Plus, a million sign up for shots in France, states are fighting back-to-school vaccine requirements, opioid overdoses soar, and more. Email not displaying correctly?
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** Summer camps are the newest COVID-19 hot spots. What does this mean for school safety?
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Julian Boyce, 14, gets a hug from his mother, Satrina Boyce, after he received his first Pfizer COVID-19 vaccination dose in New York, on May 13, 2021. Vaccination campaigns in the U.S. are ushering in a period of post-lockdown euphoria, and children are being inoculated so that they can go back to summer camp and school. (AP Photo/Richard Drew, File)

Summer camps in Texas ([link removed]) , Illinois, Florida, Ohio ([link removed]) , Missouri and Kansas have all seen COVID-19 outbreaks this summer. These new hot spots are just part of the new summer surge of COVID-19 cases, which have risen 60% in the last two weeks. Johns Hopkins researchers say the U.S. now averages 19,500 new cases each week.

In Texas and Illinois, the outbreaks started at the camps and spread when the kids returned home.

In Ohio, the Dayton Daily News reports ([link removed]) :

At least 30 coronavirus cases have been identified in people who live in Ohio and Kentucky who were among the more than 800 from June 27 to July 3 who were at the camp and conference center — 10550 Camp Trail in Miami Twp. — from Baptist churches in Ohio, Indiana, Kentucky and Illinois, according to a release from Public Health.

Public Health stated that church and camp organizers are not helping with contact tracing because they have not provided contact information for attendees and have not responded for several days after the initial cases were recognized, the health department stated.

CNN reports ([link removed]) :

A Covid-19 outbreak stemming from a Texas church summer camp has grown to about 160 cases, including infections of the highly contagious Delta variant ([link removed]) , the Galveston County local health authority said.

More than 450 people attended the camp for sixth through 12th graders in late June ([link removed]) , hosted by Clear Creek Community Church. The camp took place at Tejas Camp & Retreat in Giddings, Texas.

Of the roughly 160 people infected, six (about 3.7%) had been vaccinated, said Dr. Philip Keiser, the Galveston County local health authority ([link removed]) .

The Associated Press reports ([link removed]) :

The health department in Leon County, Florida, which includes Tallahassee, tweeted this month that an increase in cases there also was tied in part to summer camp outbreaks.

And in Kansas, about 50 people have been infected in an outbreak linked to a church summer camp held last month not far from Wichita.

Summer camp outbreaks “certainly could be a precursor” to what happens when youngsters return to classrooms in the fall, said Dr. Michelle Prickett, a pulmonary and critical care specialist at Northwestern Memorial Hospital in Chicago. The outcome will depend on vaccination rates and which virus variants are prevalent, she said.

“We just need to be vigilant,” Prickett said.


** After France threatens vaccine proof requirements, a million people signed up for shots
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People eat and drink outdoors at a terrace bar in Lyon, central France, Tuesday, July 13, 2021. Nearly 1 million people in France made vaccine appointments in a single day, as the president cranked up pressure on everyone to get vaccinated to save summer vacation and the French economy. (AP Photo/Laurent Cipriani)

You can look for people who like the idea of some sort of government mandate for COVID-19 vaccines to point to what just happened in France ([link removed]) .

French President Emmanuel Macron said, beginning in August, COVID-19 passes would soon be needed for daily activities. To get a pass, a person would have to show proof of a negative COVID-19 test or vaccination. What happened next? The vaccine appointment app, Doctolib, said 1.7 million French people signed up for shots. Most of them were under age 35.

On Tuesday, the country set a one-day record for delivering vaccines. Until now, the country averaged 570,000 shots per day. Within 24 hours after Macron’s announcement, 792,000 people got their first shot. 37% of the French population is now fully vaccinated.

Macron angered some when he said that health workers had to get vaccinated ([link removed]) by Sept. 15 or face unspecified consequences.


** States are fighting back-to-school vaccine requirements
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CNN is scouring state legislatures ([link removed]) to find out how they are handling back-to-school vaccine expectations:

A CNN analysis has found that at least seven states —Alabama ([link removed]) ,Arkansas ([link removed]) ,Florida ([link removed]) ,Indiana, ([link removed]) Montana ([link removed]) ,Oklahoma ([link removed]) andUtah ([link removed]) — have enacted legislation this year that would restrict public schools from requiring either coronavirus vaccinations or documentation of vaccination status.

As of June 22, at least 34 states had introduced bills that would limit requiring someone to demonstrate their vaccination status or immunity against Covid-19, according to the National Conference of State Legislatures ([link removed]) , which has been tracking legislation related to coronavirus vaccines. At least 13 states — Alabama, Arkansas, Florida, Indiana, Iowa, Kansas, Missouri, Montana, North Dakota, Oklahoma, Tennessee, Texas and Utah — have passed them into law, according to the document, and at least six of those include language pertaining specifically to schools or education.


** Opioid overdoses soar. How do we respond now?
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Signs are displayed at a tent during a health event on June 26, 2021, in Charleston, W.Va. Volunteers at the tent passed free doses of naloxone, a drug that reverses the effects of an opioid overdose by helping the person breathe again. Activists at the event called on the city of Charleston to declare a public health emergency for new HIV cases and prescription drug overdoses. (AP Photo/John Raby)

Now that 15 states have reached a $4.5 billion settlement ([link removed]) with Purdue Pharma ([link removed]) over how the company marketed OxyContin, how will those states use the money to battle what, by all measures, is a still rising opioid crisis?

Nothing will happen overnight. Thousands of creditors have until July 14 to vote ([link removed]) on Purdue’s reorganization plan and, even if it is approved, it would take years to pay out. On Tuesday, President Joe Biden named Rahul Gupta as the next director of the Office of National Drug Control Policy, so whatever happens next will fall on a new leader to execute.

The New York Times says ([link removed]) :

In addition to Massachusetts, New York and Minnesota, the other states who have signed on include Colorado, Hawaii, Idaho, Illinois, Iowa, Maine, Nevada, New Jersey, North Carolina, Pennsylvania, Virginia and Wisconsin.

Nine states, including California, Connecticut, Delaware, Maryland, New Hampshire, Oregon, Pennsylvania, Vermont and Washington, along with the District of Columbia, continue to oppose the agreement.

The Opioid Settlement Tracker ([link removed]) is one unofficial place where you can see the plans, sometimes tentative, for how states will distribute the money from various opioid cases. When this much money starts flowing, I always wonder if it is going to projects and programs that do the most good. Is it “new money” or is it just replacing budget cuts?

While the nation focused on the 600,000 people who died from COVID-19, another 60,000 Americans died from opioid abuse. Make no mistake, an epidemic exists inside the pandemic.
[link removed]
(Bloomberg)

Around Washington, D.C., opioid fatalities are rising, in part because of what officials call ([link removed]) a “bad batch” of fentanyl. The American Medical Association recently reported ([link removed]) , “Every state has reported a spike or increase in overdose deaths or other problems during the COVID pandemic.”

The AMA makes some specific recommendations that are worth exploration:

* U.S. Substance Abuse and Mental Health Services Administration ([link removed]) and U.S. Drug Enforcement Administration (DEA) increased flexibility for providing buprenorphine and methadone to patients with opioid use disorder.
* Increased flexibility ([link removed](DEA-DC-023)(DEA075)Decision_Tree_(Final)_33120_2007.pdf) provided by the DEA to help patients with pain obtain necessary medications. The AMA strongly recommends ([link removed]) that all of the flexibilities that have been put in place by DEA during the COVID-19 PHE be kept in place at a minimum until both the COVID19 and the opioid public health emergencies come to an end.
* Support the removal of prior authorization, step therapy and other administrative barriers for medications used to treat opioid use disorder (MOUD); ([link removed]) meaningful enforcement of mental health and substance use disorder parity laws is long overdue. Prior authorization of MOUD remains a major barrier.
* Remove existing barriers ([link removed]) for patients with pain to obtain necessary medications. This includes removing arbitrary dose, quantity and refill restrictions on controlled substances.
* Implement and support evidence-based harm reduction strategies ([link removed]) , including removing barriers to sterile needle and syringe services programs as well as strengthening Good Samaritan laws. Arizona ([link removed]) is the latest example of positive legislative action.
* Enact new laws to ensure that monies from opioid-related litigation is focused on public health, treatment and prevention efforts. Virginia ([link removed]) and Kentucky ([link removed]) are leading examples.

Here are some other resources to get you refocused on this important issue:
* Cato Institute: If Lawmakers Really Want to “Follow the Science” They Will Repeal Codified Opioid Guidelines ([link removed]) - May 24, 2021
* The Washington Post: Chronic pain can be burdensome. Isolation during the pandemic can make it worse. ([link removed]) - May 9, 2021
* Pharmacy Times: Study: 1 in 5 Pharmacies Blocks Access to Addiction Treatment Buprenorphine ([link removed]) - May 3, 2021
* NPR: Overdose Deaths Surged in Pandemic, As More Drugs Were Laced With Fentanyl ([link removed]) - April 22, 2021


** Study: Loneliness can take 5 years off a senior’s life
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This does not surprise me one bit: A new study ([link removed]) from Duke-NUS Medical School in Singapore finds that “adults over the age of 60 who say they sometimes or always feel lonely die up to five years sooner than seniors who don’t feel lonely.”

There is a good bit of research on the issue of loneliness ([link removed]) and the findings are convincing enough that you might wonder why we don’t spend more effort doing something about it. The Centers for Disease Control and Prevention says, “A report from the National Academies of Sciences ([link removed]) ,Engineering, and Medicine (NASEM) ([link removed]) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated.”

The Foundation for Art and Healing summarizes some of the data:

* Loneliness is a significant predictor of poor health. In a 2010 AARP Research survey ([link removed]) of adults age 45 and older, among respondents who rated their health as “excellent,” only 25% were likely to be lonely, compared to 55% for those who rated their health as “poor.”
* Loneliness is a common source of distress, suffering, and impaired quality of life for adults older than 60, and is a predictor of functional decline and death, according to a 2012 study ([link removed]) .
* Some 19% of older adults report feeling lonely fairly frequently, according to a study on social connectedness ([link removed]) based on data from the National Social Life Health and Aging Project. Relative to others, lonely adults tend to have lower incomes; are less likely to be married; live alone; and have poorer self-rated health, more physical limitations in carrying out daily activities, and fewer friends. They also socialize, volunteer, and participate in organized groups less frequently.

During the height of the pandemic, studies showed younger people were suffering ([link removed]) from an even higher level of loneliness than seniors.


** Only one US city is in the global top 10 cities for biking
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A man wearing a protective mask rides a bicycle past closed retail stores on the usually busy Commercial Street, Monday, May 25, 2020, in Provincetown, Mass. (AP Photo/Michael Dwyer)

Only one town — one you probably have never heard of — made City Rating’s list of best cities for biking ([link removed]) : Provincetown, Massachusetts, a Cape Cod town of 2,900. It came in third. Every other city on the list’s top tier is in Europe.

Here are six U.S. cities that try to be biker-friendly ([link removed]) . St. Paul, Minnesota, is moving up on the list ([link removed]) . Some small towns in Michigan, Iowa and beyond ([link removed]) are also trying hard to become bike-friendly.

Axios explains ([link removed]) that during the pandemic, Americans took a greater interest in biking.


** Top states for business: CNBC’s list
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I am generally not a big fan of lists of the best and biggest this and that. But CNBC puts some effort ([link removed]) into its list of best states for business. I only wish they that put a column on the list for states that have low vaccination rates and penalized them for it. But some of the worst vaccinated states are nearer the bottom of the best states of business lists for other stuff anyway.

We’ll be back tomorrow with a new edition of Covering COVID-19. Are you subscribed? Sign up here ([link removed]) to get it delivered right to your inbox.
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