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  • Elaine Soloway’s Hometown Rookie: Synchronized Flopping, Guest Towels And Friends – Floors, Doors or Blocks Away

     Synchronized Flopping

    by Elaine Soloway 

    I am a Jellyfish. My head is hanging heavy like a rock, and my arms and legs are dangling. My eyes are staring at the bottom of the pool, as if there were a mirror directly below me.

    Rachael, my swim instructor, has typed out and sent me this description, along with others designed for her toddler swimmers. I have encased her clues in plastic just as I have done for tips transcribed for me by my Aqua Swim Schools coach, Kathy. Hers include profiles of  Fish, Breast Stroke and Crawl.

    Kathy has taught me how to swim while side breathing. Rachael is teaching me how to float.  Both of these gurus and courses were inspired by times in the water with my children and grandchildren. I wrote “Over My Head” about my experiences last summer in a bay in Provincetown Harbor. This essay was influenced by the recent comedy routine on display in my daughter’s pool.

    And while I will describe my attempts, along with my loved ones’ antics and my lifelong efforts to become a calm and confident swimmer, perhaps you’ll agree that Synchronized Flopping can be a metaphor for Parenting:  sometimes we accomplish it perfectly; i.e. Esther Williams upside down in the water, and resurfacing with her makeup and smile intact. Other times, we are out-of-our-depth, looking foolish, and gasping for air.

    So now, with that considerate allusion, here’s what happened during my five days in the tucked away oasis on the east side of L.A. My daughter’s pool has a shelf, stairs, and a shallow end, which then travels several feet deep. My two daughters and my 20-year-old grandson — knowing my skittishness with water over my head — were using pool noodles (memory foam, unsinkable, buoyant) to show me how easy it was to relax while lying on, straddling, and sprawling atop the colorful cylinders.

    As I watched, with goggles atop my cap, I admired their ease. They closed their eyes to demonstrate 100% relaxation, they chatted casually with one another as evidence of the ability to multitask while prone, and they waved to me to prove that movement on these olive, red, and yellow tubes would not disturb repose. They were so adorable that I had to quell the urge to rush over and kiss their dewy foreheads.

    Thus encouraged and emboldened, I allowed my dear ones to dress me in a noodle. I managed a few seconds of pause, and the minute I attempted a shift to the pool’s edge, over I went.  Each co-conspirator tried placing me in a different position on the noodle, and then fished me out after I tipped over.

    All was not for naught, because my talented, goofy offspring and grandson choreographed a hilarious water ballet that made my mishaps worthwhile. Lining up in trio formation (Oh, why wasn’t there music!), they leaned backward with their noodles horizontal. There they rested, until one gave the cue, “and then she flopped.” With that, in perfect harmony, they capsized.

    From my perch in the shallow end, I watched their pratfalls and laughed so hard that my kin worried about my condition. After confirming I found this funny, rather than humiliating, they repeated the routine until they tired of the joke.

    So now I have new goals:  Jellyfish, Starfish (look up at the sky, further up to my eyebrows, push my hips up, puff out my tummy like I just had Thanksgiving dinner, hold my breath with puffy cheeks, and tilt my body backwards), and Tea Party (jump up with arms at the side —  As I go underwater, raise my arms over my head and out of the water. Sink down until my tush hits the bottom of the pool. Pretend I am sipping tea. Then, use my arms to push myself up above the water.) These are floats and games that may make noodles unnecessary, no matter the depth.

    As for Parenting (remember our metaphor?), I doubt if I’ll ever attain the ease and grace of a synchronized swimmer. Being perfectly in harmony with my family’s needs may at times elude me. But, I’m forever grateful that when I am over my head, my sweet and funny brood will be there to fish me out. 

  • From the GAO*: Religious-Based Hate Crimes; DOJ Needs to Improve Support to Colleges Given Increasing Reports on Campuses

    Religious-based hate crimes are on the rise on America’s college campuses, according to data from the Departments of Education and Justice.

    DOJ offers publications, webpages, and educational activities to help colleges and campus law enforcement monitor and address these crimes. However, much of DOJ’s information is outdated and difficult to find in one place. In addition, many colleges are unaware of what resources are available.

    We recommended that DOJ update, centralize, and share its information to make it easier to use.

    Religious-based Hate Crimes on College Campuses, as Reported to Education and DOJ, 2009-2017

    Line graph showing 189 reports to Education and 59 to DOJ

    • View Highlights

    What GAO Found

    Data from the Departments of Education (Education) and Justice (DOJ) show an increasing number of reported religious-based hate crimes on college campuses during the past decade. While these agencies collect slightly different data, crimes reported to Education have increased from 103 in 2009 to 189 in 2017, and crimes reported to DOJ increased from 24 to 59. These trends were largely driven by increased reports of anti-Jewish and anti-Muslim crimes, according to DOJ data. However, DOJ officials and some stakeholders GAO interviewed said DOJ data likely undercount these crimes due to underreporting. Although no federal agencies collect data on the frequency of religious bias incidents—non-criminal acts motivated by bias against a religious group—representatives of eight of the sixteen stakeholder groups GAO interviewed said the prevalence of these incidents on college campuses is also increasing.

    Incident Reported to Education and DOJ as a Religious-based Hate Crime

    U:Work in ProcessTeamsFY20 ReportsEWIS102983_6GraphicsMaster Graphics FilesFinal ai-tif-ppttifs for proofingFig HL-5 v11_102983.tif

    To prevent and respond to religious-based hate crimes and bias incidents on campuses, stakeholders GAO interviewed said some colleges have encouraged reporting, implemented new policies, and educated students and staff about their effects. Such efforts must be informed by First Amendment considerations at public colleges. Some colleges have also worked to promote religious tolerance, communicate publicly about crimes, and build relationships with religious groups.

  • Kaiser Family Foundation: 300+ FAQs Help Consumers Understand the ACA Marketplaces as Open Enrollment Begins and Closes a Month and Half Later

     woman on track starting point

    Editor’s Note: Although our former company funds part of our health expenses as retirees, not all is covered nor funded. Therefore, we too, have to explore parts of our plan for changing drug coverage, state marketplaces, lowering costs and other aspects.

    Open enrollment for the Federal and most state marketplaces begins Friday, Nov. 1, 2019 and ends on Sunday, Dec. 15, 2019. Organizations assisting consumers are encouraged to link to the FAQ web page. Each question and answer may be shared individually by direct link, via Twitter and Facebook.

    Ahead of the annual Affordable Care Act (ACA) open enrollment period, the time during which consumers can shop for health plans or renew existing coverage, KFF has updated and expanded its searchable collection of more than 300 Frequently Asked Questions about open enrollment, the health insurance marketplaces and the ACA. 

    Designed to help consumers and the navigators, brokers and others who assist them, the FAQs cover a wide range of topics including eligibility for subsidies, requirements for health coverage and information about health plans offered through state ACA marketplaces.

    The updated collection includes a new section addressing the sale of Marketplace plans on private websites, sometimes described as “direct enrollment” sites or “certified enrollment partner” sites, as well as new answers to questions about immigration status and enrollment options for those affected by Hurricane Dorian. 

    More than 180 of the FAQs in the collection are available in Spanish.

    Search the FAQs

    Open enrollment for the Federal and most state marketplaces begins Friday, Nov. 1, 2019 and ends on Sunday, Dec. 15, 2019. Organizations assisting consumers are encouraged to link to the FAQ web page. Each question and answer may be shared individually by direct link, via Twitter and Facebook.

    In addition to the FAQs, KFF also offers short, printable fact sheets on four common scenarios for consumers shopping for health plans:

    KFF’s Health Insurance Marketplace Calculator will soon be updated with 2020 premium data. Visit https://www.kff.org/understanding-health-insurance for KFF’s most current resources for consumers looking for answers about open enrollment, the marketplaces and health insurance in general.

    Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.

  • My Mother’s Cookbook; More Cookies: Frosted Chocolate, Orange Slice, and Sugar Cookies, Coconut Macaroons

    By Margaret Cullisonmacacroons

    When I returned to college after a spring vacation spent in my home town, a girl I knew from New York’s Westchester County asked if I’d had a good time. I gave her my usual response, saying that I’d had fun. She wondered what could be fun about spending spring break in Iowa. I’ve encountered the misconception that nothing much happens in small towns every so often since then and understand how people who haven’t lived in smaller communities might have that impression. The pace is decidedly slower. 

     
    Mom baked regularly, working at the much-used enamel table in the kitchen. When I came home from school in the afternoon to find her there, I’d sit at the table and watch her work, telling her the events of my day. She always made small cookies, dainty enough to serve her friends when they stopped by for impromptu coffee and a chat. Mom also offered cookies and coffee to anyone doing work in the house or yard, and they probably wished for larger cookies! 
     
    Read Margaret Cullison’s article:  http://www.seniorwomen.com/news/index.php/midwest-cookies

    Editor’s Note: We did discern the difference between Macaroons and Macarons at Shari’s Berries: https://www.berries.com/blog/many-differences-macarons-macaroons

  • Justice Ruth Bader Ginsburg’s “brilliance, grace, humor, tact, and unyielding resolve that saw her shatter barriers in the legal world”

    Tyler and GinsburgUS Supreme Court Justice Ruth Bader Ginsburg shares a laugh with Professor Amanda Tyler, her former clerk, during the inaugural Herma Hill Kay Memorial Lecture

    By Andrew Cohen 

    Small in stature but a towering icon, US Supreme Court Justice Ruth Bader Ginsburg was the obvious choice to give Berkeley Law’s inaugural Herma Hill Kay Memorial Lecture. 

    Trailblazers for women in the law and gender equality and co-authors of the first-ever casebook on sex-based discrimination, they were good friends for decades before Kay — a beloved figure who taught for 57 years at Berkeley Law and was its first woman dean — died in 2017. 

    Monday afternoon, before a packed house of Berkeley Law students, faculty, and staff at Zellerbach Hall, Ginsburg described meeting Kay at a 1971 conference on women in the law. “The rest of that decade, Herma was my best and closest working colleague,” she said.

    The justice received spirited standing ovations before and after the event. Dean Erwin Chemerinsky said, “I know it’s cliché to say while introducing someone that the person needs no introduction, but I cannot imagine an instance where it’s more true than this one. After all, this is the first justice in history who is widely publicly known by just initials.”

    UC Berkeley Chancellor Carol Christ called Ginsburg “one of the nation’s most important legal minds” and “a role model for millions.” The university’s provost while Kay was Berkeley Law’s dean from 1992 to 2000, Christ praised her “brilliance, grace, humor, tact, and unyielding resolve that saw her shatter barriers in the legal world.”

    pam_samuelsonProfessor Pamela Samuelson, whose seed gift with her husband Robert Glushko created the annual lecture, said she was “one of many thousands of women” inspired by Kay.

    Together, she said, Ginsburg and Kay (both of whom graduated from law school in 1959) were “part of a small band of outsiders who braved rejection, isolation, and hostility to establish an initial foothold in legal education. They helped pave the way for a proliferation of women lawyers, judges, and law professors … The ground they broke is now well trod and we hold them in our debt.”

    While Kay became a top authority on family law, conflicts of law, and sex-based discrimination soon after joining Berkeley Law in 1960, Ginsburg also became a revered law professor before founding the ACLU Women’s Rights Project and litigating landmark cases. Kay was just the 15th woman tenured law professor in the US and the second at Berkeley Law; Ginsburg was the 19th in the US and the first at Columbia Law School. 

    The primary drafter of California’s Family Law Act of 1969, the nation’s first no-fault divorce law that became a template for similar laws nationwide, Kay “strived to make marriage and divorce safer for women,” Ginsburg said.

    During Ginsburg’s 1993 Supreme Court confirmation hearings, Kay testified on her behalf and said, “I can tell you that her compassion is a deep as her mind is brilliant.” In 2015, Kay received the Association of American Law Schools’ Ruth Bader Ginsburg Lifetime Achievement Award from the justice herself. 

    Soon after giving prepared remarks about Kay, Ginsburg engaged in an hour-long interview with Berkeley Law Professor Amanda Tyler, her former clerk. 

    In addition to Kay’s acumen and achievements, the justice recalled her “sense of style … she had her private pilot’s license and navigated the San Francisco hills in a sleek yellow Jaguar. Herma had a remarkable quality not easily captured in words. There was a certain chemistry in play, something that made you want to be on her side.”  (more…)

  • Chargé d’Affaires William Taylor’s Ukraine Testimony’s Opening Statement and Background

    https://ua.usembassy.gov/our-relationship/our-ambassador/ 

    https://www.nytimes.com/interactive/2019/10/22/us/politics/william-taylor-ukraine-testimony.html?action=click&module=RelatedLinks&pgtype=Article

    William Taylor, Ambassador (ret.)

    William B. Taylor is Chargé d’Affaires, a.i. of the United States Embassy in Kyiv, Ukraine. Most recently, he was the Executive Vice President of the U.S. Institute of Peace. During the Arab Spring, he oversaw assistance and support to Egypt, Tunisia, Libya and Syria at the State Department. He served as the U.S. Ambassador to Ukraine from 2006 to 2009.

    He also served in Jerusalem as the U.S. Government’s representative to the Mideast Quartet, which facilitated the Israeli disengagement from Gaza and parts of the West Bank. He oversaw reconstruction in Iraq from 2004 to 2005, and served in Kabul as coordinator of international and U.S. assistance to Afghanistan from 2002 to 2003. Ambassador Taylor also coordinated U.S. assistance to the former Soviet Union and Eastern Europe. He earlier served on the staff of Senator Bill Bradley.

    He is a graduate of the United States Military Academy at West Point and Harvard University’s Kennedy School of Government and served as an infantry platoon leader and combat company commander in the U.S. Army in Vietnam and Germany.

    He is married with two adult children. 

  • Weekly Legislative Update: Hearings Tuesday for Pregnant Workers Fairness Act and Improving Benefits for Underserved Veterans

    This Week

     Right, Rep. Lydia Velazquez
    Rep. Nydia Velazquez

    Floor Action:
     
    Appropriations — This week, the Senate may consider a package of FY2020 spending bills yet to be determined.
     
    Small Business —  On Monday, the House [was] scheduled to consider H.R. 4405, the Women’s Business Centers Improvement Act, and H.R. 4406, the Small Business Development Centers Improvement Act.
     
    1. H.R. 4406 – Small Business Development Centers Improvement Act of 2019, as amended (Rep. Golden – Small Business)
    2. H.R. 4405 – Women’s Business Centers Improvements Act of 2019 (Rep. Davids – Small Business)
    3. H.R. 4407 – SCORE for Small Business Act of 2019 (Rep. Hern – Small Business)
    4. H.R. 4387 – To establish Growth Accelerator Fund Competition within the Small Business Administration, and for other purposes (Rep. Espaillat – Small Business)

    Floor Schedule and Procedure:

    Suspensions (4 bills):

    1. H.R. 4406 – Small Business Development Centers Improvement Act of 2019, as amended (Rep. Golden – Small Business)

    This bill amends the Small Business Act to improve the small business development centers program by authorizing the program for four years, requiring annual reporting, reducing burdens related outreach and awareness, and enhancing collaboration with the agency.

    1. H.R. 4405 – Women’s Business Centers Improvements Act of 2019 (Rep. Davids – Small Business)

      This bill amends the Small Business Act to modernize and strengthen the women’s business centers program by authorizing the program for four years, increasing reporting requirements, and updating and streamlining program requirements.

    3. H.R. 4407 – SCORE for Small Business Act of 2019 (Rep. Hern – Small Business)

    This bill amends the Small Business Act to strengthen the SCORE program to improve accounting, measure program performance, expand reporting and accountability, and authorize the program for three years.

    1. H.R. 4387 – To establish Growth Accelerator Fund Competition within the Small Business Administration, and for other purposes (Rep. Espaillat – Small Business)

      This bill amends the Small Business Act to establish the Growth Accelerator Fund Competition program for four years.

    Editor’s Note: The House reconvened in the afternoon:
    3:29:53 P.M.   The House convened, returning from a recess continuing the legislative day of October 21.
    3:30:05 P.M.   The Speaker announced that votes on suspensions, if ordered, will be postponed until a time to be announced.
    3:30:18 P.M. H.R. 4406 Ms. Velazquez moved to suspend the rules and pass the bill, as amended. H.R. 4406 — “To amend the Small Business Act to improve the small business development centers program, and for other purposes.”
    3:30:28 P.M. H.R. 4406 Considered under suspension of the rules.
    3:30:30 P.M. H.R. 4406 DEBATE – The House proceeded with forty minutes of debate on H.R. 4406.
    3:43:12 P.M. H.R. 4406 At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.
    3:43:38 P.M. H.R. 4405 Ms. Velazquez moved to suspend the rules and pass the bill. H.R. 4405 — “To amend the Small Business Act to improve the women’s business center program, and for other purposes.”
    3:43:48 P.M. H.R. 4405 Considered under suspension of the rules.
    3:43:49 P.M. H.R. 4405 DEBATE – The House proceeded with forty minutes of debate on H.R. 4405.
    4:02:25 P.M. H.R. 4405 On motion to suspend the rules and pass the bill Agreed to by voice vote.
    4:02:27 P.M. H.R. 4405 Motion to reconsider laid on the table Agreed to without objection.
    4:02:56 P.M. H.R. 4407 Ms. Velazquez moved to suspend the rules and pass the bill. H.R. 4407 — “To amend the Small Business Act to reauthorize the SCORE program, and for other purposes.”
    4:03:08 P.M. H.R. 4407 Considered under suspension of the rules.
    4:03:09 P.M. H.R. 4407 DEBATE – The House proceeded with forty minutes of debate on H.R. 4407.
         

  • From the CDC (Centers for Disease Control and Prevention) For the Public: What You Need to Know About Vaping

     Lung injury
     
    Español (Spanish)

    Symptoms of Lung Injury Reported by Some Patients in This Outbreak
    • Patients in this investigation have reported symptoms such as:
      • cough, shortness of breath, or chest pain
      • nausea, vomiting, abdominal pain, or diarrhea
      • fatigue, fever, or weight loss
    • Some patients have reported that their symptoms developed over a few days, while others have reported that their symptoms developed over several weeks. A lung infection does not appear to be causing the symptoms.

    If you have questions about CDC’s investigation into the lung injuries associated with use of electronic cigarette, or vaping, products, contact CDC-INFO or call 1-800-232-4636.

    On This Page

    Recommendations
    • At present, CDC recommends that people:
      • Should not use e-cigarette, or vaping, products that contain THC.
      • Should not buy any type of e-cigarette, or vaping products, particularly those containing THC, off the street.
      • Should not modify or add any substances to e-cigarette, or vaping, products that are not intended by the manufacturer, including products purchased through retail establishments.
    • Exclusive use of nicotine containing products has been reported by some patients with lung injury cases, and many patients with lung injury report combined use of THC- and nicotine-containing products. Therefore, the possibility that nicotine-containing products play a role in this outbreak cannot be excluded.
    • At present, CDC continues to recommend that people consider refraining from using e-cigarette, or vaping, products that contain nicotine.
    • If you are an adult using e-cigarettes, or vaping, products to quit cigarette smoking, do not return to smoking cigarettes. Use evidence-based treatments, including healthcare provider counseling and FDA approved medicationspdf iconexternal icon.

    If you have recently used an e-cigarette, or vaping, product, see a healthcare provider immediately if you develop symptoms like those reported in this outbreak.

    If you use e-cigarette, or vaping, products, you should:

    • Not buy any type of e-cigarette, or vaping products, particularly those containing THC, off the street and not modify or add any substances to e-cigarette, or vaping, products that are not intended by the manufacturer, including products purchased through retail establishments.
    • See a healthcare provider right away if you have symptoms like those reported in this outbreak.

    If you are an adult who is trying to quit smoking:

    • Contact your healthcare provider if you need help quitting tobacco products, including e-cigarettes.
    • Use evidence-based treatments, including counseling and FDA-approved medicationsexternal icon.

    If you are an adult using e-cigarettes, or vaping, products to quit cigarette smoking, do not return to smoking cigarettes. Use evidence-based treatments, including healthcare provider counseling and FDA approved medicationspdf iconexternal icon. If you continue to use e-cigarettes or vaping, products carefully monitor yourself for symptoms and see a healthcare provider right away if you have symptoms like those reported in this outbreak.

    If you are an adult who is addicted to marijuana:

    • Effective treatments are available and recovery is possible.
    • A number of therapy-based treatments such as cognitive-behavioral therapy, contingency management, motivational enhancement therapy, and multi-dimensional family therapy have been shown to help people who are addicted to marijuana.
    • Visit the Substance Abuse and Mental Health Services Administration’s treatment locatorexternal icon to find treatment in your area, or call 1-800-662-HELP (4357).

    If you are a teen or young adult who is trying to quit nicotine or marijuana:

    If you are concerned about your health after using an e-cigarette, or vaping, product, contact your health care provider, or you can also call your local poison control center at 1-800-222-1222.

    Regardless of this investigation, CDC recommends:

  • James Tissot: Fashion & Faith: “A painting by Mr. Tissot will be enough for the archeologists of the future to reconstruct our era.”

     Ball on shipboard

    James Tissot, “The Ball on Shipboard,” ca. 1874. Oil on canvas. Tate Britain Image courtesy of the Fine Arts Museums of San Francisco

    James Tissot: Fashion & Faith; Legion of Honor, From  October 12, 2019 – February 9, 2020

    “A painting by Mr. [James] Tissot will be enough for the archeologists of the future to reconstruct our era.” — Élie Roy, “Salon de 1869,” L’Artiste 40 (July 1869)

     James Tissot (1836–1902) was one of the most celebrated French artists during the 19th century, yet he is less known than many of his contemporaries today. Presenting new scholarship on the artist’s oeuvre, technique, and remarkable life,  James Tissot: Fashion & Faith provides a critical reassessment of Tissot through a 21st-century lens. The exhibition, co-organized by the Fine Arts Museums of San Francisco and the Musées d’Orsay et de l’Orangerie, Paris, includes approximately 60 paintings in addition to drawings, prints, photographs, and cloisonné enamels, demonstrating the breadth of the artist’s skills. The presentation at the Legion of Honor is the first major international exhibition on Tissot in two decades and the first ever on the West Coast of the United States.

    “The work of James Tissot provides a fascinating lens onto society at the dawn of the modern era. Long recognized as a keen observer of contemporary life and fashion, this exhibition brings new light to his narrative strengths and his skill in portraying the emotional and spiritual undercurrents that exist below surface appearances,” states Thomas P. Campbell, Director and CEO of the Fine Arts Museums of San Francisco. “Continuing the Fine Arts Museums’ tradition of contributing original scholarship around key works in our collection, we are thrilled to introduce the perspective of this enigmatic, prolific artist in the first exhibition of his work to take place on the West Coast.”Holy Day

    James Tissot, French, 1836–1902 “Holyday” (The Picnic), ca. 1876. Oil on canvas.  Tate Image provided courtesy of the Fine Arts Museums of San Francisco

    Tissot’s works have been highly sought after for US collections, and, as such, James Tissot: Fashion & Faith draws from the rich holdings of the Fine Arts Museums of San Francisco; the J. Paul Getty Museum, Los Angeles; the National Gallery of Art, Washington, DC; and numerous private collections, in addition to private and public collections throughout Europe and Canada, including those of Tate, London; the Musées d’Orsay et de l’Orangerie; the Petit Palais, Musée des Beaux-Arts de la Ville de Paris; the Musée d’Arts de Nantes; the National Gallery of Canada, Ottawa; and the Musée des Beaux-Arts de Montréal. In addition, new findings on Tissot’s materials and painting technique — resulting from an extensive, unprecedented study of Tissot paintings and led by the paintings conservation department at the Fine Arts Museums — are revealed in the exhibition. 

  • Vincristine Shortage – Update and Action To the Childhood Cancer Community

    Editor’s Note: We do not have anyone in our family or friends (at the moment) who are personally affected by this shortage. However, we felt that this story in The New York Times on page A21 of our San Francisco printed version should have wider distribution. 

    https://pubchem.ncbi.nlm.nih.gov/compound/Vincristine

    NIH image of Vincristine

    October 16, 2019 

    As Chair of the Children’s Oncology Group (COG), I am sending this letter to the childhood cancer community to share information we have related to the current vincristine drug shortage, summarize steps we understand are being taken to help resolve the shortage, and to propose an approach that would benefit from an advocacy effort to help address the ongoing challenge of drug shortages that directly impact children with cancer.

    Vincristine Shortage

    At the beginning of October, pharmacists at COG member institutions raised concerns about the ability to obtain vincristine. COG quickly contacted Pfizer/Hospira, now the sole supplier of vincristine in the United States, and was told that Pfizer/Hospira was experiencing a shortage of drug due to a manufacturing delay. (The other supplier of vincristine in the US, Teva Pharmaceuticals, made a “business decision” and stopped supplying drug to the US in July of 2019.) COG then contacted Captain Valerie Jensen, RPh, Associate Director of the Drug Shortages Staff at the FDA, to share this information. She reported that FDA had been contacted by Pfizer/Hospira, were exploring the drug shortage and had started working on potential solutions. An FDA update this morning stated that Pfizer/Hospira now expects vincristine distribution to resume by the end of October. We are hopeful that this distribution will help avert more patients not being able to receive drug as scheduled.

    Members of the Children’s Oncology Group strongly believe that every child with cancer whose treatment requires vincristine should receive the drug as scheduled, and that a situation that requires rationing of drug is unacceptable. We and others have had longstanding concerns about the impact of drugs shortages for children with cancer, and believe that while legislation enacted in July of 2012 with Title X of the Food and Drug Administration Safety and Innovation Act (FDASIA) was helpful and important, it did not address key underlying factors that lead to shortages. We are greatly concerned that some children are already being impacted by this shortage and by the understandable anxiety this creates for all families of children with cancer. We have previously published guidelines to help physicians who may be forced to ration drug about approaches to consider, along with steps hospitals can take to minimize the impact of a drug shortage. To emphasize again, we find the situation forced upon pediatric oncologists and families of children with cancer unacceptable (see call to action below) but welcome the news that drug distribution should be resuming soon.