Category: Health

Contributed by: Anjali Sharma 

Introduction 

Have you ever questioned the purpose of consuming Kuttu ka Atta during the nine-day Navratri fast? Navratri is a time when fasting and mindful eating are especially important. 

According to Hindu customs, eating grains during Navratri is strictly forbidden, thus people instead eat fake cereals like Kuttu (buckwheat) and Singhare ka Atta (water chestnut). Kuttu ka atta is ideal for the falahari vrat since it is produced from fruit seeds. But did you know Kuttu Atta has some very useful benefits for your health that makes it an ideal inclusion in your diet even beyond navratri.

Kuttu ka atta, also known as buckwheat, is loaded with wholesome health benefits. In fact, it contains nutrients that can boost your well-being with regular consumption.

Health benefits of Kuttu ka Atta?

High-quality protein, magnesium, vitamin B6, dietary fibre, iron, niacin (vitamin B3), thiamine (vitamin B1), and zinc are all found in abundance in buckwheat. In addition, buckwheat has a greater level of nutritional fibre than other plant-based flours. 

Due to its high fibre and nutritional value, it helps to enhance digestion and weight control by speeding up metabolism. It speeds up weight loss and increases metabolism. Kuttu atta might help you feel less bloated and indigestion prevents indigestion, as compared to regular wheat flour.

Buckwheat flour has a lot of fibre. It aids in modulating the hormones in the gastrointestinal tract that promote better digestion. For people who have bloating and indigestion, this can be quite useful. It will have a particularly big influence on helping those with Celiac Disease with their digestion. 

In fact, increasing your consumption of fibre by 5 percent can lower your chance of getting gallbladder stones by 10 percent , according to the American Journal of Gastroenterology.

Though it is packed with proteins, kuttu atta is extremely low in calories. Additionally, it is gluten-free and helps other nutrients absorb better. Making it simpler to digest than the widely used wheat flour, thereby accelerating the metabolism. Its low glycemic index is another aspect that helps in weight loss.

• Works great in improving hair and skin quality 

The antioxidant content of kuttu ka atta is high, and antioxidants are essential for the production of new skin cells and tissues that are necessary to prevent wrinkles from forming and maintain good hair.

There is no question that calcium is necessary, but magnesium consumption is just as crucial since, without it, your body cannot absorb calcium. It turns out that buckwheat is very high in magnesium content.

Easy Kuttu Atta recipes that you must try

Kuttu cutlet

Add 1 cup of handmade chenna (cheesecurd), 3 tablespoons of buckwheat flour, black pepper, and sendha namak to taste along with 1 cup of mashed potatoes. 

You can also add coriander leaves and green chillies. Make a smooth dough and flatten them, cook them with ghee in a nonstick pan and cook by flipping both sides. 

Kuttu dosa 

Take 4 tablespoons of buckwheat flour, add curd, cumin powder, green chilies, and sendha namak to make this fast dosa dish.

Let it ferment for a few hours. Pour a ladle of the batter onto a tawa, spread it out evenly and thin on the tawa, top it with 1 tsp of ghee, and cook by turning over the sides to make this tasty dosa , then eat with chutney.

Kuttu pakora 

Start by boiling a variety of vegetables and setting them aside for this simple dish. Add Ghee to a pan and wait till it heats up. In the meantime, take Kuttu Atta in a bowl, add spices and a little water to make a thick batter. Now dip the vegetables in the batter and deep fry. Serve hot with chai or coffee.

Kuttu sweet pancakes

To prepare sweet pancakes with Kuttu Atta, take 1 cup milk and add 3 tbsp kuttu ka atta, 1 ½ tbsp sugar. and whisk the batter. Put a little ghee on a tawa and pour a little quantity of the batter and spread it thin. Cook for a few minutes and your sweet pancakes are ready.

To add some excitement to the pancake, top it with nuts, dry fruits and some honey.

Final thoughts 

Due to the presence of D-chiro-inositol, which manages type-2 diabetes, kuttu ka atta is known to maintain the lipid balance in your body. This promotes glucose metabolism, ensuring that your blood sugar levels stay within safe ranges. Having stated that, we advise seeking medical advice before including it in your diet.

If you want to stay healthy, we recommend starting to eat kuttu ka atta every day even if you usually only do so during Navratri fasting.

You can try the above recipes this festive season to get the nutritional benefits and taste of kuttu atta. 

Furthermore, you should also undergo preventive health checkups. These health checks give a complete report about your health, allowing you to take necessary precautionary measures to improve your well-being and keep a host of ailments at bay.

The Food and Drug Administration has approved a controversial new drug for the fatal condition known as ALS, or Lou Gehrig’s disease.

The decision is being hailed by patients and their advocates, but questioned by some scientists.

Relyvrio, made by Amylyx Pharmaceuticals of Cambridge, Mass., was approved based on a single study of just 137 patients. Results suggested the drug might extend patients’ lives by five to six months, or more.

“Six months can be someone attending their daughter’s graduation, a wedding, the birth of a child,” says Calaneet Balas, president and CEO of the ALS Association. “These are really big, monumental things that many people want to make sure that they’re around to see and be a part of.”

Balas says approval was the right decision because patients with ALS typically die within two to five years of a diagnosis, and “right now there just aren’t a lot of drugs available.”

But Dr. David Rind, chief medical officer for the Institute for Clinical and Economic Review, isn’t so sure about Relyvrio, which will cost about $158,000 a year.

“I totally understand why people would be trying to figure out a way to get this to patients,” he says. “There’s just a general concern out there that maybe the trial is wrong.”

ALS kills about 6,000 people a year in the U.S. by gradually destroying nerve cells that control voluntary movements, like walking, talking, eating, and even breathing. Relyvrio, a combination of two existing products, is intended to slow down the disease process.

Proponents of the drug say the small trial showed that it works. But FDA scientists and an expert panel that advises the FDA, weren’t so sure.

Typically, FDA approval requires two independent studies – each with hundreds of participants – showing effectiveness, or one large study with clearly positive results.

In March, the Peripheral and Central Nervous System Drugs Advisory committee concluded that the Amylyx study did not provide “substantial evidence” that its drug was effective. Then in September, during a rare second meeting to consider a drug, the panel reversed course and voted in favor of approval.

The second vote came after Dr. Billy Dunn, director of the FDA’s Office of Neuroscience, encouraged the committee to exercise “flexibility” when considering a drug that might help people facing certain death.

A much larger study of Relyvrio, the Phoenix Trial, is under way. But results are more than a year off.

A negative result from that study would be a major blow to Amylyx and ALS patients.

“If you’ve got a drug that’s extending life by five months,” Rind says, “you ought to be able to show that in a larger trial.”

In the meantime, he says, perhaps Amylix should charge less for their drug.

Relyvrio (marketed as Albrioza in Canada) is the only product made by Amylyx, a company founded less than a decade ago by Joshua Cohen and Justin Klee, who attended Brown University together.

Klee defends the drug’s price, saying it will allow the company to develop even better treatments. “This is not a cure,” he says. “We need to keep investing until we cure ALS.”

Klee and Cohen have also promised that Amylyx will re-evaluate its drug based on the results of the Phoenix trial.

“If the Phoenix trial is not successful,” Klee says, “we will do what’s right for patients, which includes taking the drug voluntarily off the market.”

But that the decision would require support from the company’s investors, and its board of directors.

The COVID-19 pandemic changed the way many patients access the healthcare system. It’s impossible to put the genie back in the bottle, but providers still need to innovate on their digital front door strategies, said panelists during a discussion hosted by market research firm Frost & Sullivan.

The digital front door includes apps, websites, patient portals and devices that can engage or guide patients outside brick-and-mortar facilities. 

Patrick Drewry, vice president of patient engagement at Change Healthcare, said many healthcare organizations don’t think of themselves primarily as businesses and may not consider metrics like customer retention. But he argues that patients will go to other health systems if the digital front door isn’t accessible to them.

“It’s no longer a utility, an expense to set up this technology to be able to offer this to your patient,” he said. “There’s a business case here, and one that can be considered a growth or survival case. That’s the way people need to start thinking, and people are. Your competitors are, and so, if you don’t, there are consequences for that.”

Many provider organizations have built up their digital front door strategies over time, leaving them with a host of point solutions and vendors. Naomi Adams, senior vice president of customer strategy and solution engineering at League, argues that a platform approach is important so patients can find all of these digital tools in one place. 

Using data to personalize the experience could also push patients toward what action they need to take next.

“Healthcare is fundamentally complex. It’s very difficult to navigate. Getting everything in one place is step one, but then making it easy for the consumer to navigate within that,” Adams said, “both digitally and in a more omnichannel way, especially when we’re talking about provider systems where there is that real world, brick-and-mortar location that needs to be considered in the patient journey.”

Adams notes many organizations will add these engagement tools on top of the EHR since they already need to invest in the technology. But EHRs weren’t necessarily designed to be patient-facing engagement tools.

Dr. Rishi Pathak, global director of healthcare and life sciences at Frost & Sullivan, said healthcare providers are changing their strategies as they face more competitors from non-traditional players like Amazon and CVS.

“There is a big shift, wherein most of the healthcare providers are now looking towards more migration from point solutions to more of a platform and integrated solutions,” he said, “moving from data silos to have more of a patient experience and digital front door service to their patients.”

José Valdes, senior director of alliances at Castlight Health, argues that healthcare organizations need to provide action-oriented information to patients, like what they need to do next and when it needs to be done. They also should be able to manage these tasks on their phones, he added.

“I think things that the system still hasn’t addressed are some of the simple things, some of the low-hanging fruit,” Valdes said. “Making it easy to get an appointment, making it easy to communicate with your providers, making it easy to get the information that you need from the providers you are working with.” 

New York-based Grow Therapy, which offers mental health providers tools to help them start their private practice and be covered by insurance, has raised $75 million in Series B funding.

The round was led by TCV and Transformation Capital, and supported by existing investors SignalFire and SVB. 

The funds will be used to expand the company’s insurance coverage, improve its offerings and build its team. Specifically, the company will expand commercial insurance along with Medicare and Medicaid coverage from 13 states to all 50 states and broaden its online marketplace capabilities, EHR platform and clinical resources. 

WHAT THEY DO

Grow Therapy offers a technology platform providing mental health providers tools to set up in-person and virtual practices, connecting those needing treatment to those providing mental health care. 

The company also works with payers — such as Humana, Aetna, Cigna, Florida Blue Cross Blue Shield and United Healthcare — and develops deals where providers in its network are covered by insurance. 

According to Crunchbase, the startup has raised $90 million to date.

“We are nothing but optimistic for a future where starting a private practice is seamless, and accessing high-quality mental healthcare is table-stakes,” Jake Cooper, CEO of Grow Therapy, said in a statement. 

MARKET SNAPSHOT

In August, Alma, a company similar to Grow Therapy that also focuses on supporting mental health professionals in building their practices and setting up contracts, announced $130 million in a Series D funding round. The round came about a year after the company announced its $50 million Series C. 

Quartet Health is another tech-backed company that matches patients and mental health professionals. In 2021, the company announced its acquisition of InnovaTel Telepsychiatry for an undisclosed sum, just days after announcing a $60 million funding round. 

Contributed by Harleen kaur

Introduction

Your regular diet may include traditional white rice. But what if we told you that you could choose a healthier type of rice? Yes, you heard correctly! Asia has traditionally grown rice, which is cultivated in a variety of colours and one of them is known as black rice. They are nowadays gaining popularity because of their beneficial properties, and nutritional value.

If you’ve ever had black rice, you can appreciate its unique purple-black colour, chewy texture, nuttiness, and slightly sweet flavour. But this special rice is more than just delicious; it’s also remarkably healthful, and it’s been recognized as a rice ‘superfood’ in recent years.

Black rice has a higher concentration of minerals like vitamin E, calcium, and potassium that support healthy bodily functions. Compared to other types of rice, it has higher levels of protein, fibre, and iron as well as high levels of amino acids and antioxidants which are beneficial for overall well-being.

Improves eye health 

Black rice contains the antioxidants anthocyanin and vitamin E that promote eye health. Lutein and zeaxanthin, the two most significant carotenoids, are found in black rice that has been said to support and boost eye wellness. A nutritious diet rich in antioxidants and carotenoids also helps protect eye cells from the harmful effects of UV radiation. They are also important in terms of preventing eyesight problems with sight loss due to ageing.

Helps in weight loss 

Black rice is a good source of protein and fibre, which can aid in weight loss by decreasing appetite and enhancing the feeling of fullness. According to research, people who consumed a combination of brown and black rice up to three times per day on a calorie-restricted diet were seen to lose significantly more body weight and body fat than those who only consumed white rice.

Helps in controlling diabetes 

The presence of phenolic compounds present in black rice helps lower the rate of type 2 diabetes. The phenolic chemicals in black rice may be affected by the pancreatic and intestinal enzymes that break down sugars. This may result in lower blood glucose levels and a decreased risk of type 2 diabetes.

Has anti-cancerous properties 

Anthocyanins from black rice help to reduce the number of human breast cancer cells and their growth and ability to spread. According to research a higher intake of anthocyanin-rich foods is connected with a lower risk of colorectal cancer and is also beneficial for overall well-being.

Good for the heart

Your ability to control heart conditions like hypertension and atherosclerosis may be improved by including black rice in your daily diet. Black rice consumption on a regular basis may help you lower cholesterol levels and blood vessel inflammation. Additionally, it also helps to lower blood pressure levels.

Good for hair and skin

The strong antioxidant level of black rice makes it great for your hair. Aside from that, it includes vitamins and minerals that are necessary for promoting hair growth and adding lustre to your hair. 

According to experts, the high antioxidant content in black rice protects skin cells against oxidative damage. It helps treat skin conditions like acne, pimples, and other inflammatory skin conditions as well as skin ageing.

Final thoughts 

Back rice is most likely the healthiest type of rice in the market. It has enormous nutritional value, which has a variety of positive effects on your health. Almost every organ in your body benefits from regular consumption of black rice. It improves mental skills and is good for the liver, eyes, heart, and respiratory system. It has some anti-ageing properties as well.

Furthermore, it promotes weight loss and helps in managing diabetes effectively. It is simple to add black rice to your everyday diet because of its simple cooking process. It is therefore advisable to include this grain in your diet due to its high nutrient profile, and numerous health advantages.

Book The Full Body Good Health Test Today!

(PORTLAND, Ore.) — Oregon is set to become the first state in the nation to cover climate change expenses for certain low-income patients under its Medicaid program as the normally temperate Pacific Northwest region sees longer heat waves and more intense wildfires.

The new initiative, slated to take effect in 2024, will cover payment for devices such as air conditioners and air filters for Medicaid members with health conditions who live in an area where an emergency due to extreme weather has been declared by the federal government or the governor’s office, according to the Oregon Health Authority.

It aims to help people “dealing with the impact of extreme heat, wildfires and other catastrophes caused by climate change,” OHA director Patrick Allen said.

The measure is part of what the Centers for Medicare and Medicaid Services, of the U.S. Department of Health and Human Services, described as “groundbreaking Medicaid initiatives” in Oregon and Massachusetts.

Read more: Why Extreme Heat Plus Pollution Is a Deadly Combination

The federal agency on Wednesday renewed Medicaid waivers for both states. Those waivers will cover non-medical services such as food and housing assistance for people with clinical needs in a bid to tackle the underlying social issues that can cause poor health.

Oregon will receive $1.1 billion in new federal funding for the new Medicaid initiatives covering climate change, nutrition and housing, described as “health-related social needs” by health officials. The state will pilot the changes over the next five years.

“Health care does not occur in a vacuum—it’s clear that we must look beyond a traditional, siloed approach to truly meet the needs of people, particularly those experiencing complex challenges,” Oregon Gov. Kate Brown said in a statement.

Massachusetts Gov. Charlie Baker said his state will “continue to implement innovative reforms that provide quality care, better health outcomes and equity.”

---

More from TIME

---

Read more: Climate Experts Are Testing New Ways To Reach the People Most Affected by Extreme Heat

Oregon’s new Medicaid plan stands out for two first-in-the-nation policies: its climate change coverage, and a measure that will keep children continuously enrolled in Medicaid until age 6 without families having to re-enroll every year.

Officials in the Pacific Northwest have been trying to adjust to the likely reality of more intense heat spells following the region’s fatal “heat dome” weather phenomenon that prompted record temperatures and deaths in the summer of 2021.

About 800 people died in Oregon, Washington, and British Columbia during the heat wave as temperatures soared to an all-time high of 116 Fahrenheit (46.7 Celsius) in Portland and smashed heat records in cities and towns across the region. Many of those who died were older and lived alone.

In addition to covering payment for devices that maintain healthy temperatures and clean air inside the home, Oregon’s new Medicaid plan will also cover generators in the case of power outages.

“It’s based on the medical indication that you’re particularly vulnerable to heat events, or you have medical devices that are tied to being powered, or sensitive to smoke,” Allen said.

Oregon Medicaid members with health conditions will become eligible for such devices if they live in an area where an emergency due to extreme weather has been declared.

Climate change can pose risks to health, including heat-related illness during heat waves. Extreme weather events such as storms and floods can also negatively impact health, both physical and mental, and disrupt food systems. The risks disproportionately affect low-income communities, older people and those with underlying health conditions.

Medicaid is the federal-state health care insurance program that helps pay for health care for low-income people of any age. Each state determines eligibility and the full scope of services covered. The federal government reimburses a percentage of the state’s expenditures.

“There’s lots of discussion in climate change about making sure that as we address the health risks of a changing climate, that we do so in a way that reduces inequities,” said Kristie Ebi, professor in the Center for Health and the Global Environment at the University of Washington.

Oregon’s Medicaid initiative “is an opportunity to reduce some of those inequities for people who can’t afford, for example, a generator to make sure that life-saving equipment continues to run during heat waves,” Ebi said.

Read more: Extreme Heat Makes It Hard for Kids to Be Active. But Exercise Is Crucial In a Warming World

As for Medicaid coverage of food and housing assistance, Oregon and Massachusetts are expanding eligibility for such services.

Food support can include tailored meal plans based on health needs and Medicaid-funded prescriptions for fruits and vegetables. Housing services can include rental application assistance, moving help and eviction prevention.

Massachusetts will provide additional meal support for Medicaid members who are children or pregnant women with special clinical needs, according to the Centers for Medicare and Medicaid Services.

In Oregon, people experiencing life transitions, including those experiencing or at risk of homelessness, can be eligible for rental assistance for up to six months.

____

Claire Rush is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow her on Twitter @ClaireARush.

Contact us at [email protected].

Marie lives in the coastal town of Swampscott, in Massachusetts. Last December, she began having more and more trouble breathing. One morning, three days after Christmas, she woke up gasping for air. A voice in her head said, “You’re going to die.” Marie dialed 911.

“I was so scared,” Marie said later. Describing that day, the 63-year-old’s voice filled with tension, and her hand clutched at her chest.

Marie was admitted to Salem Hospital, north of Boston. The staff treated her COPD, a chronic lung condition that includes emphysema and chronic bronchitis.

After her worst symptoms subsided, a doctor came the next day to check on her. He told Marie her oxygen levels looked good and that she was stable and ready to be discharged.

NPR is not using Marie’s last name because she, like 1 in 9 hospitalized patients, has a history of addiction to drugs or alcohol. Disclosing a diagnosis like that can make it hard to find housing, a job and even medical care in hospitals where patients with an addiction may be shunned.

But talking to the doctor that morning, Marie felt she didn’t have a choice. She had to tell him about her other medical problem.

“He said I could be released,” Marie recalled. “And I said, ‘I got to tell you something. I’m a heroin addict. And I’m, like, starting to be in heavy withdrawal. I can’t literally move, please don’t make me go.'”

Without care, discharged patients risk overdose

At many hospitals in Massachusetts and across the country, Marie would likely have been discharged anyway, while still in the pain of withdrawal. Perhaps she would leave with a list of local detox programs where she might — or might not — find help.

But a crucial opportunity to intervene and treat at the hospital would have been lost — partly because most hospitals don’t have specialists available who know how to treat addiction, and other clinicians don’t know what to do.

Hospitals typically employ all sorts of specialists who focus on critical organs like hearts, lungs and kidneys — or who treat systemic or chronic diseases of the immune system or the brain. There are specialists for children, for mental illness, for childbirth and hospice.

But if your illness is an addiction or a condition related to drug or alcohol use, there are few hospitals where patients can see a clinician — whether that be an M.D., nurse, therapist or social worker — who specializes in addiction medicine.

Their absence among hospital personnel is particularly striking at a time when overdose deaths in the U.S. have reached record highs, and research shows patients face an increased risk of fatal overdose in the days or weeks after they are discharged from a hospital.

“They’re left on their own to figure it out, which unfortunately usually means resuming [drug] use because that’s the only way to feel better,” says Liz Tadie, a nurse practitioner certified in addiction care.

In the fall of 2020, Tadie launched a new approach at Salem Hospital, using $320,000 from a federal grant that the hospital had worked for several years to secure. Tadie put together what’s known as an “addiction consult service.”

At Salem, that team included Tadie, a patient case manager, and three recovery coaches — who draw on their experience with addiction to advocate for patients and help them navigate their treatment options.

What an addiction consult service brings to the bedside

So on that day, when Marie said, “Please don’t make me go,” her doctor didn’t tell Marie she had to leave. He called Tadie for a bedside consult.

Tadie started out the treatment by first prescribing methadone, a medication to treat opioid addiction. Although many patients do well on that drug, it didn’t help Marie, so Tadie switched her to buprenorphine, with better results. After a few more days, Marie was eventually discharged and continued taking buprenorphine to manage her addiction to opioids.

But Marie continued seeing Tadie for treatment as an outpatient and was able to turn to her for support and reassurance:

“Like, that I wasn’t going to be left alone,” Marie said. “That I wasn’t going to have to call a dealer ever again, that I could delete the number. I want to get back to my life. I just feel grateful.”

Among Salem’s clinical staff, Tadie helped spread the word about the expertise she can offer and how it can help patients. Success stories like Marie’s helped her make the case for addiction medicine — which also meant unraveling decades of misinformation, discrimination and ignorance about patients with an addiction and their treatment options.

Part of the problem, according to Tadie, is that doctors, nurses and other clinicians get very little training in the physiology of addiction and withdrawal, the medications and treatment options, and the emerging science about what works for these patients. What little training that doctors and nurses do get is often unhelpful.

“A lot of the facts are outdated,” Tadie says. “And people are training to use stigmatizing language — words like ‘addict’ and substance ‘abuse.'”

Tadie gently corrected doctors at Salem Hospital, for example, who thought they weren’t ever allowed to start patients on methadone in the hospital.

“Sometimes I would recommend a dose and somebody would give pushback,” Tadie says. But “we got to know the hospital doctors and they, over time, were like, “OK, we can trust you. We’ll follow your recommendations.”

Over time, addiction specialists help change the culture

Other members of Tadie’s team have also wrestled with finding their place in the hospital hierarchy. David Cave, one of the recovery coaches at Salem Hospital, is often the first person to speak to a patient who comes to the emergency room in withdrawal. He tries to help doctors and nurses understand what the person is going through and help navigate their care.

“I’m probably punching above my weight every time I try to talk to a clinician or doctor,” says Cave. “They don’t see letters after my name. It can be kind of tough.”

But naming addiction as a specialty, and hiring people with training in this particular disease, is shifting the culture of Salem Hospital, according to Jean Monahan-Doherty, a social worker who has referred patients to Tadie.

“There was finally some recognition across the entire institution that this was a complex medical disease that needed the attention of a specialist,” Monahan-Doherty says. “People are dying. This is a terminal illness unless it’s treated.”

This approach to treating addiction is winning over some Salem Hospital employees — but not all.

“Some of the medical staff continue to see it as a moral issue,” Monahan-Doherty says. “Sometimes you hear an attitude of ‘Why are you putting all this effort into this patient? They’re not going to get better.’ Well, how do we know? If a patient comes in with diabetes, we don’t say, ‘OK, they’ve been taught once and it didn’t work. So we’re not going to offer them support again.'”

Despite lingering reservations among some colleagues, the demand for their services is quite high. Many days, Tadie and her team have been overwhelmed with referrals.

With federal support, states experiment to stop overdose deaths

Four other Massachusetts hospitals also added addiction specialists in the past three years and experienced similar challenges and success. The additional staff were paid for by federal funding from the HEALing Communities study. This project is paying for a wide range of strategies across several states, to determine the most effective ways to reduce drug overdose deaths. They include mobile treatment clinics, street outreach teams, naloxone trainings and distribution, rides to treatment sites, and multilingual public awareness campaigns.

“You really do provide better care for patients and you make the care environment one that people are more satisfied working in,” says Dr. Jeffrey Samet, who leads the Massachusetts portion of this research effort. Samet practices primary care at Boston Medical Center and says adding addiction specialists in hospitals is a key piece of the solution.

Dr. Todd Kerensky, president of the Massachusetts Society of Addiction Medicine, has seen patients cry when they learn he specializes in addiction and wants to treat their disease, not shame them.

“It’s gut-wrenching to know there are a lot of institutions that don’t have this service,” says Kerensky. It’s not clear how many hospitals in Massachusetts have addiction experts on staff, but Kerensky says it’s a “distinct minority.”

There are many possible reasons. It’s a new field, so finding qualified staff members with the right certifications may be a hurdle. Some hospital leaders say they’re worried about the costs of addiction treatment and fear they’ll lose money on the efforts. Some doctors report not wanting to initiate a treatment medication while the patient is still in the hospital, because they don’t know where to refer patients after they’ve been discharged, whether that be outpatient follow-up care or a residential program. To address follow-up care, Salem Hospital started what’s known as a “bridge clinic,” where patients get help transitioning to outpatient care.

Despite these worries and reservations, hospitals that don’t have an addiction specialty team need to start one, says Dr. Honora Englander, a national leader in addiction specialty programs.

“People with substance use disorder are coming to our hospitals now,” said Englander, who directs an addiction care team at Oregon Health and Science University. “We can’t wait. We have to do better, and this is the time.”

Englander says the federal government could support the creation of more addiction consult services by offering financial incentives — or penalties for hospitals that don’t embrace them. The Centers for Medicare & Medicaid Services, which has regulatory authority over most U.S. hospitals, could require that hospitals stock the medications used to treat an addiction and track outcomes for patients hospitalized with a substance use disorder, in the same way that CMS already does when it comes to readmissions for other health conditions.

At Salem Hospital, the program is still new, and some staff worry about its future. Liz Tadie is moving to a new job at another hospital, and the federal grant ended June 30. But Salem Hospital leaders say they are committed to continuing the program, and the service will continue.

Compared to the other four Massachusetts hospitals that launched addiction consult teams using the same federal grant, Salem Hospital has helped the most patients. Over a 15-month period, its team helped 448 patients begin medication to treat their opioid use disorder.

This story comes from NPR’s health reporting partnership with WBUR and KHN (Kaiser Health News).

Recently, after a week in which 2,789 Americans died of COVID-19, President Joe Biden proclaimed that “the pandemic is over.” Anthony Fauci described the controversy around the proclamation as a matter of “semantics,” but the facts we are living with can speak for themselves. COVID still kills roughly as many Americans every week as died on 9/11. It is on track to kill at least 100,000 a year—triple the typical toll of the flu. Despite gross undercounting, more than 50,000 infections are being recorded every day. The CDC estimates that 19 million adults have long COVID. Things have undoubtedly improved since the peak of the crisis, but calling the pandemic “over” is like calling a fight “finished” because your opponent is punching you in the ribs instead of the face.

American leaders and pundits have been trying to call an end to the pandemic since its beginning, only to be faced with new surges or variants. This mindset not only compromises the nation’s ability to manage COVID, but also leaves it vulnerable to other outbreaks. Future pandemics aren’t hypothetical; they’re inevitable and imminent. New infectious diseases have regularly emerged throughout recent decades, and climate change is quickening the pace of such events. As rising temperatures force animals to relocate, species that have never coexisted will meet, allowing the viruses within them to find new hosts—humans included. Dealing with all of this again is a matter of when, not if.

In 2018, I wrote an article in The Atlantic warning that the U.S. was not prepared for a pandemic. That diagnosis remains unchanged; if anything, I was too optimistic. America was ranked as the world’s most prepared country in 2019—and, bafflingly, again in 2021—but accounts for 16 percent of global COVID deaths despite having just 4 percent of the global population. It spends more on medical care than any other wealthy country, but its hospitals were nonetheless overwhelmed. It helped create vaccines in record time, but is 67th in the world in full vaccinations. (This trend cannot solely be attributed to political division; even the most heavily vaccinated blue state—Rhode Island—still lags behind 21 nations.) America experienced the largest life-expectancy decline of any wealthy country in 2020 and, unlike its peers, continued declining in 2021. If it had fared as well as just the average peer nation, 1.1 million people who died last year—a third of all American deaths—would still be alive.

America’s superlatively poor performance cannot solely be blamed on either the Trump or Biden administrations, although both have made egregious errors. Rather, the new coronavirus exploited the country’s many failing systems: its overstuffed prisons and understaffed nursing homes; its chronically underfunded public-health system; its reliance on convoluted supply chains and a just-in-time economy; its for-profit health-care system, whose workers were already burned out; its decades-long project of unweaving social safety nets; and its legacy of racism and segregation that had already left Black and Indigenous communities and other communities of color disproportionately burdened with health problems. Even in the pre-COVID years, the U.S. was still losing about 626,000 people more than expected for a nation of its size and resources. COVID simply toppled an edifice whose foundations were already rotten.

In furiously racing to rebuild on this same foundation, America sets itself up to collapse once more. Experience is reputedly the best teacher, and yet the U.S. repeated mistakes from the early pandemic when faced with the Delta and Omicron variants. It got early global access to vaccines, and nonetheless lost almost half a million people after all adults became eligible for the shots. It has struggled to control monkeypox—a slower-spreading virus for which there is already a vaccine. Its right-wing legislators have passed laws and rulings that curtail the possibility of important public-health measures like quarantines and vaccine mandates. It has made none of the broad changes that would protect its population against future pathogens, such as better ventilation or universal paid sick leave. Its choices virtually guarantee that everything that’s happened in the past three years will happen again.

---

The U.S. will continue to struggle against infectious diseases in part because some of its most deeply held values are antithetical to the task of besting a virus. Since its founding, the country has prized a strain of rugged individualism that prioritizes individual freedom and valorizes self-reliance. According to this ethos, people are responsible for their own well-being, physical and moral strength are equated, social vulnerability results from personal weakness rather than policy failure, and handouts or advice from the government are unwelcome. Such ideals are disastrous when handling a pandemic, for two major reasons.

First, diseases spread. Each person’s choices inextricably affect their community, and the threat to the collective always exceeds that to the individual. The original Omicron variant, for example, posed slightly less risk to each infected person than the variants that preceded it, but spread so quickly that it inundated hospitals, greatly magnifying COVID’s societal costs. To handle such threats, collective action is necessary. Governments need policies, such as vaccine requirements or, yes, mask mandates, that protect the health of entire populations, while individuals have to consider their contribution to everyone else’s risk alongside their own personal stakes. And yet, since the spring of 2021, pundits have mocked people who continue to think this way for being irrational and overcautious, and government officials have consistently framed COVID as a matter of personal responsibility.

Second, a person’s circumstances always constrain their choices. Low-income and minority groups find it harder to avoid infections or isolate when sick because they’re more likely to live in crowded homes and hold hourly-wage jobs without paid leave or the option to work remotely. Places such as prisons and nursing homes, whose residents have little autonomy, became hot spots for the worst outbreaks. Treating a pandemic as an individualist free-for-all ignores how difficult it is for many Americans to protect themselves. It also leaves people with vulnerabilities that last across successive pathogens: The groups that suffered most during the H1N1 influenza pandemic of 2009 were the same ones that took the brunt of COVID, a decade later.

America’s individualist bent has also shaped its entire health-care system, which ties health to wealth and employment. That system is organized around treating sick people at great and wasteful expense, instead of preventing communities from falling sick in the first place. The latter is the remit of public health rather than medicine, and has long been underfunded and undervalued. Even the CDC—the nation’s top public-health agency—changed its guidelines in February to prioritize hospitalizations over cases, implicitly tolerating infections as long as hospitals are stable. But such a strategy practically ensures that emergency rooms will be overwhelmed by a fast-spreading virus; that, consequently, health-care workers will quit; and that waves of chronically ill long-haulers who are disabled by their infections will seek care and receive nothing. All of that has happened and will happen again. America’s pandemic individualism means that it’s your job to protect yourself from infection; if you get sick, your treatment may be unaffordable, and if you don’t get better, you will struggle to find help, or even anyone who believes you.

---

In the late 19th century, many scholars realized that epidemics were social problems, whose spread and toll are influenced by poverty, inequality, overcrowding, hazardous working conditions, poor sanitation, and political negligence. But after the advent of germ theory, this social model was displaced by a biomedical and militaristic one, in which diseases were simple battles between hosts and pathogens, playing out within individual bodies. This paradigm conveniently allowed people to ignore the social context of disease. Instead of tackling intractable social problems, scientists focused on fighting microscopic enemies with drugs, vaccines, and other products of scientific research—an approach that sat easily with America’s abiding fixation on technology as a panacea.

The allure of biomedical panaceas is still strong. For more than a year, the Biden administration and its advisers have reassured Americans that, with vaccines and antivirals, “we have the tools” to control the pandemic. These tools are indeed effective, but their efficacy is limited if people can’t access them or don’t want to, and if the government doesn’t create policies that shift that dynamic. A profoundly unequal society was always going to struggle with access: People with low incomes, food insecurity, eviction risk, and no health insurance struggled to make or attend vaccine appointments, even after shots were widely available. A profoundly mistrustful society was always going to struggle with hesitancy, made worse by political polarization and rampantly spreading misinformation. The result is that just 72 percent of Americans have completed their initial course of shots and just half have gotten the first of the boosters necessary to protect against current variants. At the same time, almost all other protections have been stripped away, and COVID funding is evaporating. And yet the White House’s recent pandemic-preparedness strategy still focuses heavily on biomedical magic bullets, paying scant attention to the social conditions that could turn those bullets into duds.

Technological solutions also tend to rise into society’s penthouses, while epidemics seep into its cracks. Cures, vaccines, and diagnostics first go to people with power, wealth, and education, who then move on, leaving the communities most affected by diseases to continue shouldering their burden. This dynamic explains why the same health inequities linger across the decades even as pathogens come and go, and why the U.S. has now normalized an appalling level of COVID death and disability. Such suffering is concentrated among elderly, immunocompromised, working-class, and minority communities—groups that are underrepresented among political decision makers and the media, who get to declare the pandemic over. Even when inequities are highlighted, knowledge seems to suppress action: In one study, white Americans felt less empathy for vulnerable communities and were less supportive of safety precautions after learning about COVID’s racial disparities. This attitude is self-destructive and limits the advantage that even the most privileged Americans enjoy. Measures that would flatten social inequities, such as universal health care and better ventilation, would benefit everyone—and their absence harms everyone, too. In 2021, young white Americans died at lower rates than Black and Indigenous Americans, but still at three times the rate of their counterparts in other wealthy countries.

By failing to address its social weaknesses, the U.S. accumulates more of them. An estimated 9 million Americans have lost close loved ones to COVID; about 10 percent will likely experience prolonged grief, which the country’s meager mental-health services will struggle to address. Because of brain fog, fatigue, and other debilitating symptoms, long COVID is keeping the equivalent of 2 million to 4 million Americans out of work; between lost earnings and increased medical costs, it could cost the economy $2.6 trillion a year. The exodus of health-care workers, especially experienced veterans, has left hospitals with a shortfall of staff and know-how. Levels of trust—one of the most important predictors of a country’s success at controlling COVID—have fallen, making pandemic interventions harder to deploy, while creating fertile ground in which misinformation can germinate. This is the cost of accepting the unacceptable: an even weaker foundation that the next disease will assail.

---

In the spring of 2020, I wrote that the pandemic would last for years, and that the U.S. would need long-term strategies to control it. But America’s leaders consistently acted as if they were fighting a skirmish rather than a siege, lifting protective measures too early, and then reenacting them too slowly. They have skirted the responsibility of articulating what it would actually look like for the pandemic to be over, which has meant that whenever citizens managed to flatten the curve, the time they bought was wasted. Endemicity was equated with inaction rather than active management. This attitude removed any incentive or will to make the sort of long-term changes that would curtail the current disaster and prevent future ones. And so America has little chance of effectively countering the inevitable pandemics of the future; it cannot even focus on the one that’s ongoing.

If change happens, it will likely occur slowly and from the ground up. In the vein of ACT UP—the extraordinarily successful activist group that changed the world’s approach to AIDS—grassroots organizations of long–haulers, grievers, immunocompromised people, and others disproportionately harmed by the pandemic have formed, creating the kind of vocal constituency that public health has long lacked.

More pandemics will happen, and the U.S. has spectacularly failed to contain the current one. But it cannot afford the luxury of nihilism. It still has time to address its bedrocks of individualism and inequality, to create a health system that effectively prevents sickness instead of merely struggling to treat it, and to enact policies that rightfully prioritize the needs of disabled and vulnerable communities. Such changes seem unrealistic given the relentless disappointments of the past three years, but substantial social progress always seems unfeasible until it is actually achieved. Normal led to this. It is not too late to fashion a better normal.