genetically AnWj negative individuals in the study including a family of Arab-Israelis.(5) The blood tested included a sample given by a lady in 2015 who was the first AnWj negative person to be discovered in the 1970s.
The research team used whole exome sequencing – the genetic sequencing of all DNA that encodes proteins – to show that these rare inherited cases were caused by homozygous DNA sequence deletions in the MAL gene, which codes for Mal protein.
Proof that Mal is responsible for binding of AnWj antibodies isolated from these rare patients was provided by experiments showing the appearance of specific reactivity with cells in which researchers introduced the normal MAL gene but not the mutant gene.
Louise Tilley, Senior Research Scientist, IBGRL Red Cell Reference at NHS Blood and Transplant, said: “The genetic background of AnWj has been a mystery for more than 50 years, and one which I personally have been trying to resolve for almost 20 years of my career. It represents a huge achievement, and the culmination of a long team effort, to finally establish this new blood group system and be able to offer the best care to rare, but important, patients.
“The work was difficult because the genetic cases are very rare. We would not have achieved this without exome sequencing, as the gene we identified wasn’t an obvious candidate and little is known about Mal protein in red cells. Proving our findings was challenging, and we appreciate the help of all our collaborators, and the patients, without whom we would not have got to this point.”
Ash Toye, Professor of Cell Biology in the School of Biochemistry and Director of the NIHR Blood and Transplant Research Unit in red cell products at the University of Bristol, said: “It’s really exciting we were able use our ability to manipulate gene expression in the developing blood cells to help confirm the identity of the AnWj blood group, which has been an outstanding puzzle for half a century. This development will help identify these rare donors and help patients in the future.”
Nicole Thornton, Head of IBGRL Red Cell Reference at NHS Blood and Transplant, said: “Resolving the genetic basis for AnWj has been one of our most challenging projects.
“There is so much work that goes into proving that a gene does actually encode a blood group antigen, but it is what we are passionate about, making these discoveries for the benefit of rare patients around the world.
“Now genotyping tests can be designed to identify genetically AnWj-negative patients and donors. Such tests can be added to the existing genotyping platforms.”
Dr Tim Satchwell, Senior Lecturer at UWE Bristol, who contributed to the study whilst a Research Fellow at the University of Bristol, said: “Mal is a very small protein with some interesting properties which made it difficult to identify and meant we needed to pursue multiple lines of investigation to accumulate the proof we needed to establish this blood group system. Being able to combine our expertise to finally achieve this has brought the whole team a lot of satisfaction.”
Paper
'Deletions in the MAL gene result in loss of Mal protein, defining the rare inherited AnWj-negative blood group phenotype' by Louise A TilleyAshley Mark ToyeTimothy J SatchwellNicole M Thornton et al. in Blood
Further information
- Donate blood and find out your ABO and rhesus blood types via www.blood.co.uk
- The research was led by NHS Blood and Transplant led the work, through its International Blood Group Reference Laboratory in Bristol. Research partners included the School of Biochemistry at the University of Bristol, the Apheresis Institute at Rabin Medical Centre in Israel, Magen David Adom National Blood Services in Israel, the NIHR Blood and Transplant Research Unit in Genomics to Enhance Microbiology Screening, the Clinical Biotechnology Centre at NHS Blood and Transplant, and the National Institute for Health Research (NIHR) Blood and Transplant Research Unit in Red Blood Cell Products.
- Blood groups are complex. The two best known blood group systems are ABO and Rh. Within each blood group, red cells can carry surface markers called antigens. For example, within the ABO blood group system, there are the A and B antigens – people with A have the A antigen, people with B have the B antigen, people with AB blood have both and people with O have neither. There are now 47 recognised blood group systems together containing more than 360 recognized blood antigens.
- AnWj is named after the first people who made the antibody (Anton and Wj).
- The disorders suppress Mal and make patients AnWj-negative, unless they have the rare inherited form (MAL deletion). The inherited AnWj-negative people are healthy.
- The first family discovered with the inherited form are Arab-Israeli and there are other cases from this region. However the ethnicity of all cases is not known and it is not yet known if the blood type is more common in any ethnicity.
Lawmakers, Including NCMS Member Greg Murphy, Introduce Radiologist-Supported Bill to Punish Payers Who Fail to Pony up Under NSA
Lawmakers on Friday introduced a radiologist-supported bill to punish payers that fail to pony up in surprise-billing disputes.
(Radiology Business, Marty Stempniak) -- NCMS member Rep. Greg Murphy, MD, R-N.C., unveiled the No Surprises Enforcement Act on Sept. 13, joined by Reps. Raul Ruiz, MD, D-Calif., and John Joyce, MD, R-Penn. The bill would close “enforcement gaps” under the landmark legislation, increasing penalties for health insurers that refuse to issue payment after losing disputes over out-of-network care.
Murphy and colleague’s legislation comes after Medicare recently released data, showing the agency had received over 16,000 complaints under the NSA. Top complaints against health plan issuers included issuing late reimbursement after disputes were resolved and failure to conform with requirements to issue reimbursements (or a notice of denial) within 30 days.
"The bipartisan No Surprises Act was a significant step forward in our efforts to end surprise medical bills. However, we now need to ensure the proper implementation of the legislation," co-sponsor and Rep. Jimmy Panetta, D-Calif. Said in a statement shared Sept. 13. “I’m proud to introduce a bipartisan bill that would increase penalties for entities that fail to protect the health and financial well-being of patients. Our bill would give the No Surprises Act the necessary strength to shield working families from unexpected medical expenses by actually enforcing the law."
In addition, the No Surprises Enforcement Act also would increase transparency in reporting requirements and provide “parity between penalties imposed against parties noncompliant with statutory patient protection provisions,” Panetta and colleagues noted. The legislation is supported by the American College of Radiology, American College of Emergency Physicians and the American Society of Anesthesiologists. The three medical societies have banded together in recent years to advocate on policy related to surprise billing.
ACR et al. noted Friday that House Resolution 9572 would impose a penalty three times the difference between the insurer’s initial payment and the independent dispute-resolution entity’s ruling per claim. The amount also be subject to compounding interest.
“There is a real need for accountability after disputes are resolved under the No Surprises Act, because right now insurance companies are often just not paying,” Alan Matsumoto, MD, chair of the American College of Radiology Board of Chancellors, said in a statement. “This situation may leave clinicians in financial peril, which in turn threatens the access to care for patients that the No Surprises Act was supposed to protect. The ACR supports this legislation and its sponsors’ continued work to protect the principles of the No Surprises Act.”
“With this bill, big insurance companies that have been gaming the No Surprises Act system will be held accountable,” American Society of Anesthesiologists President Ronald L. Harter, MD, said in the same statement. “Insurers are required to make a payment after they lose in the IDR process within 30 days, which they have failed to do in many cases. This jeopardizes the sustainability of anesthesia practices, particularly small and medium sized community-based practices, and threatens the public’s access to healthcare.”
Additional Reading
Greg Murphy Updates on Personal Health Scare.
NCMS Candidate Series Dr. Greg Murphy
Greg Murphy Shows Support for Project VBOT
Click Here for a guide to the 2024 Ballot
A Guide to Your 2024 Ballot
(Axios, Lucille Sherman and Alex Sands) -- Election Day is less than two months away, but voting is expected to start in just a few weeks. From school board races to the presidential race, you'll have quite a few decisions to make on this year's ballot.
Why it matters: Your vote always matters. But this year, North Carolina voters may decide the race for president. Voters could also help decide which party controls Congress and whether Republicans hold their supermajority in the state legislature.
To see what will be on your specific ballot:
Head to the state's voter registration lookup, search your name, and scroll until you see a heading titled "YOUR SAMPLE BALLOT." Click the link under "Your Sample Ballot(s)."
Key dates
Sept. 20: Military and oversees absentee ballots go out to people who've requested them, according to the state elections board.
Sept. 24: All other absentee ballots begin being mailed.
Oct. 11: Last day to register to vote. Do so by 5pm, unless you plan to take advantage of same-day registration during the early voting period.
Check that you're registered to vote and your information is up to date here.
Oct. 17: In-person early voting begins. Find early voting sites.
Oct. 29: Last day to request your absentee ballot. Do so by 5pm.
Nov. 2: In-person early voting ends at 3pm.
Nov. 5: Election Day. Polls are open 6:30am-7:30pm.
Don't forget your driver's license or another acceptable photo ID from this list.
Absentee ballots must be returned by 7:30pm. Here's everything you need to know about voting by mail.
Of note: Absentee ballots were scheduled to go out on Sept. 6 but that date was pushed back after the state Supreme Court ordered county elections boards to reprint ballots without former presidential candidate Robert F. Kennedy Jr.'s name on them.
Important Races Across the State
While the presidential contest takes most of the attention this fall, there are many critical races down the ballot.
Here are some of the biggest state and local contests:
Statewide races
Governor: Mark Robinson (Republican) is running against Josh Stein (Democrat) to replace term-limited Democratic Gov. Roy Cooper in one of the most expensive and competitive governor's races in the country, one that will determine which party has veto power.
- Robinson is backed by Trump and has been vocal about ensuring parents' right to have a say in what their children are taught. As the state's attorney general, Stein helped win a $26 billion opioid settlement, the second-largest state attorney general settlement in history.
Attorney general: Dan Bishop (Republican) is running against Jeff Jackson (Democrat) to be the state's top law enforcement officer, which is often a pipeline to the governor's mansion.
Superintendent of public instruction: Maurice (Mo) Green (Democrat) vs. Michele Morrow (Republican).
- The state superintendent is the "face" and head of the Department of Public Instruction, managing a $11 billion public school budget annually.
- Morrow, who upset incumbent Republican Superintendent Catherine Truitt in the primary, has captured national attention for her contentious past statements, such as calling public schools "indoctrination centers." She also attended the Jan. 6, 2021, attack on the U.S. Capitol and homeschooled her children.
- Green was formerly the executive director of the Z. Smith Reynolds Foundation, superintendent of Guilford County Schools and general counsel for the Charlotte-Mecklenburg Board of Education.
N.C. Supreme Court associate justice, seat 6: Jefferson Griffin (Republican) vs. Allison Riggs (Democrat, incumbent).
- Republicans seized a 5-2 majority on the court in the 2022 election, and the winner of this seat will determine if Democrats continue to hold two seats.
7 NCMS Members will be on the 2024 General Election Ballot
North Carolina has six physicians and one physician assistant contending for legislative seats in the 2024 General Election.
NC House of Representatives
Grant Campbell, MD – Ob/Gyn / Concord, NC
Ralph Carter, MD – Orthopaedic Surgery / Laurinburg, NC
Timothy Reeder, MD – (incumbent)Emergency Medicine / Greenville, NC
NC Senate
David Hill, MD – Pediatrics / Wilmington, NC
Mark Hollo, PA – Retired / Conover, NC
US House of Representatives
Steve Feldman, MD – Dermatologist / Winston-Salem, NC
Greg Murphy, MD – (incumbent) Urologist / Greenville, NC
Interviews with each candidate are posted online at the NCMS website and can be accessed at the QR code below.
NC Legislature Approves Medicaid Money -- But Not What DHHS Says is Needed. Follows Letter to NCGA Leaders from Chip Baggett
(Senate leader Phil Berger (R-Eden) said the General Assembly’s nonpartisan staff came up with the dollar amount that the Senate approved for the Medicaid rebase. Credit: Grace Vitaglione)
The state health department asked for $458 million to keep up with rising Medicaid costs
Approval comes one week after NCMS CEO Chip Baggett sent letter to NCGA Leadership to Support Increase
(NC HealthNews, Grace Vitaglione) -- The state legislature approved funding Wednesday to meet higher costs for NC Medicaid in the current fiscal year. But their number came in below what state health officials had been asking for — by about $81 million.
The state Department of Health and Human Services had asked for almost half a billion dollars to meet all of next year’s obligations for the program, which serves low-income children, some of their parents and low-income seniors.
But the General Assembly — which voted this week to approve their version of a “mini” budget document — only approved $277 million in recurring funds and an additional $100 million in one-time money to cover the requested $458 million.
The bill could be vetoed by Gov. Roy Cooper, but the legislature would be likely to override that veto.
(No state dollars are used to cover people who receive care as a result of Medicaid expansion. Money for that comes from different sources.)
House Speaker Tim Moore (R-Kings Mountain) said if there is a shortfall, it likely wouldn’t happen until 2025, when the legislature would be back in session and could take action to add in extra dollars.
Small changes, big dollars
The federal government pays most of North Carolina’s Medicaid expenditure, providing 65.91 cents of every dollar spent this fiscal year. Next year, that matching fund rate ticks downward to 65.06 cents for every dollar. In a program as large as Medicaid, even that small a change can make a multimillion-dollar difference.
Part of the money DHHS asked state lawmakers for is needed because the state will receive $136 million fewer federal dollars.
According to DHHS, the remainder of the requested $458 million is largely due to health care cost inflation.
NC Medicaid costs fluctuate each year, and DHHS forecasts how costs might change. They then ask the legislature for funding adjustments based on those predictions — known as the “rebase.”
Managed care plan rates, provider rates and technology upgrades are some of what drive Medicaid program costs, according to DHHS.
Now, the department is evaluating how to manage the Medicaid program with that $81 million shortfall and no additional funding for the costs associated with the Medicaid program’s switch from being state-run to being managed by large insurance companies.
Some other new costs include planning for a new Children and Families Specialty Plan, which will serve more than 30,000 current and former foster children and some of their family members.
On top of that, the department has a contract with an enrollment brokerage company that helps members to enroll in managed care plans. The department also manages multiple critical technology and operations contracts, which ease the administrative burdens on county partners, a department spokesperson wrote in an email.
Another impact could be to the NC Healthy Opportunities pilots, in which people on Medicaid can receive food, transportation or housing services, Melanie Bush, deputy director of the state’s Medicaid program, told NC Health News this summer. Plans for taking that program statewide may have to go on a back burner, she said.
Hashing out the budget
In North Carolina, lawmakers make a two-year budget in odd-numbered years right after an election. Then usually they come back in the second year of the legislative biennium to do budget adjustments and add money for desired projects.
But lawmakers left Raleigh earlier in the summer without making that second-year budget adjustment. Since no money was approved then, the gap was larger. Medicaid funds could have started running dry in the spring, Rep. Donny Lambeth (R-Winston-Salem) said at the time.
Senate leader Phil Berger (R-Eden) said the General Assembly’s nonpartisan fiscal research division came up with the dollar amount that the legislature approved for Medicaid.
“It’s not unusual for there to be some disagreement between the agency and other folks, but this is something that we’ve relied on our nonpartisan staff to give us a number, and that’s the number that’s in there,” he said.
If the money approved this week survives a possible gubernatorial veto, Medicaid won’t be totally underwater, even if the amount is too little. A DHHS spokesperson said the department plans to work “collaboratively and transparently” with partners to manage the shortfall.
Why does NC Medicaid need more money?
People enrolling in the program, costly drugs such as Wegovy, increased payments to managed care companies and increased services are some other factors in the rebase requirement, Bush said.
Money is also needed to update the information technology support for Medicaid and associated public benefits, a DHHS spokesperson said.
Senator Lisa Grafstein (D-Raleigh) said on the Senate floor Monday that changes in the Medicaid system can disrupt continuity of care for people in the program.
“People who rely on Medicaid can’t just dip into their savings,” she said.
Grafstein also complained that this mini-budget does nothing for the almost 18,000 people on a waitlist for an Innovations waiver, which allows people with intellectual and developmental disabilities to receive Medicaid services that help them live at home. Some of those folks have been waiting for over a decade to get a slot in the program.
Last year the legislature added funding for only 350 more slots for the Innovations waiver.
ADDITONAL READING FROM NCMS:
NCMS CEO Chip Baggett Asks NCGA Leadership to Support Increase in Medicaid Reimbursement
Will Physicians See Medicaid Rates Go Up in New NC Budget?
NCMS CEO Chip Baggett Asks NCGA Leadership to Support Increase in Medicaid Reimbursement
NCMS Continues it's efforts to increase Medicaid rebase
(RALEIGH) -- North Carolina Medical Society CEO Chip Baggett has issued a letter to the Leadership of the North Carolina General Assembly to support legislation to increase the Medicaid rebase in the state. In the letter, Baggett asks for an increase of roughly $458 million.
North Carolina Medicaid could face an 8 percent fiscal cut in the biennium, and if funding is delayed beyond November, the reduction could be as much as 16 percent. Baggett says "this lack of funding would be devastating for North Carolina patients who rely on Medicaid and cannot afford to pay for care out-of-pocket." He adds that it would also "exacerbate the lack of providers and further decrease access to imperative healthcare."
Physicians in North Carolina have not received an increase in the rate of reimbursement for Medicaid in over 10 years. In his letter, Baggett points out how crucial adequate reimbursement is to expanding services to underserved populations. He also explains how a lack of an increase is adding to physician burnout. "An increased Medicaid rate would help alleviate some of these pressures (for providers), allowing physicians to focus more on patient care," Baggett says.
The letter was sent to NC House Speaker Tim Moore and NC Senate Pro Tempore Phil Berger on August 29. To read the letter click here.
Additional reading:
NCMS Supports Inflationary Adjustment for Medicare Reimbursement
NCMS Project VBOT Celebrates Growing Impact in Rural Areas, Gains Treatment Partners, Gathers Support from NC Lawmakers Tillis and Murphy
Sen. Thom Tillis, Congressman Greg Murphy show support for Project VBOT
Triad Behavioral Resources, The Recovery Platform, iPill, OpiAID, Select Lab Partners, and Nexalin all join as VBOT Treatment Partners
The North Carolina Medical Society developed Project VBOT was showcased Wednesday at a meeting that brought together leaders from the world of technology, healthcare, law enforcement, and NC government. NCMS Vice President of Solutions Franklin Walker was on hand to talk about how the Virtual-Based Opioid Treatment (VBOT) program can help communities fight the opioid crisis.
It was a chance to also introduce the VBOT Treatment Partners
Project VBOT is supported by US Senator Thom Tillis and NCMS member Congressman Greg Murphy. Of the roundtable discussion, Congressman Murphy said:
"I'm grateful to have had the opportunity to discuss the devastating impact of the opioid crisis and strategies to protect our communities here in Eastern North Carolina," said Congressman Greg Murphy, M.D. "In 2023, 112,000 fatal overdoses occurred in America, and fueling this crisis is the flow of synthetic opioids into our country. These powerful and dangerous drugs are coming from China and flowing into our country through our southern border. We must make sure there are resources available to help those with addiction, and we cripple the ability of illicit drug manufacturers and cartels from bringing it into our country. I appreciate the leadership of Carteret Health Care in tackling this issue and providing a blueprint for other health care providers to replicate."
"Our coalition, Breaking Barriers, is committed to helping those struggling with opioid use disorder overcome addiction by providing a transformational approach to treatment – a virtual-based treatment model," said Pete Gratale, Chairman of Breaking Barriers and CEO of The Recovery Platform. "We are so thankful for our partners across North Carolina who have helped bring this life-saving treatment model to struggling families, and we look to expand these efforts and initiatives like the Carteret County PORT Program and their amazing results. We continue to be especially grateful to Dr. Murphy, who has worked tirelessly especially for those in America’s veterans community, for his commitment to ensuring access to treatment."
"North Carolina’s veterans, many of whom live in rural communities across our state, simply struggle to access care," said Franklin Walker, VP of the North Carolina Medical Society Foundation. "New virtual treatment options are now available in these communities, following successful pilots conducted with the North Carolina Medical Society Foundation. Dr. Murphy, a long-time member of the North Carolina Medical Society, leads on the VA Committee to help drive new treatment options and expand treatment access for our veterans – his leadership is absolutely fundamental to ensuring America’s heroes receive the care they deserve."
"Keeping Carteret County families safe starts with helping those struggling with addiction," said Sheriff Asa Buck, Carteret County. "We are excited to utilize virtual treatment models offered through Project VBOT as a tool to help support those in the criminal justice system return to their communities, on a pathway to recovery – a truly transformational approach."
The event was also covered by WCTI news. Click on the image below to see.
Here is a list of the participants:
Walker has been working on Project VBOT and other programs from the NCMS for years and says "The North Carolina Medical Society takes its commitment to the health of North Carolinians very seriously. This is an additional way we continue our work across the state."
To read more about Project VBOT click here.
FDA Approves First Automated Insulin Delivery System for People with Type 2 Diabetes
The expanded use is for those 18 and older with Type 2 diabetes
(UPI Health News, Allen Cone) -- The Food and Drug Administration on Monday approved Insulet's Omnipod 5 automated insulin delivery system for people with Type 2 diabetes.
In 2022, the FDA signed off on the system for Type 1 diabetes for those 2 years and older.
The Food and Drug Administration on Monday approved Insulet's Omnipod 5 automated insulin delivery system for people with Type 2 diabetes.
In 2022, the FDA signed off on the system for Type 1 diabetes for those 2 years and older.
"The FDA has long worked with the diabetes community to ensure access to additional options and flexibilities for diabetes management," Dr. Michelle Tarver, the acting director of the FDA's Center for Devices and Radiological Health. "The FDA is committed to advancing new device innovation that can improve the health and quality of life for people living with chronic diseases that require day-to-day maintenance like diabetes."
Insulet, a public company, applauded the approval.
"Today's announcement represents a significant milestone in providing easy-to-use, patient-centric technology for the treatment of Type 2 diabetes," Insulet Chief Executive Jim Hollingshead said in a news release.
In 2000, Intuit founder John Brooks III, a father whose son, Rob, was diagnosed with Type 1 diabetes at age 3, developed a small pump device worn directly on the body rather than using tubing.
FDA first cleared an Omnipod Insulin Management System in 2003, which didn't include a continuous monitoring system.
With the new system, a wearable, tubeless product provides up to three days of nonstop insulin delivery without the need to handle a needle. The Omnipod 5 integrates with a continuous glucose monitor to manage blood sugar with no multiple daily injections, zero fingersticks and can be controlled by a compatible smartphone or by a controller.
Insulin options for people with Type 2 diabetes were limited to methods such as injection with a syringe, an insulin pen or an insulin pump. These require patients to self-administer insulin one or more times a day and check blood glucose frequently to achieve the best results.
"Today's clearance provides a new option that can automate many of these manual tasks, potentially reducing the burden of living with this chronic disease," the FDA said in the news release.
The FDA reviewed data from a clinical study of 289 individuals 18 years and older with Type 2 diabetes for 13 weeks. The study include a range of racial and ethnic backgrounds, ages, education and income levels.
The study showed that volunteers' blood sugar control improved compared with before the study, and these improvements were seen across all demographic groups. In addition, there were no complications or serious adverse events related to the use of the SmartAdjust technology.
Adverse events were generally mild to moderate, and included hyperglycemia, or high blood sugar; hypoglycemia, or low blood sugar, and skin irritation.
In the United States, 11.6% of Americans, about 38.4 million people, are diagnosed with diabetes, according to the Centers for Disease Control and Prevention. It is a condition in which the body does not make enough or properly use the blood glucose-regulating hormone insulin.
An estimated 97.6 million adults aged 18 years or older had prediabetes in 2021. About 90% top 95% are Type 2, according to the CDC.
In Type 1, the pancreas does not make insulin, because the body's immune system attacks the islet cells in the pancreas. In Type 2, the pancreas makes less insulin than used to, and your body becomes resistant to insulin.
People with Type 2 diabetes may take medications orally or through injection that can help increase insulin secretion or improve insulin sensitivity. A healthy eating plan and physical activity are also needed.
Keeping the numbers in check reduce the need for insulin.
In March, the FDA approved the first over-the-counter continuous glucose monitor. The Dexcom Stelo Glucose Biosensor System is intended for anyone 18 years and older who does not use insulin or those without diabetes who want to better understand how diet and exercise may impact blood sugar levels.
The sensor, which is not on the market yet, is paired with a smartphone or smart device for up to 15 days.
NC Ag Commissioner Responds to Bird Flu in NC
"I wish I had paid a lot more attention in genetics when I was in college," said Agriculture Commissioner Steve Troxler
(State Affairs Pro, Clifton Dowell) -- The threat of a deadly new pandemic jumping from animals to humans is scary, but agriculture officials on Tuesday agreed that until a vaccine is developed to protect cows from bird flu, the best defense is simply to keep the number of infections as low as possible.
“I wish I had paid a lot more attention in genetics when I was in college,” Agriculture Commissioner Steve Troxler said. “But in my mind it’s a numbers game. The more virus that’s out there, the more likely it is to be mutating and spread to other species.”
The virus under discussion by a panel of experts convened by the North Carolina Department of Agriculture and Consumer Services was highly pathogenic avian influenza (HPAI), also referred to by its strain name of H5N1. It was detected in North Carolina in April after infected cows from Texas were added to a dairy herd here. The herd was quarantined and declared virus-free a month later.
Testing by the National Veterinary Services Laboratory has detected 192 infected herds in 13 states, said Dr. Eric Deeble, deputy under secretary for marketing and regulatory programs at the U.S. Department of Agriculture. Before detecting a new infected herd in Michigan yesterday, he said, the lab had gone two months without a detection. “I know at some point there will be another state,” he said.
U.S. Food and Drug Administration Commissioner Dr. Robert Califf said H5N1 for 20 years has been the No. 1 virus of concern for global pandemics. Historically around the world, when the virus has reached humans the death rate has exceeded 50%, he said. “When we got the message from USDA that there had been this infection of cows in Texas and then that spread, it just set off alarms all across the federal government because it’s been a big concern all along.”
Viruses are tricky, Califf said, because of their constant mutations. Farmworkers in the U.S. who have gotten the virus aren’t becoming seriously ill because the current version attaches to tissue around the eye, causing conjunctivitis. “If it mutates to attach to the lining of the lung like COVID did, we’re going to have a big problem,” he said.
Potential illnesses among humans may be the most worrisome threat, but it isn’t the only threat that H5N1 poses. The panel discussed the importance of protecting the nation’s food supply as well as safeguarding the economics of farming in the state.
“What we know is that high path AI is not going away and we are particularly vulnerable because of the size of our poultry industry,” Troxler said. In addition to the potential loss of valuable livestock, farming revenue is also endangered when the public changes its buying habits based on news reports of disease.
Califf said one of the first FDA studies was to make sure milk and cheese were virus-free. “Pasteurization works,” he said.
Deeble said the USDA has programs to offset the costs that dairy farmers incur for testing their herds, buying personal protective equipment and veterinary care. For dairies where infection is found, the government will pay farmers 90% of lost revenue, he said.
The aim of such programs is to make farmers feel secure about testing cows by reducing the financial risk. Another panelist, dairy farmer and veterinarian Dr. Ben Shelton, said that dairymen are generally dubious of government interventions but that he has only positive things to say about his dealings with agriculture officials in the state.
A number of candidate vaccines are being looked at by the private sector, Deeble said. Until then, identifying sick herds and isolating them is the best practice, he noted.
Biosecurity — working to make sure viruses and other pathogens aren’t spread from farm to farm — is already part of agriculture, Shelton said. With cows being moved from herd to herd, however, some spread is inevitable. “I think it’s going to become a standard part of the industry that we just have to deal with,” he said.
Additional reading from NCMS:
Could Bird Flu Pose Human Threat
The 2024 Paris Paralympics Have Begun! Meet Some of the Athletes from NC
17th Summer Paralympic Games Run Through September 8
The 2024 Summer Paralympic Games are off with a spectacular start in Paris. Elite athletes from around the world are competing in sports ranging from Archery to Wheelchair Basketball. North Carolina will be represented at the games this year.
Here are some of the athletes from the Tar Heel State:
Carson Clough: The Charlotte Latin alum played lacrosse at North Carolina starting in 2013. A subsequent boating accident in 2019 on Lake Norman led to partial amputation of his right leg.
- Sport: Paralympics triathlon
Heather Erickson: The four-time Paralympic medalist from Fayetteville has won gold twice (in Tokyo and Rio de Janeiro) and silver twice (in London and Beijing). Erickson was born with a bone that prevented her leg from fully developing, leading to its amputation when she was 9-years-old.
- Sport: Sitting volleyball
Samantha Heyison: The 19-year-old was born with constricted band syndrome and attends Wake Forest.
- Sport: Paralympics track and field
Desmond Jackson: The Durham native and Campbell University alum will compete in his second Paralympics. Jackson, who was born with a limb difference which led to the amputation of his left leg when he was 9-months-old, also competed in Rio.
- Sport: Paralympics track and field
Coverage of the games is on NBC, Peacock, USA Network, and CNBC.
Click here for a schedule of events
Eli Lilly to Sell Zepbound Directly to Consumers Without Insurance Coverage
New Option is self-pay only and will not participate in insurance
(ABC, Katie Kindelan) -- People who are in need of weight loss medications but do not have insurance coverage will soon have a new way to access one of the popular medications, Zepbound.
Eli Lilly, the maker of Zepbound, announced Tuesday it will begin selling the weight loss drug directly to consumers through the company's direct pharmacy, LillyDirect.
With a doctors' prescription, consumers will be able to purchase Zepbound in vial forms that are about half the price of the auto-injector pre-filled pens sold in pharmacies, according to Eli Lilly CEO Dave Ricks.
A one-month supply of Zepbound at a 2.5-milligram dose will cost $399, while a one-month supply at a 5-milligram dose will cost $549, according to Ricks.
"It's an exciting day for people who've been looking for a way to access and afford our weight loss medication Zepbound," Ricks told ABC News' Whit Johnson in an interview that aired Tuesday on "Good Morning America." "Now they can go to LillyDirect and, with a prescription from their doctor and a phone, access the drug in vial forms."
Medical professionals can start filling prescriptions for the Zepbound vials on Tuesday via LillyDirect and the vials will start shipping in the days ahead.
Ricks noted that the new option will be self-pay only and will not participate in insurance.
With insurance coverage, Zepbound can cost as low as $25 per month, but without coverage, the medication can cost more than $1,000 per month.
Consumers who purchase Zepbound through LillyDirect will have access to educational resources on how to administer the medication, according to Ricks.
Zepbound is approved by the U.S. Food and Drug Administration as a weight loss management treatment for people with obesity or those who are overweight with at least one related underlying condition such as high blood pressure.
However, many private insurers and Medicare do not cover weight loss drugs used for obesity.
Zepbound contains the same active ingredient, tirzepatide, as another medication, Mounjaro, which is also made by Lilly and is FDA-approved to treat Type 2 diabetes.
Tirzepatide works by helping the pancreas increase the production of insulin to move sugar from the blood into body tissues.
It also slows down the movement of food through the stomach and curbs appetite, thereby causing weight loss.
Past clinical studies have shown users of medications used for weight loss like Zepbound and Mounjaro can lose between 5% and 20% of their body weight on the medications over time.
Medical specialists point out that using medication to lose weight also requires cardio and strength training and changing your diet to one that includes proteins and less processed foods with added sugars.
The most commonly reported side effects of medications used for weight loss are nausea and constipation, but gallbladder and pancreatic disease are also reported.
Makers of these drugs recommend having a conversation about the side effect profile and personalized risks with a health care professional before starting.
ADDITIONAL READING
Child Fatality Task Force Readies for Submission of Annual Report to General Assembly
Intentional Death, Unintentional Death, and Perinatal Health Subcommittees Meet in Coming Months
(State Affairs Pro, Matthew Sasser) -- The Child Fatality Task Force will convene in a series of meetings over the next few months in anticipation of submitting its annual report to the General Assembly prior to the legislative session.
Kella Hatcher, executive director of the Child Fatality Task Force, said this study cycle over the next few months will include three meetings each of the Intentional Death, Unintentional Death and Perinatal Health subcommittees. Three meetings of the Child Fatality Task Force will consider recommendations from the subcommittees to propose to the General Assembly.
Hatcher noted that although the task force’s 2024 recommendations received little traction, 2023 saw legislative successes on various fronts.
Task force recommendations that were passed included funding for the State Office of Child Fatality Prevention with the North Carolina Department of Health and Human Services, which was restructured and strengthened through the 2023 budget — $550,000 was allotted for the operational costs of the office, and $189,000 was distributed across all 100 counties for the 2024-25 fiscal year to support changes in child death review teams.
North Carolina’s Safe Surrender Law was amended in 2023 to allow parents to legally and anonymously surrender an infant up to 30 days old to a designated safe person, defined as a health care provider, first responder or on-duty social worker.
Other task force recommendations addressed in 2023 included passing a firearm safe storage and prevention law, creating funding for resources to prevent sleep-related infant deaths, increasing funding to increase the Medicaid maternal bundle rate to improve birth outcomes, and funding for comprehensive toxicology testing for all medical-examiner jurisdiction child deaths.
Years long advocacy for increasing funding for more school nurses, social workers, counselors and psychologists was partially addressed in last year’s budget, Hatcher added.
“We’re far below nationally recommended ratios on those positions, and they play a really important role with suicide prevention and promotion of mental health and identifying kids in crisis,” Hatcher said, adding that the 120 positions approved for funding fell far short of the existing need.
When Hatcher last Thursday provided a legislative update on the task force’s 2024 recommendations to the second meeting of the Perinatal Health Committee of the year, she acknowledged the update would be short and sweet.
“As our legislative members know, there’s not a lot to tell you about what happened with respect to task force recommendations [in 2024],” Hatcher said, with Sen. Jim Burgin, R-Harnett; Sen. Gale Adcock, D-Wake; and Rep. Carla D. Cunningham, D-Mecklenburg, in virtual attendance.
“The fact that the Legislature has not passed a comprehensive budget bill this year means there wasn’t the same sort of opportunity for our recommendations to be addressed,” Hatcher added in a follow-up interview with State Affairs.
A partial 2024 General Assembly victory from a task force recommendation was securing $67.5 million in funding toward child care centers, which face losing federal dollars. Like the school nurse and social worker funding, Hatcher said, the approved funding does not rise to the need experts say exists.
Hatcher credits state legislators who have championed task force recommendations and passed corresponding legislation. Though 2023 saw legislative movement on issues that had been percolating for years, Hatcher said 2024 recommendations such as legislation to address addictive algorithms in social media, Medicaid reimbursement of doula services and support for Fetal and Infant Mortality Reviews could return to their recommendation list for the longer legislative session.
“We’re often revisiting [former recommendations] because the issues that prompted the task force to make a recommendation are still an issue,” Hatcher said. “They haven’t gone away.”
The Child Fatality Task Force will submit its annual report with General Assembly recommendations before the 2025 long session begins.
CDC: NC Life Expectancy Declining
Rate drops nationally, but at half the rate of NC
(David Raynor, The News & Observer) -- North Carolina’s average life expectancy declined by more than a year from 76.1 to 74.9 from 2020 to 2021, according to new Centers for Disease Control data for all 50 states. The rate dropped nationally, too, but at half the rate NC did: from 77 to 76.4.
All but 11 states saw their averages decline. In 2000, the CDC’s average life expectancy in NC was 76.3, 1.4 years higher than in 2021 and more comparable to 2020.
Based on this new data, the CDC now ranks North Carolina 36th in the country in life expectancy, with the state dropping one spot from 35th in 2020. In 2023, the agency released a report that did not include state data but put the national average life expectancy at 77.5, up 1.1 years from 2021.
Many factors contribute to the ranking. One is an increase in accidental and unintentional deaths and deaths from COVID-19, according to the NC Department of Health Human Services.
Average life span calculations are especially sensitive to factors that cause deaths in younger populations. North Carolina has seen a significant increase in overdose deaths in recent years, especially since COVID-19. From 2018 to 2022 there was an 89% increase in overdose deaths, from 2,301 to 4,339. The rate per 100,000 residents also very nearly doubled from 22.2 to 44.1. And opioid overdose deaths mainly occur among younger people, and have contributed to a decline in life expectancy, according to DHHS.
In 2022, the CDC reports that three-fourths of all drug overdose deaths in the country were under the age of 55. Seven out of ten who died were male.
Women still outlive men. Nationally and in North Carolina, the gap is about six years and it increased each year from 2019 to 2021, according to the CDC. The life expectancy for males in the state is 72, for females, 77.9, according to this CDC report. Nationally, for males it’s 73.5, females, 79.3. That said, the difference in life expectancy for males and females is not as great as it has been at times in the past. In 1980 in North Carolina, the gap was 8.8 years. It dropped about a year in 1990 to 7.7 and continued to decline to 6.5 years in 2000.
DHHS staff caution that life expectancy is a statistical measure, and is based on the ages at which people are dying now. To determine which factors have the largest impact in North Carolina, especially compared to the US, requires more comprehensive research and analysis.
Read source article here.
New Data Shows Congenital Syphilis Continues to Rise in NC, but Rate of Increase is Slowing
72 cases reported in 2023, 10 cases resulted in stillborn or neonatal death
(Matthew Sasser, State Affairs Pro) -- Cases of congenital syphilis continue to rise in North Carolina, but the rate of increase has slowed, according to data shared with the Perinatal Health Committee Thursday afternoon.
Dr. Victoria Mobley, the HIV/STD medical director at the North Carolina Department of Health and Human Services Division of Public Health, said 72 cases of congenital syphilis were reported in 2023, with 10 of those cases resulting in a stillborn or neonatal death.
Between January and May 2024, 41 congenital syphilis cases and three related neonatal deaths were reported, a 31% increase over the past three-year average.
“We were seeing a 50% increase in women … only just three to six months ago,” Mobley said. “So the rate of increase is low.”
Mobley said that women of color are disproportionately impacted in the reported cases but that the data shows a steady increase in reports from caucasian women.
“The majority of women who are diagnosed with syphilis during pregnancy have no clinical signs of infection at the time of their diagnosis,” Mobley said.
North Carolina public health law requires providers to screen pregnant women for syphilis three times: at their first prenatal care visit, between 28 and 30 weeks of gestation and again at delivery, regardless of reported risk factors.
Mobley said the health department has received 10 survey responses from women affected by the outbreak. While nine of them had access to prenatal care, they all reported an annual household income of less than $40,000 a year and reported having trouble meeting their basic financial responsibilities during their pregnancy.
“A significant portion of them reported seeking health care other places during their pregnancy other than their prenatal care provider, which is important because we were trying to figure out where the providers are,” Mobley said, adding that many of the women shared they knew very little about syphilis even after their diagnosis.
A social media campaign launched last December by the health department to raise awareness of congenital syphilis peaked in April, accumulating 28 million impressions overall , including 3.7 million impressions with medical providers. Mobley said the department’s Hispanic audience on social media had the highest click-through rate of any demographic during the campaign.
Plans to extend the campaign and provide more regional fact sheets for providers are in the works, Mobley said. A congenital syphilis quarterly review board in the next month will analyze every reported congenital syphilis case in the state and identify any missed opportunities for prevention.
Dr. Marty McCaffrey, a neonatologist at the University of North Carolina and director of the Perinatal Quality Collaborative of North Carolina, said screening for syphilis at admission for labor has been making a huge difference in a preterm infant project he’s a part of, filling a 4% gap of unscreened mothers at 53 hospitals.