January 31, 2020 Edition

WHO Declares Novel Coronavirus a Global Health Emergency; HHS Secretary Azar Declares Public Health Emergency


On Thursday, the World Health Organization (WHO) declared the ongoing coronavirus outbreak a public health emergency of international concern (PHEIC). WHO Director-General Tedros Adhanom Ghebreyesus announced the declaration, noting, “Over the past few weeks, we have witnessed the emergence of a previously unknown pathogen, which has escalated into an unprecedented outbreak, and which has been met by an unprecedented response.”

The global health emergency declaration can be used to coordinate international control and response activities, as well as galvanize international funding. The WHO’s procedures indicate three criteria for a global health emergency which include “an extraordinary event” that “constitutes a public health risk to other States through the international spread of disease” and that “potentially require(s) a coordinated international response.”

The most recent WHO global health emergency occurred in July 2019 during the Ebola outbreak in the Democratic Republic of Congo, as well as a 2016 declaration for the Zika virus and a 2014 declaration for the Ebola outbreak in West Africa.

The full announcement from WHO is available here.

United States

On Friday, United States Health and Human Services Secretary Azar declared a public health emergency for the nation in response to 2019 novel coronavirus. During the press conference, Azar acknowledged the risk to Americans remain low, while also noting that the virus poses a serious public health threat. The declaration is retroactive to January 27, 2020.

The press release can be viewed here.

Newsom Appoints Gilbert as DHCS Director

On Thursday, Governor Gavin Newsom announced the appointment of Bradley Gilbert as the Director of the California Department of Health Care Services (DHCS). Dr. Gilbert has been a retired annuitant at the Inland Empire Health Plan since 2019 where he previously held several positions since 1996, including medical director, chief medical officer, and chief executive officer. Gilbert served as the Public Health Director at the County of Riverside Health Services Agency Department of Public Health from 1993 to 1996 and the Public Health Director at the San Mateo County Department of Health Services Division of Public Health. He is a board member of the California Healthcare Foundation, Planned Parenthood, and Manifest Medex.

Gilbert earned a Master of Public Policy degree from the University of California, Berkeley and a Doctor of Medicine degree from the University of California, San Diego School of Medicine. Gilbert’s appointment requires Senate confirmation.

CDPH Names Ramos as Chief of Office of AIDS

This week, the California Department of Public Health (CDPH) announced that Dr. Marisa Ramos has been appointed as the Chief of the CDPH Office of AIDS. Dr. Ramos has been with CDPH for 11 years and has been serving as the Interim Office of AIDS Chief, as well as the Surveillance and Prevention Evaluation and Reporting Branch Chief within the Office of AIDS.

According to CDPH, Dr. Ramos has 25 years of experience managing research projects, data systems, and surveillance efforts and has authored publications and presented at local, state, national, and international conferences on refugee and Latino health issues. Dr. Ramos completed masters and doctoral programs in Biological Nutrition with an emphasis in Epidemiology at the University of California, Davis.

Time Runs out for Two-Year Bills in Legislature

The Legislature spent much of this week focused on passing two-year bills out of their houses as today is the final deadline. Very few managed to pass off their respective floors. Most prominently, Senator Wiener’s SB 50, which makes significant changes to local zoning laws allowing for more high-density housing near mass transit hubs, failed on the Senate Floor after two attempts at passage. Senator Wiener in a statement expressed his disappointment that the bill was rejected by his Senate colleagues but noted he will be announcing new housing legislation soon.

As a reminder, the Legislative deadline to introduce new bills for 2020 is Friday, February 21st.

Our CHEAC Weekly Bill Chart is available here.

Health Coverage/Health Care Reform

SB 175 (Pan) – SUPPORT

Senator Pan’s SB 175, which codifies in California statute the Affordable Care Act (ACA) prohibition on health insurance lifetime or annual limits, passed unanimously off the Senate Floor this week. The bill ensures that despite threats to the Affordable Care Act at the federal level, California would continue to prohibit health insurers from instituting annual or lifetime limits on insurance benefits. It now moves on to the Assembly for further consideration.

SB 406 (Pan) – SUPPORT

Senator Pan has also authored SB 406, which codifies in California statute the ACA requirement that health insurance cover preventive services. Similar to SB 175, the bill seeks to ensure that Californians continue to have access to high quality preventive care in order to stay healthy, avoid or delay the onset of these chronic diseases, lead productive lives, and reduce costs. SB 406 also passed off the Senate Floor this week on a unanimous vote and moves on to the Assembly.

ACEs Aware RFP Applications Due February 10

The Department of Health Care Services (DHCS) and the Office of the California Surgeon General continue to solicit request for proposals (RFPs) for the ACEs Aware initiative with an application due date of February 10. The initiative is California’s approach screening children and adults for adverse childhood experiences (ACEs) in primary care and to treat the impacts of toxic stress with trauma-informed care.

The ACEs Aware initiative RFP seeks to fund organizations to support training and engagement of a wide range of health providers and other professionals, as well as encourage collaborations among organizations to build networks of care. Funding opportunities exist for provider training, provider engagement, communications, and convenings. Additional information on the RFP is available here.

U.S. Surgeon General Issues Report on Smoking Cessation

U.S. Surgeon General Jerome Adams recently issued a report on smoking cessation, the 34th tobacco-related Surgeon General report published since 1964. In 1990, the Surgeon General issued the report, The Health Benefits of Smoking Cessation. The latest report summarizes the latest evidence on the health benefits of smoking cessation, including recent scientific evidence on the topic.

The 2020 Surgeon General’s report concludes the following key points:

  • Smoking cessation is beneficial at any age, reduces the risk of premature death, and can add as much as a decade to life expectancy.
  • Smoking places a substantial financial burden on smokers, healthcare systems, and society. Smoking cessation reduces this burden, including smoking-attributable healthcare expenditures.
  • Smoking cessation reduces risk for many adverse health effects, including reproductive health outcomes, cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and cancer. Quitting smoking is also beneficial to those who have been diagnosed with heart disease and COPD.
  • More than three out of five U.S. adults who have ever smoked cigarettes have quit. Although a majority of cigarette smokers make a quit attempt each year, less than one-third use cessation medications approved by the U.S. Food and Drug Administration (FDA) or behavioral counseling to support quit attempts.
  • Considerable disparities exist in the prevalence of smoking across the U.S. population with higher prevalence in some subgroups. Similarly, the prevalence of key indicators of smoking cessation—quit attempts, receiving advice to quit form a health professional, and using cessation therapies—also varies across the population with lower prevalence in some subgroups.
  • Electronic cigarettes, a continually change and heterogeneous group of products, are used in a variety of ways. Consequently, it is difficult to make generalizations about efficacy for cessation based on clinical trials involving a particular electronic cigarette, and there is presently inadequate evidence to conclude that electronic cigarettes, in general, increase smoking cessation.
  • Smoking cessation can be increased by raising the price of cigarettes, adopting comprehensive smoke-free policies, implementing mass media campaigns, requiring pictorial health warnings, and maintaining comprehensive statewide tobacco control programs.

The full U.S. Surgeon General’s report is available here. A fact sheet of key findings is available here.

American Lung Association Publishes 2020 State of Tobacco Control Report

The American Lung Association recently published its 18th annual “State of Tobacco Control” report, evaluating states and the federal government on proven-effective tobacco control laws and policies. According to the American Lung Association, the report serves as a blueprint for what state and federal leaders need to do to eliminate death and disease caused by tobacco use. Notably, this year’s report focuses on the continuing vaping epidemic among U.S. youth and young adults.

Included in the report is a roadmap offered to policymakers and relevant stakeholders of public policies needed to prevent and reduce tobacco use. To supplement and simplify the key actions needed by federal, state, and local policymakers to accomplish this goal, the American Lung Association released its 12-point plan for ending the tobacco epidemic; among the points are actions such as:

  • States, counties, and cities must include electronic cigarettes in all smoke-free policies and laws
  • Congress, states, counties, and cities must raise the tax on electronic cigarettes to parity with cigarettes and other tobacco products
  • The U.S. Food and Drug Administration (FDA), Congress, states, counties, and cities must immediately remove all flavored tobacco products from the marketplace
  • States, counties, and cities must end the use of coupons and other discounts which makes these products cheaper and more appealing to young people
  • FDA must require a “track and trace” technology on all tobacco products to prevent black market, counterfeit, and smuggling activities

The report also issues letter grades to all U.S. states in areas of tobacco prevention and cessation funding, smoke-free air, tobacco taxes, access to cessation services, and tobacco age restrictions. The Lung Association urges California elected officials to prohibit the sale of all flavored tobacco products including menthol, expand protection from secondhand smoke exposure in locations including multiunit housing and outdoor dining, and pass policies to further reduce access to tobacco products. The full American Lung Association report and associated resources are available here.