Will Humble Disease Control, Early Childhood, Wills Blog

Even More Evidence that Universal K-12 Masking is Important for Keeping Kids Safe 

Analysis Finds that Universal Masking Reduces Classroom Transmission by 800%

A new study published in BMJ last week called SARS-CoV-2 aerosol transmission in schools: the effectiveness of different interventions found that universal masking in classrooms reduced aerosol transmission by 800%. Ventilation “… through the full opening of six windows all day during the winter reduces transmission by 14x“.

The combined interventions of universal masking, natural ventilation, and HEPA filtration) reduced transmission 3,000%. Sadly, we have a governor that is actually paying schools extra money to ignore CDC recommendations on universal masking knowing full well that his policy is jeopardizing student’s health and safety.

Results: The most effective single intervention was natural ventilation through the full opening of six windows all day during the winter (14-fold decrease in cumulative dose), followed by the universal use of surgical face masks (8-fold decrease).

One HEPA filter was as effective as two windows partly open all day during the winter (2.5-fold decrease) while two filters were more effective (4-fold decrease).

Combined interventions (i.e., natural ventilation, masks, and HEPA filtration) were the most effective (≥ 30-fold decrease). Combined interventions remained highly effective in the presence of a super-spreader.

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New Evidence: 33% of COVID-19 Infections are Asymptomatic: Results Support School Testing/Masking/Ventilation

Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis | PNAS

By analyzing over 350 papers in this systematic review, the researchers found that more than one-third of infections are truly asymptomatic. The review found more asymptomatic infections among kids and fewer among older folks and people with underlying health conditions.

These results suggests that heightened vigilance is needed in schools (e.g. masking and testing) to prevent spillover into the broader community.

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Outbreak Associated with SARS-CoV-2 B.1.617.2 (Delta) Variant in an Elementary School | MMWR (cdc.gov)

Conclusion: Vaccines are effective against the Delta variant, but transmission risk remains elevated among unvaccinated persons in schools. In addition to vaccination, strict adherence to multiple nonpharmaceutical prevention strategies, including masking, are important to ensure safe school instruction.

Governor Ducey will have absolutely no interest in these new findings, as the results don’t support his pre-existing belligerence toward mitigation measures in schools.

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Congress Should Seize the Day and Finally Pass Popular Drug Pricing Reform 

It’s no secret that we’re living through a particularly heated period in American politics, and Arizona is a perfect example of the partisan divide facing the nation. In the 2020 presidential election, the Grand Canyon State was decided by a mere 10,475 votes, or 0.3 of a point, transforming political spectators across the country into Arizona election law experts and avid consumers of Maricopa County polling data.

However, drug pricing reform has cut through the thick partisan atmosphere and emerged as a rare subject of agreement between Republicans and Democrats.

Voters across the country are pushing back against the absurdly high cost of drugs with a uniquely unified voice. In our current political landscape, issues are often divided strictly along party lines, and arguments are neatly packaged into quippy talking points to be posted on Facebook and Twitter.

However, even the brutal rhetoric clogging social media and the war of words between partisan politicians have proven ineffective at dividing everyday Americans struggling to afford their medications.

It’s not just national polling numbers skewed by dark blue states that prove voters are simply sick and tired of paying a premium for their prescriptions. Even in the country’s most divided states, support for lowering the cost of drugs has incredible support across the political spectrum.

One recently released survey found that a majority of voters in key battleground states, including Arizona, support drug pricing reform. Remarkably, the survey found that eighty-seven percent of Arizona voters support allowing Medicare to negotiate with drug companies for lower prices.

This data isn’t just some blip on the radar or a result of poor polling — it’s the culmination of decades-long abuse suffered by the American public at the hands of drug giants. Over the years, the pharmaceutical industry has artificially inflated the cost of prescription drugs and passed those prices onto consumers looking to fill their prescriptions.

A recently released report demonstrated that the price of prescription drugs has skyrocketed at double the rate of inflation, spiking the cost of healthcare for the 66% of Americans who have to fill at least one prescription.

While the price of drugs is a major issue nationally, the effects of the high cost of medications are felt acutely here in Arizona, where over nine billion dollars were spent in 2019 alone on prescription drugs and over two million Arizonans reported they didn’t seek treatment for a health problem due to the cost.

Recently, politicians have finally started to listen to their constituents – making efforts to lower the cost of drugs. During the last administration, a flurry of reform bills flew around the Senate, including a bipartisan bill co-sponsored by Arizona Senator Kyrsten Sinema.

Drug pricing reformers have been buoyed by recent remarks from President Biden, who asked his colleagues in Congress to prioritize drug pricing reform.
Achieving prescription drug pricing reform (allowing Medicare to negotiate drug prices) has been out of reach for decades because the drug company lobby is so powerful that meaningful reform has been impossible.

It looks like there is finally a critical mass of support in Congress and the President to deliver widely supported reform. However, any meaningful movement on the drug pricing reform front will require the support of Kyrsten Sinema.

In the past, Senator Sinema has proven herself to be a maverick of her own in the Senate, working tirelessly to promote policies popular with both red and blue voters, and in the coming months, she’ll have the opportunity to unite Republicans and Democrats in Arizona and across the country by delivering relief to those suffering from high prescription prices.

The time is now for drug pricing reform, specifically, allowing Medicare to finally negotiate drug prices. Senator Sinema has a chance to continue leading on issues that are best for Arizona and the Country and we applaud her for doing so.

Will Humble is the Executive Director for the Arizona Public Health Association and former Director of the Arizona Department of Health Services.

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Finally, A President Decides to Tackle Unreasonable Prescription Drug Prices

It’s no secret that prescription drug prices in the U.S. are far higher than in other countries and that the current system costs taxpayers, insurance plans and people far more than it should. A huge barrier has been language in the Medicare law that prevents HHS from directly negotiating drug prices under the Medicare Part D drug benefit program. 

Achieving prescription drug pricing reform (allowing Medicare to negotiate drug prices) has been out of reach for decades because the drug company lobby is so powerful that meaningful reform has been impossible.

That may be changing. A few weeks ago President Biden held a press conference where he advocated large changes to what prices drug companies can charge. His plan is included in the next infrastructure bill that’s being discussed in congress.

He proposes to FINALLY allow Medicare (the biggest buyer of drugs by far) to negotiate drug prices with the drug manufacturers. Unbelievably, Medicare has never been able to negotiate drug prices. How would you like it if you could never comparison shop for anything you buy. You’d just have to pay whatever the one store that sells it says. Period.

Well, it’s already that way for us as a country- Medicare has to just basically pay whatever the company says (and we. the people, pick up the tab).

The US House of Representatives has already passed a measure called “H.R. 3, the Lower Drug Costs Now Act of 2019” which would require HHS to negotiate the price of between 25-125 brand-name drugs without generic competitors. That negotiated price would be available Medicare, Medicaid and private payers. Importantly, HR 3 also provides some negotiating leverage to HHS.

For one thing, it would establish an upper limit for the negotiated price equal to 120% of the Average International Market price paid by Australia, Canada, France, Germany, Japan, and the UK.

It would impose financial penalties on drug companies that don’t comply with the negotiating process. Manufacturers that fail to negotiate would face an escalating excise tax on the previous year’s gross sales of the drug in question, starting at 65% and increasing by 10% every quarter to a maximum of 95%.

President Biden’s plan goes further than H.R. 3 by allowing Medicare to negotiate drug prices across the board, not just on 25–125 drugs.

He proposed allowing Medicare to negotiate a fair drug price for all drugs – including the costs of the research and development and a reasonable profit. Drug companies could then only set prices based on the rate of inflation after it’s determined how much they’ve invested and what a reasonable profit constitutes.

Once Medicare negotiates a lower drug price, employer-based plans would get access to the same drug for the same price as Medicare.

This is a common sense intervention that would help both Medicare beneficiaries and the Medicare Trust Fund. Let’s hope that there’s finally enough support in congress to pass this long needed reform.

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