January 31, 2020 Edition
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.”
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.
announcement from WHO is available here.
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.
release can be viewed here.
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.
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.
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.
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.
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
(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
(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.
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
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.
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.
Surgeon General’s report concludes the following key points:
cessation is beneficial at any age, reduces the risk of premature death, and
can add as much as a decade to life expectancy.
places a substantial financial burden on smokers, healthcare systems, and
society. Smoking cessation reduces this burden, including smoking-attributable
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.
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.
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.
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.
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
The full U.S. Surgeon
General’s report is available here. A fact sheet of key findings is available here.
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:
counties, and cities must include electronic cigarettes in all smoke-free
policies and laws
states, counties, and cities must raise the tax on electronic cigarettes to
parity with cigarettes and other tobacco products
U.S. Food and Drug Administration (FDA), Congress, states, counties, and cities
must immediately remove all flavored tobacco products from the marketplace
counties, and cities must end the use of coupons and other discounts which
makes these products cheaper and more appealing to young people
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.