Plus the pandemic's effect on bus lines, bird flu's impact and why point-of-sale loans are catching on Email not displaying correctly?
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A nurse checks on IV fluids while talking to a COVID-19 patient at Providence Holy Cross Medical Center in Los Angeles in 2021. (AP Photo/Jae C. Hong, File)

Hospitals are just learning about ([link removed]) and are very concerned that a shortage of the fluid they use to make CT scans and MRIs more readable may last until late June.

For example, The University of Alabama at Birmingham hospital ([link removed]) sent out this alert saying it would ration use of the dye and some elective surgeries will be delayed:

COVID-19 shutdowns in Shanghai, China, have caused a significant global shortage of intravenous contrast used in imaging procedures like enhanced X-rays, CT scans and MRIs. IV contrast is also used in procedures where the dye helps show the anatomy; with a heart catheterization, the contrast makes the blood “light up” as it passes through the heart so a physician can see blood flow.

The IV contrast shortage is expected to last through at least June 30.

Hospitals worldwide are bracing for effects the shortage will have on patient care.

KIRO-TV in Seattle reported ([link removed]) on the effect the shortage was having on the University of Washington medical facility:

UWMC performs about 1,000 CT scans a week, he said. The majority use the contrast in short supply.

The contrast shortage comes from production shutdowns at Shanghai, China-based factories operated by pharmaceutical company GE Healthcare. The plants were temporarily closed due to COVID-19 lockdowns ordered by the Chinese government. While the plants are reportedly at full production again, the shutdown has resulted in a shortage that could affect hospitals into July.

Providence Swedish system, which includes Olympia’s Providence Saint Peter Hospital, said its stores of contrast are at “critical” levels. GE provides approximately 97 percent of its iodine-based contrast.

About 60 percent of CT scans use a contrast agent which is used to differentiate between organs and detect lesions. The same iodine contrast is used in other procedures such as angiograms.

It’s usually administered intravenously.

The shortage seems to have caught medical institutions off guard. UW learned of the shortage on Friday. Providence Swedish notified its staff of the shortage on Wednesday.

GE controls the majority of the contrast market in the U.S. Hospitals that contract for a drug generally only use one supplier. That can be a problem if the supplier comes up short with a particular drug.

The Greater New York Hospital Association told members the plant that makes the contrast solution is open, but it will take a while to catch up:

While the facility has reopened and ramped up production, GE anticipates an 80% reduction in supplies for the next 6-8 weeks.

MDLINX reported:

A spokesperson from the American Hospital Association (AHA) confirmed the shortage on May 5, saying hospitals have reported low supplies for about a week.

With low stockpiles of IV contrast, AHA anticipates this will affect any CT imaging requiring media. Under normal circumstances, it’s estimated that more than 75 million CT scans are performed annually in the US.

“Hospitals are exploring various conservation strategies, including the use of other imaging technologies, using other contrast agents, rationing contrast—to give a few examples—to try to continue to provide care,” Milligan said.

Milligan added that AHA has raised the issue with the Biden administration.

Interestingly, the rumors of the shortage have been circulating for a while on, of all places, Reddit. Starting on April 22, the r/medicine ([link removed]) sub-Reddit posts described impending shortages in California, Texas and Maryland.

MDLINX says this is just the latest of several shortages caused by COVID lockdowns in China.

Ongoing shortages stemming from supply-chain disruptions include heparin ([link removed]) , 50% dextrose injection ([link removed].) , diphenhydramine injection ([link removed]) , and various local anesthetics.

As with other industries, the manufacturing and shipping of drugs, medical devices, and basic supplies such as PPE has been hampered by a confluence of a number of factors.

US ports have seen record levels of congestion, making it difficult to distribute goods. Freight and transportation costs have risen with the price of fuel. Raw materials have become more difficult to source. Natural disasters—and most recently, the war in Ukraine—have disrupted markets. Labor shortages have made goods harder to manufacture and ship. And China, a major producer of medical products, is facing an energy crisis.


** COVID cases growing in NYC, mask mandates possible
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COVID-19 hospitalizations dropped back down to early April levels in New York City but the infection rate is rising ([link removed]) and Health Commissioner Dr. Ashwin Vasan told CNN the city could consider a range of options including the return of a mask mandate — if the positivity rates keeps going up.

Keep an eye on this as the week unfolds.


** Bird flu infects millions of chickens, still spreading
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This is not a threat to humans, but it is causing millions of birds in the U.S. to be killed as agriculture officials and farmers try to slow the spread of this virus. The Washington Post gives us an update: ([link removed])

Thirty-seven million chickens and turkeys have been culled on U.S. farms since February because of the latest outbreak, according to the Agriculture Department, and roughly 950 cases of bird flu have been found in wild birds, including at least 54 bald eagles.

Bird flu takes unheard-of toll on bald eagles, other birds ([link removed]) .

In Virginia, officials said they detected bird flu in February among a “backyard flock” of roughly 90 turkeys, chickens and ducks in Fauquier County. There has been no bird flu detected in D.C., officials said.

“The numbers are just staggering in terms of the poultry,” said Charlie Broaddus, the state veterinarian in Virginia.

One of the biggest factors in the bird flu’s spread this year, he said, is that it’s being carried by wild ducks and geese that are infected but “don’t typically become affected” by it.


** The pandemic’s toll on bus lines: half of them folded
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Pew’s Stateline news service ([link removed]) looked at the heavy toll that the pandemic placed on bus lines around the country.

Many private bus companies across the U.S. have faced serious hardships during the pandemic. It didn’t matter whether they ran scheduled routes from city to city, transported commuters or provided charters and tours.

Throughout the country, many people who don’t have cars or don’t drive, especially students or people with limited means, rely on intercity buses. If those routes are cut or eliminated, they may be left in the lurch.

Transportation experts consider intercity services essential infrastructure. Often, they operate in areas where there may be no alternative transportation. ([link removed])

And in many small towns, local charter bus operators serve school groups, clubs for older adults and other community organizations. Without them, residents may have few options if they want to plan for sporting events, church retreats or sightseeing trips.

The pandemic took a heavy toll on the bus industry.

Riders disappeared. White-collar employees worked from home. Schools taught students remotely, so there were no field trips or sports events.

Bus companies slashed services, eliminated routes and laid off workers. Buses sat idle. Despite $1 billion in federal aid, many companies, particularly those that ran charters, couldn’t make it and shut down.

In December 2019, there were 3,878 motorcoach carriers in the U.S., according to the Federal Motor Carrier Safety Administration. As of late February, there were 1,940.

Charter bus lines are surviving a little better but still are running way behind pre-pandemic levels. And as you might imagine, there are far fewer bus drivers now. ([link removed])


** None of the two dozen states that restrict abortion access offers paid family leave
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CBS News points out ([link removed]) that if the Supreme Court overturns Roe v. Wade, states may need to take a new look at how they support women to raise children.

More women living in states without abortion access, should Roe v. Wade be overturned, will likely carry to term. Yet not one of the two dozen states with laws on the books restricting abortion access offers paid family leave.


Eight of them have opted out of expanding Medicaid coverage under the health care law, which covers pregnancy through postpartum for low-income Americans.

And Mississippi ([link removed]) , whose abortion restriction law is at the heart of an impending Supreme Court decision to overturn Roe v. Wade, ranks as the state with the highest rate of young child poverty and low birth weight and among the highest when it comes to infant mortality rates.

Twenty-six states are either certain or likely to ban abortion ([link removed]) if Roe is overturned, according to the Guttmacher Institute. And 13 states have "trigger laws" that would institute a ban quickly after the high court's decision.

The U.S. is one of only a few countries that does not offer paid maternity leave. The Family Medical Leave Act gives up to 12 weeks off to have and take care of a baby, but without pay. Only 10 states, plus the District of Columbia, offer paid family leave, according to the National Conference of State Legislatures.


** Journalists should reconsider phrases like 'pro-life'
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The Washington Post’s Margaret Sullivan offered a ([link removed]) column on why journalists should take this moment in history to reconsider how various political sides have captured moral high ground by adopting phrases like “pro-life.” Instead, she says, journalists should find out what the person favors or opposes exactly and describe that rather than using generalized labels. The same is true for a “pro-choice” label: Tell me what the person wants to choose.

In the same way, she says, calling a physician who performs abortions as part of their practice should not make them an “abortion doctor” if that is one procedure they do in addition to many others in their practice.


** Point-of-sale loans for the TikTok generation
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SFGate explores ([link removed]) the explosive growth of point-of-sale lending that TikTok and Instagram videos exploit —and with a click or two, you can have what you want and pay for it in short-term installments.

Think of it as a cross between old-fashioned layaways and credit cards ([link removed]) . Point-of-sale buyers can get their merchandise and then pay for it in installments over a period of months. Most of the loans do not require a credit check. Unlike credit cards, you can land one of these loans by downloading an app and getting a quick approval. The terms do not include interest for people who pay on time, but miss a payment and interest rates as high as 30% plus service fees can kick in.

SFGate reports: ([link removed])

In 2021, Americans spent more than $20 billion through buy now, pay later services, an ever-increasing chunk of the $870 billion-a-year online shopping pie ([link removed]) .

Gen Z, in particular, has fallen in love with the short-term loans, spending 925% more now through point-of-sale services than in January 2020. But coupling nearly instantaneous loans with an influencer-addled social media culture that prioritizes exorbitant spending and normalizes debt could be further jeopardizing the financial futures of young people through just four easy payments.

“These buy now, pay later programs incentivize people to spend above their means, because they're like, ‘Oh, well, it's only this amount over four months,’” Celesta, a Bay Area fashion influencer on TikTok who posts as @itscelesta ([link removed]) , told SFGATE. (She declined to give her last name.) “People almost like brag or joke that ‘oh, it was only 24 payments of $20’ or ‘I got it with Afterpay, so it's technically free.’”

Retailers like these new services because when customers use them, they tend to buy a lot more stuff. The SF Gate story says about 28% of Black Americans have used a point-of-sale loan compared to 14% of whites.

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