LANSING, Mich. -- Some patients with the coronavirus experience upset stomachs, and diarrhea, as the first signs of illness, according to a new study conducted in China.

This group of patients had mild cases of the virus overall with respiratory problems showing up later, according to Dr. Brennan Spiegel, co-editor in chief of the American Journal of Gastroenterology, which published the study.

Spiegel says symptoms such as nausea and vomiting are common, often related to stress and anxiety, and it's best to do a reality check before jumping to conclusions that you have the virus.

"Just because I have diarrhea does not mean at all that I have COVID," he states. "In fact, I almost certainly don't have it if that's all you have is diarrhea. It's really a matter of trying to understand that this is one more piece of the puzzle and we're slowly trying to fill that puzzle in as we gain this new information."

The study will help doctors make better diagnoses as COVID-19 cases in states such as Michigan continue to surge.

Detroit, especially, is the center of one of the worst outbreaks in the nation, with more than 5,500 patients and more than 200 deaths.

This is the second study from China with the same findings. They're significant because folks without classic symptoms of COVID-19, such as cough, fever and shortness of breath, may go undiagnosed and could potentially spread the illness to others, Spiegel says.

But he points out that there is concern that if testing is suddenly expanded to include gastrointestinal symptoms, the demand will outstrip the supply.

"In contrast, if somebody has new-onset diarrhea and fever and they are concerned they've had a contact with somebody who's COVID-19 positive, that for me would be enough to consider testing even if they have not yet developed respiratory symptoms. But that is not yet a CDC guideline."

The study included 117 coronavirus patients. Almost 60% percent had diarrhea and 20% experienced it as a first symptom. About a third of patients with digestive symptoms never experienced a fever.


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Montana's expanded Medicaid program is set to expire next year. People who rely on it are calling on lawmakers for an extension but opponents argued Medicaid was never meant to be a long-term option for most people.

The Montana Legislature voted during its last session to expand the state's Medicaid program to cover an additional 85,000 people.

Megan Martin, a small-business owner and mother in Helena who relies on Medicaid, said she is out of health care options if the state does not extend it.

"I have looked and have been told that I could get health care off of our federal marketplace, which I don't qualify for," Martin explained. "That's terrifying because I don't make a ton of money, being a small-business owner. So, not having any other option is scary."

Gov. Greg Gianforte has not been clear on whether he supports an expansion but has said Medicaid should be a temporary program to help people get back on their feet. Data from KFF Health News show 9% fewer Montanans are covered under Medicaid now than before the pandemic.

Montana's Medicaid expansion is largely funded under the federal Affordable Care Act but is administered by the state, which is why expansion takes a legislative vote. Martin pointed out like many Montanans, she is working multiple jobs just to keep up with her family's cost of living, let alone being able to afford health care.

"How many more jobs do I have to get? How much more hustling do I have to do? How much more money do I have to put in my pocket, in order to make sure that we're all healthy?," Martin asked. "Nobody should have to worry about that, at the end of the day."

The Legislature is scheduled to consider extending the Medicaid expansion when lawmakers convene in January.


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A recent foodborne illness outbreak linked to deli meats is putting the spotlight on how these foods are regulated.

The listeria outbreak in Boar's Head products has led to 10 deaths and at least 59 people sickened across the country.

Jovana Kovacevic, associate professor of food science and technology at Oregon State University, said it is important to know listeria is prevalent in the natural environment. Kovacevic pointed out the United States has a zero-tolerance testing system for listeria, which is different from other countries and, counterintuitively, might do more harm than good than a system testing for certain levels of the bacteria.

"It would encourage industry to sample more," Kovacevic asserted. "And once they find positives, it would help them act before the food becomes contaminated and before any contaminated foods end up in the commerce."

Kovacevic pointed out listeria is most harmful for vulnerable populations, such as pregnant people, older people and those with compromised immune systems. Members of Congress recently wrote a letter to the U.S. Department of Agriculture over its concern that the agency wasn't able to prevent the outbreak.

But Kovacevic noted there has been progress on how the USDA and the Food and Drug Administration, which also monitors food safety in some situations, prevent foodborne illnesses. Still, she argued there is room for improvement.

"Standardizing our approach to listeria probably we would benefit from it," Kovacevic contended. "Consumers would benefit and the industry would benefit in terms of having the ability to look openly for listeria as opposed to fearing if they find any positive what's going to happen."

Kovacevic added there are ways consumers can prevent outbreaks, such as storing meats at the proper temperatures and cooking them thoroughly.

"There's just certain foods that are higher risk foods," Kovacevic explained. "If you're in that vulnerable group, you want to avoid those foods. So, we really need to do better to engage consumers in these discussions."


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The Missouri Foundation for Health has released two reports that reveal significant obstacles Missourians face in accessing affordable health care. The first report from "Speak Up MO" covers Missourians' health-care experiences, while the second, "Medical Debt in Missouri," focuses on policy solutions. The findings highlight disparities in access to care and the financial burden of rising healthcare costs. Alarming statistics show one in five Missourians reported being without health insurance at some point in the past year.

Samantha Bunk, health policy strategist with the Missouri Foundation for Health, warned the high cost of health care is causing further hardships for Missourians.

"When you can't afford your health care, obviously that can affect things like if you can afford your housing, your basic needs, food, paying your bills, things like that - and then when we get into talking about medical debt, which was the other report, that can always have effect in other ways as well," she explained.

22% of Missourians report struggling to secure a car loan, and one in five face difficulties when applying for an apartment or mortgage. The foundation plans to work on resolving the challenges with evidence-based policies and by working closely with communities.

The reports reveal that about two-thirds of respondents found accessing physical health care "very" or "somewhat easy." However, the findings highlight disparities across different groups, with women, LGBTQ+ individuals and people with disabilities reporting more significant difficulties in receiving the care they need. Bunk noted that rural residents encounter the biggest obstacles in accessing affordable health care.

"There are obviously fewer health-care facilities, one issue having to travel longer distances -- and then when it comes to medical debts, we also reported higher rates of medical debt with our polling as well," she comtinued.

The foundation is set to release its next report on economic well-being and personal finances, with a follow-up on civic engagement expected later this fall.