CDC Director: Drug-Resistant Superbug Means “Medicine Cabinet Is Empty”

You know that scene in action movies where the hero has fired every bullet, thrown every piece of throwable furniture, set off every explosive, but still the bad guy lurches forward? At that point, there’s nothing left for the hero to do but run and pray. After the recent discovery in the U.S. of a bacteria that is resistant to a vital last-resort antibiotic, some scientists believe we’re inching dangerously close to that run-and-pray moment in the world of medicine.

“We risk being in a post-antibiotic world,” Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention told reporters yesterday after military researchers confirmed the first-known U.S. instance of the MCR-1 gene, which provides antibiotic resistance to colistin, a drug of last resort. “That wouldn’t just be urinary tract infections or pneumonia — that could be for the 600,000 patients a year who need cancer treatment.”

Added Dr. Frieden, “The medicine cabinet is empty for some patients.”

For decades, doctors have treated multi-drug resistant bacteria with a class of antibiotics known as carbapenems. But the more you use a drug, the more the pathogens adapt to survive, so now there are carbapenem-resistant bacteria (CRE). Colistin, a potent antibiotic that had long been shelved because of its potential for kidney damage, has come back into use in recent years as a last-resort treatment for CRE infections.

While the bacteria found this month in the Pennsylvania woman is resistant to colistin and many other antibiotics, it is sensitive to carbapenems. However, now that the MCR-1 gene is stateside, some are very concerned that we’ll inevitably see bacteria that are resistant to both CRE and colistin.

“We are one step away from CRE strains that cannot be treated with antibiotics,” Dr. Lance Price, a researcher at George Washington University, tells the NY Times. “We now have all the pieces in place for it to be untreatable.”

Dr. Beth Bell of the CDC likens this fully resistant superbug to a nearly completed puzzle.

“You need lots of different pieces to get a result that is resistant to everything,” she explains to the Times. “This is the last piece of that puzzle, unfortunately, in the United States. We have that genetic element that would allow for bacteria that are resistant to every antibiotic.”

Bloomberg News today looks at the death of a child in India whose infection could not be treated by colistin.

“That is a warning to us that maybe we’re already losing this drug,” a hospital official tells Bloomberg. “If we lose colistin, we have nothing. It’s an extreme, extreme worry for us.”

Not every doctor is beating the doom-and-gloom drum about this discovery.

University of Pennsylvania hospital infectious disease specialist Neil Fishman tells Philly.com that the news is “not a death star, but a very strong warning that we really do have to be careful with antibiotics and use them optimally.”

While across town, Temple University Hospital specialist Tom Fekete cautions that he’s “not giving up the ship,” and notes that people have been declaring a “post-antibiotic world” for 20 years.

Earlier this month, the Pew Charitable Trusts released a report showing that now new types of antibiotics have been discovered in more than 30 years, raising the concern that resistance — in the absence of new drugs — could wipe out the utility of the ones we’ve been using since the golden ages of antibiotics research in the mid-Twentieth Century.

“This is definitely alarming,” said Pew’s David Hyun about yesterday’s announcement. “The fact that we found it in the United States confirms our suspicions and adds urgency to actions we need to work on antibiotic stewardship and surveillance for this type of resistance.”

The discovery of the MCR-1 gene in the U.S. has resulted in renewed calls for improved antibiotic oversight, particularly in farm animals, who consume the overwhelming majority of antibiotics in the country, primarily for the non-therapeutic purpose of growth-promotion.

“I have been sounding the alarm for years, and now, what we’ve been dreading has happened,” said Congresswoman Louise Slaughter of New York, who also happens to be a trained microbiologist. “We have an antibiotic-resistant superbug that can’t be killed by any known drug. We need swift, aggressive, global action to stop this in its tracks—now.”

by Chris Morran via Consumerist

How To Finally Get Insurance To Approve A Wheelchair For A Kid: Go Viral On Twitter

Kids grow. This may not come as a surprise to most of us, who were ourselves children one, but health insurance companies are not necessarily prepared for this facet of reality. And where reality and bureaucracy can really come into hard conflict is when kids who need durable medical equipment might — gasp — outgrow the tech, which doesn’t grow at all.

The Atlantic tells the story of one girl who suffered a sudden, virus-related paralysis. While it took some time for doctors to come to a final verdict on diagnosis and treatment, one short-term goal seemed clear: since the girl couldn’t walk, she’d need a wheelchair to get around.

The girl’s medical team wrote a prescription for a wheelchair, but the family hit a snag when it came to insurance: without a formal diagnosis of the problem, they wouldn’t pay for any equipment.

It took a crowdfunding campaign from friends and family to buy the girl her the first chair, but that one — secondhand, and adapted for someone else’s very different needs — proved to be a bad fit for the active nine-year-old.

Getting a properly-fit medical device, like a wheelchair, for an adult is one thing. But for a kid it’s a whole separate set of issues, because kids are constantly growing. At 29, your leg length, arm length, and shoe size probably aren’t going to change much in the coming weeks. At 9, though, there’s no such guarantee.

That means that one GoFundMe — even if it reaches its goal — isn’t going to be enough. A child with a disability who needs mobility aids is going to keep needing new ones for years to come — some kids, after all, are still growing as late as college.

A family seeking medical treatment for pediatric disability may find themselves having to go through the process of getting a wheelchair prescription nearly yearly… and every single one of those requests can be a lengthy back-and-forth with doctor’s offices and insurance. The longer it takes, the worse the problem gets, because a kid keeps growing — and outgrowing the requested replacement gear — while adults are arguing about the logistics.

So what is a parent to do when repeated requests from their child’s pediatrician and specialist, with literal reams of proof attached, keep getting denied? Go out-of-pocket — and go social.

Susan Mahoney, a specialist who worked with the families interviewed for the story, told The Atlantic that some families go through as many as six levels of appeals. “By the time you hit a certain level of appeal, you’re looking at six months to a year. It’s unethical,” Mahoney said. And that leaves only one venue for rapid change: “I tell the families to go to the media, if they can.”

Twitter, Facebook, and crowdfunding sites are where families in need end up going. According to The Atlantic, there are currently over 15,000 wheelchair-related campaigns happening on GoFundMe. In fact, medical expenses are far and away the most popular category of donation-seeking campaigns, accounting for 15% of all the money given on the site. (In 2012, that was worth more than $6 million.)

When multiple appeals for getting the partially paralyzed nine-year-old were denied, her mom took to Twitter and told the world about the situation with a hashtag that went viral. Cable news picked up the story, and an escalation expert from the insurance company appeared like magic to solve the family’s problems and get the girl’s new chair approved.

When the family finally got the wheelchair they had been requesting for their daughter, they didn’t stop. The mom who won the day with a blog post and twitter fight is now doing the same work on behalf of other families.

“I’m willing to loan my soapbox to anyone who needs it,” she told The Atlantic. “If they’re having trouble with their insurance company, they can come and stand on my mountain and yell.”

One Parent’s Twitter Campaign to Get Her Daughter a Wheelchair [The Atlantic]

by Kate Cox via Consumerist

Uber Testing Feature That Lets Riders Compare UberPool, UberX Prices

In some cities, Uber customers can choose to get a ride with UberPool, which allows users to share a car with strangers who are traveling along (or close to) their route. It seems the ride-hailing company is trying to nudge folks toward selecting that option, with a new test of an “upfront pricing” feature that displays prices for both UberPool and the more expensive option, UberX.

In an attempt to push UberPool, Uber is testing a version of the app that includes the “upfront pricing” feature during booking in cities including San Diego, Miami, Philadelphia, Seattle, and some New Jersey markets, the Los Angeles Times reports.

Here’s how it’ll look, as seen in a screen grab we took using the app in Philadelphia — note that UberPool is the selected option by default:

In comparison, a New Yorker trying to get somewhere would have to toggle between the UberPool and UberX options to get a price estimate for each trip — though again, UberPool is the default selection:

Upfront pricing calculates things like time of day, distance to the destination, traffic conditions, surge rates and other factors to arrive at a total cost, and customers will never pay more for a ride than the price displayed, unless you choose to change your route and go somewhere else. Rides could be cheaper than advertised at first, however, which no one would complain about.

“More people choosing to share the ride instead of traveling alone is not only good for our cities and the environment, it’s good for the pocketbook,” said an Uber spokeswoman. “By ensuring that riders can easily see how much they can save by carpooling, we’re aiming to put more butts into fewer seats.”

by Mary Beth Quirk via Consumerist

20,000 For-Profit College Students Ask Education Dept. To Cancel Their Student Loans

As the fallout continues from the collapse of Corinthian Colleges Inc. — former operator of Everest University, WyoTech, and Heald College — the Department of Education is trying to sort through nearly 20,000 loan-forgiveness requests from former students who claim that CCI and other for-profit colleges misled them into taking out huge student loans.

Unlike many loans or lines of credit, federal student loans generally can’t be discharged through bankruptcy, so even if the borrower is unable to pay, they will continue to owe the debt.

However, there are some ways in which students who have been victimized by bad schools can seek to get out from under their loan debt. If a school closes and there are no other options available to the student, they can argue for a “closed school” claim. The government has already forgiven some $75 million in loans to 5,800 former CCI students who filed this type of claim.

The other way is the heretofore little-used “borrower’s defense” claim, which involves making allegations of deception on the part of the school. CCI and a number of other for-profit schools have been accused of misleading both investors and students with trumped-up post-graduation employment statistics. Some students also didn’t find out until too late that, in spite of having paid tuitions equivalent to selective private colleges, not all of their course credits will transfer to other schools.

Urged on by consumer advocates and lawmakers, the Obama administration decided in mid-2015 to begin reviewing borrower’s defense claims. By Jan. 2016, the Education Dept. had already received 7,500 of these applications, representing around $164 million in loans.

Now the Wall Street Journal reports that this has ballooned to 19,657 borrower’s defense requests. Thus far, the government has canceled $27 million in debt for more than 3,400 borrowers; mostly former CCI students.

The review of the applications is ongoing, even though the Education Dept. has yet to receive guidelines from an advisory panel about how it should be applying the vague law that allows for borrower’s defense claims. The Journal reports that these guidelines are expected in the near future.

One big issue surrounding these claims involves how much evidence a student would need to provide to demonstrate the fraud. Should the government — as some have suggested — simply acknowledge that a school like CCI committed widespread deception in its marketing and advertising, and therefore accept applicants’ claims of deception as true? Or should the applicants need to provide some sort of evidence documenting the particular deception that resulted in them taking out student loans — and if so, how does one prove they were misled years after the fact?

by Chris Morran via Consumerist

Court Says NYC’s Salt Warning Labels Can Go Into Effect As Planned

Despite efforts from a restaurant trade group to stop New York City from requiring labels on foods high in sodium high-sodium food from going into effect, a state appeals court says the city can begin enforcement of the rule as planned starting June 6.

The decision was handed down by a panel of justices from the Appellate Division of state Supreme Court in Manhattan, and denied a request to delay the labels while a lawsuit filed by the National Restaurant Association against the city is pending appeal, The Wall Street Journal reports.

The trade group doesn’t want the city’s Board of Health to be able to enforce a 2015 rule requiring restaurant chains with at least 15 locations nationwide to add a warning label on any menu items that have more than 2,300 milligrams of sodium, or about a teaspoon’s worth.

After a state justice upheld the rule in February, saying it was an informational label that didn’t stop consumers from buying certain items, the trade group appealed.

A restaurant association spokeswoman says she hopes the health department will still delay enforcement on its own, telling the WSJ that the ruling “will force the men and women that own New York City’s restaurants to start complying with this unlawful and unprecedented sodium mandate before the court has the chance to rule on the merits of our appeal.”

City officials are pleased with the decision, say it’ll help people make better-informed decisions. Enforcement will go ahead as planned on June 6, the health department says.

“Restaurant chains throughout the city have already begun posting the warning labels on their menus and helping New Yorkers watch the salt,” said NYC Health Commissioner Dr. Mary T. Bassett in a statement [PDF]. “Diners are now empowered to make informed decisions to lower their sodium intake and reduce the risk of high blood pressure, stroke and other heart-related ailments.”

by Mary Beth Quirk via Consumerist

Oversized Box From Sears Has Enough Room To Stash Preteen Daughter

Amazon was once notorious for shipping items in comically oversized boxes, an e-commerce phenomenon that we blame on mysterious employees called the Stupid Shipping Gang. We don’t hear about over-packaging from Amazon that much anymore, perhaps because the Stupid Shipping Gang has all moved on to jobs packaging e-commerce orders at Sears.

At least, that’s how it looks based on reader Corey’s order of tools from Sears.

“The box was big enough that my daughter got in with them and they still had room for all the packing material,” Corey writes. His daughter is 12 years old, if you were wondering.

A former shipping manager contacted us a few years ago to explain how this happens.

“Having as few different sized boxes as possible is the name of the game,” the former gangster explained: using fewer box sizes means storing fewer box sizes and saving money by ordering larger quantities of the boxes you use most often.

Also, while it might seem counter-intuitive to regular people, in a commercial shipping operation, it might be cheaper to ship a larger box than a small one. How does that work?

“While you can fit more smaller boxes than larger boxes into a finite space,” our source explained, “sometimes a lot of those smaller boxes end up creating blank space through their odd dimensions, which makes it harder to fit in larger boxes.”

At least Corey has somewhere to stash his daughter, though.

by Laura Northrup via Consumerist

Bill Requiring Security Backdoors On Phones & Other Devices Appears To Be DOA

Last month, Senators Diane Feinstein of California and Richard Burr of North Carolina were set to bring forth legislation that would end the debate on whether companies like Apple should help law enforcement unlock users’ devices, by requiring them to do so. In spite of the bipartisan, high-level sponsorship and the spotlight of the disputes between Apple and the Justice Department, it looks like this controversial legislation may never even be formally introduced.

The Compliance with Court Orders Act of 2016 [PDF], which has been circulating around the Senate as a draft since mid-April, would require companies to provide, among other things, “appropriate technical assistance” to the government when presented with a warrant for data on a secured electronic device.

There has been a lot of debate about whether or not the All Writs Act — a law dating back to 1789 — gives the government the authority to compel tech companies to undermine encryption that doesn’t have built-in backdoor access for the manufacturer.

In the recent Apple cases, the company fought federal warrants trying to compel Apple’s help in unlocking iPhones that had belonged to criminals. Apple does not have a way to unlock a user’s device without their passcode (or their fingerprint, if they’ve chosen to use the device’s biometric lock), so it would have to figure out a way to break its own encryption.

This issue was never ultimately resolved, with the federal authorities finding their own ways around the encryption in both instances.

The Feinstein-Burr legislation would have made such debate pointless, as it would effectively mandate that companies never provide the maximum level of encryption, as doing so would risk violating the law.

The draft of the bill was met with a backlash from privacy advocates, electronics and software companies, and many in the public. One petition against the bill already has more than 70,000 signatures — not bad, considering the legislation hasn’t even been formally introduced.

Most importantly, even though the DOJ has been fighting Apple and other companies in court over encryption, the Feinstein-Burr bill failed to get any sort of backing from the White House.

Now, both Feinstein and Burr are telling Reuters that there is no rush to get this bill introduced. Feinstein says she is going to get feedback from additional tech stakeholders on the issue, while Burr merely said, “be patient.”

As Reuters notes, the bill may never be brought forth for serious consideration — at least not during the current administration. Aside from the fact that the present White House doesn’t seem interested in pushing this as a legislative issue, it’s probably not wise for the two senators — both from states with significant high-tech industries — to bite the hands that feed them during an election year.

by Chris Morran via Consumerist