140: COVID-19 Funding Options

ROBERT JOHSON:

This is Public Health Review Morning Edition for Thursday, March 17th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

Work is underway on Capitol Hill to bring back an emergency COVID-19 funding proposal that was taken out of the FY 22 omnibus appropriations bill last week. The $15 billion package included money for vaccines, therapeutics, and testing.

ASTHO's senior vice president of government affairs and public relations, Carolyn Mullen, says Washington has options.

CAROLYN MULLEN:

Number one, they're trying to get the standalone supplemental bill approved by Congress, and it's most likely not going to pass. They could attach the COVID supplemental funding to must-pass legislation such as FDA reauthorization, which needs to be approved by the end of September. They can use transfer authority, which means taking across the board cuts from all programs, projects, and activities as a stop gap to pay for some of the things that the White House needs. Or they could use reconciliation, which is still out there from Build Back Better, which needs a simple majority vote in the Senate.

So, I think there could be a path forward beyond just the standalone emergency supplemental bill, but it's really up to the White House and Congress to come together in agreement on how they want to secure this money so we are not left without a plan if we do have another variant or another surge in the near future.

JOHNSON:

While it advocates for stable funding for COVID-19 programs, ASTHO continues to serve as a resource for members seeking information to inform their pandemic response.

Jessica Baggett is ASTHO's COVID-19 response director.

JESSICA BAGGETT:

I think it's important for members to have a sense of how other states are approaching some of the topics around COVID-19. Oftentimes we like to say, you know, don't reinvent the wheel—there's often someone who has already created an initiative or a program who has best practices that they're willing to share. And so, it really just helps states who, you know, are interested in collaborating. We often serve as that convener and connector for states, either with other state health departments or with our federal partners.

JOHNSON:

What qualifies as normal aging versus something to be concerned about when we experience subtle changes in memory and thinking? A new report from the Alzheimer's Association says most Americans don't know, and that's worrisome when it comes to early diagnosis and treatment of dementia. Alzheimer's Association vice president of health systems, Morgan Daven, explains the findings of the 2022 Alzheimer's Disease Facts and Figures Report in today's morning conversation.

What's the bottom line conclusion of this latest report?

MORGAN DAVEN:

Early diagnosis is more important than ever. It gives families a chance to make important life decisions like legal and financial and healthcare decisions based on what's important to the person who's living with the disease.

And that early detection includes mild cognitive impairment, or MCI. MCI is characterized by changes in memory or thinking that go beyond normal aging. About one in seven Americans aged 60 and older have MCI, and in some cases it can progress to dementia. And it's important to detect MCI and to determine what's causing it. Some of the causes are treatable, such as depression, or the side effects of some medications, even sleep apnea.

Now, not everyone who has MCI will develop dementia, but studies suggest that about 10 to 15% of those who have MCI will develop dementia each year.

JOHNSON:

You also surveyed awareness about MCI and that feedback was concerning, wasn't it? I mean, people don't even know what it is.

DAVEN:

It is concerning that there's low awareness and understanding of the difference between normal aging and MCI. There's also opportunity here, and part of that is that most Americans would want to know at an early stage if they have Alzheimer's disease: in fact, 85% said they would want to know at an early stage, more than half said they'd want to know at the MCI stage. Also, primary care doctors agree that diagnosing MCI is important.

It is concerning though, like you said, Robert, in a number of ways. For example, primary care physicians are referring patients—only about half of them are referring their patients to a specialist when MCI is detected. We know that primary care doctors need tools and training and resources to be able to diagnose MCI, but also to refer to specialists for additional tests to determine if it is MCI due to Alzheimer's and also to help access clinical trials.

JOHNSON:

Public health professionals listen to this newscast. What do you want them to know about this data?

DAVEN:

We want to make sure that, for our public health leaders, that there's a real need to make sure primary care doctors have those tools and resources. And also, public education is an important part of this as well.

This year's report also includes a new section on the workforce; and so, for public health leaders, you know, this is important in terms of making sure that we have a strong healthcare workforce. And that's also called out in the early detection section of the Healthy Brain Initiative that the Alzheimer's Association and the CDC created for public health action on Alzheimer's.

We're really facing a shortage of both dementia specialists and direct care workers, so we really need to make sure that we address those gaps and have a competent workforce—both in medicine and in supportive services—for those who have this disease.

JOHNSON:

Finally today, three former ASTHO members are among USA Today's 2022 Women of the Year. Yesterday, we told you former ASTHO president Dr. Rachel Levine made the list in her new position as U.S. assistant secretary of health. But today, we wanted to let you know that ASTHO alums Dr. Ngozi Ezike from Illinois and Dr. Joneigh Khaldun from Michigan also made the list. You can see the story using the link in the show notes.

Before we go, we want to remind you to leave us a rating and a review—they help raise our profile, and that makes it easier for new listeners to find us online. Also, if you follow the show you'll never miss a single report. You can do all of this on the channel you're listening to right now.

That'll do it for today's newscast. We are back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Happy St. Patrick's Day.