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Kirabo Jackson was honored in 2020 as the where can i buy propecia over the counter usa Kershaw award recipient and other past winners include David Deming of Harvard University, Esther Duflo of Massachusetts Institute of Technology, and the late Alan Krueger of Princeton University.“We’re incredibly proud of Dr. Carley for earning this prestigious honor,” said O’Neill School Dean Siân Mooney. €œTo be recognized for such stellar achievements at this stage in her career is a testament to the work and dedication she’s invested in advancing the field of public policy.

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Worcester in how to get prescribed propecia Boston.Charles Craver, a labor and employment law professor at George Washington University, said the mandate presented a "close question" legally. But he how to get prescribed propecia said the Biden administration did have a legitimate argument that such a requirement was necessary for employers to protect the safety of workers, customers and members of the public.The thornier question, though, is how employers — and courts — will sort through requests for accommodations for employees on religious or other grounds.Though such accommodations may include having an employee work from home, "you can have a situation where someone has to be present and you can't provide an accommodation because of the danger involved," he added."I would not be a betting person if this went up before the Supreme Court," Craver said. "I could even picture the court divided 5-4, and I wouldn't bet which way it would go.".

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Worcester in Boston.Charles Craver, a where can i buy propecia over the counter usa labor and employment law professor at George Washington University, said the mandate presented a "close question" legally. But he said the Biden administration did have a legitimate argument that such a requirement was necessary for employers to protect the safety of workers, customers and members of the public.The thornier question, though, is how employers — and courts — will sort through requests for accommodations for employees on religious or other grounds.Though such accommodations may include having an employee work from home, "you can have a situation where someone has to be present and you can't provide an accommodation because of the danger involved," where can i buy propecia over the counter usa he added."I would not be a betting person if this went up before the Supreme Court," Craver said. "I could even picture the court divided 5-4, and I wouldn't bet which way it would go.".

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"What we propecia erectile dysfunction treatment do in younger and middle age will change how we end up in older age," she said. More information The American Diabetes Association has more on managing type 2 diabetes. SOURCES.

Archana Singh-Manoux, PhD, research professor, University of Paris, INSERM, Paris.

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The picture was different for people who'd been diagnosed over 10 years prior. They had where can i buy propecia over the counter usa double the risk of dementia, versus diabetes-free people their age. That may simply be because they've lived with diabetes for years. "Younger age at onset of diabetes implies longer duration, which allows all the adverse effects of diabetes to develop over a longer period," said senior researcher Archana Singh-Manoux. She is a research where can i buy propecia over the counter usa professor with the University of Paris and the French national health institute INSERM.

Type 2 diabetes arises when the body loses sensitivity to insulin, a hormone that regulates blood sugar. That causes chronically high blood sugar, which over time can damage both large and small blood vessels throughout the body. Those effects, which may impair blood where can i buy propecia over the counter usa flow to the brain, are one reason why diabetes is linked to dementia, Singh-Manoux said. She also pointed to other potential pathways. Insulin plays a role in brain function, and diabetes may hinder it from doing its job.

Meanwhile, diabetes treatment can cause frequent episodes of low blood sugar, which over long periods may also harm the brain, where can i buy propecia over the counter usa Singh-Manoux said. The findings, published April 27 in the Journal of the American Medical Association, have broad public health implications. In the United States alone, more than 34 million people have diabetes, with the vast majority having type 2, according to the American Diabetes Association. At one where can i buy propecia over the counter usa time, type 2 diabetes was a disease of older adults. But with the ever-growing prevalence of obesity — a major risk factor for type 2 diabetes — the disease is increasingly being diagnosed in young people.

"The prevalence of diabetes continues to increase," Singh-Manoux said, "and the age at onset is getting younger and younger." That means more people will be living longer with diabetes, and they will be vulnerable to the disease's complications. It's already known that the younger where can i buy propecia over the counter usa people are when diabetes arises, the greater their risk of heart disease, stroke and premature death, Singh-Manoux said. This study adds dementia to that list, she said. The research included over 10,000 adults in the United Kingdom who were between the ages of 35 and 55 at the outset, in the 1980s. Over the next three decades, 1,710 people developed type 2 diabetes, while 639 were where can i buy propecia over the counter usa diagnosed with dementia.

At age 70, people who'd developed diabetes within the past five years were at no greater dementia risk than people without diabetes. But those who'd been diagnosed more than 10 years prior showed a doubling in their dementia risk. Their actual rate of the brain disease was 18 cases per 1,000 people each year, versus about nine where can i buy propecia over the counter usa cases per 1,000 among diabetes-free adults. Overall, dementia risk at age 70 rose 24% for every five years people had been living with diabetes. That is not a surprising finding, according to Dr.

Medha Munshi, who directs the geriatrics diabetes program at Joslin where can i buy propecia over the counter usa Diabetes Center, in Boston. On the other hand, Munshi said, there is "some reassurance" in the lack of extra risk among older people more recently diagnosed with diabetes. QUESTION ______________ is another term for type 2 diabetes. See Answer The question is, can younger diabetes patients curb their dementia risk by gaining better control of their blood where can i buy propecia over the counter usa sugar?. Other studies, Singh-Manoux said, have found that people with well-controlled diabetes have slower mental decline than those with poor control.

And in this study, she noted, dementia risk was particularly high among diabetes patients who also developed heart disease. What's key, where can i buy propecia over the counter usa Munshi said, is that prevention starts early. "People in their 40s and 50s aren't usually worried about dementia," she said. "But this is the time to try to prevent it." Diabetes control often means taking medication or insulin, along with diet changes and regular exercise — both of which, Munshi noted, can have numerous long-range health benefits. "What we where can i buy propecia over the counter usa do in younger and middle age will change how we end up in older age," she said.

More information The American Diabetes Association has more on managing type 2 diabetes. SOURCES. Archana Singh-Manoux, PhD, research professor, University of Paris, INSERM, Paris.

Propecia skin rash

WASHINGTON — Even before there was a propecia skin rash treatment, some seasoned doctors and public health experts warned, Cassandra-like, that its distribution would be “a logistical nightmare.” After Week 1 index of the rollout, “nightmare” sounds like an apt description. Dozens of states say they didn’t receive nearly the number of promised doses. Pfizer says millions of doses sat in its storerooms, because no one from President Donald Trump’s Operation Warp Speed task propecia skin rash force told them where to ship them.

A number of states have few sites that can handle the ultra-cold storage required for the Pfizer product, so, for example, front-line workers in Georgia have had to travel 40 minutes to get a shot. At some hospitals, residents treating hair loss treatment patients protested that they had not received the treatment while administrators did, even though they work from home and don’t treat patients. The potential propecia skin rash for more chaos is high.

Dr. Vivek Murthy, named as the next surgeon general under President-elect Joe Biden, said this week that the Trump administration’s prediction — that the general population would get the treatment in April — was realistic only if everything went smoothly. He instead predicted wide distribution by summer or fall propecia skin rash.

The Trump administration had expressed confidence that the rollout would be smooth, because it was being overseen by a four-star general, Gustave Perna, an expert in logistics. But it turns out that getting fuel, tanks and tents into war-torn mountainous Afghanistan is in many ways simpler than passing out a treatment in our privatized, profit-focused and highly fragmented medical system. Gen.

Perna apologized this week, saying he wanted to “take personal responsibility.” It’s really mostly not his fault. Throughout the hair loss treatment propecia, the U.S. Health care system has shown that it is not built for a coordinated propecia response (among many other things).

States took wildly different hair loss treatment prevention measures. Individual hospitals varied in their ability to face this kind of national disaster. And there were huge regional disparities in test availability — with a slow ramp-up in availability due, at least in some part, because no payment or billing mechanism was established.

Why should treatment distribution be any different?. In World War II, toymakers were conscripted to make needed military hardware airplane parts, and commercial shipyards to make military transport vessels. The Trump administration has been averse to invoking the Defense Production Act, which could help speed and coordinate the process of treatment manufacture and distribution.

On Tuesday, it indicated it might do so, but only to help Pfizer obtain raw materials that are in short supply, so that the drugmaker could produce — and sell — more treatments in the United States. Instead of a central health-directed strategy, we have multiple companies competing to capture their financial piece of the propecia health care pie, each with its patent-protected product as well as its own supply chain and shipping methods. Add to this bedlam the current decision-tree governing distribution.

The Centers for Disease Control and Prevention has made official recommendations about who should get the treatment first — but throughout the propecia, many states have felt free to ignore the agency’s suggestions. Instead, Operation Warp Speed allocated initial doses to the states, depending on population. From there, an inscrutable mix of state officials, public health agencies and lobbyists seem to be determining where the treatment should go.

In some states, counties requested an allotment from the state, and then they tried to accommodate requests from hospitals, which made their individual algorithms for how to dole out the precious cargo. Once it became clear there wasn’t enough treatment to go around, each entity made its own adjustments. Some doses are being shipped by FedEx or UPS.

But Pfizer — which did not fully participate in Operation Warp Speed — is shipping much of the treatment itself. In nursing homes, some treatments will be delivered and administered by employees of CVS and Walgreens, though issues of staffing and consent remain there. The Moderna treatment, rolling out this week, will be packaged by the “pharmaceutical services provider” Catalent in Bloomington, Indiana, and then sent to McKesson, a large pharmaceutical logistics and distribution outfit.

It has offices in places like Memphis, Tennessee, and Louisville, which are near air hubs for FedEx and UPS, which will ship them out. Is your head spinning yet?. Looking forward, basic questions remain for 2021.

How will essential workers at some risk (transit workers, teachers, grocery store employees) know when it’s their turn?. (And it will matter which city you work in.) What about people with chronic illness — and then everyone else?. And who administers the treatment — doctors or the local drugstore?.

In Belgium, where many hospitals and doctors are private but work within a significant central organization, residents will get an invitation letter “when it’s their turn.” In Britain, the National Joint Committee on Vaccination has settled on a priority list for vaccinations — those over 80, those who live or work in nursing homes, and health care workers at high risk. The National Health Service will let everyone else “know when it’s your turn to get the treatment ” from the government-run health system. In the United States, I dread a mad scramble — as in, “Did you hear the CVS on P Street got a shipment?.

€ But this time, it’s not toilet paper. Combine this vision of disorder with the nation’s high death toll, and it’s not surprising that there is intense jockeying and lobbying — by schools, unions, even people with different types of preexisting diseases — over who should get the treatment first, second and third. It’s hard to “wait your turn” in a country where there are 200,000 new cases and as many as 2,000 new daily hair loss treatment deaths — a tragic per capita order of magnitude higher than in many other developed countries.

So kudos and thanks to the science and the scientists who made the treatment in record time. I’ll eagerly hold out my arm — so I can see the family and friends and colleagues I’ve missed all these months. If only I can figure out when I’m eligible, and where to go to get it.

Elisabeth Rosenthal. erosenthal@kff.org, @rosenthalhealth Related Topics Contact Us Submit a Story TipMore than 2,900 U.S. Health care workers have died in the hair loss treatment propecia since March, a far higher number than that reported by the government, according to a new analysis by KHN and The Guardian.

Fatalities from the hair loss have skewed young, with the majority of victims under age 60 in the cases for which there is age data. People of color have been disproportionately affected, accounting for about 65% of deaths in cases in which there is race and ethnicity data. After conducting interviews with relatives and friends of around 300 victims, KHN and The Guardian learned that one-third of the fatalities involved concerns over inadequate personal protective equipment.

Many of the deaths — about 680 — occurred in New York and New Jersey, which were hit hard early in the propecia. Significant numbers also died in Southern and Western states in the ensuing months. The findings are part of “Lost on the Frontline,” a nine-month data and investigative project by KHN and The Guardian to track every health care worker who dies of hair loss treatment.

One of those lost, Vincent DeJesus, 39, told his brother Neil that he’d be in deep trouble if he spent much time with a hair loss treatment-positive patient while wearing the surgical mask provided to him by the Las Vegas hospital where he worked. DeJesus died on Aug. 15.

Another fatality was Sue Williams-Ward, a 68-year-old home health aide who earned $13 an hour in Indianapolis, and bathed, dressed and fed clients without wearing any PPE, her husband said. She was intubated for six weeks before she died May 2. €œLost on the Frontline” is prompting new government action to explore the root cause of health care worker deaths and take steps to track them better.

Officials at the Department of Health and Human Services recently asked the National Academy of Sciences for a “rapid expert consultation” on why so many health care workers are dying in the U.S., citing the count of fallen workers by The Guardian and KHN. €œThe question is, where are they becoming infected?. € asked Michael Osterholm, a member of President-elect Joe Biden’s hair loss treatment advisory team and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

€œThat is clearly a critical issue we need to answer and we don’t have that.” [embedded content] The Dec. 10 report by the national academies suggests a new federal tracking system and specially trained contact tracers who would take PPE policies and availability into consideration. Doing so would add critical knowledge that could inform generations to come and give meaning to the lives lost.

€œThose [health care workers] are people who walked into places of work every day because they cared about patients, putting food on the table for families, and every single one of those lives matter,” said Sue Anne Bell, a University of Michigan assistant professor of nursing and co-author of the national academies report. The recommendations come at a fraught moment for health care workers, as some are getting the hair loss treatment while others are fighting for their lives amid the highest levels of the nation has seen. The toll continues to mount.

In Indianapolis, for example, 41-year-old nurse practitioner Kindra Irons died Dec. 1. She saw seven or eight home health patients per week while wearing full PPE, including an N95 mask and a face shield, according to her husband, Marcus Irons.

The propecia destroyed her lungs so badly that six weeks on the most aggressive life support equipment, ECMO, couldn’t save her, he said. Marcus Irons said he is now struggling financially to support their two youngest children, ages 12 and 15. €œNobody should have to go through what we’re going through,” he said.

In Massachusetts, 43-year-old Mike “Flynnie” Flynn oversaw transportation and laundry services at North Shore Medical Center, a hospital in Salem, Massachusetts. He and his wife were also raising young children, ages 8, 10 and 11. Flynn, who shone at father-daughter dances, fell ill in late November and died Dec.

8. He had a heart attack at home on the couch, according to his father, Paul Flynn. A hospital spokesperson said he had full access to PPE and free testing on-site.

Since the first months of the propecia, more than 70 reporters at The Guardian and KHN have scrutinized numerous governmental and public data sources, interviewed the bereaved and spoken with health care experts to build a count. The total number includes fatalities identified by labor unions, obituaries and news outlets and in online postings by the bereaved, as well as by relatives of the deceased. The previous total announced by The Guardian and KHN was approximately 1,450 health care worker deaths.

The new number reflects the inclusion of data reported by nursing homes and health facilities to the federal and state governments. These deaths include the facility names but not worker names. Reporters cross-checked each record to ensure fatalities did not appear in the database twice.

The tally has been widely cited by other media as well as by members of Congress. Rep. Norma Torres (D-Calif.) referenced the data citing the need for a pending bill that would provide compensation to the families of health care workers who died or sustained long-term disabilities from hair loss treatment.

Sen. Ron Wyden (D-Ore.) mentioned the tally in a Senate Finance Committee hearing about the medical supply chain. €œThe fact is,” he said, “the shortages of PPE have put our doctors and nurses and caregivers in grave danger.” This story is part of “Lost on the Frontline,” an ongoing project from The Guardian and Kaiser Health News that aims to document the lives of health care workers in the U.S.

Who die from hair loss treatment, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please share their story. Christina Jewett.

ChristinaJ@kff.org, @by_cjewett Melissa Bailey. @mmbaily Related Topics Contact Us Submit a Story TipWorkers at Garfield Medical Center in suburban Los Angeles were on edge as the propecia ramped up in March and April. Staffers in a 30-patient unit were rationing a single tub of sanitizing wipes all day.

A May memo from the CEO said N95 masks could be cleaned up to 20 times before replacement. Patients showed up hair loss treatment-negative but some still developed symptoms a few days later. Contact tracing took the form of texts and whispers about exposures.

By summer, frustration gave way to fear. At least 60 staff members at the 210-bed community hospital caught hair loss treatment, according to records obtained by KHN and interviews with eight staff members and others familiar with hospital operations. The first to die was Dawei Liang, 60, a quiet radiology technician who never said no when a colleague needed help.

A cardiology technician became infected and changed his final wishes — agreeing to intubation — hoping for more years to dote on his grandchildren. Few felt safe. Ten months into the propecia, it has become far clearer why tens of thousands of health care workers have been infected by the propecia and why so many have died.

Dire PPE shortages. Limited hair loss treatment tests. Sparse tracking of viral spread.

Layers of flawed policies handed down by health care executives and politicians, and lax enforcement by government regulators. All of those breakdowns, across cities and states, have contributed to the deaths of more than 2,900 health care workers, a nine-month investigation by over 70 reporters at KHN and The Guardian has found. This number is far higher than that reported by the U.S.

Government, which does not have a comprehensive national count of health care workers who’ve died of hair loss treatment. The fatalities have skewed young, with the majority of victims under age 60 in the cases for which there is age data. People of color have been disproportionately affected, accounting for about 65% of deaths in cases in which there is race and ethnicity data.

After conducting interviews with relatives and friends of around 300 victims, KHN and The Guardian learned that one-third of the fatalities involved concerns over inadequate personal protective equipment. Many of the deaths occurred in New York and New Jersey, and significant numbers also died in Southern and Western states as the propecia wore on. Workers at well-funded academic medical centers — hubs of policymaking clout and prestigious research — were largely spared.

Those who died tended to work in less prestigious community hospitals like Garfield, nursing homes and other health centers in roles in which access to critical information was low and patient contact was high. Garfield Medical Center and its parent company, AHMC Healthcare, did not respond to multiple calls or emails regarding workers’ concerns and circumstances leading to the worker deaths. So as 2020 draws to a close, we ask.

Did so many of the nation’s health care workers have to die?. New York’s Warning for the Nation The seeds of the crisis can be found in New York and the surrounding cities and suburbs. It was the region where the profound risks facing medical staff became clear.

And it was here where the most died. As the propecia began its U.S. Surge, city paramedics were out in force, their sirens cutting through eerily empty streets as they rushed patients to hospitals.

Carlos Lizcano, a blunt Queens native who had been with the New York City Fire Department (FDNY) for two decades, was one of them. He was answering four to five cardiac arrest calls every shift. Normally he would have fielded that many in a month.

He remembered being stretched so thin he had to enlist a dying man’s son to help with CPR. On another call, he did chest compressions on a 33-year-old woman as her two small children stood in the doorway of a small apartment. €œI just have this memory of those kids looking at us like, ‘What’s going on?.

€™â€ After the young woman died, Lizcano went outside and punched the ambulance in frustration and grief. The personal risks paramedics faced were also grave. More than 40% of emergency medical service workers in the FDNY went on leave for confirmed or suspected hair loss during the first three months of the propecia, according to a study by the department’s chief medical officer and others.

In fact, health care workers were three times more likely than the general public to get hair loss treatment, other researchers found. And the risks were not equally spread among medical professions. Initially, CDC guidelines were written to afford the highest protection to workers in a hospital’s hair loss treatment unit.

Yet months later, it was clear that the doctors initially thought to be at most risk — anesthesiologists and those working in the intensive care unit — were among the least likely to die. This could be due to better personal protective equipment or patients being less infectious by the time they reach the ICU. Instead, scientists discovered that “front door” health workers like paramedics and those in acute-care “receiving” roles — such as in the emergency room — were twice as likely as other health care workers to be hospitalized with hair loss treatment.

[embedded content] For FDNY’s first responders, part of the problem was having to ration and reuse masks. Workers were blind to an invisible threat that would be recognized months later. The propecia spread rapidly from pre-symptomatic people and among those with no symptoms at all.

In mid-March, Lizcano was one of thousands of FDNY first responders infected with hair loss treatment. At least four of them died, city records show. They were among the 679 health care workers who have died in New York and New Jersey to date, most at the height of the terrible first wave of the propecia.

€œInitially, we didn’t think it was this bad,” Lizcano said, recalling the confusion and chaos of the early propecia. €œThis city wasn’t prepared.” Neither was the rest of the country. An Elusive Enemy The propecia continued to spread like a ghost through the nation and proved deadly to workers who were among the first to how to get proscar instead of propecia encounter sick patients in their hospital or nursing home.

One government agency had a unique vantage point into the problem but did little to use its power to cite employers — or speak out about the hazards. Health employers had a mandate to report worker deaths and hospitalizations to the Occupational Safety and Health Administration. When they did so, the report went to an agency headed by Eugene Scalia, son of conservative Supreme Court Justice Antonin Scalia who died in 2016.

The younger Scalia had spent part of his career as a corporate lawyer fighting the very agency he was charged with leading. Its inspectors have documented instances in which some of the most vulnerable workers — those with low information and high patient contact — faced incredible hazards, but OSHA’s staff did little to hold employers to account. Beaumont, Texas, a town near the Louisiana border, was largely untouched by the propecia in early April.

That’s when a 56-year-old physical therapy assistant at Christus Health’s St. Elizabeth Hospital named Danny Marks called in sick with a fever and body aches, federal OSHA records show. He told a human resources employee that he’d been in the room of a patient who was receiving a breathing treatment — the type known as the most hazardous to health workers.

The CDC advises that N95 respirators be used by all in the room for the so-called aerosol-generating procedures. (A facility spokesperson said the patient was not known or suspected to have hair loss treatment at the time Marks entered the room.) Marks went home to self-isolate. By April 17, he was dead.

The patient whose room Marks entered later tested positive for hair loss treatment. And an OSHA investigation into Marks’ death found there was no sign on the door to warn him that a potentially infected patient was inside, nor was there a cart outside the room where he could grab protective gear. The facility did not have a universal masking policy in effect when Marks went in the room, and it was more than likely that he was not wearing any respiratory protection, according to a copy of the report obtained through a public records request.

Twenty-one more employees contracted hair loss treatment by the time he died. €œHe was a beloved gentleman and friend and he is missed very much,” Katy Kiser, Christus’ public relations director, told KHN. OSHA did not issue a citation to the facility, instead recommending safety changes.

The agency logged nearly 8,700 complaints from health care workers in 2020. Yet Harvard researchers found that some of those desperate pleas for help, often decrying shortages of PPE, did little to forestall harm. In fact, they concluded that surges in those complaints preceded increases in deaths among working-age adults 16 days later.

One report author, Peg Seminario, blasted OSHA for failing to use its power to get employers’ attention about the danger facing health workers. She said issuing big fines in high-profile cases can have a broad impact — except OSHA has not done so. €œThere’s no accountability for failing to protect workers from exposure to this deadly propecia,” said Seminario, a former union health and safety official.

Desperate for Safety Gear There was little outward sign this summer that Garfield Medical Center was struggling to contain hair loss treatment. While Medicare has forced nursing homes to report staff s and deaths, no such requirement applies to hospitals. More 'Lost on the Frontline' Stories Dying Young.

The Health Care Workers in Their 20s Killed by hair loss treatment By Alastair Gee, The Guardian | August 13, 2020A database of deaths compiled by KHN and The Guardian includes a significant minority under 30, leaving shattered dreams and devastated families.(Photo Credit. The Obra family)Most Home Health Aides ‘Can’t Afford Not to Work’ — Even When Lacking PPEBy Eli Cahan | October 16, 2020Home health aides flattened the curve by keeping the most vulnerable patients — seniors, the disabled, the infirm — out of hospitals. But they’ve done it mostly at poverty wages and without overtime pay, hazard pay, sick leave or health insurance.(Photo Credit.

Tamarya Burnett)They Cared for Some of New York’s Most Vulnerable Communities. Then 12 Died.By Danielle Renwick, The Guardian | August 27, 2020Immigrant health workers help keep the U.S. Health system afloat — and they’re dying of hair loss treatment at high rates.(Photo Credit.

Pablo Monsalve/VIEWpress via Getty Images)These Front-Line Workers Could Have Retired. They Risked Their Lives Instead. By Shoshana Dubnow | November 20, 2020 An investigation by KHN and The Guardian shows that 329 health care workers age 65 or older have reportedly died of hair loss treatment.(Photo Credits.

Tom Miles, David Brown, Bethany MacDonald) Yet as the focus of the propecia moved from the East Coast in the spring to Southern and Western states, health care worker deaths climbed. And behind the scenes at Garfield, workers were dealing with a lack of equipment meant to keep them safe. Complaints to state worker-safety officials filed in March and April said Garfield Medical Center workers were asked to reuse the same N95 respirator for a week.

Another complaint said workers ran out of medical gowns and were directed to use less-protective gowns typically provided to patients. Staffers were shaken by the death of Dawei Liang. And only after his death and a rash of s did Garfield provide N95 masks to more workers and put up plastic tarps to block a hair loss treatment unit from an adjacent ward.

Yet this may have been too late. The hair loss can easily spread to every corner of a hospital. Researchers in South Africa traced a single ER patient to 119 cases in a hospital — 80 among staff members.

Those included 62 nurses from neurology, surgical and general medical units that typically would not have housed hair loss treatment patients. By late July, Garfield cardiac and respiratory technician Thong Nguyen, 73, learned he was hair loss treatment-positive days after he collapsed at work. Nguyen loved his job and was typically not one to complain, said his youngest daughter, Dinh Kozuki.

A 34-year veteran at the hospital, he was known for conducting medical tests in multiple languages. His colleagues teased him, saying he was never going to retire. Kozuki said her father spoke up in March about the rationing of protective gear, but his concerns were not allayed.

Dinh Kozuki’s father, Thong Nguyen, died of hair loss treatment-related complications after nearly 35 years of service at Garfield Medical Center in Los Angeles. Nguyen’s supervisor told him he’d have to reuse personal protective equipment. €œHe definitely should not have passed [away],” Kozuki said.(Heidi de Marco / KHN) The PPE problems at Garfield were a symptom of a broader problem.

As the propecia spread around the nation, chronic shortages of protective gear left many workers in community-based settings fatally exposed. Nearly 1 in 3 family members or friends of around 300 health care workers interviewed by KHN or The Guardian expressed concerns about a fallen workers’ PPE. Health care workers’ labor unions asked for the more-protective N95 respirators when the propecia began.

But Centers for Disease Control and Prevention guidelines said the unfitted surgical masks worn by workers who feed, bathe and lift hair loss treatment patients were adequate amid supply shortages. Mary Turner, an ICU nurse and president of the Minnesota Nurses Association, said she protested alongside nurses all summer demanding better protective gear, which she said was often kept from workers because of supply-chain shortages and the lack of political will to address them. €œIt shouldn’t have to be that way,” Turner said.

€œWe shouldn’t have to beg on the streets for protection during a propecia.” At Garfield, it was even hard to get tested. Critical care technician Tony Ramirez said he started feeling ill on July 12. He had an idea of how he might have been exposed.

He’d cleaned up urine and feces of a patient suspected of having hair loss treatment and worked alongside two staffers who also turned out to be hair loss treatment-positive. At the time, he’d been wearing a surgical mask and was worried it didn’t protect him. Yet he was denied a free test at the hospital, and went on his own time to Dodger Stadium to get one.

His positive result came back a few days later. As Ramirez rested at home, he texted Alex Palomo, 44, a Garfield medical secretary who was also at home with hair loss treatment, to see how he was doing. Palomo was the kind of man who came to many family parties but would often slip away unseen.

A cousin finally asked him about it. Palomo said he just hated to say goodbye. Palomo would wear only a surgical mask when he would go into the rooms of patients with flashing call lights, chat with them and maybe bring them a refill of water, Ramirez said.

Paramedics work behind an ambulance at the Garfield Medical Center in Monterey Park, California, on March 19. (Frederic J. Brown / AFP via Getty Images) Ramirez said Palomo had no access to patient charts, so he would not have known which patients had hair loss treatment.

€œIn essence, he was helping blindly.” Palomo never answered the text. He died of hair loss treatment on Aug. 14.

And Thong Nguyen had fared no better. His daughter, a hospital pharmacist in Fresno, had pressed him to go on a ventilator after seeing other patients survive with the treatment. It might mean he could retire and watch his grandkids grow up.

But it made no difference. €œHe definitely should not have passed [away],” Kozuki said. Nursing Homes Devastated During the summer, as nursing homes recovered from their spring surge, Heather Pagano got a new assignment.

The Doctors Without Borders adviser on humanitarianism had been working in cholera clinics in Nigeria. In May, she arrived in southeastern Michigan to train nursing home staffers on optimal -control techniques. Federal officials required worker death reports from nursing homes, which by December tallied more than 1,100 fatalities.

Researchers in Minnesota found particular hazards for these health workers, concluding they were the ones most at risk of getting hair loss treatment. Pagano learned that staffers were repurposing trash bin liners and going to the local Sherwin-Williams store for painting coveralls to backfill shortages of medical gowns. The least-trained clinical workers — nursing assistants — were doing the most hazardous jobs, turning and cleaning patients, and brushing their teeth.

She said nursing home leaders were shuffling reams of federal, state and local guidelines yet had little understanding of how to stop the propecia from spreading. €œNo one sent trainers to show people what to do, practically speaking,” she said. As the propecia wore on, nursing homes reported staff shortages getting worse by the week.

Few wanted to put their lives on the line for $13 an hour, the wage for nursing assistants in many parts of the U.S. The organization GetusPPE, formed by doctors to address shortages, saw almost all requests for help were coming from nursing homes, doctors’ offices and other non-hospital facilities. Only 12% of the requests could be fulfilled, its October report said.

And a propecia-weary and science-wary public has fueled the propecia’s spread. In fact, whether or not a nursing home was properly staffed played only a small role in determining its susceptibility to a lethal outbreak, University of Chicago public health professor Tamara Konetzka found. The crucial factor was whether there was widespread viral transmission in the surrounding community.

€œIn the end, the story has pretty much stayed the same,” Konetzka said. €œNursing homes in propecia hot spots are at high risk and there’s very little they can do to keep the propecia out.” The treatment Arrives From March through November, 40 complaints were filed about the Garfield Medical Center with the California Department of Public Health, nearly three times the statewide average for the time. State officials substantiated 11 complaints and said they are part of an ongoing inspection.

For Thanksgiving, AHMC Healthcare Chairman Jonathan Wu sent hospital staffers a letter thanking “frontline healthcare workers who continue to serve, selflessly exposing themselves to the propecia so that others may cope, recover and survive.” The letter made no mention of the workers who had died. €œA lot of people were upset by that,” said critical care technician Melissa Ennis. €œI was upset.” By December, all workers were required to wear an N95 respirator in every corner of the hospital, she said.

Ennis said she felt unnerved taking it off. She took breaks to eat and drink in her car. Garfield said on its website that it is screening patients for the propecia and will “implement prevention and control practices to protect our patients, visitors, and staff.” On Dec.

9, Ennis received notice that the treatment was on its way to Garfield. Nationwide, the treatment brought health workers relief from months of tension. Nurses and doctors posted photos of themselves weeping and holding their small children.

At the same time, it proved too late for some. A new surge of deaths drove the toll among health workers to more than 2,900. And before Ennis could get the shot, she learned she would have to wait at least a few more days, until she could get a hair loss treatment test.

She found out she’d been exposed to the propecia by a colleague. Shoshana Dubnow and Anna Sirianni contributed to this report. Video by Hannah Norman.

Web production by Lydia Zuraw. This story is part of “Lost on the Frontline,” an ongoing project from The Guardian and Kaiser Health News that aims to document the lives of health care workers in the U.S. Who die from hair loss treatment, and to investigate why so many are victims of the disease.

If you have a colleague or loved one we should include, please share their story. Christina Jewett. ChristinaJ@kff.org, @by_cjewett Related Topics Contact Us Submit a Story TipJournalists from KHN and The Guardian have identified 2,921 workers who reportedly died of complications from hair loss treatment after they contracted it on the job.

Reporters are working to confirm the cause of death and workplace conditions in each case. They are also writing about the people behind the statistics — their personalities, passions and quirks — and telling the story of every life lost.Explore the new interactive tool tracking those health worker deaths.(Note. The previous total announced by The Guardian and KHN was approximately 1,450 health care worker deaths.

The new number reflects the inclusion of data reported by nursing homes and health facilities to the federal and state governments. These deaths include the facility names but not worker names. Reporters cross-checked each record to ensure fatalities did not appear in the database twice.) More From This Series.

Related Topics Health Industry hair loss treatment Doctors Investigation Lost On The Frontline Nursing HomesCan’t see the audio player?. Click here to listen on SoundCloud. hair loss treatment was the dominant — but not the only — health policy story of 2020.

In this special year-in-review episode of KHN’s “What the Health?. € podcast, panelists look back at some of the biggest non-hair loss stories. Those included Supreme Court cases on the Affordable Care Act, Medicaid work requirements and abortion, as well as a year-end surprise ending to the “surprise bill” saga.

This week’s panelists are Julie Rovner of KHN, Joanne Kenen of Politico, Anna Edney of Bloomberg News and Sarah Karlin-Smith of Pink Sheet. Among the takeaways from this week’s podcast. The hair loss propecia strengthened the hand of ACA supporters, even as the Trump administration sought to get the Supreme Court to overturn the federal health law.

Many people felt it was an inopportune time to get rid of that safety valve while so many Americans were losing their jobs — and their health insurance — due to the economic chaos from the propecia.Preliminary enrollment numbers released by federal officials last week suggest that more people were taking advantage of the option to buy coverage for 2021 through the ACA marketplaces than for 2020, even in the absence of enrollment encouragement from the federal government.The ACA’s Medicaid expansion had a bit of a roller-coaster ride this year. Voters in two more states — Oklahoma and Missouri — approved the expansion in ballot measures, but the Trump administration continued its support of state plans that require many adults to prove they are working in order to continue their coverage. The Supreme Court has agreed to hear a challenge to that policy.

Although lower courts have ruled that the Medicaid law does not allow such restrictions, it’s not clear how the new conservative majority on the court will view this issue.Concerns are beginning to grow in Washington about the near-term prospect of the Medicare trust fund going insolvent. That can likely be fixed only with a remedy adopted by Congress, and that may not happen unless lawmakers feel a crisis is very near.The Trump administration has sought to bring down drug out-of-pocket expenses for Medicare beneficiaries. Among those initiatives is a demonstration project to lower the cost of insulin.

About a third of Medicare beneficiaries will be enrolled in plans that offer reduced prices in 2021. But the effort could have a hidden consequence. Higher insurance premiums.Many members of Congress began this session two years ago with grand promises of working to lower drug prices — but they never reached an agreement on how to do it.President Donald Trump, however, was strongly motivated by the issue and late this year issued an order to set many Medicare drug prices based on what is paid in other industrialized nations.

Drugmakers detest the idea and have vowed to fight it in court. Although some Democrats endorse the concept, it seems unlikely that President-elect Joe Biden would want to spend much capital in a legal battle for a plan that hasn’t been carefully vetted.The gigantic spending and hair loss treatment relief bill that Congress finally approved Monday includes a provision to protect consumers from surprise medical bills when they are unknowingly treated by doctors or hospitals outside their insurance network. The law sets up a mediation process to resolve the charges, but the process favors the doctors.

Insurers are likely to pass along any extra costs to consumers through higher premiums. To hear all our podcasts, click here. And subscribe to What the Health?.

on iTunes, Stitcher, Google Play, Spotify, or Pocket Casts. Related Topics Contact Us Submit a Story Tip.

WASHINGTON — Even before there was a treatment, some seasoned doctors and public health experts warned, Cassandra-like, that its distribution would be “a logistical nightmare.” After Week 1 of the where can i buy propecia over the counter usa rollout, “nightmare” sounds like an apt description. Dozens of states say they didn’t receive nearly the number of promised doses. Pfizer says where can i buy propecia over the counter usa millions of doses sat in its storerooms, because no one from President Donald Trump’s Operation Warp Speed task force told them where to ship them.

A number of states have few sites that can handle the ultra-cold storage required for the Pfizer product, so, for example, front-line workers in Georgia have had to travel 40 minutes to get a shot. At some hospitals, residents treating hair loss treatment patients protested that they had not received the treatment while administrators did, even though they work from home and don’t treat patients. The potential for where can i buy propecia over the counter usa more chaos is high.

Dr. Vivek Murthy, named as the next surgeon general under President-elect Joe Biden, said this week that the Trump administration’s prediction — that the general population would get the treatment in April — was realistic only if everything went smoothly. He instead predicted wide where can i buy propecia over the counter usa distribution by summer or fall.

The Trump administration had expressed confidence that the rollout would be smooth, because it was being overseen by a four-star general, Gustave Perna, an expert in logistics. But it turns out that getting fuel, tanks and tents into war-torn mountainous Afghanistan is in many ways simpler than passing out a treatment in our privatized, profit-focused and highly fragmented medical system. Gen.

Perna apologized this week, saying he wanted to “take personal responsibility.” It’s really mostly not his fault. Throughout the hair loss treatment propecia, the U.S. Health care system has shown that it is not built for a coordinated propecia response (among many other things).

States took wildly different hair loss treatment prevention measures. Individual hospitals varied in their ability to face this kind of national disaster. And there were huge regional disparities in test availability — with a slow ramp-up in availability due, at least in some part, because no payment or billing mechanism was established.

Why should treatment distribution be any different?. In World War II, toymakers were conscripted to make needed military hardware airplane parts, and commercial shipyards to make military transport vessels. The Trump administration has been averse to invoking the Defense Production Act, which could help speed and coordinate the process of treatment manufacture and distribution.

On Tuesday, it indicated it might do so, but only to help Pfizer obtain raw materials that are in short supply, so that the drugmaker could produce — and sell — more treatments in the United States. Instead of a central health-directed strategy, we have multiple companies competing to capture their financial piece of the propecia health care pie, each with its patent-protected product as well as its own supply chain and shipping methods. Add to this bedlam the current decision-tree governing distribution.

The Centers for Disease Control and Prevention has made official recommendations about who should get the treatment first — but throughout the propecia, many states have felt free to ignore the agency’s suggestions. Instead, Operation Warp Speed allocated initial doses to the states, depending on population. From there, an inscrutable mix of state officials, public health agencies and lobbyists seem to be determining where the treatment should go.

In some states, counties requested an allotment from the state, and then they tried to accommodate requests from hospitals, which made their individual algorithms for how to dole out the precious cargo. Once it became clear there wasn’t enough treatment to go around, each entity made its own adjustments. Some doses are being shipped by FedEx or UPS.

But Pfizer — which did not fully participate in Operation Warp Speed — is shipping much of the treatment itself. In nursing homes, some treatments will be delivered and administered by employees of CVS and Walgreens, though issues of staffing and consent remain there. The Moderna treatment, rolling out this week, will be packaged by the “pharmaceutical services provider” Catalent in Bloomington, Indiana, and then sent to McKesson, a large pharmaceutical logistics and distribution outfit.

It has offices in places like Memphis, Tennessee, and Louisville, which are near air hubs for FedEx and UPS, which will ship them out. Is your head spinning yet?. Looking forward, basic questions remain for 2021.

How will essential workers at some risk (transit workers, teachers, grocery store employees) know when it’s their turn?. (And it will matter which city you work in.) What about people with chronic illness — and then everyone else?. And who administers the treatment — doctors or the local drugstore?.

In Belgium, where many hospitals and doctors are private but work within a significant central organization, residents will get an invitation letter “when it’s their turn.” In Britain, the National Joint Committee on Vaccination has settled on a priority list for vaccinations — those over 80, those who live or work in nursing homes, and health care workers at high risk. The National Health Service will let everyone else “know when it’s your turn to get the treatment ” from the government-run health system. In the United States, I dread a mad scramble — as in, “Did you hear the CVS on P Street got a shipment?.

€ But this time, it’s not toilet paper. Combine this vision of disorder with the nation’s high death toll, and it’s not surprising that there is intense jockeying and lobbying — by schools, unions, even people with different types of preexisting diseases — over who should get the treatment first, second and third. It’s hard to “wait your turn” in a country where there are 200,000 new cases and as many as 2,000 new daily hair loss treatment deaths — a tragic per capita order of magnitude higher than in many other developed countries.

So kudos and thanks to the science and the scientists who made the treatment in record time. I’ll eagerly hold out my arm — so I can see the family and friends and colleagues I’ve missed all these months. If only I can figure out when I’m eligible, and where to go to get it.

Elisabeth Rosenthal. erosenthal@kff.org, @rosenthalhealth Related Topics Contact Us Submit a Story TipMore than 2,900 U.S. Health care workers have died in the hair loss treatment propecia since March, a far higher number than that reported by the government, according to a new analysis by KHN and The Guardian.

Fatalities from the hair loss have skewed young, with the majority of victims under age 60 in the cases for which there is age data. People of color have been disproportionately affected, accounting for about 65% of deaths in cases in which there is race and ethnicity data. After conducting interviews with relatives and friends of around 300 victims, KHN and The Guardian learned that one-third of the fatalities involved concerns over inadequate personal protective equipment.

Many of the deaths — about 680 — occurred in New York and New Jersey, which were hit hard early in the propecia. Significant numbers also died in Southern and Western states in the ensuing months. The findings are part of “Lost on the Frontline,” a nine-month data and investigative project by KHN and The Guardian to track every health care worker who dies of hair loss treatment.

One of those lost, Vincent DeJesus, 39, told his brother Neil that he’d be in deep trouble if he spent much time with a hair loss treatment-positive patient while wearing the surgical mask provided to him by the Las Vegas hospital where he worked. DeJesus died on Aug. 15.

Another fatality was Sue Williams-Ward, a 68-year-old home health aide who earned $13 an hour in Indianapolis, and bathed, dressed and fed clients without wearing any PPE, her husband said. She was intubated for six weeks before she died May 2. €œLost on the Frontline” is prompting new government action to explore the root cause of health care worker deaths and take steps to track them better.

Officials at the Department of Health and Human Services recently asked the National Academy of Sciences for a “rapid expert consultation” on why so many health care workers are dying in the U.S., citing the count of fallen workers by The Guardian and KHN. €œThe question is, where are they becoming infected?. € asked Michael Osterholm, a member of President-elect Joe Biden’s hair loss treatment advisory team and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

€œThat is clearly a critical issue we need to answer and we don’t have that.” [embedded content] The Dec. 10 report by the national academies suggests a new federal tracking system and specially trained contact tracers who would take PPE policies and availability into consideration. Doing so would add critical knowledge that could inform generations to come and give meaning to the lives lost.

€œThose [health care workers] are people who walked into places of work every day because they cared about patients, putting food on the table for families, and every single one of those lives matter,” said Sue Anne Bell, a University of Michigan assistant professor of nursing and co-author of the national academies report. The recommendations come at a fraught moment for health care workers, as some are getting the hair loss treatment while others are fighting for their lives amid the highest levels of the nation has seen. The toll continues to mount.

In Indianapolis, for example, 41-year-old nurse practitioner Kindra Irons died Dec. 1. She saw seven or eight home health patients per week while wearing full PPE, including an N95 mask and a face shield, according to her husband, Marcus Irons.

The propecia destroyed her lungs so badly that six weeks on the most aggressive life support equipment, ECMO, couldn’t save her, he said. Marcus Irons said he is now struggling financially to support their two youngest children, ages 12 and 15. €œNobody should have to go through what we’re going through,” he said.

In Massachusetts, 43-year-old Mike “Flynnie” Flynn oversaw transportation and laundry services at North Shore Medical Center, a hospital in Salem, Massachusetts. He and his wife were also raising young children, ages 8, 10 and 11. Flynn, who shone at father-daughter dances, fell ill in late November and died Dec.

8. He had a heart attack at home on the couch, according to his father, Paul Flynn. A hospital spokesperson said he had full access to PPE and free testing on-site.

Since the first months of the propecia, more than 70 reporters at The Guardian and KHN have scrutinized numerous governmental and public data sources, interviewed the bereaved and spoken with health care experts to build a count. The total number includes fatalities identified by labor unions, obituaries and news outlets and in online postings by the bereaved, as well as by relatives of the deceased. The previous total announced by The Guardian and KHN was approximately 1,450 health care worker deaths.

The new number reflects the inclusion of data reported by nursing homes and health facilities to the federal and state governments. These deaths include the facility names but not worker names. Reporters cross-checked each record to ensure fatalities did not appear in the database twice.

The tally has been widely cited by other media as well as by members of Congress. Rep. Norma Torres (D-Calif.) referenced the data citing the need for a pending bill that would provide compensation to the families of health care workers who died or sustained long-term disabilities from hair loss treatment.

Sen. Ron Wyden (D-Ore.) mentioned the tally in a Senate Finance Committee hearing about the medical supply chain. €œThe fact is,” he said, “the shortages of PPE have put our doctors and nurses and caregivers in grave danger.” This story is part of “Lost on the Frontline,” an ongoing project from The Guardian and Kaiser Health News that aims to document the lives of health care workers in the U.S.

Who die from hair loss treatment, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please share their story. Christina Jewett.

ChristinaJ@kff.org, @by_cjewett Melissa Bailey. @mmbaily Related Topics Contact Us Submit a Story TipWorkers at Garfield Medical Center in suburban Los Angeles were on edge as the propecia ramped up in March and April. Staffers in a 30-patient unit were rationing a single tub of sanitizing wipes all day.

A May memo from the CEO said N95 masks could be cleaned up to 20 times before replacement. Patients showed up hair loss treatment-negative but some still developed symptoms a few days later. Contact tracing took the form of texts and whispers about exposures.

By summer, frustration gave way to fear. At least 60 staff members at the 210-bed community hospital caught hair loss treatment, according to records obtained by KHN and interviews with eight staff members and others familiar with hospital operations. The first to die was Dawei Liang, 60, a quiet radiology technician who never said no when a colleague needed help.

A cardiology technician became infected and changed his final wishes — agreeing to intubation — hoping for more years to dote on his grandchildren. Few felt safe. Ten months into the propecia, it has become far clearer why tens of thousands of health care workers have been infected by the propecia and why so many have died.

Dire PPE shortages. Limited hair loss treatment tests. Sparse tracking of viral spread.

Layers of flawed policies handed down by health care executives and politicians, and lax enforcement by government regulators. All of those breakdowns, across cities and states, have contributed to the deaths of more than 2,900 health care workers, a nine-month investigation by over 70 reporters at KHN and The Guardian has found. This number is far higher than that reported by the U.S.

Government, which does not have a comprehensive national count of health care workers who’ve died of hair loss treatment. The fatalities have skewed young, with the majority of victims under age 60 in the cases for which there is age data. People of color have been disproportionately affected, accounting for about 65% of deaths in cases in which there is race and ethnicity data.

After conducting interviews with relatives and friends of around 300 victims, KHN and The Guardian learned that one-third of the fatalities involved concerns over inadequate personal protective equipment. Many of the deaths occurred in New York and New Jersey, and significant numbers also died in Southern and Western states as the propecia wore on. Workers at well-funded academic medical centers — hubs of policymaking clout and prestigious research — were largely spared.

Those who died tended to work in less prestigious community hospitals like Garfield, nursing homes and other health centers in roles in which access to critical information was low and patient contact was high. Garfield Medical Center and its parent company, AHMC Healthcare, did not respond to multiple calls or emails regarding workers’ concerns and circumstances leading to the worker deaths. So as 2020 draws to a close, we ask.

Did so many of the nation’s health care workers have to die?. New York’s Warning for the Nation The seeds of the crisis can be found in New York and the surrounding cities and suburbs. It was the region where the profound risks facing medical staff became clear.

And it was here where the most died. As the propecia began its U.S. Surge, city paramedics were out in force, their sirens cutting through eerily empty streets as they rushed patients to hospitals.

Carlos Lizcano, a blunt Queens native who had been with the New York City Fire Department (FDNY) for two decades, was one of them. He was answering four to five cardiac arrest calls every shift. Normally he would have fielded that many in a month.

He remembered being stretched so thin he had to enlist a dying man’s son to help with CPR. On another call, he did chest compressions on a 33-year-old woman as her two small children stood in the doorway of a small apartment. €œI just have this memory of those kids looking at us like, ‘What’s going on?.

€™â€ After the young woman died, Lizcano went outside and punched the ambulance in frustration and grief. The personal risks paramedics faced were also grave. More than 40% of emergency medical service workers in the FDNY went on leave for confirmed or suspected hair loss during the first three months of the propecia, according to a study by the department’s chief medical officer and others.

In fact, health care workers were three times more likely than the general public to get hair loss treatment, other researchers found. And the risks were not equally spread among medical professions. Initially, CDC guidelines were written to afford the highest protection to workers in a hospital’s hair loss treatment unit.

Yet months later, it was clear that the doctors initially thought to be at most risk — anesthesiologists and those working in the intensive care unit — were among the least likely to die. This could be due to better personal protective equipment or patients being less infectious by the time they reach the ICU. Instead, scientists discovered that “front door” health workers like paramedics and those in acute-care “receiving” roles — such as in the emergency room — were twice as likely as other health care workers to be hospitalized with hair loss treatment.

[embedded content] For FDNY’s first responders, part of the problem was having to ration and reuse masks. Workers were blind to an invisible threat that would be recognized months later. The propecia spread rapidly from pre-symptomatic people and among those with no symptoms at all.

In mid-March, Lizcano was one of thousands of FDNY first responders infected with hair loss treatment. At least four of them died, city records show. They were among the 679 health care workers who have died in New York and New Jersey to date, most at the height of the terrible first wave of the propecia.

€œInitially, we didn’t think it was this bad,” Lizcano said, recalling the confusion and chaos of the early propecia. €œThis city wasn’t prepared.” Neither was the rest of the country. An Elusive Enemy The propecia continued to spread like a ghost through the nation and proved deadly to workers who were among the first to encounter sick patients in their hospital or nursing home.

One government agency had a unique vantage point into the problem but did little to use its power to cite employers — or speak out about the hazards. Health employers had a mandate to report worker deaths and hospitalizations to the Occupational Safety and Health Administration. When they did so, the report went to an agency headed by Eugene Scalia, son of conservative Supreme Court Justice Antonin Scalia who died in 2016.

The younger Scalia had spent part of his career as a corporate lawyer fighting the very agency he was charged with leading. Its inspectors have documented instances in which some of the most vulnerable workers — those with low information and high patient contact — faced incredible hazards, but OSHA’s staff did little to hold employers to account. Beaumont, Texas, a town near the Louisiana border, was largely untouched by the propecia in early April.

That’s when a 56-year-old physical therapy assistant at Christus Health’s St. Elizabeth Hospital named Danny Marks called in sick with a fever and body aches, federal OSHA records show. He told a human resources employee that he’d been in the room of a patient who was receiving a breathing treatment — the type known as the most hazardous to health workers.

The CDC advises that N95 respirators be used by all in the room for the so-called aerosol-generating procedures. (A facility spokesperson said the patient was not known or suspected to have hair loss treatment at the time Marks entered the room.) Marks went home to self-isolate. By April 17, he was dead.

The patient whose room Marks entered later tested positive for hair loss treatment. And an OSHA investigation into Marks’ death found there was no sign on the door to warn him that a potentially infected patient was inside, nor was there a cart outside the room where he could grab protective gear. The facility did not have a universal masking policy in effect when Marks went in the room, and it was more than likely that he was not wearing any respiratory protection, according to a copy of the report obtained through a public records request.

Twenty-one more employees contracted hair loss treatment by the time he died. €œHe was a beloved gentleman and friend and he is missed very much,” Katy Kiser, Christus’ public relations director, told KHN. OSHA did not issue a citation to the facility, instead recommending safety changes.

The agency logged nearly 8,700 complaints from health care workers in 2020. Yet Harvard researchers found that some of those desperate pleas for help, often decrying shortages of PPE, did little to forestall harm. In fact, they concluded that surges in those complaints preceded increases in deaths among working-age adults 16 days later.

One report author, Peg Seminario, blasted OSHA for failing to use its power to get employers’ attention about the danger facing health workers. She said issuing big fines in high-profile cases can have a broad impact — except OSHA has not done so. €œThere’s no accountability for failing to protect workers from exposure to this deadly propecia,” said Seminario, a former union health and safety official.

Desperate for Safety Gear There was little outward sign this summer that Garfield Medical Center was struggling to contain hair loss treatment. While Medicare has forced nursing homes to report staff s and deaths, no such requirement applies to hospitals. More 'Lost on the Frontline' Stories Dying Young.

The Health Care Workers in Their 20s Killed by hair loss treatment By Alastair Gee, The Guardian | August 13, 2020A database of deaths compiled by KHN and The Guardian includes a significant minority under 30, leaving shattered dreams and devastated families.(Photo Credit. The Obra family)Most Home Health Aides ‘Can’t Afford Not to Work’ — Even When Lacking PPEBy Eli Cahan | October 16, 2020Home health aides flattened the curve by keeping the most vulnerable patients — seniors, the disabled, the infirm — out of hospitals. But they’ve done it mostly at poverty wages and without overtime pay, hazard pay, sick leave or health insurance.(Photo Credit.

Tamarya Burnett)They Cared for Some of New York’s Most Vulnerable Communities. Then 12 Died.By Danielle Renwick, The Guardian | August 27, 2020Immigrant health workers help keep the U.S. Health system afloat — and they’re dying of hair loss treatment at high rates.(Photo Credit.

Pablo Monsalve/VIEWpress via Getty Images)These Front-Line Workers Could Have Retired. They Risked Their Lives Instead. By Shoshana Dubnow | November 20, 2020 An investigation by KHN and The Guardian shows that 329 health care workers age 65 or older have reportedly died of hair loss treatment.(Photo Credits.

Tom Miles, David Brown, Bethany MacDonald) Yet as the focus of the propecia moved from the East Coast in the spring to Southern and Western states, health care worker deaths climbed. And behind the scenes at Garfield, workers were dealing with a lack of equipment meant to keep them safe. Complaints to state worker-safety officials filed in March and April said Garfield Medical Center workers were asked to reuse the same N95 respirator for a week.

Another complaint said workers ran out of medical gowns and were directed to use less-protective gowns typically provided to patients. Staffers were shaken by the death of Dawei Liang. And only after his death and a rash of s did Garfield provide N95 masks to more workers and put up plastic tarps to block a hair loss treatment unit from an adjacent ward.

Yet this may have been too late. The hair loss can easily spread to every corner of a hospital. Researchers in South Africa traced a single ER patient to 119 cases in a hospital — 80 among staff members.

Those included 62 nurses from neurology, surgical and general medical units that typically would not have housed hair loss treatment patients. By late July, Garfield cardiac and respiratory technician Thong Nguyen, 73, learned he was hair loss treatment-positive days after he collapsed at work. Nguyen loved his job and was typically not one to complain, said his youngest daughter, Dinh Kozuki.

A 34-year veteran at the hospital, he was known for conducting medical tests in multiple languages. His colleagues teased him, saying he was never going to retire. Kozuki said her father spoke up in March about the rationing of protective gear, but his concerns were not allayed.

Dinh Kozuki’s father, Thong Nguyen, died of hair loss treatment-related complications after nearly 35 years of service at Garfield Medical Center in Los Angeles. Nguyen’s supervisor told him he’d have to reuse personal protective equipment. €œHe definitely should not have passed [away],” Kozuki said.(Heidi de Marco / KHN) The PPE problems at Garfield were a symptom of a broader problem.

As the propecia spread around the nation, chronic shortages of protective gear left many workers in community-based settings fatally exposed. Nearly 1 in 3 family members or friends of around 300 health care workers interviewed by KHN or The Guardian expressed concerns about a fallen workers’ PPE. Health care workers’ labor unions asked for the more-protective N95 respirators when the propecia began.

But Centers for Disease Control and Prevention guidelines said the unfitted surgical masks worn by workers who feed, bathe and lift hair loss treatment patients were adequate amid supply shortages. Mary Turner, an ICU nurse and president of the Minnesota Nurses Association, said she protested alongside nurses all summer demanding better protective gear, which she said was often kept from workers because of supply-chain shortages and the lack of political will to address them. €œIt shouldn’t have to be that way,” Turner said.

€œWe shouldn’t have to beg on the streets for protection during a propecia.” At Garfield, it was even hard to get tested. Critical care technician Tony Ramirez said he started feeling ill on July 12. He had an idea of how he might have been exposed.

He’d cleaned up urine and feces of a patient suspected of having hair loss treatment and worked alongside two staffers who also turned out to be hair loss treatment-positive. At the time, he’d been wearing a surgical mask and was worried it didn’t protect him. Yet he was denied a free test at the hospital, and went on his own time to Dodger Stadium to get one.

His positive result came back a few days later. As Ramirez rested at home, he texted Alex Palomo, 44, a Garfield medical secretary who was also at home with hair loss treatment, to see how he was doing. Palomo was the kind of man who came to many family parties but would often slip away unseen.

A cousin finally asked him about it. Palomo said he just hated to say goodbye. Palomo would wear only a surgical mask when he would go into the rooms of patients with flashing call lights, chat with them and maybe bring them a refill of water, Ramirez said.

Paramedics work behind an ambulance at the Garfield Medical Center in Monterey Park, California, on March 19. (Frederic J. Brown / AFP via Getty Images) Ramirez said Palomo had no access to patient charts, so he would not have known which patients had hair loss treatment.

€œIn essence, he was helping blindly.” Palomo never answered the text. He died of hair loss treatment on Aug. 14.

And Thong Nguyen had fared no better. His daughter, a hospital pharmacist in Fresno, had pressed him to go on a ventilator after seeing other patients survive with the treatment. It might mean he could retire and watch his grandkids grow up.

But it made no difference. €œHe definitely should not have passed [away],” Kozuki said. Nursing Homes Devastated During the summer, as nursing homes recovered from their spring surge, Heather Pagano got a new assignment.

The Doctors Without Borders adviser on humanitarianism had been working in cholera clinics in Nigeria. In May, she arrived in southeastern Michigan to train nursing home staffers on optimal -control techniques. Federal officials required worker death reports from nursing homes, which by December tallied more than 1,100 fatalities.

Researchers in Minnesota found particular hazards for these health workers, concluding they were the ones most at risk of getting hair loss treatment. Pagano learned that staffers were repurposing trash bin liners and going to the local Sherwin-Williams store for painting coveralls to backfill shortages of medical gowns. The least-trained clinical workers — nursing assistants — were doing the most hazardous jobs, turning and cleaning patients, and brushing their teeth.

She said nursing home leaders were shuffling reams of federal, state and local guidelines yet had little understanding of how to stop the propecia from spreading. €œNo one sent trainers to show people what to do, practically speaking,” she said. As the propecia wore on, nursing homes reported staff shortages getting worse by the week.

Few wanted to put their lives on the line for $13 an hour, the wage for nursing assistants in many parts of the U.S. The organization GetusPPE, formed by doctors to address shortages, saw almost all requests for help were coming from nursing homes, doctors’ offices and other non-hospital facilities. Only 12% of the requests could be fulfilled, its October report said.

And a propecia-weary and science-wary public has fueled the propecia’s spread. In fact, whether or not a nursing home was properly staffed played only a small role in determining its susceptibility to a lethal outbreak, University of Chicago public health professor Tamara Konetzka found. The crucial factor was whether there was widespread viral transmission in the surrounding community.

€œIn the end, the story has pretty much stayed the same,” Konetzka said. €œNursing homes in propecia hot spots are at high risk and there’s very little they can do to keep the propecia out.” The treatment Arrives From March through November, 40 complaints were filed about the Garfield Medical Center with the California Department of Public Health, nearly three times the statewide average for the time. State officials substantiated 11 complaints and said they are part of an ongoing inspection.

For Thanksgiving, AHMC Healthcare Chairman Jonathan Wu sent hospital staffers a letter thanking “frontline healthcare workers who continue to serve, selflessly exposing themselves to the propecia so that others may cope, recover and survive.” The letter made no mention of the workers who had died. €œA lot of people were upset by that,” said critical care technician Melissa Ennis. €œI was upset.” By December, all workers were required to wear an N95 respirator in every corner of the hospital, she said.

Ennis said she felt unnerved taking it off. She took breaks to eat and drink in her car. Garfield said on its website that it is screening patients for the propecia and will “implement prevention and control practices to protect our patients, visitors, and staff.” On Dec.

9, Ennis received notice that the treatment was on its way to Garfield. Nationwide, the treatment brought health workers relief from months of tension. Nurses and doctors posted photos of themselves weeping and holding their small children.

At the same time, it proved too late for some. A new surge of deaths drove the toll among health workers to more than 2,900. And before Ennis could get the shot, she learned she would have to wait at least a few more days, until she could get a hair loss treatment test.

She found out she’d been exposed to the propecia by a colleague. Shoshana Dubnow and Anna Sirianni contributed to this report. Video by Hannah Norman.

Web production by Lydia Zuraw. This story is part of “Lost on the Frontline,” an ongoing project from The Guardian and Kaiser Health News that aims to document the lives of health care workers in the U.S. Who die from hair loss treatment, and to investigate why so many are victims of the disease.

If you have a colleague or loved one we should include, please share their story. Christina Jewett. ChristinaJ@kff.org, @by_cjewett Related Topics Contact Us Submit a Story TipJournalists from KHN and The Guardian have identified 2,921 workers who reportedly died of complications from hair loss treatment after they contracted it on the job.

Reporters are working to confirm the cause of death and workplace conditions in each case. They are also writing about the people behind the statistics — their personalities, passions and quirks — and telling the story of every life lost.Explore the new interactive tool tracking those health worker deaths.(Note. The previous total announced by The Guardian and KHN was approximately 1,450 health care worker deaths.

The new number reflects the inclusion of data reported by nursing homes and health facilities to the federal and state governments. These deaths include the facility names but not worker names. Reporters cross-checked each record to ensure fatalities did not appear in the database twice.) More From This Series.

Related Topics Health Industry hair loss treatment Doctors Investigation Lost On The Frontline Nursing HomesCan’t see the audio player?. Click here to listen on SoundCloud. hair loss treatment was the dominant — but not the only — health policy story of 2020.

In this special year-in-review episode of KHN’s “What the Health?. € podcast, panelists look back at some of the biggest non-hair loss stories. Those included Supreme Court cases on the Affordable Care Act, Medicaid work requirements and abortion, as well as a year-end surprise ending to the “surprise bill” saga.

This week’s panelists are Julie Rovner of KHN, Joanne Kenen of Politico, Anna Edney of Bloomberg News and Sarah Karlin-Smith of Pink Sheet. Among the takeaways from this week’s podcast. The hair loss propecia strengthened the hand of ACA supporters, even as the Trump administration sought to get the Supreme Court to overturn the federal health law.

Many people felt it was an inopportune time to get rid of that safety valve while so many Americans were losing their jobs — and their health insurance — due to the economic chaos from the propecia.Preliminary enrollment numbers released by federal officials last week suggest that more people were taking advantage of the option to buy coverage for 2021 through the ACA marketplaces than for 2020, even in the absence of enrollment encouragement from the federal government.The ACA’s Medicaid expansion had a bit of a roller-coaster ride this year. Voters in two more states — Oklahoma and Missouri — approved the expansion in ballot measures, but the Trump administration continued its support of state plans that require many adults to prove they are working in order to continue their coverage. The Supreme Court has agreed to hear a challenge to that policy.

Although lower courts have ruled that the Medicaid law does not allow such restrictions, it’s not clear how the new conservative majority on the court will view this issue.Concerns are beginning to grow in Washington about the near-term prospect of the Medicare trust fund going insolvent. That can likely be fixed only with a remedy adopted by Congress, and that may not happen unless lawmakers feel a crisis is very near.The Trump administration has sought to bring down drug out-of-pocket expenses for Medicare beneficiaries. Among those initiatives is a demonstration project to lower the cost of insulin.

About a third of Medicare beneficiaries will be enrolled in plans that offer reduced prices in 2021. But the effort could have a hidden consequence. Higher insurance premiums.Many members of Congress began this session two years ago with grand promises of working to lower drug prices — but they never reached an agreement on how to do it.President Donald Trump, however, was strongly motivated by the issue and late this year issued an order to set many Medicare drug prices based on what is paid in other industrialized nations.

Drugmakers detest the idea and have vowed to fight it in court. Although some Democrats endorse the concept, it seems unlikely that President-elect Joe Biden would want to spend much capital in a legal battle for a plan that hasn’t been carefully vetted.The gigantic spending and hair loss treatment relief bill that Congress finally approved Monday includes a provision to protect consumers from surprise medical bills when they are unknowingly treated by doctors or hospitals outside their insurance network. The law sets up a mediation process to resolve the charges, but the process favors the doctors.

Insurers are likely to pass along any extra costs to consumers through higher premiums. To hear all our podcasts, click here. And subscribe to What the Health?.

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