Dec 1, 2021 - Podcasts

The new travel bans

The World Health Organization yesterday advised people 60 or older to postpone any travel because of the new COVID-19 variant, Omicron. The new strain was first identified in South Africa and may have originated there or Botswana, which has led to many countries — including the U.S. — banning travelers from that part of the world.

  • Plus, what Congress has to do this month.
  • And, ER doctors’ role in prescribing drugs to prevent opioid overdoses.

Guests: Axios' Bryan Walsh and Alayna Treene; Dr. Keith Kocher, emergency physician at University of Michigan Health in Ann Arbor.

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, Alex Sugiura, Sabeena Singhani, Lydia McMullen-Laird, Michael Hanf, and David Toledo. 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 Wednesday December 1st

I’m Niala Boodhoo.

Here’s how we’re making you smarter today: what Congress has to do this month. Plus, ER doctors’ role in prescribing drugs to prevent opioid overdoses.

But first, today’s One Big Thing: the new travel bans.

The World Health Organization yesterday advised people 60 or older to postpone any travel because of the new Covid-19 variant, Omicron. The new strain was first identified in South Africa and may have originated there or Botswana - which has led to many countries - including the US to ban travelers from that part of the world. We wanted to check in with Axios’ Bryan Walsh to find out how effective these travel restrictions really are. Hey, Bryan.


NIALA: So the US has banned travel from eight countries in Southern Africa. Meanwhile, Israel has completely closed their borders to everyone. And I think a lot of people are asking whether or not these travel bans work, but is that even the right question to ask?

BRYAN: I'm not sure it is quite the right question to ask because if you're asking, will these keep this variant out of the United States or other countries that are doing travel bans right now? The answer is almost certainly no. In fact, it's likely here already, it just hasn't yet been identified but there is an argument to be made that it can slow it down.

NIALA: So you're saying that travel bands can be productive in the sense of slowing things down because buying time before we know what we're dealing with is really kind of the goal here.

BRYAN: Yeah, I think in that particular case, and what also matters really is what you do next. If you leave this ban in place for weeks and weeks, months and months, even after it becomes clear this variant has made it to the U S and is spreading here, that doesn't make sense.

That's harming the countries that are being banned. That's unfair but in this very short period of time when we're all essentially waiting for scientists to do the work to figure out the full nature of this virus - yes, I think there's some logic to it. It's, it's hard to know how much of what we're seeing is we're looking more, or some countries have greater capacity to actually find these, which South Africa does. So when you see the fact that there are many cases in South Africa that doesn't automatically mean there are more cases there than anywhere else.

It could just be, they got a jumpstart on finding it. They alerted the world, which is exactly what they're supposed to do. These are very blunt instruments, travel bans. I understand why they seem very unfair but this seemed like a reasonable move to make at least to buy you some time. The question then of course, is what do you do with that time?

NIALA: Bryan, I wanted to ask you something that you and I were talking about before we were recording this conversation, which is that you said you're frustrated when people say these bans are counter-productive. Why does that frustrate you?

BRYAN: We have learned over the 18 months of the pandemic, that controlling movement of people across borders can be a tool to slow or prevent COVID. Now the question is how big are those bans going to be? You look at a country like Australia or New Zealand. What they did to really keep COVID out of their countries was to really shut down, travel almost altogether. The U.S. is not doing that. There should be some lessons learned here on the part of the public health community. It was always the gospel that you don't do travel bans, they’re counter-productive. I don't think we conclude that to the same degree. And when you hear people saying that, I wonder to some degree where they've been the last 18 months.

NIALA: Axios’ Bryan Walsh. Thanks, Bryan.

BRYAN: Thank you.

NIALA: We’ll be back in 15 seconds with the looming deadlines for lawmakers on Capitol Hill.

[ad break]

NIALA: Welcome back to Axios Today! I’m Niala Boodhoo. It’s the first day of the last month of the year - which means members of Congress who have been delaying important action on government funding for months are now facing a real crunch. Here to break it down for us is Axios congressional reporter Alayna Treene.

Alayna, what deadlines are coming up for congress in December?

ALAYNA TREENE: The first one that we'll see is midnight on December 3rd, this is Friday, government funding runs out. It looks like there is going to be some sort of short-term funding agreement that will get them out of this pickle and push the can further down the road. But that's the first big deadline. The next is December 15th. That's the date that treasury secretary Janet Yellen set as the deadline for which they need to raise the debt limit or risk defaulting on their funds. Some economists say that it might be more late December or into January. The other two deadlines are December 31st. So one of them is Chuck Schumer's soft deadline to pass Biden's Build Back Better package. We'll see if they actually make that, it's looking like it might be, um, tough to pull that off by the 31st. And then also Congress must pass the national defense authorization act to the NDAA by December 31st as well. That funds the military and our defense capabilities. And we're seeing some of the haggling and negotiations heat up this week in the Senate.

NIALA: That’s Axios congressional reporter Alayna Treene.

A few weeks ago, we talked about the record number of drug overdose deaths in the U.S. and how to make those numbers lower. One way is by increasing access to two potentially life-saving medications naloxone, and buprenorphine, which you might also know by Suboxone.

But a new study led by Michigan medicine found that less than 10% of patients treated for opioid overdoses in emergency rooms receive those medications before they leave the hospital. Dr. Keith Kocher is one of the authors of the study in an emergency physician at University of Michigan Health in Ann Arbor.

Dr. Kocher, thanks for being here. You work in the ER, and you've seen some of this firsthand. I know when someone comes to an ER visit having overdosed, you call it a sentinel event. Can you explain why?

DR. KOCHER: You know, one of the things that I think makes me think about this as sentinel events is about 1% of patients after they leave the emergency department with an overdose and are discharged home die within a month and about 5% die within a year. And this is a key opportunity to really reduce the harms from those with opioid use disorder and prevent those deaths. And this is a, a key point of intervention for us the health systems, in this moment of vulnerability, to help these kinds of patients when they need it.

NIALA: But your research found that it's actually pretty rare that people are prescribed this. Why do you think that's the case?

DR. KOCHER: Some of it has to do with stigma. I think this is a disease that we still don't prioritize relative to other problems like we do in more common kinds of illnesses. One of the things we did to provide some context for the numbers being so surprisingly low was we also looked at a analogy kind of problem that we see. So patients with anaphylaxis, so basically a severe allergic reaction, you come into the emergency room, and look to see how frequently they received or prescribed an antidote for their allergic reaction in the future are called epinephrine also called an epi pen. And we found that it was about half the time that those patients received that medication within 30 days. That's not acondition or a medical problem that is really stigmatized at all, relative to somebody with opioid use disorder.

NIALA: Do you feel like the epi pen analogy is completely fair because an epi pen you just have to use once. I mean, it is expensive, but you have it, but if you go into an electric shock, you just have to use it once. It's pretty easy to administer. That's not how naloxone or suboxone work.

DR. KOCHER: I would say it's pretty similar to how naloxone works. They both need to be give when somebody, suffering the medical problem, I guess one difference maybe is that an epi pen frequently can be given by yourself, versus naloxone oftentimes you have to rely on somebody else to give it. So a lot of times, you know, it's important to have naloxone within the kind of social circles that people who use drugs use drugs are, um, using drugs. But I think the analogy works pretty well in serving that context. You can both die from it, um, you need that medication pretty immediately, to prevent that.

NIALA: That's Michigan medicine’s Dr. Keith Kocher. Thank you, Dr. Kocher.

DR. KOCHER: You're welcome.

NIALA: One last thing - anytime I can talk about Rihanna you can be sure she will be included in this podcast.

RIHANNA: The people - y'all are the true heroes of Barbados. And I take y'all with me wherever I go.

NIALA: That’s Rihanna yesterday at a ceremony where Barbados officially cut ties with Queen Elizabeth. The island not only swore in their first president, Sandra Mason, they also declared Rihanna a national hero.

The ceremony was held 55 years to the day since the Caribbean nation gained full independence - but had kept the British monarchy in a ceremonial role.

That’s all we’ve got for you today!

You can reach our team at podcasts at axios dot com or reach out to me on twitter. You can also text me at (202) 918-4893.

I’m Niala Boodhoo - thanks for listening - stay safe and we’ll see you back here tomorrow morning.

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