80% of NYC gun suspects get released from custody following arrest: Adams

 More than 80% of pistol-packing perps were put back on the streets after getting busted for gun possession in New York City this year, Mayor Eric Adams said Wednesday.

“When when it comes to guns, this year, 2,386 people were arrested with a gun. Of those, approximately 1,921 are out on the street,” Adams said during a news conference on bail reform and recidivism.

“Arrested with a gun, out on the street.”

Adams added: “Gun arrests in custody: 19.5%. Out of custody: over 80%.”

“How do you take a gun law seriously when the overwhelming numbers are back on the streets after carrying a gun?” he asked.

Adams also highlighted the number of gun suspects who’ve been re-arrested — and re-released.

“This year, 165 people were arrested with a second gun charge,” he said. 

“Of those, 82 — out on the street. Not one arrest but two gun arrests —  back out on the street,” he fumed.

Mayor Eric Adams questioned how anyone could take a gun law seriously if they are released from custody so quickly.

NYC Special Narcotics Prosecutor

Around 80% of perps for gun arrests are released to the streets.

Robert Miller

Adams didn’t specify how many defendants were released without bail or how many posted bail to get sprung.

All gun-possession charges are eligible for bail under New York law, which requires judges to impose the least restrictive conditions necessary to ensure defendants return to court.

In 2019, the year before the state’s controversial bail reform law took effect, “we arrested 80 people for a gun crime who had an open gun arrest,” Adams said.

Adams has continuously challenged state lawmakers on bail reform.

Robert Miller

In 2021, he said, “the number was 259” — more than three times as many.

Adams also said that in 2019, 20 people arrested in shootings already had pending gun-possession charges but that last year, the number spiked nearly fourfold, to 77.

Also during Wednesday’s news conference at One Police Plaza, NYPD Chief of Crime Control Strategies Michael Lipetri said, “We like to talk about credible messengers when we work with our social service providers … to deliver the message to the crew member about stop the violence.”

But Lipetri said that “the credible messenger today in New York City is the crew member that was arrested with a gun yesterday, that’s out today, that’s telling that crew, ‘Well, look at me, I can carry a gun in New York City.'”  

Lipetri said the NYPD was investigating 716 suspected of committing 30% of the roughly 2,400 shootings that have taken place since 2021.

“Of those individuals, 54% — almost 385 — today have an open felony,” he said.

https://nypost.com/2022/08/03/80-of-nyc-gun-suspects-get-released-from-custody-following-arrest-eric-adams/

U.S. regulators defend requiring more data on monkeypox drug

As U.S. monkeypox cases rise, U.S. health agencies in a medical journal article published on Wednesday defended their decision to require human trial data to show that SIGA Technologies' experimental drug TPOXX is safe and effective to treat the virus.

U.S. agencies have been under pressure to ease access to the drug, which is being distributed by the U.S. Centers for Disease Control and Prevention (CDC) under a special "compassionate use" access that requires doctors to request it from the agency or their health department and enroll each patient in a study.

As of July 22, 223 people have been treated with the drug, compared with more than 6,000 known cases in the United States.

The FDA approved TPOXX in 2018 for smallpox in adults and children based on studies of animals infected with monkeypox and rabbitpox, as well as safety data in healthy people. It can only be sold to the U.S. Strategic National Stockpile.

Authors of the article in the New England Journal of Medicine from the Food and Drug Administration, the CDC and the National Institutes of Health (NIH) said the latter is planning a U.S.-based randomized clinical trial.

Data from that study will be used to determine whether the drug gains U.S. approval for monkeypox.

The drug, also known as tecovirimat, is approved for both smallpox and monkeypox in the UK and Europe. The European Union approved it under an "exceptional circumstances" pathway that allows for marketing approval when data cannot be obtained even after authorization.

Although TPOXX was only tested in healthy people, the European Medicines Agency said it expects side effects to be similar in infected people, and deemed the drug's benefits to be greater than its risks.

Dr. Jay Varma, director of the Cornell Center for Pandemic Prevention and Response who has advocated for broader access to the drug, said the FDA's standards ensure U.S. drugs are safe and set a high bar for the world, but in some circumstances, "those strict standards are harming us."

There were 1.7 million doses of the treatment in the U.S. Strategic National Stockpile at the start of the current outbreak in May.

On July 21, the CDC and the FDA began allowing doctors to prescribe the drug before the trial paperwork is completed, but still requires approval of a hospital's institutional review board for each dose.

"It's definitely better. It's still very burdensome," said Dr. Karen Krueger, an infectious disease expert at Northwestern Medicine in Chicago, who said there is additional paperwork after the patient visit and for several follow-up visits.

"It's doable but certainly a lot more challenging than how we normally prescribe drugs."

Neither the FDA nor the CDC immediately responded to a request for comment.

Northwestern has treated at least 20 monkeypox patients with TPOXX and will be one of the sites for the NIH trial.

To win approval, SIGA Chief Scientific Officer Dennis Hruby estimates it will likely take a 500-patient, placebo-controlled clinical trial in the United States.

If cases remain high, the trial could be fully enrolled within a few months. "It's not a terribly long trial," he said.

SIGA Chief Executive Phillip Gomez said the company is working to launch trials in the UK, Canada, the United States and Europe.

If the United States declares monkeypox a national emergency, Gomez said the drug could be granted an emergency use authorization. However, because the FDA has been "very clear" they want full, placebo-controlled trials, that could still take time, he said.

https://www.marketscreener.com/quote/stock/SIGA-TECHNOLOGIES-INC-10830/news/U-S-regulators-defend-requiring-more-data-on-monkeypox-drug-41189873/

How HCA, Tenet, CHS and UHS fared in Q2

 Four major for-profit hospital operators saw profits decline in the second quarter of 2022. 

• Nashville, Tenn.-based HCA Healthcare, a 182-hospital system, reported revenues of $14.82 billion in the second quarter of this year, up from $14.44 billion in the same period last year. HCA said same-facility admissions declined 1.2 percent year over year in the second quarter of this year. Emergency room visits were up 7.3 percent year over year. HCA's net income totaled $1.16 billion in the second quarter of 2022, down from $1.45 billion in the same period a year ago. The second quarter of this year included $32 million in losses on the sales of facilities and and losses on retirement of debt of $78 million. 
  
  

• Dallas-based Tenet Healthcare reported revenues of $4.64 billion in the second quarter of this year, down from $4.95 billion in the same period a year earlier. The decrease was primarily attributed to the sale of the company's Miami-area hospitals in the third quarter of 2021 and the impact of a cybersecurity incident. The 60-hospital system ended the second quarter of this year with net income of $38 million, down from $119 million in the same quarter last year. 
  
  

• Franklin, Tenn.-based Community Health Systems, which operates 83 hospitals, said revenues and admissions were down in the three months ended June 30. Admissions declined 3.4 percent year over year and revenues were down 2.4 percent compared to the second quarter of 2021. After factoring in costs and one-time expenses, the for-profit hospital operator ended the second quarter with a net loss of $326 million on revenues of $2.93 billion. CHS reported net income of $6 million on revenues of $3 billion in the same period a year earlier. 
  
  

• King of Prussia, Pa.-based Universal Health Services reported higher revenue but a lower profit in the second quarter of 2022. The hospital chain's revenues increased 3.9 percent year over year to $3.3 billion in the second quarter of this year. UHS said the nationwide shortage of nurses and other clinical staff has been a significant operating issue. After factoring in nonoperating items, UHS ended the second quarter of this year with net income of $164.06 million. The company reported net income of $325.28 million in the same period of 2021. 

https://www.beckershospitalreview.com/finance/how-hca-tenet-chs-and-uhs-fared-in-q2.html

Monkeypox respiratory transmission appears rare, but not yet fully understood

 Current messaging surrounding how monkeypox spreads is focused on sustained physical contact. But as the outbreak grows, with more than 6,000 cases now confirmed in the U.S., questions are also rising about whether and to what extent respiratory transmission plays a role. 

According to the CDC, monkeypox is often spread via direct contact with infectious sores, scabs or body fluids, which often happens during intimate physical contact. The current outbreak supports that, with 98 percent of U.S. cases so far among men who have sex with men. The same is true for global cases, according to the World Health Organization. 

As of Aug. 2, cases in the U.S. have surpassed 6,000, with health experts issuing warnings that the window is closing to contain the monkeypox outbreak and prevent the virus from becoming endemic. Experts have assured the public the virus doesn't transmit nearly as easily as COVID-19, with most reported monkeypox cases, again, involving close, sustained physical contact. But there appears to be at least some risk level regarding respiratory transmission. 

The CDC does list contact with respiratory secretions as a method of transmission, but notes "scientists are still searching" for "how often" it's spread this way and when an infected, symptomatic person "might be more likely to spread the virus through respiratory secretions." 

When a person has monkeypox, ulcers, lesions or sores in the mouth can be infectious, "meaning the virus can spread through direct contact with the mouth, respiratory droplets and possibly through short-range aerosols," according to the WHO. "Possible mechanisms of transmission through the air for monkeypox are not yet well understood and studies are underway to learn more."

The bottom line is there is at least some level of transmission risk tied to respiratory secretions people should be aware of, said Robert Pitts, MD, an infectious disease specialist at New York City-based NYU Langone Health. 

"These aren't secretions that are airborne for long periods of time," Dr. Pitts told Becker's. "They typically come into the air very shortly after they leave the person who is infected, and so in order for there to be that transmission with respiratory secretions, you have to have close, sustained contact with the person who's infected … I wouldn't consider it the highest risk of transmission, but something that we need to consider as we learn more about monkeypox."

There is also some evidence to support that the virus can be suspended in the air, according to a July study published ahead of peer review in medRXiv. The U.K. researchers conducted the study to inform infection prevention control measures after a U.K. healthcare worker was suspected to have contracted the virus while changing bedding. The study took place in U.K. healthcare facilities, and the researchers found the virus in air samples collected after bedding changes in isolation rooms used for infected patients, supporting the theory the virus may be present in suspended skin particles or dust. 

"These data demonstrate significant contamination in isolation facilities and potential for aerosolization of [monkeypox virus] during specific activities," the study said. 

Eric Feigl-Ding, PhD, an epidemiologist and former faculty member at Boston-based Harvard Medical School, has also raised concern about the potential for respiratory transmission. "It's not really true that it's 'not known to linger in the air,'" he wrote in a July 28 tweet, referencing the U.K. study and a CDC tweet that said monkepox is not known to linger in the air. 

But even with early evidence suggesting the virus can become airborne in some capacity, it's not yet fully clear whether it can infect someone. 

Like the early months of the COVID-19 pandemic, there have been discrepancies in the messaging surrounding how monkeypox spreads, leading to confusion among the public. 

"This is very reminiscent of our experience with COVID, and I think we can all remember the discrepancies around wearing masks, the transmissibility of COVID, who was at risk, and I think … this all reminiscent of that," Dr. Pitts said. 

"I think the messaging should just be clear that there is a [respiratory] risk and the risk is really maximized when you have sustained close contact with someone," Dr. Pitts said. 

https://www.beckershospitalreview.com/public-health/monkeypox-respiratory-transmission-appears-rare-but-not-yet-fully-understood.html

Senate review blames deaths, illnesses on mistakes in organ transplant screening

 The Senate Finance Committee released a report Wednesday linking dozens of deaths and illnesses to a lack of oversight from the organization in charge of overseeing organ transplants in the U.S.

The congressional committee linked 70 deaths caused by donor-derived disease to a lack of oversight from the Organ Procurement and Transplantation Network (OPTN), which is the organization in charge of overseeing organ transplants and testing in the U.S.

The committee’s investigation found that the OPTN failed to provide adequate oversight, resulting in fewer available organs for transplant. The OPTN is overseen by the United Network for Organ Sharing (UNOS), a nonprofit organization the Finance committee said was responsible for “avoidable failures” that resulted in viable organs being lost or destroyed.

The UNOS has been the only contractor to have or bid for the OPTN contract offered by the Department of Health and Human Services in the network’s nearly 40 years of operation.

Between January 2008 and September 2015, it was discovered that 211 donors transmitted diseases through their organs and 249 recipients developed donor-derived diseases. Of the 249 who developed diseases from their donated organs, 70 died.

“This data illustrates the lethality of diseases contracted during a transplantation and the need for exacting scrutiny of such transmissions,” the committee wrote.

These deaths represent a relatively small percentage of the thousands of transplants performed every year. Roughly 20,600 organ transplants are believed to have been performed just this year as of June.

Other organ recipients were harmed or nearly died due to error, with the Senate panel pointing to multiple instances where patients received organs with the wrong blood type. Several other organs were negatively impacted by transportation failures and could not be transplanted.

The OPTN is also in charge of overseeing 57 organ procurement organizations (OPOs), which are not-for-profit organizations that procure viable transplant organs from deceased individuals. The committee’s investigation was first launched over concerns that OPOs were failing to procure thousands of viable organs.

The report noted that the Centers for Medicare and Medicaid Services recently issued a rule changing the way that OPO performance is evaluated. Under the new evaluation method, 22 out of the 57 OPOs would fail to meet expected outcomes and be decertified.

“The Committee’s investigation shows that despite the efforts of UNOS and its internal committees, OPOs continue to experience recurring and systemic patient safety issues, including packaging and labeling errors, transportation failures, failure to identify transmissible diseases in donors, and even allegations of fraud,” read the report.

The panel issued several recommendations on the basis that the U.S. transplant network was not working “from the top down,” including enhancing transparency and accountability in the organ procurement process. Many recommendations were made to increase the pool of potential bidders for the OPTN contract.

https://thehill.com/homenews/senate/3586785-senate-review-blames-deaths-illnesses-on-mistakes-in-organ-transplant-screening/

Senseonics Shares Rise 19% After Anthem Provides Coverage for Implantable CGM

 Senseonics Holdings Inc. shares were up 19% to $1.51 Wednesday after the company said that health insurer Anthem is providing coverage for implantable continuous glucose monitoring, which includes the Eversense CGM System.

The company said Anthem's decision will add more than 45 million covered lives for the long-term implantable CGM system to help manage their diabetes.

This allows Ascensia Diabetes Care, Senseonics' global commercial partner, to introduce the Eversense CGM System to more people living with diabetes.

Through its affiliated companies, Anthem, now Elevance Health Inc., serves people across 14 states, including more than 45 million within its family of health plans.

https://www.marketscreener.com/quote/stock/SENSEONICS-HOLDINGS-INC-26786073/news/Senseonics-Shares-Rise-19-After-Anthem-Provides-Coverage-for-Implantable-CGM-41184928/

UnitedHealth struggling to sell Brazilian unit Amil

 UnitedHealth Group Inc, the top U.S. healthcare company by market capitalization, is struggling to sell Brazilian unit Amil due to antitrust issues and growing losses from individual health plans, according to four people with knowledge of the matter.

After studying ways to divest Amil 10 years after acquiring it, UnitedHealth decided last month to suspend the sale process, the sources said, asking for anonymity because the discussions were private.

UnitedHealth had agreed to pay acquirers for Amil's loss-making units and lose money on the sale of the whole company, but did not receive an attractive proposal, the sources added.

The latest talks involved Brazilian medical labs company Diagnosticos de America SA, or Dasa, and the insurance unit of Banco Bradesco SA. As Dasa shares fell 44% this year, the idea of a deal paid partially in shares became much less viable, the people added.

UnitedHealth declined to comment on details of its Brazilian operations or negotiations.

"UHG is a long term investor in Brazil, first entering the market in 2012, and UHG intends to continue to serve the Brazilian health care market," UnitedHealth spokesman Matthew Stearns said in an e-mailed statement.

Private equity funds also looked at the deal, but decided not to bid due to its complexity, a fifth source said.

Dasa and Bradesco proposed delayed payment while keeping UnitedHealth as minority shareholder, which the U.S. company rejected, the sources added.

Dasa and Bradesco declined to comment. BTG Pactual, which is handling the mandate, did not reply to a request for comment.

UnitedHealth had accepted to lose money on the sale, as it had become clear that it would not fetch the $5 billion it paid for the company 10 years ago, according to the people. The value of the Brazil business is now estimated at $1 billion, said two of the sources.

UnitedHealth has not booked any loss related to Amil. In January, the company changed how it reports international businesses. Amil is now part of the employer & individual health plan division, which includes operations in the United States.

Some of Amil's largest rivals, such as hospital chain Rede D'Or Sao Luiz SA, had looked into a potential acquisition in January, sources said, but closed other deals after that, creating potential antitrust restrictions.

Rede D'Or announced in February acquisition of insurer SulAmerica SA. .

Rede D'Or did not immediately respond to requests for comment.

REGULATORY HEADACHES

UnitedHealth Group CEO Andrew Witty took the decision to sell Amil soon after taking the helm last year, one of the sources said.

UnitedHealth has 3.4 million health insurance beneficiaries in Brazil, 2.2 million clients of dental benefits, and owns and manages 31 hospitals and 82 clinics. The Brazilian hospitals and part of the insurance portfolio are profitable, sources said.

Gaps in the public healthcare system have led a growing number of Brazilians to rely on private health insurance, which now serves around 49 million people.

However, decisions by Brazilian healthcare regulator ANS have created headaches for the segment since UnitedHealth acquired Amil. Its portfolio of 340,000 individual healthcare plans is subject to the regulator's strict pricing caps, while coverage has expanded due to rulings by courts and regulators.

Many insurers in Brazil stopped selling individual health plans due to mounting losses, but Amil cannot cancel its existing portfolio.

Under one proposal, UnitedHealth offered to pay an investment firm $550 million to take over the individual insurance portfolio, but regulators blocked the deal.

Meanwhile, UnitedHealth has almost tripled its global revenue since acquiring Amil in 2012, to $290 billion last year, dwarfing its investment in Brazil. In addition to health plans, UnitedHealth runs pharmacy services, data analytics and medical practices.

https://www.marketscreener.com/quote/stock/REDE-D-OR-SAO-LUIZ-S-A-119084194/news/UnitedHealth-struggling-to-sell-Brazilian-unit-Amil-sources-41186320/