93-year-old California hospital to close over inability to meet new seismic standards


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Community Medical Center Long Beach (Calif.), which opened in 1924 and is part of Fountain Valley, Calif.-based MemorialCare Health System, will close in the near future due to the inability to retrofit the hospital to meet California’s seismic standards.

When MemorialCare acquired Community Medical Center Long Beach in 2011, officials knew it had seismic challenges. However, the hospital consulted with seismic experts, structural engineers and architects as part of recent seismic studies, which revealed the fault running below the hospital is larger and more active than previously known, hospital officials said Monday, according to The Grunion. This means the hospital will not meet California’s new earthquake safety requirements for acute care hospitals, which go into effect June 30, 2019.

John Bishop, CEO of the three MemorialCare hospitals in Long Beach, said because the wide fault zone is under the majority of the hospital campus, no work can be done to make the hospital viable, according to the Long Beach Post.

“We are all saddened that the findings were not more encouraging for the future of Community Medical Center Long Beach,” said Mr. Bishop. He said MemorialCare has no choice but to close the hospital. However, he said hospital and city officials will work together on transition plans to meet the needs of the community.

“Nothing involved in this was an elective decision. We had no choice,” Mr. Bishop said. “I’m saddened by this, but I want to assure Long Beach residents MemorialCare continues to be dedicated to providing the healthcare the city needs.”

Mr. Bishop said hospital officials will discuss the matter with city officials to determine how long the hospital and its emergency department will remain open, according to the report.

Gun Death Rate Rose Again in 2016, C.D.C. Says

The rate of gun deaths in the United States rose to about 12 per 100,000 people, the second consecutive increase after a period of relative stability.

The rate of gun deaths in the United States rose in 2016 to about 12 per 100,000 people, the Centers for Disease Control and Prevention said in a report released on Friday. That was up from a rate of about 11 for every 100,000 people in 2015, and it reflected the second consecutive year that the mortality rate in that category rose in the United States.

The report, compiled by the C.D.C.’s National Center for Health Statistics, showed preliminary data that came after several years in which the rate was relatively flat.

“The fact that we are seeing increases in the firearm-related deaths after a long period where it has been stable is concerning,” Bob Anderson, chief of the mortality statistics branch at the health statistics center, said in a telephone interview on Friday. “It is a pretty sharp increase for one year.”

Mr. Anderson also said the rates for the first quarter of this year showed an upward trend, compared with the same three-month period of 2016.

“It clearly shows an increase,” he said, while emphasizing the data was preliminary. “With firearm-related deaths it is seasonal — the rates generally are a little higher in the middle of the year than they are at the end of the year,” he added. “Homicides are more common in the summer.”

More than 33,000 people die in firearm-related deaths in the United States every year, according to an annual average compiled from C.D.C. data.

The data released on Friday did single out other causes of death in the United States that were higher than the firearm-related rate. The drug overdose rate, for example, was almost 20 deaths per 100,000 last year, up from 16.3 in 2015.

The death rate for diabetes was about 25 per 100,000 people; cancer was 185 per l00,000, and heart disease about 196 deaths per 100,000 people.

But statistics about gun deaths, nearly two-thirds of which are suicides, have been ingrained in the national discourse in the United States, particularly after mass shootings, such as the one in Las Vegas last month in which 58 people were killed, and in debates over legislation related to guns.

In June 2016, the 49 fatalities in the Pulse nightclub shooting in Orlando represented one of the highest death tolls in a single mass shooting in recent United States history. But gun violence researchers note that although mass shooting fatalities account for no more than 2 percent of total deaths from firearm violence, they are having an outsize effect.

Garen J. Wintemute, director of the Violence Prevention Research Program at the University of California, Davis, School of Medicine, wrote in the Annals of Internal Medicine after the Las Vegas shooting that mass killings are “reshaping the character of American public life.”

“Whoever we are, they happen to people just like us; they happen in places just like our places,” he wrote. “We all sense that we are at risk.”

Dr. Wintemute said the latest C.D.C. report means the nation is approaching two decades since there has been any substantial improvement in the rate of gun deaths. The rate for the first three months of 2017 was about the same as the corresponding period in 2016. Hopefully, that is a sign it will level off again, Dr. Wintemute told The Associated Press.

Mr. Anderson said the data was not broken down by states, which each have different levels of comprehensiveness in their reporting to the federal agency. “As they get more and more timely we hope to include state-level information in these reports,” he said.

Suicides account for about 60 percent of firearm-related deaths, and homicides about 36 percent, Mr. Anderson said. Unintentional firearm deaths and those related to law enforcement officials account for about 1.3 percent each. The rest are undetermined.

The final data for 2016 will be released in the first week of December, Mr. Anderson said. “It could be this is a sort of blip, where it will stabilize again,” he said. “It is hard to predict.”

Harvey pounded the nation’s chemical epicenter. What’s in the foul-smelling floodwater left behind?


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The pounding rains of Hurricane Harvey washed over the conduits, cooling towers, ethylene crackers and other esoteric equipment of the nation’s largest complex of chemical plants and petroleum refineries, leaving behind small lakes of brown, foul-smelling water whose contents are a mystery.

Broken tanks, factory fires and ruptured pipes are thought to have released a cocktail of toxic chemicals into the waters. Explosions that released thick black smoke were reported at the Arkema Inc. chemical plant, where floods knocked out the electricity, leaving the facility outside Houston without refrigeration needed to protect volatile chemicals.

Meanwhile, emissions into the air have soared as the petrochemical industry shut down and then started up chemical operations, a cycle that causes an uptick in releases.

The potential health problems were magnified by overflowing sewers, inoperative treatment plants and the residues of animal waste, including carcasses.

Nobody is sure how much long-term health impact, if any, will result from the tidal wave of toxins and bacteria that swept through the nation’s fourth largest city.

Exhaustive investigations by the Environmental Protection Agency and the National Academy of Engineering after Hurricane Katrina, in which floodwaters languished in New Orleans for about six weeks, showed that toxic concentrations and the resulting exposures were too low to cause significant long-term health problems.

That festering flood caused a stench for weeks that left soldiers gagging for air as they flew helicopters 2,000 feet over the city. The Army Corps of Engineers had to pump the water out of New Orleans, much of which lies below sea level.

A report by the National Academy of Engineering in March 2006 said the floodwaters contained elevated levels of contaminants. The inorganic compounds were below drinking-water standards, while arsenic levels, attributed in part to lawn fertilizer, were above those standards.

The EPA took 1,800 samples of residue and soil from across the New Orleans area after Hurricanes Katrina and Rita and found that generally “the sediments left behind by the flooding from the hurricanes are not expected to cause adverse health impacts to individuals returning to New Orleans.”

The situation is far different in Houston, where the floodwaters are receding much faster.

But because Houston is far more industrialized, Harvey could have a much larger potential for leaving a toxic trail.

Without question, air emissions rose significantly during and after the storm, said Elena Craft, a toxicologist and senior scientist at the Texas branch of the Environmental Defense Fund.

The industry shutdown and startup cycle released 2 million pounds of pollutants, equal to 40% of all the emissions from 2016, Craft said, based on reports the industry made to the Texas Commission on Environmental Quality.

“In a few days, we have had months of exposure,” Craft said.

Marathon Oil, for example, reported to the state that heavy rain had pounded the roof of a storage tank so hard that it tilted, exposing gasoline to the air.

The emissions reports also included such carcinogens and suspected carcinogens as benzene and butadiene.

Craft said that sewage treatment plants in Beaumont went off line. A pipe carrying anhydrous hydrogen chloride was compromised in La Porte. Harris County’s 26 federal Superfund toxic waste sites may have been affected, including one that contains dioxins from a former paper mill along the San Jacinto River.

The fire at the Arkema chemical plant in Crosby released organic hydrogen peroxide, which officials said is an irritant but not toxic.

Tommy Newsom, who lives about 7 miles from the plant, said he felt fine but wondered what other chemicals might be involved. “Who knows how much of what they’re telling us is true?” he said.

“I think the wind’s in my favor,” said Newsom, a 60-year-old port worker, pointing to Texas state and U.S. flags at the entrance to his housing development.

Jennifer Sass, a senior scientist with the Natural Resources Defense Council’s health program, said the situation in Houston is a perfect breeding ground for hepatitis and tetanus.

“The flood is so large and slow-moving and the area is packed with dirty industries that are poorly regulated. Because the oil and gas industries down here are not as safe, we are concerned those toxins and chemicals are leaking,” she said.

Texas regulators urged caution. “Floodwaters may contain many hazards, including infectious organisms, intestinal bacteria, and other disease agents,” the Texas Commission on Environmental Quality said in a statement. “Precautions should be taken by anyone involved in cleanup activities or any others who may be exposed to floodwaters.”

The American Chemistry Council said its members are in constant communication with state and federal regulators about the status of their operations.

“Hurricane Harvey has presented extreme and unique challenges for the city of Houston and the surrounding areas in southeast Texas and Louisiana, warranting an unprecedented response effort, including that by local industry,” the trade group said in a statement.

Where Lead Lurks And Why Even Small Amounts Matter


Katherine Du for NPR

When There’s Lead Underground

When there is a problem with lead in drinking water, service lines are the most likely culprit. Service lines are like tiny straws that carry water from a utility’s water main, usually running below the street, to each building.

In older cities, many of them in the Midwest and Northeast, these service lines can be made of pure lead.

Wherever lead service lines are in place, there is a risk of water contamination. The toxic metal can leach into the water whenever something jostles the pipes, like nearby construction, a heavy truck coming down the road or when the water just sits still for too long.

Civil engineer Marc Edwards, the Virginia Tech professor who helped document the lead problems with water in Flint, calls lead service lines “ticking time bombs.”

Some biosimilars are just as good as some pricey biologics

Some biosimilars are just as good as some pricey biologics

A new study suggests that a group of biosimilar drugs, which are used to treat such afflictions as rheumatoid arthritis, psoriasis, and inflammatory bowel disease, appear as safe and effective as their more expensive brand-name counterparts, which are known as biologics. A biosimilar drug is a nearly identical variant of a biologic and is expected to provide the same result in patients.

The analysis arrives as the US health care system, which is increasingly overwhelmed by high-priced medicines, looks toward biosimilars to provide savings. In the United States, where regulators have approved just two such drugs, some estimates say prices will be 20 percent to 30 percent less than the cost of biologics.

But until more biosimilars become available, there is some debate over the extent to which physicians will become sufficiently comfortable prescribing these drugs. Biologics are made from living cells and the brand-name biotech industry, for instance, says the complex processes needed to develop biosimilar drugs may produce slight changes that can affect safety and effectiveness. The threat of lower-priced competition has prompted brand-name drug makers to petition the Food and Drug Administration to delay approvals, among other tactics.

The study authors, however, argue their findings should put some of those concerns to rest. After analyzing 19 studies, they maintain the available data indicates biosimilar drugs based on brand-name versions of anti-TNF inhibitors should be considered interchangeable. The anti-TNF inhibitors include such big sellers as Amgen’s Enbrel, AbbVie’s Humira, and Johnson & Johnson’s Remicade.

“This is the $1 billion question — are the biosimilar versions comparable? And we found, in just about every outcome examined, that the biosimilars fare very well,” said Dr. Caleb Alexander, who is codirector of the Johns Hopkins University Center for Drug Safety and Effectiveness, and one of the authors of the study, which appeared today in the Annals of Internal Medicine.

Congress Shouldn’t Pass The 21st Century Cures Act In A Summer Rush

Congress Shouldn’t Pass The 21st Century Cures Act In A Summer Rush


On Saturday June 25, six former FDA commissioners from Democratic and Republican administrations suggested at the Aspen Ideas Festival that Congress make the agency independent of the Department of Health and Human Services — similar to the Securities Exchange Commission, for example. With regulatory purview over products that represent a quarter of the U.S. economy, the group said the FDA is harmed by an unstable federal budget process and persistent political meddling. The group said they would issue a white paper on their proposal for the next administration. That’s another reason why Congress should postpone consideration of these bills until 2017.

Opponents sue to stop California’s vaccination law


vaccine protest


For This Man, Reducing Gun Violence Is A Life’s Mission

For This Man, Reducing Gun Violence Is A Life’s Mission


As the ancient Chinese proverb says, from crisis comes opportunity. That is certainly true for Garen Wintemute, a leading gun-violence researcher and emergency room doctor who finds “teaching moments” in the grief-filled days and weeks following mass shootings in America.

He is currently seizing a window of opportunity recently opened by the recent mass shooting in Orlando, Florida.

Wintemute, once named a “hero of medicine” by Time magazine, has led the Violence Prevention Research Program at the University of California, Davis Medical Center for 25 years. Twenty years ago, the federal Centers for Disease Control and Prevention abruptly stopped funding Wintemute’s program. He has since put up $1.3 million of his own money to keep it running.

World Health Organization Lacks Leadership to Combat Pandemics