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By the way, medical abortion is now more tightly restricted in Texas, too

Another piece of crap from the special session.

Misoprostol

A new law limiting the use of abortion-inducing medication in Texas goes into effect Thursday.

The law makes it a felony to provide the medication after seven weeks of pregnancy, putting Texas at odds with federal regulations. It also makes it a crime to send the medication through the mail.

Medical abortion is the most common way women in Texas terminate their pregnancies, according to state data.

These new restrictions reflect a growing concern among abortion opponents about the rise of “self-managed” abortions, in which pregnant people obtain the medications from out-of-state or international providers, with or without a prescription.

There’s evidence that more women turn to self-managed abortions when legal abortion is restricted. Texans have been unable to access abortions after about six weeks of pregnancy since Sept. 1, when a controversial new ban went into effect.

“Texas is looking at the ways that people are navigating around restrictions and trying to essentially make that as unsafe and as frightening for people as possible in order to deter them,” said Farah Diaz-Tello, senior legal counsel for If/When/How, a reproductive justice legal group.

Diaz-Tello and other advocates worry that the new criminal penalties may make pregnant Texans fearful of seeking medical care after a self-managed abortion.

[…]

Texas’ new law also specifies that no one may provide abortion medication “by courier, delivery or mail service.”

Texas already required the medication to be provided by a physician in person. But this specific clause addresses a growing concern among abortion opponents that patients are trying to circumvent the required doctor visit by getting the drugs by mail, especially with the state’s new restrictions that bans abortions after around six weeks.

Called a “self-managed abortion,” this usually entails ordering abortion-inducing drugs online, with or without a prescription, from doctors, pharmacies and other providers out of state or overseas.

The FDA has attempted to crack down on some providers, including AidAccess, a group founded in 2018 by Dr. Rebecca Gomperts, a European doctor. AidAccess provides abortion-inducing medications to women in areas that have restricted access to the procedure.

Gomperts has said she will continue prescribing to patients in Texas. She told CBS News in September that she believes she is on solid legal ground since it is legal to prescribe this medication where she is based.

See here for the backgroun; I didn’t blog it at the time for whatever the reason. A bit more than half of all abortions in Texas are medical abortions, which the FDA says are safe up to ten weeks. I suspect Dr. Gomperts and others like her if they exist will get more business now, despite the prohibition on sending the medication via mail. It’s really a matter of enforcement, and it’s not clear to me how Texas will be able to do that. That FDA action against her was from 2019, by the way. It would be nice for the current FDA to maybe revisit that now. I don’t have anything positive to end with. This is where we are right now.

The Pfizer pill

This would be a big step forward.

Pfizer Inc. said [recently] that its experimental antiviral pill for COVID-19 cut rates of hospitalization and death by nearly 90% in high-risk adults, as the drugmaker joined the race for an easy-to-use medication to treat the coronavirus.

Currently most COVID-19 treatments require an IV or injection. Competitor Merck’s COVID-19 pill is already under review at the Food and Drug Administration after showing strong initial results, and on Thursday the United Kingdom became the first country to OK it.

Pfizer said it will ask the FDA and international regulators to authorize its pill as soon as possible, after independent experts recommended halting the company’s study based on the strength of its results. Once Pfizer applies, the FDA could make a decision within weeks or months.

Since the beginning of the pandemic last year, researchers worldwide have been racing to find a pill to treat COVID-19 that can be taken at home to ease symptoms, speed recovery and keep people out of the hospital.

Having pills to treat early COVID-19 “would be a very important advance,” said Dr. John Mellors, chief of infectious diseases at the University of Pittsburgh, who was not involved in the Pfizer study.

“If someone developed symptoms and tested positive we could call in a prescription to the local pharmacy as we do for many, many infectious diseases,” he said.

[…]

Study participants were unvaccinated, with mild-to-moderate COVID-19, and were considered high risk for hospitalization due to health problems like obesity, diabetes or heart disease. Treatment began within three to five days of initial symptoms, and lasted for five days. Patients who received the drug earlier showed slightly better results, underscoring the need for speedy testing and treatment.

Pfizer reported few details on side effects but said rates of problems were similar between the groups at about 20%.

It’s much better to prevent COVID than to treat it, in the same way that it’s much better to prevent malware from getting on your computer than to clean up after it. As such, getting vaccinated is still far and away the best thing to do to mitigate the risk of COVID. But if I want to extend the cybersecurity analogy, you must have multiple layers of defense to truly have good security practices, and so having a safe and reliable treatment to COVID that can keep people out of the hospital is crucial. I look forward to both the Pfizer and Merck pills getting approved by the FDA.

More kids are getting their COVID shots

So good to see.

The possibility of the parties, vacations and family gatherings energized six families who attended the COVID-19 vaccination event on Wednesday inside Memorial Hermann, the morning after the Centers for Disease Control and Prevention officially expanded eligibility to kids from 5- to 11-years-old. Eager parents are clamoring for an opportunity to vaccinate their children after an especially challenging wave of infections, which hit a peak in late August just as kids returned to school.

Texas Children’s Hospital administered its first dose of the vaccine at 6:15 a.m., and is expected to administer thousands more throughout the week to children with an appointment, which are now only available as soon as Nov. 18. Memorial Hermann is making the vaccine available to walk-ins at its hospital campuses, beginning Thursday morning.

Parents, many of whom were affiliated with the Memorial Hermann system, shared their own harrowing experiences with the virus at Thursday’s vaccine event. Chris Lange, the father of 8-year-old and 5-year-old girls, said he is still dealing with brain fog after an aggressive bout with COVID during the February winter freeze.

The kids caught a less severe infection, but the experience raised the urgency of vaccination, he said.

“This whole (pandemic) is just such a drain on everyone,” he said. “Knowing that now maybe we don’t have to worry about schools closing. We don’t have to worry about kids staying home. I mean, that’s a big win.”

I’ve seen plenty of celebrating, on Facebook and Twitter, by friends who have kids in the 5-11 age range, much as I did when the shots were cleared for ages 12 and up. I figure we’ll see a big spike in vax rates in the first couple of weeks, then it will settle at a much lower level as the eager folks all get it done and what’s left are the more hesitant and resistant. Every little bit helps, that much is for sure.

Get your kids ready for their COVID shots

At long last.

The U.S. Food and Drug Administration on Friday authorized the emergency use of the Pfizer-BioNTech COVID-19 vaccine on children ages 5-11, marking a long-awaited milestone in the nearly two-year fight against the deadly virus that experts say has likely already infected nearly half the population in that age group.

In Texas, that makes up to 2.9 million children eligible for the vaccine.

The federal regulatory agency said the vaccine is safe and effective for children in that age group. The Pfizer test results shared with the FDA show that its vaccine prevents symptoms in most children and causes no side effects more serious than those already seen in older age groups. FDA panelists decided that the benefits of the vaccine for children ages 5-11 — many of whom have suffered isolation, depression and learning loss throughout the course of the pandemic — outweigh the risks associated with the Pfizer shot.

“As a mother and a physician, I know that parents, caregivers, school staff, and children have been waiting for today’s authorization. Vaccinating younger children against COVID-19 will bring us closer to returning to a sense of normalcy,” said Dr. Janet Woodcock, acting FDA commissioner. “Our comprehensive and rigorous evaluation of the data pertaining to the vaccine’s safety and effectiveness should help assure parents and guardians that this vaccine meets our high standards.”

Still uncertain, however, is whether the U.S. Centers for Disease Control and Prevention will limit the shots to only children with preconditions that put them at high risk of serious disease from COVID-19 — a decision expected next week.

The FDA’s announcement, which follows a recommendation by its vaccine advisory panel earlier this week, triggers an initial federal allocation of more than a million doses destined for children ages 5-11 to providers in nearly half of Texas counties. Those will start landing in Texas pharmacies, pediatrics offices, health clinics and hospitals within a few days, state health officials said.

After the first federal shipment, others will continue on a weekly basis. The amounts will vary based on providers’ requests, officials said.

Most of the parents I know nowadays have older kids who are already vaccinated, and yet I know plenty more who will be ready and eager to get their kids vaxxed. As with every other instance of this vaccine, I expect there will be a big surge up front as all of the willing people stampede to get it done, followed by a long fallow period in which the reluctant, the folks with access issues, and eventually some of the holdouts who meet up with mandates of one form or another get around to it. The boost to the overall vaccination rate in the state should help keep things under control, more or less, through the winter. It’s good news for many, and we have been waiting for it. The Chron has more.

More on the Abbott max anti-vaxx order

Businesses will face a choice that they would rather not have to face.

Companies doing business in Texas face new and complicated challenges after Gov. Greg Abbott this week banned COVID-19 vaccine mandates for all entities in the state — including private businesses — for employees or customers.

The ramifications for businesses could begin as soon as Friday, when companies that enter into contract work with the federal government will be required to have all employees vaccinated under orders from the White House.

This conflicts with Abbott’s ban on vaccine mandates, putting the many Texas businesses that receive federal contracts in a tough position: Comply with federal law and violate Abbott’s ban, or comply with Abbott and turn down business from the federal government.

[…]

“This harms Texans directly,” Karen Vladeck, an employment lawyer in Austin, said of the new order from Abbott. “I just think it wasn’t well thought out.”

Abbott’s office did not reply to a request for comment.

On top of prohibiting any entity in Texas from requiring vaccinations, Abbott’s order also lists several expanded exemptions. Vladeck and other employment lawyers said that this adds to the vaccine dilemma facing businesses in Texas. Under Abbott’s new rule, people may opt out of a vaccine requirement for medical reasons, including if they prove they have had COVID-19 in the past, despite scientists widely agreeing that this does not protect people against contracting the virus.

“The executive order’s medical reason language is a bit strange because usually you exempt people for medical reasons if they have a severe allergic reaction to a vaccine,” said Elizabeth Sepper, a law professor at the University of Texas at Austin. Abbott’s order is “meant to cover people who don’t want to get the vaccine because they believe, quite wrongly, that they’re completely protected by already having COVID.”

Abbott’s rule also allows people to opt out of a vaccine requirement if they prove they hold a deep personal belief against getting jabbed.

Any entity that fails to comply with Abbott’s rule could receive up to a $1,000 fine.

Abbott’s Monday order is a reversal from his position in August, when the Pfizer vaccine received final approval from the U.S. Food and Drug Administration. At the time, Abbott’s spokesperson said that businesses had the option of mandating vaccination for employees and “private businesses don’t need government running their business.”

“It’s all about company choice in Texas, except now it’s come to something that they don’t like what the companies are choosing,” Vladeck said. “It puts a big burden on employers.”

See here for the background. So far, businesses that are also federal contractors, including airlines and companies like IBM, will ignore Abbott’s order, while others are awaiting the OSHA rules before making a decision. Multiple business groups, the same organizations that often turn to the state for a legislative solution to local ordinances they don’t like, harshly criticized Abbott’s order for making their lives more difficult. Harris County Attorney Christian Menefee released a statement encouraging businesses that want to be able to get their employees vaccinated to file a lawsuit against Abbott over the order. And in the end, even wingnut talk radio hosts weren’t impressed by Abbott’s order. It’s almost as if he were a weak, gutless leader.

More on the San Antonio ISD vaccination mandate litigation

I’m a little confused at this point, but I’ll cope.

Judge Mary Lou Alvarez of the 45th District Court denied the state of Texas’ request for a temporary injunction Friday, allowing the San Antonio Independent School District to continue requiring its employees to be vaccinated against the coronavirus.

Former SAISD Superintendent Pedro Martinez, who has since left the district to take a job in Chicago, issued the vaccine mandate on Aug. 16, requiring all staff members to be vaccinated by Oct. 15. SAISD board President Christina Martinez said Thursday that about 90% of SAISD staff has been vaccinated.

Alvarez’s decision came after a hearing on the state’s request for temporary relief against the vaccine mandate was delayed. Another state district judge denied the school district’s challenge on Sept. 23 that the state and Gov. Greg Abbott did not have jurisdiction to sue. SAISD then appealed that ruling, pushing back the original hearing for the state’s lawsuit; the appeal was dropped earlier this week.

After Alvarez’s ruling, the state’s legal team said they planned to appeal. A trial for the lawsuit is set for Jan. 19, 2022.

[…]

Attorney Steve Chiscano, who represented SAISD, dismissed the state’s lawsuit as a political ploy.

“We are sitting in an injunction hearing that the AG is hoping to win so he can spin off another press release on how proud he is that he beat up on this district,” Chiscano said. “It is so obvious and so clear that this is happening that I believe at the end of the day, you’ll see that what the governor is doing is not supported by any law.”

See here and here for the background. I’ve decided that we had a motion by SAISD to dismiss the lawsuit, which was denied, and then the state asked for a temporary restraining order against SAISD, which was also denied. The source of my initial confusion was the change in judges between the two, but I think that may just be how Bexar County rolls. In any event, true to form and as the story notes, Paxton – who was not present for the hearing – did indeed tweet about it and how he’s fighting for the freedom of people who want to get sick and die and take others with them. Ultimately, this judge did not buy the state’s argument that the Abbott executive order was enough on its own to prevent SAISD from responding to the pandemic in this fashion. A higher court may intervene before the hearing for an injunction, but in the meantime I sure hope that SAISD is making progress in getting shots into arms. That is what really matters. The Current has more.

SAISD vaccine mandate update

Still in place for now, but clearly on shaky ground.

Best mugshot ever

San Antonio Independent School District can continue requiring its staff to get vaccinated against COVID-19, despite a judge ruling against the district Thursday in a case filed by the Texas attorney general.

Judge Angelica Jimenez of the 408th District Court denied SAISD’s plea on Thursday that state Attorney General Ken Paxton lacks the legal authority to enforce Gov. Greg Abbott’s Aug. 25 executive order, which banned public entities, such as school districts, from mandating COVID-19 vaccines. Steve Chiscano, the attorney representing SAISD, immediately appealed the ruling.

Appealing Jimenez’s jurisdiction ruling delayed a hearing requested by the state to stop SAISD’s vaccine mandate with a temporary restraining order. The school district and attorney general’s office will make their arguments again before the 4th Court of Appeals. Case information is due at the court Oct. 4, according to online court records. The lawyers will file briefs, and justices will make a decision at an undetermined date.

[…]

In a statement, the district said Jimenez’s ruling does not enforce Abbott’s executive order prohibiting vaccine mandates and that SAISD would continue its vaccine protocols.

“We do not believe the Governor and Attorney General have the legal authority to continue this lawsuit, and we respectfully disagree with the judge’s ruling,” the district said in the statement. “We know that following the executive order and not requiring vaccination of our employees is potentially deadly, and we will do what is necessary to protect the children and staff of the district.”

See here for the previous update. I’ve always thought that the vaccine mandate was a heavier lift than the mask mandates, so I won’t be surprised if Paxton eventually wins this one. But as long as that mandate remains in place, SAISD can move closer to a goal of maximizing the number of its employees who have been vaccinated. No matter the odds, that’s worth fighting for.

The COVID shot for kids is coming

Not a moment too soon.

On Monday, Pfizer released the initial trial results, showing that its vaccine is safe and effective for the 5-11 age group. The findings are a key step toward inoculating a younger population that so far has been unprotected from the virus.

“It’s good to hear the studies are paying off,” García said. “We are happy to be part of the process to help other people get more trust in the vaccine, so we can start getting back to normal as soon as possible.”

The announcement summarized results from 2,268 trial participants. The findings show that children develop an antibody response similar to the 16- to 25-year-old age group when given a lower dosage of the vaccine.

Pfizer and BioNTech, the company’s German partner, plan to include the data in a “near-term submission for Emergency Use Authorization” while safety research is ongoing. Dr. Bill Gruber, a Pfizer senior vice president, told The Associated Press that the company plans to apply for emergency use by the end of the month.

My kids are thankfully old enough to already be vaccinated, but I know a lot of people who have been eagerly awaiting this announcement. I expect there will be a surge of new vaccinations in the weeks following the emergency use grant, and while it will surely fall well short of the full total of eligible kids, it will make a decent dent in the overall vaccination rate. We’re going to need every bit of this. The 19th and Daily Kos have more.

Paxton sues again over SAISD’s vaccine mandate

Yes, vaccine mandate. For teachers and staff.

Best mugshot ever

For the second time in a month, Texas Attorney General Ken Paxton sued San Antonio Independent School District and Superintendent Pedro Martinez for requiring all staff to be vaccinated against COVID-19.

Martinez issued a staff vaccine mandate and mask mandate Aug. 16 for everyone inside school buildings. Three days later, Paxton sued Martinez and SAISD over both mandates, stating in the lawsuit that the superintendent and the district were “deliberately violating state law,” as a July executive order from Gov. Greg Abbott prohibits any entity that receives public funds from mandating COVID-19 vaccines that had received only emergency approval from the federal government.

But the federal Food and Drug Administration granted full approval for the Pfizer COVID-19 vaccine on Aug. 23, and the lawsuit was dropped. Two days later, Abbott issued a new executive order, banning governmental entities from requiring any COVID-19 vaccine, regardless of FDA approval status.

Paxton filed the second lawsuit against SAISD in Bexar County on Sept. 9, seeking a temporary restraining order barring the school district from mandating vaccines. In the petition, Paxton claims SAISD and Martinez are again violating state law by “flouting” the August executive order.

“The decision to openly violate state law and devote district resources to defending Superintendent Martinez’s unlawful actions is irresponsible,” Paxton said in a statement. “But if school districts decide to use their limited funding to try to get away with breaking the law, my office will oppose them and uphold the rule of law in Texas.”

See here and here for some background. My reaction when Paxton filed the first lawsuit was that he was likely to prevail, and despite the FDA approval and Biden mandate (which has been announced but not yet fully implemented), I don’t see any reason why that would change. I will of course be happy to be wrong, and if it is the case that some people have gotten vaccinated as a result of the SAISD mandate then it’s a win no matter what happens in court. The main thing to remember here is that Ken Paxton, like Greg Abbott, is objectively pro-COVID, and we need to make them pay at the ballot box for it.

Hospital systems have no excuse for not mandating COVID vaccines now

So get on with it already.

Local hospitals reacted Friday to President Joseph Biden’s sweeping vaccine mandates directed at the health care workers, who make up much of the Houston workforce.

In a move that overrides Gov. Greg Abbott’s executive order barring public institutions from issuing their own COVID-19 restrictions, the administration said it would require vaccinations for employees at health care facilities that accept Medicare and Medicaid reimbursement.

Baylor College of Medicine’s dean of clinical affairs, Dr. James McDeavitt, said Thursday he supported the new measures.

“It is the right thing to do,” he said.

Still, he wished the plan had come sooner. “It is not going to help us with the current delta surge,” he added.

[…]

Five Houston hospital systems already require a vaccine. In June, Houston Methodist became the first hospital in the nation to announce it would require its staff to be fully vaccinated, a move that met months of resistance, including a lawsuit by some employees. Memorial Hermann and Baylor College of Medicine enacted their own vaccine mandates in July; St. Luke’s Health and Texas Children’s Hospital announced similar plans in August.

Thursday’s executive order will bring similar mandates to the city’s remaining health systems.

Until now, Harris Health System and UTHealth had encouraged worker vaccinations but were unable to require it under the governor’s order.

But on Friday, Harris Health System said it “fully intends to embrace the vaccine mandate” for workers at its two hospitals, 18 community health centers and 10 clinics serving the greater Houston area. The system has not yet set a date.

UT Health said it would wait for guidance from the Centers for Medicare & Medicaid Service, expected in October. It had not instituted a mandate as of Friday afternoon.

St. Joseph Medical Center and UTMB Galveston said they are still evaluating Biden’s plan.

While Kelsey-Seybold Clinic said in August it was waiting for full vaccine approval from the U.S. Food and Drug Administration before asking employees to provide proof of immunization, the clinic has not announced a mandate since the Pfizer-BioNTech vaccine gained full U.S. Food and Drug Administration approval late last month.

See here for the background. I agree that the mandate coming out now will have little to no effect on the current surge, given that it takes a few weeks to get both shots and the full effect of them, and that it will take time for these hospital systems to get their programs going. It would still be nice if some of them had more of a sense of urgency about it. This is still by far the best thing we can do for the medium to longer term, and at the very least these hospital systems should be setting a better example. Get it done already, y’all. The Trib has more.

The legal situation with the heartbeat bill

I’m writing this at eight PM, and will very likely be asleep before SCOTUS takes any action, if they do take action. So let’s start with what we have as of now:

That was in reply to this:

See here for the previous entry. If I see that SCOTUS has taken action when I get up in the morning, I’ll update this post. If not, you can assume that there’s basically no such thing as abortion in Texas until further notice. And that will include medical abortion.

Two days before one of the strictest abortion laws in the country is set to go into effect in Texas, the state Legislature tentatively approved another bill Monday evening that would restrict the procedure during the first term of pregnancy.

Senate Bill 4 remains identical to the version of the bill passed by the Texas Senate. Texas Democrats were unable to attach amendments to the bill, despite more than a dozen attempts, which means the bill will head straight to Gov. Greg Abbott’s desk if it is finally approved with no changes.

The legislation would limit patients’ access to abortion-inducing pills, preventing physicians or providers from giving abortion-inducing medication to patients who are more than seven weeks pregnant. Current law allows practitioners to give these pills to patients who are up to 10 weeks pregnant.

Notably, the U.S. Food and Drug Administration set its guidelines in 2016 advising that abortion-inducing pills are safe to use up to 70 days, or 10 weeks, after initial conception.

These pills have increasingly become the most common method for women to terminate a pregnancy if they are aware of their pregnancy early enough. According to the Guttmacher Institute, a reproductive health research institute that supports abortion rights, 60% of women elect to take a pill over having surgery.

It’s grim. This bill might have a chance of being knocked down by litigation, but who can even say at this point.

It should be noted that there is some state litigation happening, but that will not have the effect of blocking SB8.

Travis County District Judge Amy Clark Meachum issued a temporary restraining order barring the anti-abortion organization Texas Right To Life; John Seago, its legislative director, and others from “instituting any private enforcement lawsuits” under SB 8 against the plaintiff, a Dallas attorney, according to the order.

But the full scope of the order was narrow, and does not apply to a majority of providers or Texans.

“While the temporary restraining order issued by the Texas state court in Austin provides some relief to the two individuals and one nonprofit organization against lawsuits from the Texas Right to Life, it does not provide the full relief needed to ensure all Texans can access their constitutional right to an abortion,” said Julie Murray, staff attorney for Planned Parenthood Federation of America.

Here’s a bit more on that litigation from KXAN:

District Judge Amy Clark Meachum considered three cases on Tuesday morning: one, brought by an attorney and sexual assault victim’s advocate named Michelle Tuegel; another brought by Bridge Collective, a resource group for people seeking an abortion; and another brought by Allie Van Stean, a woman who regularly donates to women’s health clinics.

On Tuesday morning, the judge granted temporary restraining orders (TROs) in all three instances, against the group Texas Right to Life. According to attorneys for these three plaintiffs, the TRO’s prevent Texas Right to Life from filing lawsuits under the new fetal heartbeat law, until the court can conduct a full-scale temporary injunction hearing later in September.

Their attorneys say the ruling is significant for their clients because they had to prove “probable right to relief” to get the TRO — meaning they were able to show the judge evidence supporting their challenge to the law’s constitutionality.

KXAN spoke to Van Stean earlier this month, who explained, “Simply donating to places like Planned Parenthood count as aiding and abetting an abortion… If I’m donating to Planned Parenthood, I’m not necessarily giving with the intent to assist women in getting an abortion. Planned Parenthood and other places provide necessary and needed services like birth control at a lower cost, affordable option for women who can’t afford it.”

A spokesperson for Texas Right to Life told KXAN on Tuesday, the judge’s ruling was “narrow” and does not block the Texas Heartbeat Act from being broadly enforced at midnight.

Rewire wrote a story about Michelle Tuegel, who had filed a lawsuit in Dallas. In that one she sued a whole lot of people, mostly legislators. I don’t know what happened to that suit or if it is related in some way to this one. You should read that story, which links to this one about how Tuegel won a big judgment against US Gymnastics over the Larry Nassar case. If nothing else, I’m glad to have someone like that fighting the good fight.

And that’s all I know right now. If there’s any news in the morning, I’ll include it here. Daily Kos has more.

UPDATE: No word from SCOTUS, so SB8 officially became law at midnight last night. They can – and some people think they will – still act today. But SB8 is in effect until and unless they do.

The financial incentive

At this point, whatever works.

A week after public health officials in Texas’ most populous county started handing out $100 cash cards to locals getting their first COVID-19 shot, the number of daily vaccinations has shot up to six times its previous rate, Harris County Judge Lina Hidalgo said Tuesday.

“We had an inkling that something was going right when I started my announcement [about the incentive] at noon, and by the time I was done, 30 minutes later, there was a line of cars waiting to receive the vaccine,” Hidalgo said. “We haven’t seen those lines for months.”

To accommodate and encourage the increased demand, the county will be opening an additional mass vaccination site and expanding its mobile vaccine program, Hidalgo said.

“You have to be creative, and we’re seeing the results and we’re doubling down on it,” Hidalgo said.

Harris County officials began the incentive program last Tuesday in a bid to jumpstart stalled vaccinations in Houston and surrounding areas, and to provide relief to the region’s stressed hospitals during what health officials say is the worst surge of infections the area has seen since the pandemic began last year.

For the three weeks before the program started, Hidalgo said, Harris County Public Health was administering an average of 431 first doses per day. The day the announcement was made, the number jumped to 914. The next day, 1,596 people sought the first doses from public health providers.

On Saturday, four days into the program, some 2,700 people got their first injection, Hidalgo said.

“This is an incredible achievement,” she said.

As the story notes, more vaccination sites are being opened to accommodate what I hope will be a sharp uptick in demand. The FDA approval of the Pfizer shot, and more companies telling their employees to get vaxxed may help push the numbers up as well. I honestly don’t care what the cause is, as long as it happens. And it needs to happen at a higher rate than this – even with the uptick statewide, we’re at less than 30% of the shots-per-day peak in April. Let’s get closer to that, and then we’ll really have something.

Greg Abbott remains COVID’s best friend

It’s hard to even know what to say.

Gov. Greg Abbott on Wednesday announced an executive order banning COVID-19 vaccine mandates regardless of a vaccine’s approval status with the U.S. Food and Drug Administration.

He also said he was adding the issue to the agenda for the current special session of the Texas Legislature.

The order comes two days after the FDA granted full approval to the Pfizer vaccine. That raised questions about the fate of a previous Abbott order that prohibited vaccine mandates, but only for those under emergency authorization.

Abbott’s latest order is simple, saying “no governmental entity can compel any individual to receive a COVID-19 vaccine.” The order preserves exceptions for places like nursing homes and state-supported living centers.

At the same time, Abbott asked lawmakers to consider legislation addressing whether state or local governments could issue vaccine mandates and, if so, which exemptions should apply.

“Vaccine requirements and exemptions have historically been determined by the legislature, and their involvement is particularly important to avoid a patchwork of vaccine mandates across Texas,” Abbott said in a statement.

[…]

There specifically appeared to be the fresh potential for cities, counties and school districts to require their employees to get vaccinated against COVID-19. San Antonio Independent School District had already announced mandatory employee vaccinations, prompting a lawsuit from Attorney General Ken Paxton.

District officials said Wednesday they will move forward with the mandate — despite Abbott’s latest order.

“We strongly believe that the safest path forward as a school district is for all staff to become vaccinated against COVID-19,” the district said in a statement.

See here for some background, and here for a copy of the order. As the story notes, this would prevent government entities from ordering their employees from getting COVID shots, though as you can see that’s already being challenged. Private employers are not affected by this, so if you work for one of the increasing number of them that are imposing COVID vax mandates, you’re out of luck. A bill passed during the regular session forbids businesses from requiring proof of vaccination from their customers, though that doesn’t take effect until September 1 so Harry Styles can still do what he wants.

I don’t think this is anywhere near the end of it. The same arguments being made about mask mandate bans – successfully, so far – by multiple counties and school districts is that the Disaster Act of 1975 doesn’t actually give Abbott this power. That would be equally true for vaccine mandate bans, I would think. That doesn’t mean the courts, by which I mostly mean the Supreme Court, will eventually accept that argument, just that these same entities will give it a try. The federal government will have a say as well, and let’s not forget the federal lawsuit, too. We’re also going to have an election next year, and we have the option of electing a Governor who wants to fight against the COVID virus instead of fighting for it. There’s a lot more of this story to be written. The Current and the Chron have more.

The approval and the mandates

As I’m sure you’ve heard by now, the FDA has given its final approval to the Pfizer vaccine for COVID-19. That should mean a lot of good things, but among them it should mean broader vaccine mandates are now in play.

The U.S. Food and Drug Administration’s full approval of the Pfizer vaccine Monday is cracking open the door for Texas cities, counties and school districts to compel their employees to get vaccinated against COVID-19 — moves previously blocked by Gov. Greg Abbott.

Abbott had banned public schools and local governments from enacting their own vaccine mandates. But the governor’s executive order specifies that the ban on mandates applies to COVID-19 vaccines that are under emergency authorization — a designation that no longer applies to the Pfizer two-dose vaccination.

Already, one major school district is pressing forward with its plan to require vaccinations for teachers and staff.

Pedro Martinez, superintendent for San Antonio Independent School District, called for mandatory employee vaccinations last week — drawing a lawsuit from Attorney General Ken Paxton, who accused the district and Martinez of breaching Abbott’s ban on vaccine mandates.

But with the FDA’s approval, San Antonio school officials are moving forward with their vaccine requirement for district employees.

In a statement, Martinez called the FDA approval “a positive step forward in the fight against COVID-19 nationwide and a step forward in helping keep schools safe for learning here at home.”

Here’s Superintendent Martinez on CNN discussing his fight against Greg Abbott over this. Most of the fights so far have been about mask mandates, but as we noted recently, San Antonio ISD has notified its employees that they must get vaccinated, which has drawn a lawsuit from Ken Paxton. Which, apparently, has been withdrawn now, as the executive order against vaccine mandates only covered “vaccines administered under an emergency use authorization”.

Here’s more from the Chron.

The Pfizer vaccine’s change in status appears to give cities, school districts and universities a way around the governor’s ban.

“Receiving a COVID-19 vaccine under an emergency use authorization is always voluntary in Texas and will never be mandated by the government, but it is strongly encouraged for those eligible to receive one,” Abbott’s most recent executive order reads.

A spokeswoman for Abbott did not immediately respond to a request for comment on Monday.

The update means San Antonio Independent School District, which was sued by the state after requiring its employees to get the shots by Oct. 15, is still moving forward with its mandate. The district had clarified late last week that it would not compel workers to get a vaccine that wasn’t fully approved by the FDA.

Attorney General Ken Paxton touted that as a win in a news release Monday, distributed less than an hour after the FDA granted full approval.

“State law could not be clearer: ‘No governmental entity can compel any individual to receive a COVID-19 vaccine administered under an emergency use authorization,’” Paxton said in the release. “But San Antonio ISD tried to play by its own set of rules. Thankfully, we stopped them.”

San Antonio school officials say the full authorization now allows the district to go ahead with its requirement that all employees get the shots by mid-October, they say. In his clarification statement last week, Superintendent Pedro Martinez had stipulated that the timeline would only change if the FDA hadn’t fully authorized the vaccine by Sept. 10.

Hey, if you want to declare victory while you’re surrendering and retreating, it’s fine by me. Just keep on surrendering and retreating, that’s all I ask.

The remaining questions are 1) What about Moderna and J&J; 2) What will other government entities do about this new ability; and 3) What about the mask mandates? In short,

1) “In May, Pfizer and BioNTech submitted their license application. Moderna began its application in June, and Johnson & Johnson said it will begin the process later this year.” As such, I’d assume the Moderna approval will come sometime in September or October, and J&J will be later than that. But most people have Pfizer or Moderna shots, so that’s the main thing.

2) My guess is they will move more slowly, but once the first domino falls I’d expect others to follow quickly. Note that this will be about mandates for local government employees, not residents. It’ll help, but it won’t apply to everyone.

3) Not the same thing, so we’re still waiting for the lawsuits to play out.

In the meantime, go tell all your vax-hesitant family, friends, neighbors, co-workers, acquaintances, and whoever else that now is the time for them to get their shots. It’s all officially approved, there’s no need to wait any longer.

“Universal masking” for school children recommended

Seems like a sensible idea, especially given that children under the age of 12 can’t get the vaccine yet.

The American Academy of Pediatrics on Monday recommended that all children over the age of 2 wear masks when returning to school this year, regardless of vaccination status.

The AAP, which said its important for children to return to in-person learning this year, recommends that school staff also wear masks. The AAP is calling the new guidance a “layered approach.”

“We need to prioritize getting children back into schools alongside their friends and their teachers — and we all play a role in making sure it happens safely,” said Sonja O’Leary, chair of the AAP Council on School Health. “Combining layers of protection that include vaccinations, masking and clean hands hygiene will make in-person learning safe and possible for everyone.”

The AAP said universal masking is necessary because much of the student population is not vaccinated, and it’s hard for schools to determine who is as new variants emerge that might spread more easily among children.

Children 12 and over are eligible for Covid-19 vaccinations in the U.S. And the FDA said last week that emergency authorization for vaccines for children under 12 could come in early to midwinter.

[…]

Universal masking will also protect students and staff from other respiratory illnesses that could keep kids out of school, the AAP said.

The Centers for Disease Control and Prevention recommended this month that vaccinated students do not have to wear masks in classrooms.

Dr. Francis Collins, director of the National Institutes of Health, said on MSNBC that the CDC may have been trying to be a little more lenient, allowing people to make judgment calls “depending on the circumstances in your school and your community.”

But he said he understands where the AAP is coming from.

“They will not be popular amongst parents and kids who are sick of masks, but you know what? The virus doesn’t care that we’re sick of masks,” Collins said. “The virus is having another version of its wonderful party for itself. And to the degree that we can squash that by doing something that maybe is a little uncomfortable, a little inconvenient … if it looks like it’s going to help, put the mask back on for a while.”

That was from last week. Yesterday, the CDC caught up.

To prevent further spread of the Delta variant, the US Centers for Disease Control and Prevention updated its mask guidance on Tuesday to recommend that fully vaccinated people wear masks indoors when in areas with “substantial” and “high” transmission of Covid-19, which includes nearly two-thirds of all US counties.

“In recent days I have seen new scientific data from recent outbreak investigations showing that the Delta variant behaves uniquely differently from past strains of the virus that cause Covid-19,” CDC Director Dr. Rochelle Walensky told a media briefing on Tuesday.

“This new science is worrisome and unfortunately warrants an update to our recommendations,” she said. “This is not a decision that we or CDC has made lightly.”

[…]

Earlier this month, the CDC’s Covid-19 school guidance noted that fully vaccinated people do not need to wear masks, and then about a week later the American Academy of Pediatrics issued stricter guidance recommending that everyone older than 2 wear a mask in schools, regardless of vaccination their status.

Now the updated CDC guidance recommends everyone in schools wear masks.

“CDC recommends that everyone in K through 12 schools wear a mask indoors, including teachers, staff, students and visitors, regardless of vaccination status. Children should return to full-time, in-person learning in the fall with proper prevention strategies in place,” Walensky said. “Finally, CDC recommends community leaders encourage vaccination and universal masking to prevent further outbreaks in areas of substantial and high transmission. With the Delta variant, vaccinating more Americans now is more urgent than ever.”

The updated CDC guidance makes “excellent sense,” Dr. David Weber, professor at the University of North Carolina School of Medicine in Chapel Hill and board member of the Society of Healthcare Epidemiology, told CNN on Tuesday.

“Breakthrough disease clearly occurs, and for those cases, we know they’re much more mild in vaccinated people, but we don’t know how infectious vaccinated people are,” he said. “But clearly, if you want to protect your children under 12 or grandchildren, or protect immunocompromised people, as well as protect your own health — from even mild disease — then you should be wearing a mask, particularly in areas of high transmission when indoors.”

My kids have been vaccinated, but they’re still regular mask-wearers, especially the younger one. I fully expect them to continue to do so in school, at least for the fall. I’ve been wearing a mask again for indoor spaces as well. I will admit it’s kind of annoying, as we have been vaccinated for months now and have been pretty damn careful all along, but it is what it is. That said, I have a lot of sympathy for this position:

Some of that is happening in other states, but who knows, maybe we’ll get it for federal buildings and air travel, too. And who knows, maybe this will work.

As leaders in other parts of the country require government employees to get COVID-19 vaccinations, San Antonio and Bexar County are considering following suit, the Express-News reports.

Such a step would come as vaccination rates plateau and the highly contagious delta variant leads to a rise in infections, hospitalizations and deaths in Texas. California and New York City this week said they will make employees get the vaccine or submit to weekly coronavirus tests. Veterans Affairs became the first federal agency to mandate COVID vaccinations for frontline staff.

“We are supportive of the efforts of New York and California,” San Antonio Mayor Ron Nirenberg and County Judge Nelson Wolff said in a joint statement supplied to Express-News. “We will be reviewing the legalities and practicalities of requiring a COVID-19 vaccine and/or weekly testing in conformity with CDC guidelines in order to protect the health and well-being of city/county workforce.”

A city and county vaccine mandate would apply to roughly 18,000 workers, according to the daily, which reports that both Nirenberg and Wolff are unsure whether the requirement would be allowable under state law.

I think we can say with extreme confidence that the state would bring all its fight against such a move. That doesn’t mean it’s not worth the effort, but it’s not a move to be made lightly. Be prepared to hire a bunch of expensive lawyers, and have a solid communication strategy in place, that would be my advice.

As for masks in schools, well…

What did you expect? Greg Abbott has already said there won’t be any mask mandate in schools, and it’s impossible to imagine him changing his mind. It’s all up to the parents and school staff. I would not feel safe having my not-yet-vaccinated kids in school without a full-mask situation, which by the way is what we did in this past spring semester. I don’t even know what the argument against is. Doesn’t much matter when the power is on that side. The Trib and Daily Kos have more.

Pfizer shot approved for younger kids

Yes!

The Food and Drug Administration cleared the first coronavirus vaccine for emergency use in children as young as 12 on Monday, expanding access to the Pfizer-BioNTech shot to adolescents ahead of the next school year and marking another milestone in the nation’s battle with the virus.

The decision that the two-shot regimen is safe and effective for younger adolescents had been highly anticipated by many parents and pediatricians, particularly with the growing gap between what vaccinated and unvaccinated people may do safely. Evidence suggests that schools can function at low risk with prevention measures, such as masks and social distancing. But vaccines are poised to increase confidence in resuming in-person activities and are regarded as pivotal to returning to normalcy.

“Adolescents, especially, have suffered tremendously from the covid pandemic. Even though they’re less likely than adults to be hospitalized or have severe illness, their lives really have been curtailed in many parts of the country,” said Kawsar R. Talaat, an assistant professor of international health at the Johns Hopkins Bloomberg School of Public Health. “A vaccine gives them an extra layer of protection and allows them to go back to being kids.”

Expert advisers to the Centers for Disease Control and Prevention are scheduled to meet Wednesday to recommend how the vaccine should be used in that age group, and the vaccine can be administered as soon as the CDC director signs off on the recommendation.

In a news briefing Monday evening after the announcement, FDA officials said the Pfizer authorization for 12- to 15-year-olds was a straightforward decision because the data showed that the vaccine was safe and that the response to the vaccine was even better than among the 18- to 25-year-olds who got the shots.

Our almost-17-year-old has had her shots. We’ll be getting the 14-year-old signed up as soon as we can. “Herd immunity” may never be a thing we achieve with COVID, but having a greater share of the population vaxed is a good thing, and adding this group to the eligible list moves towards that goal. I’m ready for this.

More vaccines coming

Bring ’em.

The Food and Drug Administration approved Johnson & Johnson’s COVID-19 vaccine on Saturday for use in the U.S., the third vaccine to be approved since the pandemic began.

Texas could initially receive more than 200,000 doses, according to the Texas Department of State Health Services, but the agency hasn’t received a timeline for when they would arrive. The company has said it plans to ship 20 million shots in the U.S. by the end of March and an additional 80 million doses before the end of June.

Texas received about 1.5 million vaccine doses by Pfizer and Moderna this week, including doses that had been undelivered earlier in the month because of the winter storm.

Unlike those vaccines, Johnson & Johnson’s formulation is the first to only require one dose, and it can be stored at regular refrigeration temperatures. The others require two doses, and Pfizer doses must be stored at below-freezing temperatures.

[…]

Five million vaccine doses have been administered overall in Texas as of Feb. 25. That equals about 5.8% of the state’s population — a long way from the 70% to 80% that experts estimate is necessary to achieve herd immunity. It would require nearly 100% of adults to be vaccinated to reach those figures, according to census numbers.

Scientists are still monitoring how well vaccines prevent the spread of the coronavirus, and health officials advise those who are vaccinated to continue wearing masks, social distance and follow other COVID-19 safety guidelines.

Hopefully, the J&J vaccine will really kick this up a notch, since it only requires the one shot. But as always, it’s first a matter of supply, and just having another supplier should help. If J&J is delivering 80 million doses nationally by the end of June, that should be six or seven million for Texas. It’s all about the numbers.

Vaccination progress

Making progress.

One in eight Harris County residents 16 and older have received at least one dose of the COVID-19 vaccines, according to state and local data.

A Chronicle analysis found that the first dose of the Pfizer-BioNTech or Moderna vaccines have gone to 12.4 percent of the county’s population in that age range, or 447,861 people.

That number is expected to rise as the Federal Emergency Management Agency opens a vaccine supersite in Houston at NRG Park. The site can vaccinate 42,000 people per week, targeting residents in high-risk ZIP codes.

Federal regulators are also likely to authorize the Johnson & Johnson COVID-19 vaccine, boosting vaccine supply at a critical time, when some say the inventory does not match demand. On Wednesday, the U.S. Food and Drug Administration said it had reviewed the pharmaceutical giant’s trial data and determined it was consistent with the recommendations of the emergency use guidelines.

That’s about nine percent of the total population in Harris County, and a bit less than half of these people have gotten both dose. With the one-shot Johnson and Johnson vaccine on its way, we should really make a dent in the numbers quickly.

The super sites should help, too, even if people had to wait longer than they expected on the first day.

Lauren Lefebvre, regional director for the Federal Emergency Management Agency, said late Wednesday that there were a variety of reasons for the delays. Some people had issues with the electronic codes required to check in for appointments, and officials may tweak some of their procedures to decrease the amount of paperwork required to enter.

Traffic issues were further exacerbated by cars arriving early or late. Lefebvre said FEMA expects to add more workers in the coming days, and some of the traffic routes could change around the stadium to ease the flow of cars trying to enter.

The city and county have made vulnerable populations — including the unhoused, and those without Internet or the ability to travel — a focal point of their pandemic response. The NRG site is drive-in only, which has raised concerns about equitable access.

Houston Health Department Director Stephen Williams added that the NRG site is only one part of the city’s broader vaccination efforts, and will open up availability for “other providers, many of which are located in hard-hit areas but have been unable to keep up with demand.

“Of course we’re trying to target those individuals who are most vulnerable, but (NRG) is not exclusively for individuals that are most vulnerable,” he said. “Having an additional 6,000 slots to see people is a really good thing for Houston and Harris County — and we don’t want to minimize the value of that — but it isn’t everything.”

Yes, more is still needed. But we’re way ahead of where we were in January, and the curve is sloping upward.

Mutant mosquito update

Keeping you informed on the news you can really use.

Four years ago, the Zika virus became an issue. More than 300 people were infected in Texas. Zika can cause birth defects and fetal neurodevelopmental abnormalities in pregnant women.

The vector is Aedes (rhymes with ladies) aegypti and Aedes albopictus mosquitoes. The Aedes mosquitoes transmit Zika, chikungunya, dengue and yellow fever, which prompted state and county health officials to discuss actionable solutions to control the mosquito.

Talks about releasing genetically modified mosquitoes in Houston began in 2018 between Harris County and Oxitec, a United Kingdom-based company that produces sustainable technologies or transgenic methodologies to stem the impact of disease-spreading insects. Talk also began about a similar action in Monroe County, Fla.

However, ecological concerns have been raised about the use of these mosquitoes.

“We had stakeholders there who wanted to use it,” said Kevin Gorman, head of field operations at Oxitec. “We had vector control authorities who were keen to try the technology.”

The Environmental Protection Agency stated in a May 2020 press release that it approved an experimental use permit to Oxitec to field-test its genetically engineered mosquito in the United States.

The genetically modified Aedes aegypti mosquitoes are males that mate with wild female Aedes aegypti, essentially causing the offspring to die before they can reproduce due to a genetic variation.

Oxitec had two successful years of controlling the Aedes aegypti in Brazil with its current generation of mosquito and had several years of efficacy in Brazil with its first-generation, Gorman said.

[…]

A release in Florida seems imminent, but not in Texas. Despite an established relationship and much communication, it looks like the Florida Keys will be going solo.

“Although we really enjoyed a sort of really great relationship with Houston at the moment we’re in a holding pattern with Houston,” Gorman said. “And we’re unlikely to be releasing there, and there certainly aren’t firm plans to do so in the next year.”

He cited uncertainty due to personnel changes in the county government as the reason for the decision.

A statement sent to Reform Austin by Sam Bissett, a communications specialist with Harris County Public Health, said the choice to not move forward with the release was made last year by both parties.

“At this time, there are no agreements or approval in place for Harris County to work with Oxitec in 2021. While we have had discussions with Oxitec previously about a potential partnership with Harris County Public Health, those discussions were paused last year between both sides.”

See here for my previous post on Oxitec and mutant mosquitoes, from 2017. There’s a lot more to the story and it’s hard to just capture the essence of it, so go read the whole thing. Apparently, the Aedes aegypti mosquito is more abundant in the Rio Grnade Valley than in Harris County, so maybe we’re not the best place to test this out in the US. Harris County also employs mosquito traps and dragonfly armies to control the local skeeter population. Which all seems a whole lot more quaint these days, but Zike and its ilk haven’t gone away just because we’re mostly inside these days. We will be spending more time outside again, and when we do we’d like to not be at significant risk from some other emergent deadly disease, thank you very much. Maybe next time we’ll be able to work something out.

We could have had an excise tax on e-cigarettes

But then Greg Abbott got involved.

At the urging of the nation’s biggest tobacco company, Gov. Greg Abbott launched a late-hour push to change Texas legislation creating a 10% state retail excise tax on e-cigarette and vapor smoking products.

That bill died in House action Thursday night due to a legislative maneuver, known as a point of order, offered by Republican Rep. Jonathan Stickland of Bedford. It has no realistic chance of revival because of legislative deadlines and the mandate that tax measures originate in the House, not the Senate.

Stickland said Friday his aides spotted the technical error and he pointed it out in the House out of concern about ladling taxes on e-cigarettes and vape products.

“A lot of people have used e-cigarettes to quit other bad habits,” Stickland said Friday. “It’s just a freedom issue for me. I think that taxes are theft.”

After the bill’s death, Dallas Democrat Nathan Johnson, the author of the Senate version of the bill, said in a text message: “I’m disappointed, to say the least. This bill would protect kids and save public costs. It had overwhelming support in the House.”

Critics said earlier that Abbott’s late move — targeting a bill touted as deterring youths from buying addictive e-cigs — would effectively ease taxation of products such as Juul pods that concentrate nicotine in not much liquid.

[…]

Abbott’s suggested changes would have scrapped a proposed first-in-the-nation retail tax predicted to generate about $20 million a year for public education. Instead, Texas would tax vape products at the wholesale level at five cents per milliliter of “consumable liquid solution.”

Four states — Delaware, Kansas, Louisiana and North Carolina — tax vape products at five cents per milliliter, according to the Campaign for Tobacco-Free Kids, with New Jersey and West Virginia levying higher rates.

The Abbott-backed changes also would have put a $1 per ounce tax on every initial sale of heated tobacco products, which produce an inhalable aerosol primarily by heating, not burning, tobacco. The FDA authorized U.S. sales of the products, made by Philip Morris International, late last month. Corey Henry of Philip Morris International said in an email that the product will be commercialized by Altria in the U.S. through a licensing agreement.

Proceeds from the double-barreled tax were to help fund public schools.

Rob Crane, an Ohio State University physician who heads the Preventing Tobacco Addiction Foundation, said in an email that the resulting e-cig tax would have been so light, it would make “no difference” to children or adults considering purchases of such nicotine delivery products.

The first link in the story gives some background on the bill, as it was and what it was intended for. I confess, I wasn’t aware of any of this before I read the story, so I don’t have much to add beyond what you can read at the two links. Mostly, this is a reminder of why it’s hard to pass bills in the Lege. Time is against you, there are many veto points, and the closer you get to the end of the session the easier it is kill things. All you can do is note how far you got this time, and vow to try again in two years.

Let’s use mutant mosquitoes to fight Zika

What could possibly go wrong?

The Bayou City’s teeming mosquito population spawns in dark, wet nooks and carries a slew of deadly tropical diseases that could ravage the region.

So Houston is pondering a sneak attack, something akin to a Trojan Horse. Harris County officials are negotiating with a British biotech company, Oxitec, to create and release mutant mosquitoes genetically engineered so that after they’re set loose in the wild, offspring die, and the mosquito population dwindles.

Deric Nimmo, principal scientist at Oxitec, said it is a paradigm shift – “the release of mosquitoes to control mosquitoes.”

If an agreement is finalized, Harris County could become one of the first locations in the United States to use the mosquitoes, going far beyond the chemicals and public-awareness campaigns the county has long relied upon.

[…]

Oxitec spun off from Oxford University 15 years ago to commercialize proprietary strains of insects, namely mosquitoes. The hope is that they can help reduce populations of Aedes aegypti mosquitoes, which carry the Zika virus, dengue fever and chikungunya, among other deadly illnesses. The mosquitoes are common in the Houston region.

Oxitec inserts a “self-limiting gene” into a male mosquito and releases several into the environment. Those mosquitoes then mate with females – Oxitec claims their special males out-compete normal males – and the resulting offspring die before they become adults. Over time, the overall population of the Aedes mosquito declines.

Male mosquitoes do not bite and can’t spread disease.

The company has conducted field trials in Brazil, Panama and the Cayman Islands and says it has reduced the Aedes mosquito populations by up to 90 percent in each location.

“It looks like we’re going to do or plan to do some sort of trial initially to test out the system,” Nimmo said.

Oxitec has yet to try out its technology in the U.S.

[…]

According to the FDA, if Oxitec wanted to conduct a field trial in Harris County, the company would have to submit an environmental assessment to the agency.

Another complication: Regulatory authority over Oxitec’s mosquitoes would then likely shift to the Environmental Protection Agency.

Mustapha Debboun, director of the Harris County Mosquito Control Division, said working with Oxitec could provide another tool in the fight against Zika and other mosquito-borne illnesses.

“We’re not abandoning the tried-and-true” approaches, said Harris County Precinct 4 Commissioner Jack Cagle, who has been leading the efforts. “We’re willing to see – What can we add to the tried-and-true that can make this better, especially considering that the tried-and-true has some flaws?”

Unseasonably warm weather has prompted the division to boost staff during winter months. It has seven investigators now, compared to four, and two additional public education staffers, Debboun said.

In August, officials nearly doubled the number of Aedes mosquito traps across the county to 134. Harris County also continues to partner with Microsoft to develop high-tech traps that will sense and nab only certain species of mosquitoes, like those that carry Zika or dengue, and eventually hopes to utilize drones to find and target hot spots.

After receiving a federal grant, the county hopes by May to start research on whether mosquitoes in the region that could carry Zika are developing resistance to certain pesticides. The county also will use that money to test more mosquitoes for Zika, Debboun said.

“The crucial part of all this is to find out if the mosquito has the virus in it,” he said.

Yes, remember the Microsoft Mosquito Drone story? Nice to hear about it again, even if there isn’t much to report yet. As far as Oxitec goes, their approach is one I’ve heard about as a possible way to limit the growth of the A. aegypti population and the many diseases it helps propagate. Maybe it will work without serious unanticipated side effects, but we would be the US pioneers for such a test. I’m not sure how I feel about that, but as the consequences of doing too little are West Nile and Zika, I’m not sure how wishy washy one can be about this. What do you think?

Use of abortion pill rises

Until the Lege reconvenes, anyway.

Misoprostol

There’s been a sharp increase in the number of Texas women who are using the abortion pill to end their pregnancies now that federal officials have eased restrictions on the drug, according to officials at Planned Parenthood of Greater Texas.

Until recently, the number of women seeking medically induced abortions at Texas’ Planned Parenthood facilities had dipped to about 1 percent because of stringent guidelines put in place by state lawmakers, officials say.

That changed in late March, when the U.S. Food and Drug Administration relaxed guidelinesfor women taking mifepristone, a pill geared to induce abortion early in a pregnancy.

“We have seen a fourfold increase in the number of our patients choosing medication abortion since the FDA updated its protocol,” said Sarah J. Wheat, chief external affairs officer at Planned Parenthood. “From our perspective, it’s restoring options for women.

“It’s putting decisions back in the hands of women instead of politicians at the Capitol.”

No firm numbers are available yet, but Texas researchers and abortion providers say they see the increase and hope to have better estimates in the coming months.

[…]

Planned Parenthood continues to run clinics statewide, including the Southwest Fort Worth Health Center, a privately funded $6.5 million licensed ambulatory surgical center that opened in 2013.

A medical abortion has remained an option for patients at these facilities, but fewer women have used it because Texas law required them to visit the clinic four times for it, said Daniel Grossman, an investigator with the Texas Policy Evaluation Project and a professor at the University of California, San Francisco.

“In the six months after HB 2 went into effect, there was a 70 percent decline in medication abortions performed statewide,” said Grossman, who is working with researchers at the University of Texas at Austin to determine the impact of legislation on abortions. “Interviews with women … [showed they were] incredibly frustrated when they had a preference for medication abortion” and couldn’t get it.

Wheat said some women have had to travel 100 miles or more to reach a Planned Parenthood clinic, which put a hardship on them for multiple visits.

“That requirement alone created huge barriers for our patients,” she said.

Now that the FDA change has loosened restrictions in Texas — requiring a lower dose, 200 milligrams instead of 600 milligrams; fewer doctor visits; and allowing the medication up to 10 weeks in a pregnancy instead of seven weeks — more women are choosing the medical abortion option, Wheat and Grossman say.

Exact numbers won’t be available for weeks or months, but “many of the independent abortion providers who have already started using the new FDA regimen are saying their numbers are back up,” Grossman said. “Many women have a preference and prefer this.”

[…]

Now the question is whether Texas lawmakers will weigh in on the issue when they return to work in January.

Planned Parenthood officials say they hope not.

“The restrictions the Legislature put in place were not based in science,” Wheat said. “The FDA is the national expert in how medications are provided, and they approved these updates.

See here for the background. I’d laugh at the futility of hoping that science and rationality would prevail if it weren’t so painful. The best hope as I see it is for HB2 to be sufficiently gutted by the Supreme Court. That will surely only slow down the zealots, but it’s probably the best we can expect until we start electing different leaders.

FDA makes medical abortion safer

Good news, at least until the Legislature reconvenes.

Misoprostol

Texas women will be able to obtain medical abortions later into their pregnancies under newly approved changes by the federal Food and Drug Administration.

The FDA on Wednesday announced revised rules for drug-induced abortions — a method used early in a pregnancy — that will increase the number of days women can take medication to induce abortions from 49 days of gestation to 70 days. Other revisions to the original FDA label for medication that induces abortions include a lower dosage of the drug, known as mifepristone.

First approved in 2000, mifepristone, when taken with another drug called misoprostol, is used to terminate early pregnancies.

Doctors in many states already followed common, evidence-based protocols that strayed from the FDA’s previous label for the drug, but Texas doctors were prohibited from doing so by state law. Among the provisions of the 2013 abortion law known as House Bill 2, Texas doctors were required to follow the FDA’s protocol for drug-induced abortions rather than evidence-based protocols.

[…]

Abortion providers and representatives of the medical community had long asked for an update to the FDA rules, arguing the original FDA label for mifepristone was based on outdated evidence from the 1990s.

“Today, science has prevailed where the state legislature has failed,” said Yvonne Gutierrez, executive director of Planned Parenthood Texas Votes, the organization’s political arm in the state.

While the medication to end a pregnancy must still be administered in Texas by a physician, the FDA revisions also say the second drug can now be taken “at a location appropriate for the patient.” It’s unclear what that means for Texas women who under state law must take the pill in front of a doctor.

A spokesman for the Texas Medical Board, which regulates physicians, said it was “still in the process of analyzing the FDA’s updated regimen.”

Of course, plenty of women have taken matters into their own hands on this, so this is at least a small step in the direction of safety. Don’t expect the Lege to be deterred by this, of course. They will figure out a way to make this as burdensome and punitive as possible. We may get a favorable ruling from SCOTUS in the HB2 case, but this would be a separate matter that would have to be litigated all over again. So enjoy this while you can, it’s got a limited shelf life. Sorry to be such a drag. Think Progress, the Chron, the Press, Daily Kos, and the AusChron have more.

On e-cigarettes

From the Rivard Report:

After a 2011 ordinance banned indoor smoking in public places around San Antonio, some smokers were left trying to find options to leave tobacco behind. In the ensuing three years, electronic cigarettes and vaporizers have seen exponential growth around the country, with several retail outlets popping up in and around San Antonio.

Monster Vape, co-founded by Christopher Zieg, opened its doors in 2012, and in two years expanded into two more San Antonio stores and a Corpus Christi franchise.

Zieg, a former U.S. Military medic, said he knew the dangers of smoking, but had trouble quitting until he attended a concert and saw the singer vaping onstage. His personal success with quitting smoking after switching to vaping five years ago inspired him to set up shop as he finished his military service in San Antonio.

“Being a medic and seeing what e-cigs have done for me, I wanted to pass that on to other people,” Zieg said, citing a number of benefits, including a lack of tobacco smells on clothing and vehicles, better energy levels, and perhaps most importantly the fewer number of chemicals found in the fluids used in vaporizers.

The health effects of e-cigarettes are currently unknown, and some early reports have mixed news so far. The new smokes are not yet regulated by the FDA, but I strongly suspect they will come under close scrutiny. I also suspect that local governments, which have been very active in banning tobacco use in public spaces, will not wait for a final word from the FDA to act on their own.

While the federal government works out new rules for electronic users, several city governments have started the push to include electronics in existing anti-smoking ordinances. In December, an ordinance passed by New York City Council added vaporizers to the city’s smoking ordinance, treating them as tobacco products and prohibiting their use indoors. Similar ordinances have passed in Chicago, Los Angeles, and King County, Washington, which includes several cities, most notably Seattle.

Cities in Texas have followed suit, including Georgetown, Soccoro, and Frisco, which – like New York – amended previous ordinances, and San Marcos, which made a last-minute inclusion of vaporizers to its first smoking ordinance during its final reading, drawing criticism from shop owners.

“I just don’t think they did their research before making that decision,” said Sharon Teal, owner of Ahh Vapors, LLC in San Marcos. She cited studies released by the Consumer Advocates for Smoke Free Alternatives Association, showing e-cigarettes to be far less harmful than cigarettes.

In cities where the jury is still out on the inclusion of electronics in smoking ordinances, several businesses have introduced their own bans shutting out vaporizers. To Zieg, this will cause vaporizer users to find other businesses where they can vape.

“If you have two coffee shops and one says ‘no’ and one says ‘yes,’ the vapers are going to go where they’re allowed to do what they love,” Zieg says.

That may be true, but it’s as likely that the non-vapers, of whom there are many more, will choose to stay away. Be that as it may, I don’t know how much this is on the radar of Texas cities yet. I admit I don’t get out much, but I think I’ve maybe seen one or two people vaping ever, whereas I still see plenty of the old-fashioned kind of smokers. On the one hand, it would probably be easy enough for most cities to simply amend their existing no-smoking ordinances to include e-cigs – at this time, I doubt there would be that much organized opposition, certainly not as much as there was when the ordinances were first passed. On the other hand, I doubt there’s much of an organized push to get those ordinances updated, either, so for now I’d say most city councils have bigger fish to fry. What do you think about this? Would you like to see Houston or your city act now on e-cigs, or maybe consider the matter later? Would you go even farther than that? Leave a comment and let us know.

There are limits to caffeination after all

No caffeinated gum for you.

Wrigley’s new caffeinated gum, Alert Energy Gum, only lasted a couple of weeks on the shelves of supermarkets, grocery stores and convenient stores after the FDA became concerned about the amount of caffeine each piece of gum offered.

With 40 milligrams of caffeine (equal to half a cup of coffee) in each piece, it’s no shock as to why the FDA was concerned, especially because we live in a world where energy drinks and coffee thrive. Although other gum companies have released their own caffeinated items, like Mentos’s Up2U Gum and Jolt’s energy gum, the FDA has become recently concerned with the amount of added caffeine in foods and drinks.

In fact, the main worry the FDA has about caffeinated beverages and foods is that most of the products are marketed to children, who shouldn’t be consuming energy drinks and coffee throughout the day. The FDA’s limit for caffeine consumed each day is 400 milligrams, the equivalent of four or five cups of coffee. This limit is set for adults, but the FDA discourages the consumption of caffeine or caffeinated items by children and youths.

Gum is an item consumed by people of all ages, so unlike alcohol, it isn’t blocked from being purchased by children or adolescents. In a statement from the FDA, Michael R. Taylor, the deputy commissioner for foods and veterinary medicine at the agency says, “One pack of this gum is like having four cups of coffee in your pocket. Caffeine is even being added to jelly beans, marshmallows, sunflower seeds and other snacks for its stimulant effect.”

So after caffeinated Cracker Jacks, air, beer, soap, doughnuts, and potato chips, we have finally reached a bridge too far. You’ll just have to get juiced by other means. On the bright side, there’s a caffeinated toothbrush coming out soon, so the range of options continues to expand.

Cracker Jack’d

Buy me some peanuts and caffeinated Cracker Jacks

Coming soon to a store near you: Cracker Jack’D, a new twist on the popcorn candy that offers Power Bites with as much caffeine in every serving as a cup of coffee. That could mean kids could get an overdose of caffeine if they consume more than one serving at a time, warns the Center for Science in the Public Interest, a nonprofit nutrition activist group based in Washington, DC.

The addition of caffeine to a growing number of snack foods comes at a time when warning bells have sounded over the hazards of caffeinated energy drinks. US Food and Drug Administration officials told the New York Times on Wednesday that they’ve received reports of 13 deaths linked to 5-Hour Energy shots over the past four years. And the agency is also investigating heart attacks attributed to Monster energy drink, including the death of a 14-year-old Maryland teen.

An excessive amount of caffeine can cause heart palipitations, increased blood pressure, nausea, dizziness, and insomnia — and kids may be particularly sensitive to the chemical’s effects.

The nutrition activist group fired off a protest letter on Wednesday to manufacturer Frito Lay and to the FDA. “Whether or not they are advertised directly to children, it is certain that young children will consume Cracker Jack’d…and sometimes consume it to excess,” wrote the Center’s director Michael Jacobson.

Besides the energy drink craze, caffeine has also been added recently to foods you’d never suspect like the low-calorie beverage Crystal Light, Sport Beans jelly beans, and MiO Liquid Water Enhancer, a flavoring that’s squirted into water.

[…]

Frito-Lay spokesperson Chris Kuechenmeister pointed out in an emailed statement that the new Cracker Jack’D Power Bites line have “two flavors that will contain coffee, a natural source of caffeine.” The company expects each 2-ounce serving to contain about 70 milligrams of caffeine, the FDA limit for a 12-ounce serving of cola.

“Cracker Jack’D is a product line specifically developed for adult consumers and will not be marketed to children,” wrote Kuechenmeister. “The package design and appearance are wholly different from Cracker Jack to ensure there is no confusion among consumers.”

Yes, I’m sure no children will ever consume this product. At the rate we’re going, it’s a matter of what isn’t caffeinated any more, not what is. Via Jezebel.

Snorting caffeine

The next frontier in caffeination: Caffeinated air.

Breathe in the buzz

U.S. Food and Drug Administration officials plan to investigate whether inhalable caffeine sold in lipstick-sized canisters is safe for consumers and if its manufacturer was right to brand it as a dietary supplement.

AeroShot went on the market late last month in Massachusetts and New York, and it’s also available in France. Consumers put one end of the canister in their mouths and breathe in, releasing a fine powder that dissolves almost instantly.

Each grey-and-yellow plastic canister contains B vitamins, plus 100 milligrams of caffeine powder, about the equivalent of the caffeine in a large cup of coffee.

AeroShot inventor, Harvard biomedical engineering professor David Edwards, says the product is safe and doesn’t contain taurine and other common additives used to enhance the caffeine effect in energy drinks.

It was bound to happen. I mean, after caffeinating beer, soap, doughnuts, and potato chips, where else was there to go?

What do they have against food?

The Lunch Tray is peeved.

The Associated Press reports that late Tuesday, the House Appropriations Committee approved an agriculture appropriations bill which would essentially gut all of the recent, hard-won legislative victories to improve the health of Americans, especially children.

Remember how hard it was to get the Healthy, Hunger-Free Kids Act passed, the law that will for the first time in fifteen years meaningfully improve the nutritional quality of school food? Sorry, says the House GOP. Too costly to implement, not to mention that Representatives from potato-growing states aren’t pleased with the fact that french fries and tater tots can no longer stand in as the daily vegetable on school lunch trays.

There’s a lot more, so go take a look. I’m afraid it’s just another day at the office for the Republicans in Congress. Kos has more.