News from the USA, United States of America

Source: 132nd Maine State Legislature
H.P. 1123
Dale: April 17, 2025
URL:
https://legislature.maine.gov/legis/bills/getPDF.asp?paper=HP1123&item=1&snum=132


FIRST SPECIAL SESSION-202
-------------------------
An Act to Encourage Continuing Education Relating to Certain
Infection-associated Chronic Conditions for Physicians and Nurses

Reference to the Committee on Health Coverage, Insurance and Financial
Services suggested and ordered printed.

Presented by Representative RANA of Bangor.
Cosponsored by Senator STEWART of Aroostook and Representatives: JULIA
of Waterville, MATHIESON of Kittery, ROEDER of Bangor, Senators: BAILEY
of York, INGWERSEN of York

Be it enacted by the People of the State of Maine as follows:

(...)

Sec. 1. 32 MRSA paragraph 2158 is enacted to read:
Paragraph 2158. Medical education relating to infection-associated
chronic conditions
The board shall encourage a licensee or applicant for relicensure under
this chapter to attend continuing education, including continuing
education required for licensure of an advanced practice registered
nurse, relating to infection-associated chronic conditions, including
long COVID, chronic Lyme disease, myalgic encephalomyelitis, postural
orthostatic tachycardia syndrome and dysautonomia.

(...)


Sec. 2. 32 MRSA paragraph 2581, as amended by PL 2017, c. 189, paragraph
1, is further amended by enacting at the end a new paragraph to read:
The board shall encourage a licensee or applicant for relicensure to
attend continuing education approved by the board under this section
relating to infection-associated chronic conditions, including long
COVID, chronic Lyme disease, myalgic encephalomyelitis, postural
orthostatic tachycardia syndrome and dysautonomia.

(...)

Sec. 3. 32 MRSA paragraph 3280-A, sub-paragraph 5 is enacted to read:
5. Continuing medical education relating to infection-associated
chronic conditions. The board shall encourage a licensee to attend
continuing medical education under subsection 2, paragraph B, relating
to infection-associated chronic conditions, including long COVID,
chronic Lyme disease, myalgic encephalomyelitis, postural orthostatic
tachycardia syndrome and dysautonomia.

(...)


SUMMARY

This bill requires the Board of Osteopathic Licensure, the Board of
Licensure in Medicine and the State Board of Nursing to encourage
licensees and applicants for relicensure to attend continuing education
relating to infection-associated chronic conditions, including long
COVID, chronic Lyme disease, myalgic encephalomyelitis, postural
orthostatic tachycardia syndrome and dysautonomia.
 
MedPage Today Special Report: Medical Journals Get Letters From DOJ

— At least three journals received letters from a U.S. Attorney asking about "competing viewpoints"

A federal prosecutor sent a letter to a medical journal editor, probing whether the publication is "partisan" when it comes to "various scientific debates."

Edward R. Martin Jr., U.S. Attorney for the District of Columbia, sent a list of questions to CHEST Editor-in-Chief Peter Mazzone, MD, MPH, of the Cleveland Clinic, asking how the journal handles "misinformation" and "competing viewpoints," among other things.

"It has been brought to my attention that more and more journals and publications like CHEST Journal are conceding that they are partisans in various scientific debates," the letter stated.

Martin's letter asks five questions, including how the journal assesses its "responsibilities to protect the public from misinformation," and how it "clearly articulates to the public when you have certain viewpoints that are influenced by your ongoing relations with supporters, funders, advertisers, and others."

It also asks whether the journal accepts manuscripts from "competing viewpoints" as well as how it assesses the role of "funding organizations like the National Institutes of Health in the development of submitted articles."

Finally, it asks how the journal handles allegations that authors "may have misled their readers."

"I am also interested to know if publishers, journals, and organizations with which you work are adjusting their method of acceptance of competing viewpoints," Martin wrote. "Are there new norms being developed and offered?"

Adam Gaffney[*], MD, MPH, a pulmonary and critical care physician at Cambridge Health Alliance in Massachusetts, said the letter "should send a chill down the spine of scientists and physicians."

"It is yet another example of the Trump administration's effort to control academic inquiry and stifle scientific discourse -- an administration, it warrants mentioning, that has embraced medical misinformation and pseudoscience to reckless effect," Gaffney said in an email to MedPage Today. "Journal editors should join together and publicly renounce this as yet more thinly guised anti-science political blackmail."

---
* Adam Gaffney a frequent social media commenter noted here - and not in a good way.
 
4/21/25 - "Docology with Dr. Howard Zucker - Ian Lipkin interview"

Excerpts from a 40 minute sit-down with Ian Lipkin below

Lipkin: “Myalgic Encephalomyelitis….it is a crippling disorder...the irony is that over the past five years, we've come so close to be able to talk about clinical trials that would help these people...we got some support from the Hutchinson Family Foundation and then more recently from the NIH. Losing that means that I can't do any work because the university won't let me do work on this project because it's not funded anymore and we were told to stop working on the project."

Question from audience: "Can you clarify where the funding status currently sits between Columbia's ME/CFS Center for Solutions and the Trump administration freeze?"

Lipkin: "The answer is we don't know. The communication breakdown has been quite extraordinary. So my institution has a sponsored project administration - tells me that the grant has been terminated, and then when I call my Program Officer at NIH, she tells me that she has no record of that. So, it’s like the right hand doesn’t know what the left hand is doing. What I do know is that I cannot work on that project, with the exception of a piece of it. Fortunately, I have a benefactor, a donor, who is funding one of the people in our group to continue to work on that. And it's really, it's really exciting - I mean, it's been years that we've been trying to get out of the force. And I think we're finally there.

So, I will tell you that what I find the most interesting is that it looks as though there's some sort of a trigger for innate immunity. Innate immunity is sort of the early immune system. It actually precedes things like antibodies, T-cells and NK cells. Any sort of a microbial exposure triggers the innate immune system to activate, and that gives you the problems that you have. Now, with some of these viruses that we think are implicated, they also do direct damage to mitochondria…So Herpes viruses particularly have the ability to fragment these mitochondria inside the cells. So, with this information in hand, we were poised to do a final set of experiments and make some very specific proposals for what the control clinical trials should be. But that's all stopped. So, if anybody here online has any way of breaking through that logjam, please do.

As you know, we don't we don't have diagnostic tests, and we don't have the treatment. This is insane. I think we could. We should."

Question from audience: "Dr. Lipkin, in a Fierce Biotech report it was stated that the Columbia ME/CFS team recently submitted a paper for publication that suggests certain approved drugs could possibly be repurposed for ME - will this publication be visible at some point to the public and community?"

Lipkin: "It will. So, we want to get it into a major periodical, because we think that that's the best way to have an impact, particularly as the drugs we're talking about, we have to convince people to invest in, right? But the answer is, absolutely, we intend to publish that, no question. I'm sorry for the delay."
 
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4/22/25, Health Affairs: 'Addressing The Long COVID Quandary'

By Michael S. Sinha & Monica Verduzco-Gutierrez

'As COVID-19 cases continue in the United States, waves of newly disabled people are now fighting for recognition and access to health care, largely on their own. Anthony Fauci, MD, characterized Long COVID as an “insidious” public health emergency affecting millions of people.'

'While Long COVID presents new challenges, its pathophysiology is not entirely novel. Other infection-associated chronic conditions such as myalgic encephalomyelitis/chronic fatigue syndrome, postural orthostatic tachycardia syndrome, chronic Epstein-Barr virus, and post-treatment Lyme disease syndrome often arise after an infection and present with heterogenous symptoms.'

'With millions of people experiencing post-COVID impairments, the need for a dramatic scale-up of health care services has never been more urgent.'

Proposal: The Long COVID Recover Strong Initiative (LCRSI)

'Following the blueprint of the hugely impactful Ryan White HIV/AIDS Program, a federal Long COVID program is necessary to promote, develop, and enhance comprehensive multidisciplinary Long COVID clinics with clinicians trained in infection-associated chronic care..'

'Like the Ryan White HIV/AIDS program, the Long COVID Recover Strong Initiative (LCRSI) would provide accessible health care services and improve quality of care, particularly for underserved, rural, vulnerable, or minoritized populations who are disproportionately impacted by Long COVID.'

'Long COVID remains a major public health issue that demands urgent attention'
 
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Northwestern: 'Post-treatment Lyme disease syndrome may be driven by remnants of infection'

'Researchers learn why the body may continue to respond to an invisible threat long after bacterial death'

'Lyme’s post-infection features share some similarities to long COVID-19 and could be due to lingering antigens'

'This matches one theory behind the underlying causes of long COVID-19 in that persisting viral molecules may encourage a strong, albeit unnecessary, immune response, said bacteriologist Brandon L. Jutras.'

“Lyme and long COVID-19 are clearly vastly different diseases, but it’s possible that they share a more general mechanism of inappropriate inflammation caused by remnants of a previous infection,” said Jutras, who led the research. “The maladaptive response is a product of an infection, but perhaps not necessarily an active one in all cases.”

----

Report from STAT News on study here.

"Proal said it’s possible the antigens are being actively produced by bacteria lingering in hidden reservoirs, as is the case with the SARS-CoV-2 virus in long Covid."

"In both studies, the scientists used mouse models to explore unique chemical components that persist in the roughly 15% of people who don’t recover from Lyme infections and go on to develop a syndrome similar to other infection-associated illnesses, including long Covid. One study tracked antigens among the bacterial remnants that travel to the liver, and the other study screened more than 500 approved antibiotics to find one that may be safer and more effective at a lower dose than standard-of-care doxycycline."

Thread here: Peptidoglycan of Borrelia burgdorferi can persist in discrete tissues and cause systemic responses consistent with chronic illness, McClune et al,2025
 
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Western University: 'Global clinical trial to test existing drugs as long COVID treatments'

'Western and Schmidt Initiative for Long Covid will enroll more than 300 patients across four continents’

'The trial, funded by SILC, will examine whether upadacitinib and pirfenidone – approved for treating arthritis and lung disease, respectively – can be repurposed to reduce or eliminate symptoms of long COVID.'

'The drugs were identified by an earlier SILC-funded study that, over the past 18 months, examined over 5,400 blood proteins from 1,028 participants with and without long COVID and found 13 common biological pathways for the progression of the disease. Upadacitinib and pirfenidone were identified using artificial intelligence as two existing drugs that could interrupt several of those pathways.’

'Researchers will track five symptoms – fatigue, breathing issues, memory and thinking problems, muscle and joint aches and circulation – to determine which is most severe in each patient. Researchers will investigate the two drugs versus placebos for the first three months, perform an analysis, and then monitor participants for an additional three months.'

Thread here: Global clinical trial to test existing drugs as long COVID treatments
 
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Harvard T.H. Chan School of Public Health: "A long COVID researcher continues to search for answers"

'Beth Stelson, postdoctoral research fellow in the Department of Epidemiology, long COVID researcher, and herself a patient, discusses her research and the ramifications of the office’s closure (HHS Office of Long Covid Research and Practice).'

'We’ve made huge headway in understanding the pathophysiology of how this condition can develop and have uncovered similarities with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and dysautonomia, which are also conditions that are often overlooked in health care'

'I’d like to see more investment in clinical trials to test treatments. We also need to invest in long-term cohorts so we can study patients over time.'

'..it feels like a kick in the gut to have it closed at a time when we have really put long COVID on the map as a condition and as a health care and public health crisis. We need more awareness around long COVID, not less.'
 
The Lancet Editorial Supporting medical science in the USA

Peter Marks, the former head of the FDA's Center for Biologics Evaluation and Research, said in his March 28 resignation letter that “It has become clear that truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies.” Calls for Kennedy's resignation are growing. The Executive Director of the American Public Health Association, Georges Benjamin, called for Kennedy's resignation or removal on April 9. The Treatment Action Group and Doctors for America have also called for him to go. Given Kennedy's support for the gutting of the NIH, CDC, and FDA, alongside his espousal of unscientific treatments and theories, The Lancet joins Benjamin's call for Kennedy's resignation.
 
(10 minute documentary) 4/26/25, 'Invisible - Life With Long COVID'

'For millions of Americans, the pandemic is not a thing of the past. With limited answers, debilitating consequences, and threats to funding, long COVID continues to hamper the lives..rendering them virtually invisible..'

Produced by: Henry Bova, Lauren Salemo, Renée Nearing

Special thank you to: Jill Fitzgerald, Julie Sullivan, David Systrom, M.D., Ellen Alden and Jody Santos, our instructor

From Producer below (on LinkedIn)

Text: "All semester long, Lauren Salemo, Renee Nearing, and I have been working on a documentary about an issue near and dear to my heart: the plight of long COVID patients. We drove around Massachusetts interviewing doctors, experts, and people who have had their lives upended by the chronic condition to uncover what complicating factors continue to undermine successful treatments, from mysteries about the disease itself to funding threats. I'm proud to say that our 10-minute-long documentary, "INVISIBLE," is now available to watch on YouTube.

The three of us would like to thank all the wonderful people we spoke with: david systrom, Julie Sullivan, Ellen Alden, and Jill Fitzgerald. We would also like to thank our instructor, Jody Santos, who was immeasurably helpful throughout the process, as well as our classmates, who offered well-tuned feedback to help us shape our final cut."
 

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In Austin, Texas, we've had 2 measles cases recently, 1, an unvaccinated infant, and the other, a vaccinated adult man. For this 2nd case, the local news has provided a list of places he went to recently before getting diagnosed.

Texas now has 646 cases of measles since late January of this year.
 
4/28/25, Long COVID Clinical Podcast: “Innovative Research with Dr. Amal Amer”

‘..Andrew Schamess and Anita Chopra discuss recent research on Long COVID at Ohio State University. They are joined by Dr. Amal Amer, a Professor of Microbial Infection and Immunity, and Dr. Heba Amer, who works in Dr. Amal's lab. Dr. Amal shares her personal experience with Long COVID and details her research on the inflammasome and caspase-4/11, proteins linked to severe inflammation and cognitive issues in Long COVID.'

Dr. Amer: “I thought I recovered, but when I went back to work, I realized I couldn’t understand the papers that I had to read. I couldn’t put my ideas together..or type an email..when my students were presenting their data, I couldn’t follow..I realized something was really wrong.."

Dr. Amer: "It feels like the cytokines have gone rogue..."

Host: "What are you able to tell us about your findings so far?"

Dr. Heba Amer: "What I believe that I can say, using the experiment designs that we've laid out, we have been able to see and prove that Long COVID mice really do have very, very distinctive differences in their behavior and their cognitive functions than mice who have never been to exposed to Long COVID...we're pretty excited about our findings so far, and we hope to get it published relatively soon.."

Dr. Amal Amer: "I think this is a major finding in the field....you lose the ability to do sequential steps in your brain to achieve something...this is what this amazing machine does, so the mouse has to do sequential steps...we focused on sequential thinking, remembering...even in the mouse model, you can see they cannot process sequential thinking and deep thinking to achieve something...I hope this paper will help researchers everywhere..."

Host: "..one of the great mysteries in post-COVID, is what is happening now? Why are these symptoms still persisting and what the pathophysiology is...it is so frustrating to be speaking with someone dealing with these symptoms and not have a firm answer...I think the solution for this illness is to nail down the pathophysiology..."

Dr. Amal Amer: "..we are fortunate in Ohio State there are several biobanks, many of them were collecting samples during the pandemic, we have a lot of samples of the acute form...for the samples of Long COVID...there was a huge initiative from the NIH to collect samples from acute and Long COVID patients and they have thousands of samples...you can apply for these samples to continue the work your doing..."
 
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Bangor Daily News: 'Maine bill offer better recognition and treatment of post-infection related illnesses'

By Kristi Woods, a resident of Augusta.

"..in Maine, there is a big move being made towards change. The Maine Legislature is reviewing LD 1688: An Act to Encourage Continuing Education Relating to Certain Infection-Associated Chronic Conditions for Physicians and Nurses.This bill does not cost any government funding but will bring a spotlight to long neglected conditions such as postural orthostatic tachycardia syndrome (POTS), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and chronic Lyme in addition to the more recent phenomenon of long COVID. For those who are suffering from these diseases, getting diagnosed in this state is extremely challenging."
 
Sharing two recent provider resources produced by MDH’s (MN Dept. of Health) Long COVID Guiding Council below for sight (both uploaded on 4/28/25)

1) Minnesota Dept. of Health, Long COVID Guiding Council: 'Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Informational Tool for Primary Care Providers"

'Activity management strategies that incorporate scheduled, regular increases in activity (such as graded exercise therapy) are not recommended.'

'Thank you to Dr. Stephanie Grach of Mayo Clinic for lead authorship of this document, and work group members, Dr. Ravindra Ganesh of Mayo Clinic and Dr. Bazak Sharon, Independent Consultant, and the Long COVID Guiding Council for their review and input. Special thank you to the members of MEAction Network and the members of the MN Chapter of MEAction for their review and helpful feedback.'

2) Minnesota Dept. of Health, Long COVID Guiding Council: 'Update from the Field: Low Dose Naltrexone for Treatment of Long COVID'

'Naltrexone may suppress cytokines and other pro-inflammatory factors acting on microglia, astrocytes and which are known to promote nociception, allodynia, and hyperalgesia. Furthermore, transient receptor potential melastatin 3 (TRMP3) restoration via LDN has been suggested as a mechanism for regulating abnormal natural killer cell function. Based on the neuroinflammatory mechanisms of Long COVID, LDN therefore presents an opportunity for potential management in at least a subgroup of patients. It is also being explored in related conditions such as myalgic encephalomyelitis and autoimmune conditions such as inflammatory bowel disease.'

The work group members included:
• Stephanie Grach, MD, MBBS, Mayo Clinic
• Ravindra Ganesh, MD, MBBS, Mayo Clinic
• Bazak Sharon, MD, Independent Consultant

'This project is funded through the State of Minnesota'
 
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Nebraska Public Media: 'Long-COVID research funding was pulled, then brought back. Patients say the research is vital'

'It made people like Jen Robinson feel stressed, forgotten and frustrated'

“It's already been five years...it's discouraging.”

“It was like my body was out of my control. I was no longer in charge of it. It was just going haywire, and I couldn't stop it,” she said.

'And it’s because of people like Robinson sharing their experiences that funding was eventually restored for some grants to continue researching the chronic illness, according to Meighan Stone.'
 
Wall Street Journal: 'How to Lead a Chronic Disease Revolution'

'Washington has an opportunity to help tens of millions'

By Akiko Iwasaki & Harlan Krumholz

'Millions of Americans struggle with debilitating fatigue, cognitive difficulties and heart palpitations—symptoms of what is called long Covid.'

'Postinfection syndromes aren’t unique to Covid. Such conditions as myalgic encephalomyelitis/chronic fatigue syndrome and chronic Lyme disease also leave patients grappling with life-altering symptoms after an infection. What sets long Covid apart is the scientific momentum and patient advocacy it has generated to study infections’ long-term effects.'

'Advancing this research is one of the most effective ways to improve the lives of the tens of millions of Americans with chronic diseases.'
 
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