Aug 6, 2021 - Podcasts

The opioid crisis and HIV outbreaks in West Virginia

The CDC has called the HIV outbreak in West Virginia's Kanawha County the most concerning HIV outbreak in the entire U.S. associated with injection drug use. This week, the CDC issued a report on how to manage the outbreak, but its recommendations are almost impossible to implement because of current local laws.

  • Plus, Biden gets tough with GOP governors on COVID.
  • And, lab-grown salmon is coming to a sushi bar near you.

Guests: Mountain State Spotlight’s Lauren Peace and Axios' Margaret Talev and Bryan Walsh.

Credits: Axios Today is produced in partnership with Pushkin Industries. The team includes Niala Boodhoo, Sara Kehaulani Goo, Dan Bobkoff, Alexandra Botti, Nuria Marquez Martinez, Sabeena Singhani, and Alex Sugiura. Music is composed by Evan Viola. You can reach us at [email protected] You can text questions, comments and story ideas to Niala as a text or voice memo to 202-918-4893.

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NIALA BOODHOO: Good morning! Welcome to Axios Today!

It’s Friday, August 6th. I’m Niala Boodhoo.

Here’s what you need to know today: Biden gets tough with GOP governors on Covid. Plus, lab-grown salmon coming to a sushi bar near you.

But first, today’s One Big Thing: how the opioid crisis is fueling HIV outbreaks in West Virginia and beyond.

One of our listeners, Lucas from Charleston, West Virginia texted me recently about a local outbreak of HIV in his town. Earlier this year, the CDC called this outbreak, in Charleston, Kanawha County the most concerning HIV outbreak in the entire U.S. associated with injection drug use.

This week the CDC issued a report on how to manage this outbreak, but their recommendations are almost impossible to implement because of current local laws. Lucas suggested we speak with Mountain State Spotlight’s public health reporter, Lauren Peace who’s been covering what’s happening in West Virginia - so we called her up! Hi Lauren.

LAUREN PEACE: Hi, thanks so much for having me.

NIALA: So what does the CDC recommending in their report that they put out this week?

LAUREN: They were called into town, earlier this summer to address the outbreak in Charleston, in West Virginia’s capital city where 72 new cases of HIV linked to injection drug use have been identified. To put that in perspective, a city of Charleston’s size, and a county the size of Kanawha in a typical year in the U.S. would have fewer than one new cases of HIV linked to injection drug use. One of the number one recommendations that came in this report was to increase access to sterile needles for people who inject drugs. But because of the legislation that was passed, that's not currently an option.

NIALA: Lauren, can you tell us when this HIV outbreak first started?

LAUREN: So, it's actually kind of the result of a closure of a harm reduction program which offered clean needle services or syringe access services to people who inject drugs between 2015 and 2018. So the harm reduction program run by the health department in Charleston became highly politicized during a race for city mayor in 2018. There was a lot of misinformation about the program at the time that it was operating, and it ultimately closed. Without access to sterile syringes, we started to see cases of HIV linked to injection drug use rise.

NIALA: What you're saying is that the opioid crisis and the lack of needle exchange has now led to this HIV outbreak?

LAUREN: Absolutely. These programs are also a really major provider of Naloxone which is an overdose reversal medication. During this last year, because of the pandemic, we've seen overdose deaths surge. 2020 was actually the most deadly year for overdoses in West Virginia.

NIALA: And is this happening in other cities across the U.S.?

LAUREN: Yeah, not long after Charleston City Council passed its ordinance restricting these programs, Atlantic City lawmakers actually voted to shut down their syringe service program. As did Scott County, Indiana and Scott County, Indiana was ground zero for HIV outbreaks linked to injection drug use in 2015. The response to that outbreak at the time was to increase access to sterile needles and six years later they're backtracking.

There's some irony in the middle of a pandemic, right? We, over the past year have seen the importance of taking preventative measures to prevent the spread of harmful and dangerous and costly disease and as stigma results in the closure of programs that epidemiologists have been advocating for for years, we're going to see our neighbors get really sick when they don't have to.

NIALA: Lauren Peace is a public health reporter at the non-profit civic news organization in West Virginia, The Mountain State Spotlight. Thanks Lauren.

LAUREN: Thank you so much for having me, I appreciate it.

NIALA: If you have a local story you think the whole country needs to know about, you can text me at 202-918-4893.

We’ll be back in 15 seconds with the biggest politics stories of the week, with Margaret Talev.

[ad break]

NIALA: Welcome back to Axios Today. I'm Niala Boodhoo and it's Friday which means we have some of the biggest political stories of the week for you with none other than Margaret Talev. Hey, Margaret.


NIALA: Let's start with Joe Biden facing off with different GOP governors on COVID. This has been going on for a while, but the rhetoric really ratched up between Florida Governor DeSantis and President Biden this week. Is it going to make any difference?

MARGARET: I think the numbers are part of what's going to make the difference, the rise in the cases, and the other thing that's going to make the difference are individual businesses where we're beginning to see employers impose these mandates. But Biden's tough talk message is not just about trying to appeal to donors or, pre-game a 2024 presidential race. It's also really about getting results in the face of a mounting crisis.

NIALA: On the other side of Pennsylvania Avenue, Congress in particular, the Senate has been very busy on infrastructure. What's the latest with that?

MARGARET: The Senate is now poised to move forward with final passage on this $1.2 trillion bipartisan plan that we've been talking about for so many weeks. When that happens, it will be a huge victory for Democrats and for President Biden. But we all know that this hits a buzzsaw in the House almost immediately, and almost certainly, that progressives will attack it. And that if Democrats need to act unilaterally to save it, they're poised to do so.

NIALA: Speaking of progressives, Margaret, at the beginning of the week, we were talking about a rare rift in the Democratic party with President Biden over the eviction moratorium. The Biden administration said very pointedly that they could not find a legal way to delay it, but then they did.

MARGARET: It's really interesting. I think the way we've often thought about the progressives and Democratic politics is that they're great at raising money. They're great at inspiring the base but they're not as good at getting things done. And what we saw this week is a real reversal of that notion where we saw progressives continue to lose in some Democratic primaries, but really to absolutely get stuff done from a policy perspective, namely Cori Bush, who you know once upon a time was homeless and who mounted this very successful galvanizing sort of national protest on the steps of the Capitol, right, camping out. We saw the president himself say let's pull together legal experts, figure out another way. It was a real change of heart that was absolutely prompted by pressure from Democratic progressives.

NIALA: Axios’ managing editor of politics, Margaret Talev. Thanks, Margaret.

MARGARET: Thanks so much.

NIALA: As someone who doesn't eat red meat, I have become a big fan of the impossible burger and beyond sausages, which is why I wanted to talk to Axios’ future correspondent, Bryan Walsh about his latest story on startups that are getting close to selling fish grown in lab-like facilities. Bryan, how does this work?

BRYAN WALSH: So, essentially you take fish cells in this case from a salmon fish, and you're able to sort of grow it in these, as you said, lab-like facilities in tanks, directing these cells to grow into fat tissue, into muscle tissue, into everything that goes into essentially a fish filet. It looks like a block of a fish filet, a block of salmon filet. You just produce the part of the fish that you actually want.

NIALA: How did it taste?

BRYAN: It tasted really well. Like I thought it tasted, like, I would say like a B+ sushi dinner, like not the best sushi I've ever had, but a lot better than sort of your standard neighborhood take out. And it's quite remarkable, I have to say and there's something really special about seafood here because we are having a real over-fishing problem.

So if we can shift some of that production from farms and wild caught fish to something that can be made within a facility, that can be cultivated, that's not just an improvement for the environment, but that's a real conservation win as well.

NIALA: Could we see this in supermarkets in the near future?

BRYAN: It's going to take a little time both to get the price down, at this point, it's still much more expensive than either wild-caught or farmed fish and the FDA still has to approve it fully for commercial consumption. But actually this company, Wild Type - If you're in San Francisco, they're going to be opening up a sushi bar in their facility where they actually grow it. They're working with sushi chefs in San Francisco and elsewhere in the U.S. to kind of introduce consumers to this new sort of technology.

NIALA: Axios’ Bryan Walsh, one of the authors of the What's Next newsletter and our future correspondent. Thanks for being with us.

BRYAN: Thank you.

NIALA: That’s all for this week. Axios Today is brought to you by Axios and Pushkin Industries.

We’re produced by Alexandra Botti, Nuria Marquez Martinez, and Sabeena Singhani. Our sound engineer is Alex Sugiura. Dan Bobkoff is our Executive Producer. Sara Kayheanli Goo is our Executive Editor. And special thanks Axios co-founder Mike Allen.

I’m Niala Boodhoo. Have a great weekend.

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