Tag: Colorado

5 trabajadores avícolas en Colorado dieron positivo para la gripe aviar, duplicando los casos de este año

Cinco trabajadores de una granja avícola en el noreste de Colorado han dado positivo para la gripe aviar, informó el Departamento de Salud Pública estatal el 14 de julio. Esto eleva el número conocido de casos en Estados Unidos a nueve.

Es probable que las cinco personas se infectaran por manipular pollos, a los que se les había encargado sacrificar en respuesta a un brote de gripe aviar en esa granja.

Más de 99 millones de pollos y pavos se han infectado con una cepa altamente patógena de la gripe aviar que surgió en las granjas avícolas del país a principios de 2022.

Desde entonces, el gobierno federal ha compensado a los granjeros avícolas con más de $1,000 millones por destruir bandadas y huevos infectados para frenar la propagación de los brotes.

El virus de la gripe aviar H5N1 se ha estado propagando entre las granjas avícolas de todo el mundo durante casi 30 años. Se estima que 900 personas se han infectado por aves y aproximadamente la mitad han muerto por la enfermedad.

Este año, en Estados Unidos, el virus hizo un cambio sin precedentes “saltando” al ganado lechero. Esto representa una amenaza mayor porque significa que el virus se ha adaptado para replicarse dentro de las células de las vacas, que son más parecidas a las humanas.

Las otras cuatro personas diagnosticadas este año en el país trabajaban en tambos que estaban sufriendo brotes.

Los científicos han advertido que el virus podría mutar para propagarse de persona a persona, como la gripe estacional, y desencadenar una pandemia. Aún no hay señales de que esto esté ocurriendo.

Hasta ahora, los nueve casos reportados este año han sido leves: con irritación ocular, secreción nasal y otros síntomas respiratorios. Sin embargo, los números siguen siendo demasiado bajos para decir algo certero sobre la enfermedad porque, en general, los síntomas de la gripe pueden variar entre las personas y solo una minoría necesita hospitalización.

El número de personas que han contraído el virus de las aves de corral o el ganado puede ser mayor que nueve. Los Centros para el Control y Prevención de Enfermedades (CDC) han hecho pruebas solo a unas 60 personas en los últimos cuatro meses, y los laboratorios de diagnóstico más grandes, que típicamente detectan enfermedades, aún no tienen permitido realizar pruebas.

Es muy importante hacerles estas pruebas a los trabajadores de granjas para detectar el virus de la gripe aviar H5N1, estudiarlo y frenarlo antes que se convierta en parte de sus ecosistemas.

Los investigadores han instado a una respuesta más agresiva por parte de los CDC y otras agencias federales para prevenir futuras infecciones. Muchas personas expuestas regularmente al ganado y a las aves de corral en las granjas aún carecen de equipo de protección y no reciben ningún tipo de educación sobre la enfermedad.

Y todavía no tienen permiso para recibir una vacuna contra la gripe aviar.

Casi una docena de expertos en virología y brotes entrevistados recientemente por KFF Health News no están de acuerdo con la decisión de los CDC de no vacunar, lo que, dicen, podría ayudar a prevenir la infección y hospitalización por gripe aviar.

“Deberíamos hacer todo lo posible para eliminar las posibilidades de que los trabajadores en tambos y granjas de aves contraigan este virus”, dijo Angela Rasmussen, viróloga de la Universidad de Saskatchewan, en Canadá. “Si este virus tiene suficientes oportunidades para saltar de las vacas o las aves de corral a las personas, eventualmente se volverá mejor para infectarlas”.

Para comprobar si los casos no se están detectando, investigadores en Michigan han enviado a los CDC muestras de sangre de trabajadores de tambos. Si detectan anticuerpos contra la gripe aviar, es probable que las personas se infecten más fácilmente por el ganado de lo que se creía anteriormente.

“Es posible que las personas hayan tenido síntomas que no se sintieran cómodas informando, o que sus síntomas fueran tan leves que no pensaron que valiera la pena mencionarlos”, dijo Natasha Bagdasarian, directora ejecutiva de salud médica del estado de Michigan.

Con la esperanza de frustrar una posible pandemia, Estados Unidos, el Reino Unido, Países Bajos y una docena de otros países están almacenando millones de dosis de una vacuna contra la gripe aviar fabricada por la compañía de vacunas CSL Seqirus.

La formulación más reciente de Seqirus fue aprobada el año pasado por el equivalente europeo de la Administración de Drogas y Alimentos (FDA), y una versión anterior tiene la aprobación de la FDA. En junio, Finlandia decidió ofrecer vacunas a las personas que trabajan en granjas de pieles como medida de precaución porque sus granjas de visones y zorros sufrieron duros golpes por la gripe aviar el año pasado.

De manera controversial, los CDC han decidido no ofrecer vacunas contra la gripe aviar a los grupos de riesgo.

Aunque hay millones de dosis disponibles, Demetre Daskalakis, director del Centro Nacional para la Inmunización y Enfermedades Respiratorias de los CDC, dijo a KFF Health News que en este momento la agencia no está recomendando una campaña de vacunación por varias razones. Una de ellas es que los casos aún parecen ser limitados y el virus no se está propagando rápidamente entre las personas a medida que estornudan y respiran.

La agencia sigue calificando el riesgo público como bajo. En una declaración publicada en respuesta a los nuevos casos de Colorado, los CDC dijeron que sus recomendaciones sobre la gripe aviar siguen siendo las mismas: “Una evaluación de estos casos ayudará a determinar si esta situación justifica un cambio en la evaluación del riesgo para la salud humana”.

5 Cases of Bird Flu Reported in Colorado Poultry Workers, Doubling This Year’s US Tally

Five people who work at a poultry farm in northeastern Colorado have tested positive for the bird flu, the Colorado public health department reported July 14. This brings the known number of U.S. cases to nine.

The five people were likely infected by chickens, which they had been tasked with killing in response to a bird flu outbreak at the farm.

More than 99 million chickens and turkeys have been infected with a highly pathogenic strain of the bird flu that emerged at U.S. poultry farms in early 2022. Since then, the federal government has compensated poultry farmers more than $1 billion for destroying infected flocks and eggs to keep outbreaks from spreading.

The H5N1 bird flu virus has spread among poultry farms around the world for nearly 30 years. An estimated 900 people have been infected by birds, and roughly half have died from the disease.

The virus made an unprecedented shift this year to dairy cattle in the U.S. This poses a higher threat because it means the virus has adapted to replicate within cows’ cells, which are more like human cells. The four other people diagnosed with bird flu this year in the U.S. worked on dairy farms with outbreaks.

Scientists have warned that the virus could mutate to spread from person to person, like the seasonal flu, and spark a pandemic. There’s no sign of that, yet.

So far, all nine cases reported this year have been mild, consisting of eye irritation, a runny nose, and other respiratory symptoms. However, numbers remain too low to say anything certain about the disease because, in general, flu symptoms can vary among people with only a minority needing hospitalization.

The number of people who have gotten the virus from poultry or cattle may be higher than nine. The Centers for Disease Control and Prevention has tested only about 60 people over the past four months, and powerful diagnostic laboratories that typically detect diseases remain barred from testing. Testing of farmworkers and animals is needed to detect the H5N1 bird flu virus, study it, and stop it before it becomes a fixture on farms.

Researchers have urged a more aggressive response from the CDC and other federal agencies to prevent future infections. Many people exposed regularly to livestock and poultry on farms still lack protective gear and education about the disease. And they don’t yet have permission to get a bird flu vaccine.

Nearly a dozen virology and outbreak experts recently interviewed by KFF Health News disagree with the CDC’s decision against vaccination, which may help prevent bird flu infection and hospitalization.

“We should be doing everything we can to eliminate the chances of dairy and poultry workers contracting this virus,” said Angela Rasmussen, a virologist at the University of Saskatchewan in Canada. “If this virus is given enough opportunities to jump from cows or poultry into people, it will eventually get better at infecting them.”

To understand whether cases are going undetected, researchers in Michigan have sent the CDC blood samples from workers on dairy farms. If they detect bird flu antibodies, it’s likely that people are more easily infected by cattle than previously believed.

“It’s possible that folks may have had symptoms that they didn’t feel comfortable reporting, or that their symptoms were so mild that they didn’t think they were worth mentioning,” said Natasha Bagdasarian, chief medical executive for the state of Michigan.

In hopes of thwarting a potential pandemic, the United States, United Kingdom, Netherlands, and about a dozen other countries are stockpiling millions of doses of a bird flu vaccine made by the vaccine company CSL Seqirus.

Seqirus’ most recent formulation was greenlighted last year by the European equivalent of the FDA, and an earlier version has the FDA’s approval. In June, Finland decided to offer vaccines to people who work on fur farms as a precaution because its mink and fox farms were hit by bird flu last year.

The CDC has controversially decided not to offer at-risk groups bird flu vaccines. Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases, told KFF Health News that the agency is not recommending a vaccine campaign at this point for several reasons, even though millions of doses are available. One is that cases still appear to be limited, and the virus isn’t spreading rapidly between people as they sneeze and breathe.

The agency continues to rate the public’s risk as low. In a statement posted in response to the new Colorado cases, the CDC said its bird flu recommendations remain the same: “An assessment of these cases will help inform whether this situation warrants a change to the human health risk assessment.”

Colorado expulsó a beneficiarios de Medicaid como si fuera un estado republicano

Colorado se encuentra entre los 10 estados que han desafiliado a la mayor proporción de beneficiarios de Medicaid desde que el gobierno de Estados Unidos levantara una restricción de la pandemia sobre la eliminación de afiliados al programa médico.

Es el único estado demócrata entre un grupo de estados republicanos con altas tasas de desafiliación, que incluye a Idaho, Montana, Texas y Utah, en un proceso de Medicaid que comenzó en la primavera de 2023.

Colorado también es el único estado que tenía todos los ingredientes políticos para amortiguar las consecuencias de este proceso, según analistas de políticas de Medicaid en KFF.

Pero al parecer esta amortiguación no se puso en marcha.

“Realmente hay una división en Colorado entre nuestras políticas progresistas y nuestra administración subfinanciada y fragmentada”, dijo Bethany Pray, directora legal y de políticas del Colorado Center on Law and Policy, un grupo de asistencia legal con sede en Denver.

Según los datos de KFF, durante las desafiliaciones, Colorado ha visto una caída neta en la inscripción a Medicaid y al Programa de Seguro Médico Infantil (CHIP), mayor que cualquier estado excepto Utah.

Defensores del acceso a la atención médica, investigadores y administradores de condados —quienes manejan la mayor parte de las redeterminaciones de Medicaid en Colorado— dicen que los problemas principales involucran una tecnología obsoleta y bajas tasas de renovaciones automáticas. Ambos crean obstáculos para la inscripción que socavan a las políticas progresistas del estado.

Los funcionarios estatales tienen una visión más optimista. Dicen que la caída en la inscripción es una señal de que hicieron un buen trabajo inscribiendo a las personas en el apogeo de la pandemia de covid-19. En segundo lugar, dicen que la economía de Colorado está funcionando bien, por lo que más personas pueden obtener seguro a través de sus trabajos.

“Cuando tenemos una tasa de desempleo realmente estelar, no tantas personas necesitan programas de la red de seguridad, y estamos orgullosos de eso. Nuestra gente está prosperando”, dijo Kim Bimestefer, quien lidera el Departamento de Política y Financiamiento de Atención Médica y es la principal funcionaria de Medicaid del estado. Su departamento también ha dicho que algunas personas optan por no llenar sus documentos de elegibilidad porque saben que sus ingresos son demasiado altos para calificar.

Los datos de la Oficina de Estadísticas Laborales muestran que, si bien es cierto que la tasa de desempleo de Colorado es más baja que la del país en su conjunto, es más alta de lo que era antes de la pandemia.

Funcionarios del estado dicen que creen que las inscripciones en Medicaid disminuyeron porque muchas de esas personas encontraron trabajo, como lo reflejan las tasas de desempleo más bajas. Pero ese escenario ocurrió en menos de la mitad de los condados del estado, según un análisis de KFF Health News.

Notablemente, en 11 condados donde el desempleo se estancó o aumentó de enero de 2020 a abril de 2024, la proporción de la población cubierta por Medicaid se redujo. Una baja tasa de desempleo no significa necesariamente que haya menos necesidad de cobertura de Medicaid, porque muchas personas empleadas ganan salarios lo suficientemente bajos como para seguir calificando para el programa.

Colorado aumentó la inscripción en Medicaid y CHIP en un 35% durante la emergencia de salud pública de covid, en comparación con aproximadamente el 30% a nivel nacional, y entre los estados que expandieron Medicaid.

“Crecimos más, lo que significa, lógicamente, que vamos a dar de baja a más personas”, dijo Bimestefer. “Subimos alto, vamos a bajar más bajo, porque nuestra economía es estelar”.

El sitio web de su departamento inicialmente afirmó que la inscripción en Medicaid de Colorado había crecido más que cualquier otro estado con Medicaid expandido, excepto Hawaii. Pero los datos de los Centros de Servicios de Medicare y Medicaid (CMS) muestran que el aumento de la inscripción durante la pandemia en otros estados, incluidos Indiana, Dakota del Norte, Virginia y Nevada, también superaron a la de Colorado.

Incluso si hubiera crecido más, el argumento de que lo que sube debe bajar no se sostiene, dijeron analistas de políticas de Medicaid.

“Un argumento contrario a eso es que sabemos que nunca hubo una participación total en Medicaid antes de la pandemia”, dijo Jennifer Tolbert, subdirectora del Program on Medicaid and the Uninsured de KFF.

Tolbert dijo que estaba sorprendida por la magnitud de las pérdidas de inscripción en Medicaid de Colorado, dado que era el único estado en la nación que cumplía con todos los criterios que KFF esperaba que amortiguaran los efectos de las desafiliaciones. Esas políticas incluyen haber expandido Medicaid bajo la Ley de Cuidado de Salud a Bajo Precio (ACA) y el procesamiento automático de renovaciones.

Tolbert fue una de varios investigadores que dijeron que incluso si el desempleo volviera a los niveles previos a la pandemia, esperarían una proporción más alta, no más baja, de habitantes de Colorado inscritos en la cobertura de la red de seguridad.

Ally Sullivan, portavoz del gobernador demócrata Jared Polis, dijo que un factor que complica ls cosas en el sistema de Colorado es que es uno de los pocos estados donde la mayor parte del trabajo de verificación de elegibilidad recae en los condados, “lo que agregó complejidad al proceso de desafiliaciones”.

“Colorado está comprometido a garantizar que sus habitantes que ya no califican para la cobertura de Medicaid se conecten a otras fuentes asequibles de cobertura lo antes posible, y el estado está haciendo grandes esfuerzos para hacerlo”, decía el comunicado.

Minnesota es otro estado donde la verificación de elegibilidad recae en gran medida en los condados. Sin embargo, dio de baja solo al 26% de su población bajo Medicaid, en comparación con el 48% de Colorado.

Al igual que Colorado, Minnesota tiene un gobernador demócrata. También se parece a Colorado en su población, aumento de inscripción durante la pandemia, el porcentaje de sus residentes que viven en áreas prósperas y su tasa de desempleo, por debajo de la nacional.

Pero Bimestefer descartó cualquier comparación. “No me importa Minnesota”, dijo Bimestefer. “Esto es Colorado. No me importa lo que hizo Minnesota”.

Defensores del acceso a la atención médica e investigadores dijeron que un conjunto de problemas tecnológicos y administrativos han contribuido a que la tasa de desafiliaciones fuera alta.

Primero, la base de datos de elegibilidad de Colorado, el Sistema de Gestión de Beneficios de Colorado, está obsoleta, según personas que la usan o están familiarizadas con sistemas en otros estados.

“Es como seguir usando un viejo celular”, dijo Sarah Grusin, abogada del Programa Nacional de Ley de Salud. “Tenemos cosas mejores”.

Las organizaciones de Grusin y Pray presentaron una queja de derechos civiles ante varias agencias federales diciendo que los problemas del sistema que terminaron con la cobertura de los habitantes de Colorado discapacitados equivalían a discriminación.

“Tomó muchos meses arreglar algo que no parece tan complicado”, dijo Pray.

Bimestefer dijo que su departamento está trabajando en un plan para mejorar el sistema, que es administrado por Deloitte bajo un contrato de $354.4 millones hasta 2027. Una reciente investigación de KFF Health News sobre sistemas de elegibilidad administrados por Deloitte encontró problemas generalizados. En Colorado, una auditoría ordenada por el estado en 2020 halló que a muchos beneficiarios de Medicaid se les habían enviado avisos y plazos incorrectos.

Kenneth Smith, ejecutivo de Deloitte que lidera su división nacional de servicios humanos, dijo que Deloitte es uno de los muchos actores que administran los beneficios de Medicaid, y que los estados son los dueños de la tecnología y toman las decisiones sobre su implementación.

Los problemas tecnológicos de Colorado también han debilitado su capacidad para usar una herramienta poderosa en la inscripción: la renovación automática.

Bimestefer dijo que, el otoño pasado, su agencia tuvo que elegir entre arreglar el sistema para que dejara de dar de baja a niños que no debían perder la cobertura, o comenzar a renovar automáticamente a personas sin ingresos o con ingresos por debajo del nivel federal de pobreza. No podía hacer ambas cosas, dijo.

Expertos como Tricia Brooks, profesora investigadora del Centro de Niños y Familias de la Universidad de Georgetown, dijeron que es especialmente importante aumentar las renovaciones automáticas en estados como Colorado, donde la mayor parte del trabajo de renovación recae en personal de los gobiernos de los condados.

“¿Qué pasa cuando no se obtiene una alta tasa de renovaciones automáticas? Estás enviando esos formularios de renovación”, dijo Brooks, lo que significa más bajas. “No recibieron el correo. El aviso fue confuso. Intentaron obtener ayuda a través del centro de llamadas. La lista de por qué las personas no renuevan es larga”.

De hecho, dos tercios de los habitantes de Colorado dados de baja perdieron la cobertura por razones de procedimiento. Eso concuerda con el promedio nacional, según KFF. Pero junto con el hecho de que Colorado ha dado de baja a tanta gente en general, eso significa que más de 500,000 habitantes del estado, o aproximadamente el 9% de la población, fueron dados de baja por razones de procedimiento. Más que la población de su segunda ciudad más grande, Colorado Springs.

Se determinó que al menos un tercio de los dados de baja eran elegibles para Medicaid.

Funcionarios de centros comunitarios de salud de Colorado y centros de salud mental dicen que están viendo un aumento de pacientes que llegan a sus puertas sin seguro, una señal, dicen, de que los habitantes de Colorado dados de baja de Medicaid no necesariamente están mejor en términos de seguro de salud.

El 58% de los que fueron dados de baja han regresado a Medicaid o ahora tienen otro seguro. Pero el estado aún no sabe qué pasó con el 42% restante de las personas que fueron dadas de baja, y dijo que realizaría una encuesta para averiguarlo.

Colorado Dropped Medicaid Enrollees as Red States Have, Alarming Advocates for the Poor

Colorado stands out among the 10 states that have disenrolled the highest share of Medicaid beneficiaries since the U.S. government lifted a pandemic-era restriction on removing people from the health insurance program.

It’s the only blue state in a cluster of red states with high disenrollment rates — a group that includes Idaho, Montana, Texas, and Utah — in the Medicaid “unwinding” underway since spring 2023.

Colorado also is the only state that had all the policy ingredients in place to cushion the fallout from the unwinding, according to Medicaid policy analysts at KFF.

But it seems the cushion hasn’t been deployed.

“There’s really a divide in Colorado between our progressive policies and our underfunded and fragmented administration,” said Bethany Pray, chief legal and policy officer at the Colorado Center on Law and Policy, a Denver-based legal aid group.

According to KFF data, during the unwinding Colorado has seen a bigger net drop in enrollment in Medicaid and the Children’s Health Insurance Program than any state except Utah.

Advocates for health care access, researchers, and county administrators — the administrators handling the bulk of the Medicaid redeterminations in Colorado — say that the major issues involve outdated technology and low rates of automatic renewals. Both create obstacles to enrollment that undercut the state’s progressive policies.

State officials have a rosier view. They say the drop in enrollment is a sign that they did a good job enrolling people at the height of the covid-19 pandemic. Secondly, they say Colorado’s economy is doing well, so more people can get insurance through their jobs.

“When we have a really stellar unemployment rate, not as many people need safety-net programs, and we’re proud of that. Our people are rising and thriving,” said Kim Bimestefer, who leads the Department of Health Care Policy and Financing and is the state’s top Medicaid official. Her department has also said that some people choose not to fill out their eligibility paperwork because they know their incomes are too high to qualify.

Bureau of Labor Statistics data shows that while it’s true Colorado’s unemployment rate is lower than the nation’s as a whole, it’s higher than it was before the pandemic.

State officials say they believe Medicaid enrollments dropped because many of those people found jobs, as reflected by the lower unemployment rates. But that scenario happened in fewer than half of the state’s counties, a KFF Health News analysis found. Notably, in 11 counties where unemployment stagnated or increased from January 2020 to April 2024, the share of the population covered by Medicaid shrank. A low unemployment rate does not necessarily mean there is less of a need for Medicaid coverage, because many employed people earn wages low enough to still qualify for the program.

Colorado increased enrollment in Medicaid and the related Children’s Health Insurance Program by 35% during the covid public health emergency, compared with about 30% nationally and among Medicaid expansion states.

“We grew more, which means, logically, we’re going to disenroll more,” said Bimestefer.“We went up higher, we’re going to come down lower, because our economy is stellar.”

Her department’s website initially claimed Colorado’s Medicaid enrollment grew more than any other Medicaid expansion state except Hawaii. But data from the Centers for Medicare & Medicaid Services shows pandemic enrollment growth in other states, including Indiana, North Dakota, Virginia, and Nevada, also exceeded that of Colorado.

Even if it had grown the most, the argument that what comes up must come down doesn’t hold water, Medicaid policy analysts said.

“A counterargument to that is we know that there was never a full participation in Medicaid prior to the pandemic,” said Jennifer Tolbert, deputy director of the KFF Program on Medicaid and the Uninsured.

Tolbert said she was surprised by the extent of Colorado’s Medicaid enrollment losses, given it was the one state in the nation that met all the criteria that KFF expected would cushion the effects of the unwinding. Those policies include adopting the Affordable Care Act’s Medicaid expansion and the automatic processing of renewals.

Tolbert was among several policy researchers who said that even if unemployment returned to pre-pandemic levels, they would expect a higher, not lower, share of Coloradans to be enrolled in safety-net coverage.

Ally Sullivan, a spokesperson for Gov. Jared Polis, a Democrat, said one complicating factor in Colorado’s system is that it’s among the handful of states where most of the eligibility verification work falls on counties, “which added complexity to the state’s unwind process.”

“Colorado is committed to ensuring that Coloradans who no longer qualify for Medicaid coverage are connected to other affordable sources of coverage as soon as possible, and the state is going to great lengths to do so,” the statement said.

Minnesota is another state where verifying eligibility is largely left to the counties. Yet it disenrolled just 26% of its Medicaid population in the unwinding, compared with Colorado’s 48%. Like Colorado, Minnesota is led by a Democratic governor. Minnesota also mirrors Colorado in its population, pandemic-era increase in enrollment, the percentage of its residents living in prosperous areas, and its better-than-national unemployment rate. But Bimestefer dismissed any comparison.

“I don’t care about Minnesota,” Bimestefer said. “This is Colorado. I don’t care what Minnesota did.”

Advocates for health care access and researchers said a cluster of technological and administrative issues have contributed to Colorado’s high disenrollment rate.

First, Colorado’s eligibility database, the Colorado Benefits Management System, is outdated and clunky, according to people who use it or are familiar with systems in other states.

“It’s like still using the old flip phone where you’re trying to play Snake,” said Sarah Grusin, an attorney at the National Health Law Program. “We have better stuff.”

Grusin and Pray’s organizations filed a civil rights complaint with several federal agencies saying that the system issues that terminated disabled Coloradans’ coverage amounted to discrimination.

“It took many months to fix something that doesn’t sound that complicated,” Pray said.

Bimestefer said her department is working on a plan to improve the system, which is managed by Deloitte under a $354.4 million contract that lasts until 2027. A recent KFF Health News investigation of eligibility systems managed by Deloitte found widespread problems. In Colorado, a state-commissioned audit in 2020 found that many Medicaid beneficiaries were sent incorrect notices and deadlines.

Kenneth Smith, a Deloitte executive who leads its national human services division, said that Deloitte is one player among many who together administer Medicaid benefits, and that the states own the technology and make the decisions about their implementation.

Colorado’s technology woes have also weakened its ability to use a powerful tool in enrollment: automatic renewal.

Last fall, Bimestefer said, her agency had to choose between fixing the system so that it would stop disenrolling children who shouldn’t lose coverage, or start automatically renewing people with no income or with income below the federal poverty level. It couldn’t do both, she said.

Experts such as Tricia Brooks, a research professor with the Center for Children and Families at Georgetown University, said it’s especially important to increase automatic renewals in states like Colorado where most of the renewal work falls on county government staff.

“What happens when you’re not getting a high rate of automated renewals? You’re sending out those renewal forms,” Brooks said — meaning more disenrollments. “They didn’t get the mail. The notice was confusing. They tried to get help through the call center. The list goes on as to why people don’t renew.”

Indeed, two-thirds of disenrolled Coloradans lost coverage for procedural reasons. That’s in line with the national average, according to KFF. But paired with Colorado having disenrolled so many people overall, that means more than 500,000 Coloradans, or about 9% of the state’s people, were disenrolled for procedural reasons — more than the population of its second-largest city, Colorado Springs.

At least a third of those disenrolled were later determined to be eligible for Medicaid.

Officials at Colorado community health centers and mental health centers say they’re seeing a rise in uninsured patients coming through their doors — a sign, they say, that Coloradans dropped from Medicaid aren’t necessarily moving on to greener health insurance pastures.

Fifty-eight percent of those who were disenrolled have returned to Medicaid, or now have another form of insurance. But the state doesn’t yet know what happened to the remaining 42% of people who were dropped and said it would conduct a survey to find out.

Finlandia ofrece vacunas contra la gripe aviar a sus trabajadores agrícolas. Estados Unidos debería hacer lo mismo, dicen expertos

A medida que la gripe aviar se propaga entre las vacas lecheras en Estados Unidos, veterinarios e investigadores han tomado nota de la decisión de Finlandia de vacunar a los trabajadores agrícolas que corren el riesgo de infectarse. Y se preguntan por qué su gobierno no se hace lo mismo.

“Los trabajadores agrícolas, veterinarios y productores están manejando grandes volúmenes de leche que pueden contener altos niveles del virus de la gripe aviar”, dijo Kay Russo, veterinaria de ganado y aves de corral en Fort Collins, Colorado. “Si una vacuna parece proporcionar algo de inmunidad, creo que también habría que ofrecérsela a ellos”.

La mayoría de una docena de expertos en virología y brotes epidémicos entrevistados por KFF Health News, está de acuerdo con Russo.

Dijeron que a las personas que trabajan en tambos se les debería ofrecer la vacuna contra una enfermedad que ha matado a aproximadamente la mitad de las personas que se sabe que la han contraído en todo el mundo durante las últimas dos décadas, que ha matado a gatos en Estados Unidos este año, y que tiene potencial pandémico.

Sin embargo, otros investigadores están de acuerdo con la posición de los Centros para el Control y Prevención de Enfermedades (CDC), que recomiendan no vacunar por ahora. Consideran que no hay evidencia de que el virus de la gripe aviar de este año se propague entre personas, o cause enfermedad grave en humanos. Y que tampoco está lo suficientemente claro qué tan eficaz es la vacuna disponible a la hora de prevenir cualquiera de estos escenarios.

Sin embargo, para Jennifer Nuzzo, directora del Centro Pandémico de la Universidad Brown, la táctica de esperar y ver “es una apuesta”. “Para cuando tengamos consecuencias graves, muchas personas ya se habrán contagiado”, aseguró.

“Ahora es el momento de ofrecer las vacunas a los trabajadores agrícolas en Estados Unidos”, dijo Nahid Bhadelia, directora del Centro de Enfermedades Infecciosas Emergentes de la Universidad de Boston. Agregó que en el país hasta las medidas más apremiantes están retrasadas.  Bhadelia considera que es urgente realizar análisis tanto a los trabajadores agrícolas como a las vacas para detectar la presencia del virus de la gripe aviar H5N1, estudiarlo y erradicarlo antes de que se establezca en las granjas, lo que representaría una amenaza pandémica constante.

Demetre Daskalakis, director del Centro Nacional de Inmunización y Enfermedades Respiratorias de los CDC, explicó que la agencia se toma muy en serio a la gripe aviar y que se están almacenando 4.8 millones de dosis de la vacuna. Pero admitió que “no hay ninguna recomendación para lanzar una campaña de vacunación”.

“Se trata de la relación riesgo-beneficio”, comentó Daskalakis. Los beneficios todavía son inciertos porque no contamos con suficientes testeos como para entender con qué facilidad el virus pasa de las vacas a las personas, y tampoco sabemos cuán grave puede ser la enfermedad.

Este año, en Estados Unidos, solo cuatro personas han dado positivo y fueron casos leves. Es un número muy limitado, que no permite sacar conclusiones definitivas.

También informaron que han estado enfermos otros trabajadores agrícolas y veterinarios que trabajan en granjas lecheras donde se han detectados casos de gripe aviar. Sin embargo, no se les hicieron los análisis correspondientes. Desde que se detectó el brote en marzo, los hospitales públicos han examinado solo a unas 50 personas que podrían haberse contagiado.

De todos modos, Daskalakis aseguró que los CDC no están preocupados por la posibilidad de que la agencia esté pasando por alto infecciones significativas de gripe aviar debido a su sistema de vigilancia de la influenza. Los hospitales reportan pacientes con casos graves de gripe y este año los números se mantienen normales.

Otro indicio que tranquiliza a la agencia es que el virus aún no ha desarrollado mutaciones que le permitan propagarse rápidamente cuando la gente estornuda o respira. “Si comenzáramos a ver cambios en el virus, ese sería un factor que incidiría en la decisión de pasar de una fase de planificación a una fase operativa”, explicó Daskalakis.

Para evaluar si administrar o no las vacunas, la agencia se basó en el brote de gripe porcina de 1976. En aquel momento, los funcionarios temían que se pudiera repetir la pandemia de gripe porcina de 1918, que mató aproximadamente a medio millón de personas en Estados Unidos. Por lo tanto, en un año vacunaron rápidamente a casi 43 millones de personas.

Pero ese año los casos de gripe porcina resultaron ser leves. Esto hizo que la campaña de vacunación se considerara innecesariamente riesgosa ya que surgieron varios informes de un trastorno potencialmente mortal, el síndrome de Guillain-Barré.

Hay que tener en cuenta que, según los CDC, aproximadamente una persona de cada millón que son vacunadas contra la influenza puede desarrollar ese síndrome. En el balance, el beneficio de la prevención supera al riesgo. Desde el 1 de octubre por lo menos 830,000 personas han sido hospitalizadas por la gripe estacional y entre 25,000 y 75,000 han muerto.

Un informe elaborado tiempo después respecto de las acciones frente a la gripe porcina de 1976 habló de una “experiencia aleccionadora y con moraleja” sobre qué pasa si se responde prematuramente a una amenaza incierta para la salud pública.

“Es una historia sobre lo que sucede cuando lanzas un programa de vacunación en el que se está aceptando correr riesgos sin que haya un beneficio demostrado”, señaló Daskalakis.

Paul Offit, virólogo del Hospital Infantil de Philadelphia, se alinea con la decisión que tomaron los CDC. “Esperaría a tener más datos”, dijo.

Sin embargo, otros investigadores dicen que el escenario de 1976 fue distinto. Nadie está sugiriendo vacunar a decenas de millones de personas: se está hablando de una vacuna totalmente voluntaria para los miles de trabajadores que están en contacto cotidiano con el ganado, lo que reduce la posibilidad de efectos adversos raros.

La vacuna contra la gripe aviar que está disponible, fabricada por la empresa de vacunas contra la gripe CSL Seqirus, fue autorizada el año pasado por el equivalente europeo de la Administración de Drogas y Alimentos (FDA). Una versión previa tiene la aprobación de la FDA, pero la más reciente aún no recibió la luz verde.

Aunque la vacuna está dirigida a una cepa diferente de gripe aviar que la H5N1, que es la que circula actualmente entre las vacas, los estudios muestran que desencadena una respuesta inmune contra ambas variantes. Se considera segura porque utiliza la misma tecnología en base a huevo que se despliega cada año en las vacunas contra la gripe estacional.

Por estas razones, Estados Unidos, el Reino Unido, Holanda y otra docena de países están almacenando millones de dosis. Finlandia espera ofrecérselas este mes también a quienes trabajan en granjas peleteras, como precaución porque sus granjas de visones y zorros fueron golpeadas por la gripe aviar el año pasado.

En contraste, las vacunas de ARNm que se están desarrollando contra la gripe aviar serían las primeras de su tipo también para la influenza. El 2 de julio, el gobierno de Estados Unidos anunció que pagaría a la farmacéutica Moderna $176 millones por su desarrollo y que las vacunas podrían entrar en la etapa de ensayos clínicos el próximo año.

Utilizadas ampliamente contra covid-19, esta nueva tecnología emplea ARNm para enseñar al sistema inmune cómo reconocer virus particulares.

Mientras tanto, Florian Krammer, virólogo especializado en gripe en la Escuela de Medicina Icahn de Mount Sinai, señaló que las personas que trabajan en tambos deberían tener la opción de recibir la vacuna basada en huevo. Esta vacuna desencadena una respuesta inmunitaria contra un componente principal del virus H5N1 de la gripe aviar, lo que debería brindar un grado de protección contra la infección y la enfermedad grave, explicó.

Aun así, la protección no sería del 100%. Y nadie sabe cuántos contagios y hospitalizaciones podría prevenir esta vacuna, ya que no se ha utilizado para combatir el virus de este año. Esos datos deben recopilarse en estudios que rastreen qué resultado tuvo en las personas que opten por ser vacunadas, agregó.

A Krammer no lo tranquiliza que no se hayan detectado casos graves de gripe aviar en las clínicas. “Porque cuando los indicios llegan a los hospitales, significa que la situación ya se encuentra fuera de control, que estamos frente a una pandemia”, dijo. “Y eso es lo que queremos evitar”.

El virólogo y otros especialistas enfatizaron que Estados Unidos debería estar haciendo todo lo posible para frenar las infecciones antes de octubre, cuando comienza la temporada de gripe. La vacuna podría proporcionar una capa adicional de protección, que se sumaría a las evaluaciones, el uso de guantes y gafas, y la desinfección del equipo de ordeñe.

Algunos científicos temen que, si las personas contraen la gripe aviar y la gripe estacional simultáneamente, los virus de la gripe aviar podrían generar adaptaciones de los virus estacionales que les permitieran propagarse rápidamente entre humanos.

También dicen que podría llevar meses distribuir las vacunas después que se recomiende oficialmente, ya que ese tipo de campaña requiere grandes esfuerzos de divulgación.

Bethany Boggess Alcauter, directora de investigación del National Center for Farmworker Health, comentó que las personas que trabajan con vacas lecheras aún carecen de información sobre el virus, cuatro meses después del inicio de este brote.

Los funcionarios de salud han hablado con los propietarios de tambos, pero las entrevistas de Boggess con los trabajadores agrícolas permiten pensar que esas conversaciones no han llegado a su personal.

Un trabajador agrícola en el Panhandle de Texas le contó a Boggess que en su trabajo le dijeron que se desinfectara las manos y las botas para proteger a las vacas de enfermedades que los trabajadores puedan transmitir. “Nunca nos dijeron que la vaca podría infectarnos con alguna enfermedad”, dijo el hombre en español.

El ritmo siempre lento en que se divulga la información es un recordatorio de que todo lleva tiempo, incluidas las decisiones sobre vacunación. Para resolver si recomendar las vacunas, los CDC normalmente buscan orientación de su Comité Asesor sobre Prácticas de Inmunización, o ACIP. Un consultor del grupo, el investigador de enfermedades infecciosas William Schaffner, ha pedido repetidamente a la agencia que presente su opinión sobre la vacuna contra la gripe aviar de Seqirus.

En lugar de preocuparse por la situación de la gripe porcina de 1976, Schaffner sugirió que los CDC consideren la pandemia de gripe porcina de 2009-10. Esta pandemia causó más de 274,000 hospitalizaciones y 12,000 muertes en Estados Unidos en un año. Para cuando comenzó la vacunación, dijo, gran parte del daño ya estaba hecho.

“El momento de discutir esto con ACIP es ahora”, sostuvo Schaffner. Es decir, antes de que la gripe aviar se convierta en una emergencia de salud pública. “No queremos que se comience a discutir cuando ya sea demasiado tarde”.

Finland Is Offering Farmworkers Bird Flu Shots. Some Experts Say the US Should, Too.

As bird flu spreads among dairy cattle in the U.S., veterinarians and researchers have taken note of Finland’s move to vaccinate farmworkers at risk of infection. They wonder why their government doesn’t do the same.

“Farmworkers, veterinarians, and producers are handling large volumes of milk that can contain high levels of bird flu virus,” said Kay Russo, a livestock and poultry veterinarian in Fort Collins, Colorado. “If a vaccine seems to provide some immunity, I think it should be offered to them.”

Among a dozen virology and outbreak experts interviewed by KFF Health News, most agree with Russo. They said people who work with dairy cows should be offered vaccination for a disease that has killed roughly half of the people known to have gotten it globally over the past two decades, has killed cats in the U.S. this year, and has pandemic potential.

However, some researchers sided with the Centers for Disease Control and Prevention in recommending against vaccination for now. There’s no evidence that this year’s bird flu virus spreads between people or causes serious disease in humans. And it’s unclear how well the available vaccine would prevent either scenario.

But the wait-and-see approach “is a gamble,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University. “By the time we see severe outcomes, it means a lot of people have been infected.”

“Now is the time to offer the vaccines to farmworkers in the United States,” said Nahid Bhadelia, director of the Boston University Center on Emerging Infectious Diseases. Even more urgent measures are lagging in the U.S., she added. Testing of farmworkers and cows is sorely needed to detect the H5N1 bird flu virus, study it, and extinguish it before it becomes a fixture on farms — posing an ever-present pandemic threat.

Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases, said the agency takes bird flu seriously, and the U.S. is stockpiling 4.8 million doses of the vaccine. But, he said, “there’s no recommendation to launch a vaccine campaign.”

“It’s all about risk-benefit ratios,” Daskalakis said. The benefits are blurry because there hasn’t been enough testing to understand how easily the virus jumps from cows into people, and how sick they become. Just four people in the United States have tested positive this year, with mild cases — too few to draw conclusions.

Other farmworkers and veterinarians working on dairy farms with outbreaks have reported being sick, Russo said, but they haven’t been tested. Public health labs have tested only about 50 people for the bird flu since the outbreak was detected in March.

Still, Daskalakis said the CDC is not concerned that the agency is missing worrisome bird flu infections because of its influenza surveillance system. Hospitals report patients with severe cases of flu, and numbers are normal this year.

Another signal that puts the agency at ease is that the virus doesn’t yet have mutations that allow it to spread rapidly between people as they sneeze and breathe. “If we start to see changes in the virus, that’s another factor that would be part of the decision to move from a planning phase into an operational one,” Daskalakis said.

On July 8, researchers reported that the virus may be closer to spreading between people than previously thought. It still doesn’t appear to do so, but experiments suggest it has the ability to infect human airways. It also spread between two laboratory ferrets through the air.

In considering vaccines, the agency takes a cue from a 1976 outbreak of the swine flu. Officials initially feared a repeat of the 1918 swine flu pandemic that killed roughly half a million people in the United States. So they rapidly vaccinated nearly 43 million people in the country within a year.

But swine flu cases turned out to be mild that year. This made the vaccine seem unnecessarily risky as several reports of a potentially deadly disorder, Guillain-Barré Syndrome, emerged. Roughly one of every million people who get influenza vaccines may acquire the disorder, according to the CDC. That risk is outweighed by the benefits of prevention. Since Oct. 1, as many as 830,000 people have been hospitalized for the seasonal flu and 25,000 to 75,000 people have died.

An after-action report on the 1976 swine flu situation called it a “sobering, cautionary tale” about responding prematurely to an uncertain public health threat. “It’s a story about what happens when you launch a vaccine program where you are accepting risk without any benefit,” Daskalakis said.

Paul Offit, a virologist at the Children’s Hospital of Philadelphia, sides with the CDC. “I’d wait for more data,” he said.

An areal view of a large-scale vaccination set up in a warehouse-like room.
Health officials distributed 16,000 swine flu vaccinations to residents in San Francisco in December 2009. But they were deployed too late to have much of an impact on the epidemic.(Paul Chinn/The San Francisco Chronicle via Getty Images)

However, other researchers say this isn’t comparable to 1976 because they aren’t suggesting that the U.S. vaccinate tens of millions of people. Rather they’re talking about a voluntary vaccine for thousands of people in close contact with livestock. This lessens the chance of rare adverse effects.

The bird flu vaccine on hand, made by the flu vaccine company CSL Seqirus, was authorized last year by the European equivalent of the FDA. An older variety has FDA approval, but the newer variety hasn’t gotten the green light yet.

Although the vaccine targets a different bird flu strain than the H5N1 virus now circulating in cows, studies show it triggers an immune response against both varieties. It’s considered safe because it uses the same egg-based vaccine technology deployed every year in seasonal flu vaccines.

For these reasons, the United States, the United Kingdom, the Netherlands, and about a dozen other countries are stockpiling millions of doses. Finland expects to offer them to people who work on fur farms this month as a precaution because its mink and fox farms were hit by the bird flu last year.

In contrast, mRNA vaccines being developed against the bird flu would be a first for influenza. On July 2, the U.S. government announced that it would pay Moderna $176 million for their development, and that the vaccines may enter clinical trials next year. Used widely against covid-19, this newer technology uses mRNA to teach the immune system how to recognize particular viruses.

In the meantime, Florian Krammer, a flu virologist at Mount Sinai’s Icahn School of Medicine, said people who work on dairy farms should have the option to get the egg-based vaccine. It elicits an immune response against a primary component of the H5N1 bird flu virus that should confer a degree of protection against infection and serious sickness, he said.

Still, its protection wouldn’t be 100%. And no one knows how many cases and hospitalizations it would prevent since it hasn’t been used to combat this year’s virus. Such data should be collected in studies that track the outcomes of people who opt to get one, he said.

Krammer isn’t assuaged by the lack of severe bird flu cases spotted in clinics. “If you see a signal in hospitals, the cat is out of the bag. Game over, we have a pandemic,” he said. “That’s what we want to avoid.”

He and others stressed that the United States should be doing everything it can to curb infections before flu season starts in October. The vaccine could provide an additional layer of protection on top of testing, wearing gloves, and goggles, and disinfecting milking equipment. Scientists worry that if people get the bird flu and the seasonal flu simultaneously, bird flu viruses could snag adaptations from seasonal viruses that allow them to spread swiftly among humans.

They also note it could take months to distribute the vaccines after they’re recommended since it requires outreach. People who work beside dairy cows still lack information on the virus, four months into this outbreak, said Bethany Boggess Alcauter, director of research at the National Center for Farmworker Health.

Health officials have talked with dairy farm owners, but Boggess’ interviews with farmworkers suggest those conversations haven’t trickled down to their staff. One farmworker in the Texas Panhandle told her he was directed to disinfect his hands and boots to protect cows from diseases that workers may carry. “They never told us if the cow could infect us with some illness,” the farmworker said in Spanish.

The slow pace of educational outreach is a reminder that everything takes time, including vaccine decisions. When deciding whether to recommend vaccines, the CDC typically seeks guidance from its Advisory Committee on Immunization Practices, or the ACIP. A consultant to the group, infectious disease researcher William Schaffner, has repeatedly asked the agency to present its thinking on Seqirus’ bird flu vaccine.

Rather than fret about the 1976 swine flu situation, Schaffner suggested the CDC consider the 2009-10 swine flu pandemic. It caused more than 274,000 hospitalizations and 12,000 deaths in the U.S. within a year. By the time vaccines were rolled out, he said, much of the damage had been done.

“The time to discuss this with ACIP is now,” said Schaffner, before the bird flu becomes a public health emergency. “We don’t want to discuss this until the cows come home in the middle of a crisis.”

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In a first, the legislation extends privacy rights to the neural data increasingly coveted by technology companies.

How a Friend’s Death Turned Colorado Teens Into Anti-Overdose Activists

Gavinn McKinney loved Nike shoes, fireworks, and sushi. He was studying Potawatomi, one of the languages of his Native American heritage. He loved holding his niece and smelling her baby smell. On his 15th birthday, the Durango, Colorado, teen spent a cold December afternoon chopping wood to help neighbors who couldn’t afford to heat their homes.

McKinney almost made it to his 16th birthday. He died of fentanyl poisoning at a friend’s house in December 2021. His friends say it was the first time he tried hard drugs. The memorial service was so packed people had to stand outside the funeral home.

Now, his peers are trying to cement their friend’s legacy in state law. They recently testified to state lawmakers in support of a bill they helped write to ensure students can carry naloxone with them at all times without fear of discipline or confiscation. School districts tend to have strict medication policies. Without special permission, Colorado students can’t even carry their own emergency medications, such as an inhaler, and they are not allowed to share them with others.

“We realized we could actually make a change if we put our hearts to it,” said Niko Peterson, a senior at Animas High School in Durango and one of McKinney’s friends who helped write the bill. “Being proactive versus being reactive is going to be the best possible solution.”

Individual school districts or counties in California, Maryland, and elsewhere have rules expressly allowing high school students to carry naloxone. But Jon Woodruff, managing attorney at the Legislative Analysis and Public Policy Association, said he wasn’t aware of any statewide law such as the one Colorado is considering. Woodruff’s Washington, D.C.-based organization researches and drafts legislation on substance use.

Naloxone is an opioid antagonist that can halt an overdose. Available over the counter as a nasal spray, it is considered the fire extinguisher of the opioid epidemic, for use in an emergency, but just one tool in a prevention strategy. (People often refer to it as “Narcan,” one of the more recognizable brand names, similar to how tissues, regardless of brand, are often called “Kleenex.”)

The Biden administration last year backed an ad campaign encouraging young people to carry the emergency medication.

Most states’ naloxone access laws protect do-gooders, including youth, from liability if they accidentally harm someone while administering naloxone. But without school policies explicitly allowing it, the students’ ability to bring naloxone to class falls into a gray area.

Ryan Christoff said that in September 2022 fellow staff at Centaurus High School in Lafayette, Colorado, where he worked and which one of his daughters attended at the time, confiscated naloxone from one of her classmates.

“She didn’t have anything on her other than the Narcan, and they took it away from her,” said Christoff, who had provided the confiscated Narcan to that student and many others after his daughter nearly died from fentanyl poisoning. “We should want every student to carry it.”

Boulder Valley School District spokesperson Randy Barber said the incident “was a one-off and we’ve done some work since to make sure nurses are aware.” The district now encourages everyone to consider carrying naloxone, he said.

Zoe Ramsey, a high school senior from Durango, Colorado, testified before state lawmakers in February 2024 about a bill to clarify that students may carry naloxone, a drug that can reverse opioid overdoses. (Rae Ellen Bichell/KFF Health News)

Community’s Devastation Turns to Action

In Durango, McKinney’s death hit the community hard. McKinney’s friends and family said he didn’t do hard drugs. The substance he was hooked on was Tapatío hot sauce — he even brought some in his pocket to a Rockies game.

After McKinney died, people started getting tattoos of the phrase he was known for, which was emblazoned on his favorite sweatshirt: “Love is the cure.” Even a few of his teachers got them. But it was classmates, along with their friends at another high school in town, who turned his loss into a political movement.

“We’re making things happen on behalf of him,” Peterson said.

The mortality rate has spiked in recent years, with more than 1,500 other children and teens in the U.S. dying of fentanyl poisoning the same year as McKinney. Most youth who die of overdoses have no known history of taking opioids, and many of them likely thought they were taking prescription opioids like OxyContin or Percocet — not the fake prescription pills that increasingly carry a lethal dose of fentanyl.

“Most likely the largest group of teens that are dying are really teens that are experimenting, as opposed to teens that have a long-standing opioid use disorder,” said Joseph Friedman, a substance use researcher at UCLA who would like to see schools provide accurate drug education about counterfeit pills, such as with Stanford’s Safety First curriculum.

Allowing students to carry a low-risk, lifesaving drug with them is in many ways the minimum schools can do, he said.

“I would argue that what the schools should be doing is identifying high-risk teens and giving them the Narcan to take home with them and teaching them why it matters,” Friedman said.

Writing in The New England Journal of Medicine, Friedman identified Colorado as a hot spot for high school-aged adolescent overdose deaths, with a mortality rate more than double that of the nation from 2020 to 2022.

“Increasingly, fentanyl is being sold in pill form, and it’s happening to the largest degree in the West,” said Friedman. “I think that the teen overdose crisis is a direct result of that.”

Gavinn McKinney died of fentanyl poisoning at a friend’s house in December 2021. McKinney was part of the Thunder Clan of the Citizen Potawatomi Nation. He also had Kickapoo and Assiniboine heritage. (Trennie Burch)

If Colorado lawmakers approve the bill, “I think that’s a really important step,” said Ju Nyeong Park, an assistant professor of medicine at Brown University, who leads a research group focused on how to prevent overdoses. “I hope that the Colorado Legislature does and that other states follow as well.”

Park said comprehensive programs to test drugs for dangerous contaminants, better access to evidence-based treatment for adolescents who develop a substance use disorder, and promotion of harm reduction tools are also important. “For example, there is a national hotline called Never Use Alone that anyone can call anonymously to be supervised remotely in case of an emergency,” she said.

Taking Matters Into Their Own Hands

Many Colorado school districts are training staff how to administer naloxone and are stocking it on school grounds through a program that allows them to acquire it from the state at little to no cost. But it was clear to Peterson and other area high schoolers that having naloxone at school isn’t enough, especially in rural places.

“The teachers who are trained to use Narcan will not be at the parties where the students will be using the drugs,” he said.

And it isn’t enough to expect teens to keep it at home.

“It’s not going to be helpful if it’s in somebody’s house 20 minutes outside of town. It’s going to be helpful if it’s in their backpack always,” said Zoe Ramsey, another of McKinney’s friends and a senior at Animas High School.

“We were informed it was against the rules to carry naloxone, and especially to distribute it,” said Ilias “Leo” Stritikus, who graduated from Durango High School last year.

But students in the area, and their school administrators, were uncertain: Could students get in trouble for carrying the opioid antagonist in their backpacks, or if they distributed it to friends? And could a school or district be held liable if something went wrong?

He, along with Ramsey and Peterson, helped form the group Students Against Overdose. Together, they convinced Animas, which is a charter school, and the surrounding school district, to change policies. Now, with parental permission, and after going through training on how to administer it, students may carry naloxone on school grounds.

Durango School District 9-R spokesperson Karla Sluis said at least 45 students have completed the training.

School districts in other parts of the nation have also determined it’s important to clarify students’ ability to carry naloxone.

“We want to be a part of saving lives,” said Smita Malhotra, chief medical director for Los Angeles Unified School District in California.

Gavinn McKinney’s mother, whose name is being withheld because they are part of a state confidentiality program for survivors of domestic violence, at the Colorado state Capitol for a hearing in February on a bill to clarify that students in the state may carry naloxone.( Rae Ellen Bichell/KFF Health News)

Los Angeles County had one of the nation’s highest adolescent overdose death tallies of any U.S. county: From 2020 to 2022, 111 teens ages 14 to 18 died. One of them was a 15-year-old who died in a school bathroom of fentanyl poisoning. Malhotra’s district has since updated its policy on naloxone to permit students to carry and administer it.

“All students can carry naloxone in our school campuses without facing any discipline,” Malhotra said. She said the district is also doubling down on peer support and hosting educational sessions for families and students.

Montgomery County Public Schools in Maryland took a similar approach. School staff had to administer naloxone 18 times over the course of a school year, and five students died over the course of about one semester.

When the district held community forums on the issue, Patricia Kapunan, the district’s medical officer, said, “Students were very vocal about wanting access to naloxone. A student is very unlikely to carry something in their backpack which they think they might get in trouble for.”

So it, too, clarified its policy. While that was underway, local news reported that high school students found a teen passed out, with purple lips, in the bathroom of a McDonald’s down the street from their school, and used Narcan to revive them. It was during lunch on a school day.

“We can’t Narcan our way out of the opioid use crisis,” said Kapunan. “But it was critical to do it first. Just like knowing 911.”

Now, with the support of the district and county health department, students are training other students how to administer naloxone. Jackson Taylor, one of the student trainers, estimated they trained about 200 students over the course of three hours on a recent Saturday.

“It felt amazing, this footstep toward fixing the issue,” Taylor said.

Each trainee left with two doses of naloxone.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

Covid Closed the Nation’s Schools. Cleaner Air Can Keep Them Open.

Scientists and educators are searching for ways to improve air quality in the nation’s often dilapidated school buildings.