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Journal Articles

Health Care Claims Data May Be Useful For COVID-19 Research Despite Significant Limitations

Maimuna S. Majumder, Sherri Rose
Health Affairs , 2020

Although health care billing claims data have been widely used to study health care use, spending, and policy changes, their use in the study of infectious disease has been limited. Other data sources, including from the Centers for Disease Control and Prevention (CDC), have provided timelier reporting to outbreak experts.

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Journal Articles

Health Care Claims Data May Be Useful For COVID-19 Research Despite Significant Limitations

Maimuna S. Majumder, Sherri Rose
Health Affairs , 2020

Although health care billing claims data have been widely used to study health care use, spending, and policy changes, their use in the study of infectious disease has been limited. Other data sources, including from the Centers for Disease Control and Prevention (CDC), have provided timelier reporting to outbreak experts.

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Journal Articles

An Impact-Oriented Approach to Epidemiological Modeling

Nirav R. Shah, Debbie Lai, C. Jason Wang
Journal of General Internal Medicine , 2020

Epidemiological modeling has emerged as a crucial tool to help decision-makers combat COVID-19, with calls for non-pharmaceutical interventions such as stay-at-home orders and the wearing of masks. But those models have become ubiquitous and part of the public lexicon — so Nirav Shah and Jason Wang write that they should follow an impact-oriented approach.

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Journal Articles

Association of Adverse Pregnancy Outcomes With Risk of Atherosclerotic Cardiovascular Disease in Postmenopausal Women

Mark A. Hlatky, Marcia Stefanick
JAMA Cardiology , 2020

Cardiovascular disease is the leading cause of death among women in the U.S. and identification of sex-specific risk factors could enhance cardiovascular risk assessment and prevention. Pregnancy is an exposure unique to women: 85% of women give birth at least once in their lives, and up to 30% may experience an adverse pregnancy outcome (APO).

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Journal Articles

Fair Regression for Healthcare Spending

Anna Zink, Sherri Rose
Journal of the International Biometric Society , 2020
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Journal Articles

Modeling Contact Tracing Strategies for COVID-19 in the Context of Relaxed Physical Distancing Measures

Alyssa Bilinski , Farzad Mostashari, Joshua Salomon
JAMA Network Open , 2020

Stanford Health Policy’s Joshua Salomon, a professor of medicine and senior fellow at the Freeman Spogli Institute for International Studies, and colleagues developed a mathematical model to examine the potential for contact tracing to reduce the spread of the coronavirus.

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Journal Articles

Hepatitis C Treatment in Prisons — Incarcerated People’s Uncertain Right to Direct-Acting Antiviral Therapy

Alexandra M. Daniels , David Studdert
New England Journal of Medicine , 2020

In a recent perspective published by the New England Journal of Medicine(NEJM), Stanford Law student Alexandra Daniels analyzed a growing body of federal litigation brought by prisoners with the hepatitis C virus (HCV) who are seeking access to treatment for their condition.

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Journal Articles

Operational Considerations on the American Academy of Pediatrics Guidance for K-12 School Reentry

C. Jason Wang, Henry Bair
JAMA Pediatrics , 2020

There is general consensus among experts that K-12 schools should aim to reopen for in-person classes during the 2020-2021 school year. Globally, children constitute a low proportion of coronavirus disease 2019 (COVID-19) cases and are far less likely than adults to experience serious illness. Yet, prolonged school closure can exacerbate socioeconomic disparities, amplify existing educational inequalities, and aggravate food insecurity, domestic violence, and mental health disorders. The American Academy of Pediatrics (AAP) recently published its g

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Journal Articles

Attacks on Public Health Officials During COVID-19

Michelle Mello, Jeremy A. Greene , Joshua M. Sharfstein
JAMA Network , 2020

In June 24, 2020, California Governor Gavin Newsom remarked on a disturbing phenomenon: health officers are “getting attacked, getting death threats, they’re being demeaned and demoralized.” At least 27 health officers in 13 states (including Nichole Quick of Orange County in southern California, Ohio Health Director Amy Acton, and West Virginia Health Officer Cathy Slemp) have resigned or been fired since the start of the coronavirus disease 2019 (COVID-19) pandemic.

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Journal Articles

Partitioning the Curve — Interstate Travel Restrictions During the Covid-19 Pandemic

David Studdert, Mark Hall, Michelle Mello
New England Journal of Medicine , 2020

Since the onset of the Covid-19 crisis in the United States, government action taken to “flatten” the curve of disease transmission has varied dramatically among states, counties, and cities. The early epicenters — New York City, Washington State, and the San Francisco Bay Area — implemented aggressive measures in mid-March, many of which remain in place. Other states and localities opted for milder restrictions, acted much later, or barely intervened at all. Many states began unwinding restrictions weeks ago, although surging case numbers are prompting some to change course.

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Journal Articles

The Legal Authority for States’ Stay-at-Home Orders

Mark A. Hall, Michelle Mello, David Studdert
New England Journal of Medicine , 2020

In March 2020, when many U.S. states and localities issued their first emergency orders to address Covid-19, there was widespread acceptance of the government’s legal authority to respond quickly and aggressively to this unprecedented crisis. Today, that acceptance is fraying. As initial orders expire and states move to extend or modify them, legal challenges have sprouted. The next phase of the pandemic response will see restrictions dialed up and down as threat levels change.  As public and political resistance grows, further legal challenges are inevitable.

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Journal Articles

Respecting Disability Rights — Toward Improved Crisis Standards of Care

Michelle Mello, Govind Persad , Douglas B. White
New England Journal of Medicine , 2020

In times of emergency, many legal strictures can flex. For example, to enable hospitals to respond to Covid-19, the Department of Health and Human Services (HHS) recently waived a swath of federal regulatory requirements. But though officials’ emergency powers are extensive, the ability to discard antidiscrimination protections is not among them. A hallmark of our legal system is that our commitment to prohibiting invidious discrimination remains steadfast even in times of emergency.

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Journal Articles

COVID-19 Policies: Remember Measles

Deparati Guha-Sapir , Maria Moitinho de Almeida, Mory Keita, Gregg Greenough, Eran Bendavid
Science Magazine , 2020

Nearly 120 million children in 37 countries are at risk of missing their measlescontaining vaccine (MCV) shots this year, as preventive and public health campaigns take a back seat to policies put in place to contain coronavirus disease 2019 (COVID-19). In March, the World Health Organization (WHO) issued guidelines indicating that mass vaccination campaigns should be put on hold to maintain physical distancing and minimize COVID-19 transmission.

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Case Studies

Evidence-Based Practice for Public Health Emergency Preparedness and Response

Jeremy Goldhaber-Fiebert, Douglas K. Owens, et al.
National Academies of Sciences, Engineering and Medicine , 2020

Yet there has been no national-level, comprehensive review of the evidence for public health emergency preparedness and response (PHEPR) practices. Recognizing this deficiency, the Centers for Disease Control and Prevention (CDC) went to the National Academies of Sciences, Engineering and Medicine three years ago and asked them to convene a national panel of public health experts to review the evidence for emergency preparedness and response. The committee members included Stanford Health Policy Director Douglas K.

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Journal Articles

Disease Control, Civil Liberties, and Mass Testing — Calibrating Restrictions during the Covid-19 Pandemic

David Studdert, Mark A. Hall
New England Journal of Medicine , 2020

Urgent responses to the Covid-19 pandemic have halted movement and work and dramatically changed daily routines for much of the world’s population. In the United States, many states and localities have ordered or urged residents to stay home when able and to practice physical distancing when not. Meanwhile, unemployment is surging, schools are closed, and businesses have been shuttered. Resistance to drastic disease-control measures is already evident. Rising infection rates and mortality, coupled with scientific uncertainty about Covid-19, should keep resentment at bay — for a while.

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Journal Articles

Ensuring Uptake of Vaccines against SARS-CoV-2

Michelle Mello, Ross D. Silverman, Saad B. Omer
New England Journal of Medicine , 2020

As Covid-19 continues to exact a heavy toll, development of a vaccine appears the most promising means of restoring normalcy to civil life. Perhaps no scientific breakthrough is more eagerly anticipated. But bringing a vaccine to market is only half the challenge; also critical is ensuring a high enough vaccination rate to achieve herd immunity. Concerningly, a recent poll found that only 49% of Americans planned to get vaccinated against SARS-CoV-2.

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Commentary

Coronavirus Could Make America’s Gun Problem Even Deadlier

David Studdert, Matthew Miller, Garen Wintemute
The New York Times , 2020

Millions of Americans have experienced the coronavirus pandemic directly, as they or their loved ones suffered through infection. But for most of us, the experience is defined by weeks and months on end stuck at home. The shut-ins are testing the safety of our home environments.

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Journal Articles

Handgun Ownership and Suicide in California

David Studdert, Yifan Zhang , Sonja A. Swanson, Lea Prince, Jonathan A. Rodden, Erin E. Holsinger, Matthew J. Spittal, Garen G. Wintemute , Matthew Miller
New England Journal of Medicine , 2020

BACKGROUND

Research has consistently identified firearm availability as a risk factor for suicide. However, existing studies are relatively small in scale, estimates vary widely, and no study appears to have tracked risks from commencement of firearm ownership.

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Journal Articles

Ethics and Governance for Digital Disease Surveillance

Michelle Mello, C. Jason Wang
Science Magazine , 2020

Digital epidemiology—the use of data generated outside the public health system for disease surveillance—has been in use for more than a quarter century [see supplementary materials (SM)]. But several countries have taken digital epidemiology to the next level in responding to COVID-19. Focusing on core public health functions of case detection, contact tracing, and isolation and quarantine, we explore ethical concerns raised by digital technologies and new data sources in public health surveillance during epidemics.

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Journal Articles

Thinking Globally, Acting Locally — The U.S. Response to Covid-19

Rebecca L. Haffajee, Michelle Mello
New England Journal of Medicine , 2020

Covid-19 has exposed major weaknesses in the United States’ federalist system of public health governance, which divides powers among the federal, state, and local governments. SARS-CoV-2 is exactly the type of infectious disease for which federal public health powers and emergencies were conceived: it is highly transmissible, crosses borders efficiently, and threatens our national infrastructure and economy. Its prevalence varies around the country, with states such as Washington, California, and New York hit particularly hard, but cases are mounting nationwide with appalling velocity.

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Journal Articles

How to Prevent and Manage Hospital-Based Infections During Coronavirus Outbreaks: Five Lessons from Taiwan

C. Jason Wang, Henry Bair, Ching-Chuan Yeh
Journal of Hospital Medicine , 2020

During the severe acute respiratory syndrome (SARS) outbreak in 2003, Taiwan reported 346 confirmed cases and 73 deaths. Of all known infections, 94% were transmitted inside hospitals. Nine major hospitals were fully or partially shut down, and many doctors and nurses quit for fear of becoming infected. The Taipei Municipal Ho-Ping Hospital was most severely affected.

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Journal Articles

Examining Pharmaceutical Benefits in the United States—A Framework

Alex Chan, Kavin Schulman
JAMA Network , 2020

Pharmacy benefit managers (PBM) are important intermediaries in the pharmaceutical supply chain in the US. Under the general umbrella of administering outpatient prescription drug benefits for health plans, PBMs took on a variety of roles, including managing the drug formulary, negotiating with drug manufacturers and retailers, and processing drug claims.

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Journal Articles

Federal Funding For State And Local Contact Tracing Efforts Is An Urgent Priority, And A Bargain

Joshua Salomon, Arthur L. Reingold
Health Affairs , 2020

Rallying cries around COVID-19 have shifted from “flatten the curve” to “reopen America.” After weeks of restrictions on movement, commerce, and social connections across most areas of the country, the tantalizing possibility of relaxing current measures in time for summer baseball and beach parties eroded the resolve of many communities in lockdown. At least 30 states have already moved to reopen some businesses or loosen stay-at-home orders against the warnings of health experts.

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Journal Articles

Privileges and Immunity Certification During the COVID-19 Pandemic

Mark A. Hall, David Studdert
JAMA Network , 2020

As the coronavirus disease 2019 (COVID-19) crisis enters its next phase, attention turns to the widespread testing programs needed to resume and maintain normal life activities. Effective prevention and surveillance require testing for active infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and for antibodies that indicate prior infection and potential immunity. There is an established approach for infected individuals: mild cases self-isolate; and severe cases receive treatment. But what is the appropriate response for people with positive antibody tests?

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Commentary

Standing Up against Gender Bias and Harassment — A Matter of Professional Ethics

Michelle Mello, Reshma Jagsi
New England Journal of Medicine , 2020

“We believe health professionals have a moral duty to practice `upstanding’ — intervening as bystanders — in response to sexual harassment and general bias and that this obligation should be described in codes of medical professional ethics and supported within institutional training,” the authors write. While many medical professional societies now mention sexual harassment in their ethical codes, these guidelines fall short in that they do not encourage professionals to respond to the behaviors and intervene when they become aware of discrimination or harassment.

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