LOS ANGELES – Today, supporters of an initiative to reform the dialysis industry are filing more than 600,000 signatures with county officials up and down the state in an effort to get on the November ballot. The so-called "Fair Pricing for Dialysis Act" would limit dialysis corporations' revenues to 15 percent above what they spend on patient care – and rebate anything above that to insurance companies.

However, it does not require insurers to pass that on to consumers. Sean Wherley, senior communications specialist for the union SEIU-United Healthcare Workers West, says the idea is to incentivize the companies to plow more profits back into patient care.

"Hiring staff is patient care. Getting new equipment is patient care. Improving the facilities is patient care,” says Wherley. “If they do all that, they can charge more. They just can't take more than 15 percent above that cost."

Wherley notes that dialysis giants Fresenius and DaVita made $3.9 billion in 2016 – and says the union has heard complaints that some clinics are dirty, have faulty equipment or are so understaffed, patients with low blood pressure pass out while others soil themselves waiting to be unhooked in order to go to the restroom.

DaVita and Fresenius argue that limiting revenues will cause clinics to cut back or close, limiting access for the 66,000 Californians with kidney disease who could die if they don't get their blood filtered several times a week.

Miguel Estrada, a patient-care tech for almost 20 years, belongs to the group "Patients and Caregivers to Protect Dialysis Patients," which is funded by DaVita and Fresenius. He argues that the initiative's definition of patient care doesn't cover necessary staff such as the physician medical director. And he thinks the union has an ulterior motive.

"Clinics are gonna close, and then my patients are gonna be at risk,” he says. “I mean, this initiative is really just a way to negotiate because the union has been trying to get into dialysis for the last almost two years without success."

Last year, a bill to establish minimum staffing levels in dialysis clinics, Senate Bill 349, passed the state Senate but is still awaiting a vote in the State Assembly. About 16,000 people work at 570 clinics in California.


get more stories like this via email

Some New York doctors are working on new ways to treat advanced cancers.

Chimeric Antigen Receptor, or CAR, T-cell therapy treats certain blood cancers by genetically modifying a person's T-cells to attack cancer cells.

It's been a long-growing effort from doctors at Roswell Park Comprehensive Cancer Center in Buffalo over several decades.

Dr. Renier Brentjens, the center's deputy director and chair of medicine, developed CAR T-cell therapy - and explained that it acts differently than chemotherapy.

"It doesn't have as many or as severe side effects that we see with chemotherapies," said Brentjens, "where the drugs we see in the chemotherapies that we use tend to be less specific - and so, these chemotherapies both target healthy cells as well as cancer cells."

He said there are primary side effects of CAR T-cell therapy. It can cause flu-like symptoms, low blood pressure, muscle pain and nerve damage.

Dr. Brentjens noted that one of the main challenges he faced was the initial skepticism about whether it could work.

Since its proven success with blood cancers, he said he plans to see if it can be used to treat cancerous tumors, which are more common.

Chris Vogelsang is a Western New Yorker who's faced lymphoma for 14 years after multiple relapses. After one recurrence, he was given the chance by Roswell Park to try CAR T-cell therapy.

He could have tried another stem cell transplant, but that would require finding a donor. Vogelsang said the side effects from his first stem cell treatment and chemotherapy were tougher than the CAR T-cell therapy.

"Having been 10, 12 years out of my first round of treatment, I knew it was pretty taxing," said Vogelsang. "I essentially lost 30 pounds in both cases. I think there was more nausea and physical illness from the stem cell transplant, as far as going through chemotherapy."

He said he's now back to an active lifestyle of playing tennis and golf.

CAR T-cell therapy has boosted survival rates for certain cancers. Studies show initial treatments for blood cancers had a prognosis of 10% to 15%. This therapy has boosted it to 40%.

Nearly four in ten Americans say they feel gloomy during colder, darker months, according to a recent American Psychiatric Association study. But there are ways to shake these winter blues.

UCHealth Clinical Psychologist and Wellness Director Dr. Justin Ross said a big reason people feel down is lack of sunlight, a critical source of vitamin D.

And colder temperatures also make heading outdoors less inviting.

"We lose energy, we may feel a little bit cognitively fuzzy," said Ross. "We have a tendency to stay indoors, and it sort of perpetuates this cycle of just feeling kind of blah for a period of up to several months at a time."

Ross recommended soaking up whatever sunshine is available for at least 30 minutes early in the day. On cloudy days, aim to be outdoors for up to an hour.

If the winter blues develop into something more serious and interfere with your daily life - if you're not able to perform at school or work, or if you're withdrawing from family and friends - he recommends reaching out to a health professional for help.

February is also a time when people begin to assess their New Year's resolutions, which can also dampen moods. Ross said a goal such as losing weight can seem overwhelming.

Focus on the daily steps to get there, diet and exercise, which are 100% within your control.

"They also are much more accomplishable on a daily basis," said Ross. "So recommitting to behaviors that you have within your control is a really important strategy, not only for managing those resolutions but also for thinking about combating those wintertime blues."

Ross also pointed to the Scandinavian concept of Hygge, the art of cozy winter living.

Sip your favorite warm beverage from a beautiful mug. Read a book in a comfy chair. Snuggle up with someone under a blanket by fire or candlelight. Settle into activities that are slow, quiet, and still.

"And what those Scandinavian countries tend to really focus on is embracing that," said Ross. "And finding a way to celebrate that, through comfort and coziness and connection to one another, just in a different way."




get more stories like this via email

By Dawn Attride for Sentient Climate.
Broadcast version by Edwin J. Viera for Connecticut News Service reporting for the Sentient-Public News Service Collaboration

Since President Donald J. Trump’s inauguration on Monday, public health officials have found themselves at a confusing — and potentially dangerous — standstill. On a global scale, the newly elected president has pulled the U.S. out of the World Health Organization (WHO), and now, has paused external communications for a number of government agencies. The move comes at a critical time for public health as human cases of bird flu have slowly increased, resulting in one death earlier this month, and a number of former public health officials have said the government is not testing enough for bird flu.

The sudden freeze means agencies like The Center for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) are unable to release communications such as scientific reports and health updates. Of particular concern: the pause has no concrete end date, which has left agency employees “confused” on its scope, according to The Washington Post.

Key Public Health Meetings and Research Canceled

Among the fallout is the cancellation of National Institute of Health (NIH) grant review panels, study sections and an indefinite ban on travel. “Asking for a pause on issuing new policy or regulations is reasonable while the new administration settles in, but a blanket freeze on all communications is unusual and could impair critical functions like outbreak response,” Sarah Sorscher, director of regulatory affairs for the Center for Science in the Public Interest, tells Sentient.

These specific measures for health agencies are worrying researchers nationwide, who have taken to social media platforms to air their experiences and frustrations. “All NIH study sections canceled indefinitely. This will halt science and devastate research budgets in universities,” writes Prof. Jane M. Liebschutz on BlueSky.

“Above and beyond the immediate fear and confusion that this freeze and communication blackout has caused, the longstanding implications will largely be determined by how long this situation lasts (I’ve seen insider estimates of February 1) and what is removed from NIH during the freeze,” Daniel P. Moriarity, an assistant professor of psychology at the University of Pennsylvania, writes to Sentient in an email. Interruption of NIH funding, for example, “could have direct consequences on the availability of physicians and clinicians to provide health care,” he writes.

While it’s unclear how long this freeze will last, the 2025 presidential advisory meeting on combating antibiotic-resistant bacteria scheduled for January 28 and 29 has been canceled, indicating the pause could continue for quite some time.

How Will the ‘Pause’ Affect Public Health Warnings?

It appears the freeze is already delaying CDC publications, such as their main weekly report that provides the public with timely health advice and research. This week’s iteration — scheduled for earlier this week –– has not yet been published and was supposed to include new studies and data on the ongoing H5N1 avian influenza virus outbreak. This is not the first time these CDC reports have been affected by the Trump administration — in 2020, officials at the HHS tried to “change, delay and prevent” such reports, particularly those related to COVID-19.

There is also ambiguity as to the breadth of the communications covered, according to a Center for Science in the Public Interest statement, which could hinder agency coordination during an outbreak of foodborne illness. 

A spokesperson for the Department of Health and Human Services (HHS) tells Sentient that a pause on communications and public appearances are “not directly related to emergencies or critical to preserving health.” They also said, “This is a short pause to allow the new team to set up a process for review and prioritization. There are exceptions for announcements that HHS divisions believe are mission critical, but they will be made on a case-by-case basis.” A representative for the CDC declined to comment.

Halting Agency Coordination Could Exacerbate Bird Flu Outbreaks

The shutdown of external agency communications and delayed report from the CDC on key bird flu updates comes at a critical time for vital health messaging between federal agencies and the public, considering the current outbreaks. 

Avian flu has been circulating on factory farms, where the virus can spread through direct contact between workers and animals or droppings between infected (usually wild) birds and farm animals. The close-quarter conditions of factory farms makes them particularly susceptible to outbreaks, requiring stringent biosecurity protocols to stop the spread. Although rare, humans can get bird flu by coming into contact with infected animals, which is why dairy workers are largely affected by the current H5N1 strain, which has infected cow herds in 16 states, mainly California. So far, 67 humans have been sickened and one person has died from bird flu in the U.S.

At present, the current strain of avian flu cannot spread human-to-human, but this may change if the virus mutates, which is why epidemiologists rely on accurate data from agencies like the CDC to track the spread. Another cause for concern is raw milk, which has been found to contain the virus but so far has only infected animals who consumed it.

As the pause only came into effect Tuesday, it remains to be seen how long this directive among federal health agencies will continue to hinder key reports, research and public health information.


Dawn Attride wrote this article for Sentient.


get more stories like this via email