Friday, October 21, 2022 – Kaiser Health News

Kaiser Health News Original Stories
Texas Revamps ‘Active-Shooter’ Drills at K-12 Schools to Minimize Trauma
School lockdown drills are designed to prepare students for violent threats. But for some students, especially those with special needs, the drills can trigger or exacerbate mental health problems. Texas is taking a step toward balancing safety and mental health with new regulations around how the drills are conducted. “If some kids are coming away traumatized or we’re magnifying existing trauma, we’re not moving in the right direction,” one expert says. (Renuka Rayasam and Colleen DeGuzman, )
Labor Tries City-by-City Push in California for $25 Minimum Wage at Private Medical Facilities
Service Employees International Union-United Healthcare Workers West is testing the waters on a $25 minimum wage for support staff at health care facilities in Southern California. Opposition from hospitals and health facilities is driving an expensive battle. (Rachel Bluth, )
Awaiting Voters’ Decision on Abortion, When Medicine and Politics Collide
As Michigan and several other states await voters’ verdicts on ballot measures about abortion, the providers, patients, and activists on both sides strategize their next steps. (Andrea King Collier, )
KHN’s ‘What the Health?’: Biden Hits the Road to Sell Democrats’ Record
With the midterm elections rapidly approaching, President Joe Biden has taken to the road to convince voters that he and congressional Democrats have delivered for them during two years in power. Among the health issues highlighted by the administration this week are pandemic preparedness and the availability of over-the-counter hearing aids. The president also promised to sign a bill codifying the abortion protections of Roe v. Wade if Democrats maintain control of the House and Senate — even though it’s a long shot that there will be enough votes for that. Sarah Karlin-Smith of the Pink Sheet, Sandhya Raman of CQ Roll Call, and Mary Agnes Carey of KHN join KHN’s Julie Rovner to discuss these topics and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too. ( )
Political Cartoon: 'Half-Life Crisis?'
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Half-Life Crisis?'" by Bob and Tom Thaves.
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This contest goes up in smoke
at the strike of 5!
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Vaccines and Covid Treatments
CDC Vaccine Advisers Vote To Add Covid Shot To Pediatric Schedule
The Advisory Committee on Immunization Practices unanimously voted in favor of including the covid vaccine on the list of routine immunizations that doctors follow when recommending vaccinations and that schools consult when setting requirements.
Axios: CDC Panel Votes To Add COVID Shots To Immunization Schedule
Advisers to the Centers for Disease Control and Prevention on Thursday unanimously voted to add COVID-19 vaccines to the 2023 schedule of childhood and adult immunizations. (Moreno and Dreher, 10/20)
CIDRAP: ACIP Adds COVID Vaccine To Pediatric Immunization Schedule
The vote came a day after ACIP approved adding COVID vaccines to the Vaccines for Children (VFC) program, which provides free vaccines to children who don't have health insurance or who can't afford them. (10/20)
AP: Panel Votes To Add COVID Shots To Recommended Vaccinations
The expert panel’s decisions are almost always adopted by the CDC director and then sent to doctors as part of the government’s advice on how to prevent disease. State and local officials often look to the lists in making decisions about vaccination requirements for school attendance, but local officials don’t always adopt every recommendation. Flu and HPV shots, for example, aren’t required by many schools. (Stobbe, 10/20)
Politico: CDC Advisers Recommend Adding Covid Shots To Routine Immunization Schedules For Kids, Adults
“This doesn’t represent new recommendations. This represents sort of a summary of existing recommendations,” said advisory panel member Matthew Daley, a senior investigator at the Institute for Health Research at Kaiser Permanente Colorado. “But I will acknowledge … there is symbolism in adding Covid-19 to the childhood immunization schedule, and that symbolism is that we view this as routine and that we view this as Covid is here to stay.” (Gardner, 10/20)
Florida’s governor says his state’s schools won’t require shots —
Politico: DeSantis Says Florida Won't Mandate Covid-19 Vaccines For Kids Following CDC Panel's Recommendation
"We will make sure that your freedom to make those decisions on behalf of your kids remains intact in the state of Florida, regardless of what the CDC does,” DeSantis said during a press conference in Fort Myers. “There are probably many, many more, who've watched how the CDC has performed since Covid and understand there's a lot of political ideology that has seeped into this.” (Sarkissian, 10/20)
And stirring online controversy —
The Hill: Megyn Kelly Faces Backlash Over COVID Tweet
“A scary # of kids are dying after taking the Covid vax — from myocarditis among other injuries,” Kelly wrote in her post on Wednesday afternoon. “HOW DARE THE CDC ADD THIS TO ITS LIST OF SCHOOL VACCINATIONS? Don’t listen. Be v careful w/ your teenage boys in partic but girls too. These are not honest brokers. This is dangerous!” (Mastrangelo, 10/20)
Meanwhile, a winter covid surge is anticipated, and RSV is rising —
San Francisco Chronicle: 90% Odds For A Winter Wave, Epidemiologist Says
Dr. Katelyn Jetelina, the founder and author of the Your Local Epidemiologist newsletter, says it is “90% likely” that the U.S. will see a winter COVID-19 wave. (Vaziri, 10/20)
The Atlantic: What Europe’s COVID Wave Means For The U.S.
The U.S. may not be far behind. America’s COVID numbers are falling when aggregated across the country, but this isn’t true in every region. The decline is largely driven by trends in California, says Samuel Scarpino, the vice president of pathogen surveillance at the Rockefeller Foundation’s Pandemic Prevention Initiative. In chillier New England, hospitalization numbers have already ticked up by as much as nearly 30 percent, and more virus is showing up in wastewater, too. (Zhang, 10/20)
The Hill: Children’s Hospitals, Overflowing With Respiratory Patients, Consider Calling National Guard
“We just don’t have as many critical care beds [for children] as we have adult critical care beds simply because we don’t usually need them,” said Dr. Juan Salazar, physician in chief of Connecticut Children’s Medical Center. Cases began spiking in early September and rose exponentially, he said, which is something he’s never seen before. (Masciadrelli and Martichoux, 10/20)
Reproductive Health
Pentagon To Fund Abortion Travel For Service Members And Families
Defense Secretary Lloyd Austin issued a series of policies Thursday aimed at shoring up access to reproductive health care for troops and their dependents. The moves include paying travel costs for families assigned to states that restrict abortion, extending the time a pregnancy must be disclosed, and adding privacy protections.
AP: Pentagon To Provide Funds, Help For Troops Seeking Abortions
The Pentagon will provide travel funds and support for troops and their dependents who seek abortions but are based in states where they are now illegal, according to a new department policy released Thursday. The military will also increase privacy protections for those seeking care. The order issued by Defense Secretary Lloyd Austin outlines the rights and protections service members and their dependents will have regardless of where they are based, which was a key concern of troops after the Supreme Court overturned Roe v. Wade in June. (Copp, 10/20)
Politico: Pentagon Will Pay For Service Members To Travel For Abortions
“Our Service members and their families are often required to travel or move to meet our staffing, operational, and training requirements. Such moves should not limit their access to reproductive health care,” Austin wrote. The “practical effects of recent changes” will ultimately hurt military readiness, Austin wrote, referring to the Supreme Court’s June decision to strike down Roe v. Wade. (Seligman, 10/20)
President Biden made his own move to support abortion rights —
Axios: First Look: Biden Backs Federal Fund For Abortion Support
President Biden would support a federal fund for people who need to take time off work and pay for childcare to obtain an abortion, he said in an interview forum with NowThis that will air Sunday on social media. (Fischer, 10/20)
In news from Arizona —
The 19th: Abortion In Arizona: Back-And-Forth Decisions On State Laws Create Confusion
When the Supreme Court overturned Roe v. Wade on June 24, almost every clinic in Arizona immediately stopped providing abortions, worried that a ban passed in 1864 might now outlaw the procedure entirely. Over the next three and a half months, the laws would bounce from court to court as different judges offered different interpretations of the right to abortion in Arizona and whether clinics could provide any abortions at all. (Luthra, 10/20)
Also —
KHN: Awaiting Voters’ Decision On Abortion, When Medicine And Politics Collide
The fight over abortion is steaming toward a political resolution across the state as activists, policymakers, politicians, providers, and would-be-patients eye the Nov. 8 election. Voters will decide on Proposal 3, which, if approved, would install protections for a woman’s right to have an abortion in the Michigan Constitution. (King Collier, 10/21)
Drugmakers Seeking Some Relief On New Medicare Rules
The Inflation Reduction Act, which allows Medicare to negotiate the prices of some drugs, was strongly opposed by drugmakers and one of their very rare losses on Capitol Hill. They are now hoping to help influence the Biden administration as it sets the regulations from the new law.
The Wall Street Journal: Drugmakers Look To Limit Medicare’s New Power To Negotiate Lower Drug Prices
Drugmakers are trying to blunt Medicare’s newfound power to negotiate medicine prices while coping with internal industry disputes and ebbing influence in Washington, D.C. Under the Inflation Reduction Act, Congress gave Medicare, the country’s biggest buyer of prescription drugs, the authority to negotiate how much it pays for certain high-price therapies, and to get rebates on treatments whose prices rise more than the rate of inflation. (Hopkins, 10/20)
Stat: Medicare Will Soon Cap Drug Spending. There’s No Limit For Hospital Bills
By 2025, people on Medicare who take expensive medications will feel significant financial relief: They will not have to pay more than $2,000 in a year for all of their drugs. But the 35 million people who are enrolled in the traditional Medicare program still won’t have that same relief anytime soon for their hospital, outpatient, home health, and nursing home care, leaving them exposed to potentially unlimited costs if they become seriously ill and don’t have supplemental coverage. (Herman, 10/21)
Meanwhile, Ohio and Kentucky make some changes to Medicaid, the federal-state programs for people with low-incomes —
Columbus Dispatch: Ohio Rolls Out Single Pharmacy Benefit Manager
Advocates say having a single pharmacy benefit manager will prevent millions of taxpayer dollars from being overcharged. The launch is arguably the most-watched recent reform to Medicaid, which provides government-funded health care for nearly 3 million low-income people ‒ or nearly 1 in 4 Ohioans. (Wu, 10/20)
AP: Kentucky Offers Expanded Medicaid Health Coverage For Adults
Gov. Andy Beshear on Thursday extended Medicaid coverage for dental, vision and hearing care to hundreds of thousands of Kentucky adults, saying the sweeping initiative will remove some of the health-related obstacles keeping people from getting jobs. (Schreiner, 10/20)
Capitol Watch
Obamacare Takes A Back Seat In Midterm Campaign
After a decade of pledging to "repeal and replace" the Affordable Care Act, Republicans this year are not talking much about the health law. Meanwhile, efforts at the CDC to improve responses to crises are lagging.
Axios: ACA Is MIA From Campaign Fights For First Time In More Than A Decade
The Affordable Care Act, a trigger point in political campaigns for more than a decade, has been conspicuously absent from debates and campaign rhetoric this year. The question is how much that's depriving Democrats of a valuable talking point. (Knight and Solender, 10/21)
Politico: Republicans Look To Obamacare's 'Family Glitch' Fix For Post-Midterm Fight
House Republicans on Thursday asked the Treasury Department to preserve documents related to the administration’s fix of Obamacare's “family glitch,” preparing for an investigation of what they claim was an "illegal expansion" of health coverage should the GOP regain control of the chamber in the midterms. (Payne, 10/20)
As the president speaks on the matter, data show voters care about health costs —
Axios: Poll: Voters May Cross Party Lines For Lower Health Care Costs
Almost 40% of Americans are willing to split their ticket and vote for a candidate from the opposing party who made a top priority of lowering health costs, according to a Gallup/West Health poll published Thursday. (Knight, 10/20)
The Hill: Biden Says Oz Is For ‘Undoing Everything We Have Done’
Biden also jabbed at the GOP for its stance on healthcare, lamenting that “not a single Republican” voted in favor of his administration’s attempts to lower prescription drug prices. “They want to get rid of or fundamentally change Social Security and Medicare,” Biden said of Republicans. (Folmar, 10/20)
Reform at the Centers for Disease Control and Prevention hits snags —
Politico: ‘No Quick Fixes’: Walensky’s Push For Change At CDC Meets Reality
The CDC’s new push to get information about health crises out faster to Americans is already running up against its limited authority, congressional inaction and the agency’s own entrenched culture. (Mahr and Banco, 10/21)
Also —
The Hill: Ocasio-Cortez Fires Back At Pence: ‘Absolutely No One Wants To Hear What Your Plan Is For Their Uterus’
Rep. Alexandria Ocasio-Cortez (D-N.Y.) shot back at Mike Pence on Wednesday night after the former vice president said Republican majorities in Congress will protect the right to life, telling Pence on Twitter, “Absolutely no one wants to hear what your plan is for their uterus.” (Schnell, 10/20)
The New York Times: Herschel Walker Calls His Mental Illness Cured. Experts Say It’s Not So Simple
But experts say Mr. Walker’s assertion that he has “overcome” the disorder is simplistic at best: Like other mental illnesses, dissociative identity disorder cannot be cured in the classic sense. Psychiatrists say that while patients can learn to manage this disorder — and even live symptom-free for extended periods — the symptoms can recur, often triggered by stress. (Stolberg, 10/20)
KHN: KHN’s ‘What The Health?’: Biden Hits The Road To Sell Democrats’ Record
With the midterm elections rapidly approaching, President Joe Biden has taken to the road to convince voters that he and congressional Democrats have delivered for them during two years in power. (10/20)
Public Health
Gas Stoves Can Emit Cancer-Causing Benzene, Even When Off: Study
The potential dangers of natural gas in homes mount as researchers find that stoves and pipes in California homes leak toxic pollutants, even when not in use. The concentrations of detected benzene — a chemical linked to cancer — was as high as seven times the state's safety levels.
NBC News: Gas Stoves Can Leak Chemicals Linked To Cancer, Evidence Shows
A study published Thursday in the journal Environmental Science and Technology found at least 12 hazardous air pollutants emitted from gas stoves in California, including benzene — a chemical known to cause cancer in some people with long-term exposure. (Bendix, 10/20)
The New York Times: Researchers Find Benzene And Other Dangers In Gas Piped To California Homes
The gas that is piped into millions of California homes contains hazardous air pollutants including benzene, a chemical linked to cancer, a new study found. The researchers estimated that each year California gas appliances and infrastructure leak the same amount of benzene as is emitted by nearly 60,000 cars, but these leaks are unaccounted for in the state’s records. (Shao, 10/20)
Los Angeles Magazine: Pipes And Stoves In California Homes Are Spewing Carcinogenic Gas
According to the scientists, “Unburned natural gas emissions from household appliances, even while they are off, have the potential to be a health-relevant source of benzene in indoor air.” It grows darker still. “Additionally, we found that NG leakage from stoves and ovens while not in use can result in indoor benzene concentrations that can exceed the California Office of Environmental Health Hazard Assessment 8-h Reference Exposure Level of 0.94 [parts per billion per volume]─benzene concentrations comparable to environmental tobacco smoke.” (Spiegelman, 10/20)
Mental Health
Workplace Issues Hurt Mental, Physical Health: Surgeon General
Media outlets report on words from U.S. Surgeon General Dr. Vivek Murthy concerning risks to workers' health from unhappy workplace environments. Separately, Murthy's efforts to tackle youth mental health are facing stiff criticism, but efforts to tackle military suicides are working.
Stat: Surgeon General: Workplaces Take A Toll On Health
Your job can be hazardous to your health, according to a new report from the U.S. Surgeon General that highlights how the Covid-19 pandemic has revealed fractures in working Americans’ mental health and well-being. (Cooney, 10/20)
The Wall Street Journal: Toxic Workplaces Are Bad For Mental And Physical Health, Surgeon General Says
“Toxic workplaces are harmful to workers—to their mental health, and it turns out, to their physical health as well,” Dr. Murthy said. The surgeon general’s guidance on the role of the workplace in well-being comes as many workers report work stress and difficulty concentrating. Meanwhile, companies have stepped up spending on mental-health and well-being benefits in recent years. (Ellis, 10/20)
Meanwhile, on youth mental health —
Politico: As Murphy Prioritizes Youth Mental Health, Lawmakers And Advocates Blast His Plan To Defund School-Based Services
“This is not a modernization or expansion of the current model. It’s an elimination of the current model,” James Earle, superintendent of Trenton Public Schools, told lawmakers Wednesday during at a virtual meeting of the Joint Committee on the Public Schools. The administration’s proposed plan, Earle said, “pulls services away from schools and therefore it creates barriers to access that the original model was designed to eliminate.” (Sitrin, 10/20)
On mental health matters in the military —
AP: Military Suicides Drop As Leaders Push New Programs
Suicides across the active duty U.S. military decreased over the past 18 months, driven by sharp drops in the Air Force and Marine Corps last year and a similar decline among Army soldiers during the first six months of this year, according to a new Pentagon report and preliminary data for 2022. (Baldor, 10/20)
Health Industry
Pfizer To Soon Quadruple Price Of Covid Shots In US
Prices will rise to about $110 to $130 per dose after the current United States government's current purchase program expires, Reuters reports. Meanwhile, pressure on drugmakers to widen access to medicines comes even as Novartis says it will allow some generic leukemia drug production.
Reuters: Pfizer Expects To Hike U.S. COVID Vaccine Price To $110-$130 Per Dose
Pfizer Inc expects to roughly quadruple the price of its COVID-19 vaccine to about $110 to $130 per dose after the United States government's current purchase program expires, Pfizer executive Angela Lukin said on Thursday. (Erman, 10/21)
In news on pharmaceutical companies and drug accessibility —
Stat: Major Investors Press Drugmakers To Widen Access To Medicines
Three dozen institutional investors are urging the boards at several of the world’s largest pharmaceutical companies to establish concrete metrics for linking executive compensation with policies that widen access to medicines to low- and middle-income countries. (Silverman, 10/20)
Bloomberg: Novartis Allows Generic Leukemia Drug Production In Seven Nations
Novartis AG agreed to allow generic drugmakers in seven middle-income nations to produce a leukemia treatment, the first time a voluntary license has been granted for a patented cancer drug as part of a public health initiative. (Sguazzin, 10/20)
Stat: Novartis To License Cancer Drug To Low- And Middle-Income Countries
Amid a push to widen access to medicines to poor countries, Novartis has reached an agreement to license one of its best-selling cancer treatments so that generic manufacturers can produce copies for distribution to 44 low- and middle-income nations. (Silverman, 10/20)
On clinical trials —
Stat: Supporting Family Caregivers Would Improve Clinical Trials
During the Covid-19 pandemic, America’s 53 million family caregivers gained some long overdue recognition for their vital role as unpaid extenders of an under-resourced health care workforce. The clinical trial enterprise, however, has yet to appreciate caregivers — and fully engage them — as critical partners in recruiting and supporting people who are older, disabled, or have Alzheimer’s disease, cancer, or other chronic medical conditions for research studies. (Sharon Inouye and Jason Resendez, 10/21)
And in other industry news —
Reuters: U.S. Justice Dept Seeks More Details On $8 Bln CVS-Signify Health Deal
The U.S. Department of Justice has asked for more details on CVS Health Corp's proposed $8 billion deal to buy Signify Health, in a possible indication that the companies face a longer deal investigation rather than a quick approval. (10/20)
The Boston Globe: Coalition Urges Federal Officials To Put New Research Agency In Mass.
A group of universities, hospitals, and life science companies is ramping up its efforts to persuade federal officials to locate a new federal health research agency in Massachusetts. The Coalition for Health Advances & Research in Massachusetts released a letter on Thursday with some 80 signatories stating that the state has the “density of resources” necessary for the Advanced Research Projects Agency for Health, aka ARPA-H. (10/20)
Politico: Industry Blasts EPA Plan For 'Forever Chemicals' Crackdown
While the organizations said they supported EPA's commitment to cleaning up sites polluted with per- and polyfluoroalkyl substances, they balked at the agency's plans to use the Comprehensive Environmental Response, Compensation and Liability Act to target the two most notorious compounds. EPA is currently in the process of designating PFOA and PFOS as hazardous substances under the law, which will allow regulators to recoup major costs from polluters. (Crunden, 10/20)
Reuters: Indivior Partner Dodges Monopoly Claims Over Opioid Treatment Drug
Specialty pharmaceutical company Aquestive Therapeutics Inc has escaped a lawsuit by a group of 42 states accusing it of helping Indivior Inc use illegal tactics to shield its opioid addiction treatment Suboxone from generic competition. (Pierson, 10/20)
Data Breach Exposed Health Info Of 3 Million In Illinois, Wisconsin
Up to 3 million patients may have had personal information exposed to outside companies thanks to a data tracking issue at Advocate Aurora Health. Separately, a new study suggests to minimize impacts on public health, health conspiracy theories online should be debunked in real time.
AP: Health System Discloses Breach Tied To Online Data Tracker
Personal health information of up to 3 million patients in Illinois and Wisconsin may have been exposed to outside companies through tracking technology used on a large hospital system’s electronic health records website. (Foody, 10/20)
Chicago Tribune: Advocate Data Breach Affects As Many As 3 Million
A data breach at hospital system giant Advocate Aurora Health may have exposed the information of as many as 3 million patients who use its online patient portals and other tools, the system said. (Schencker, 10/20)
On online conspiracies and public health —
Bloomberg: Public Health Conspiracy Theories On TikTok, Social Should Be Debunked Live
Misinformation spreads so quickly that public health officials should be monitoring social media platforms in real time to debunk bogus claims as fast as possible, a new study suggested. (Ighodaro, 10/20)
On matters relating to employment —
AP: Fewer Americans Apply For Jobless Benefits Last Week
The number of Americans applying for unemployment benefits fell last week and remains historically low even as the U.S. economy slows in the midst of decades-high inflation. (Ott, 10/20)
KHN: Labor Tries City-By-City Push In California For $25 Minimum Wage At Private Medical Facilities
A class of health care facility support staff, including nursing assistants, security guards, and janitors, has worked alongside doctors and nurses throughout the covid-19 pandemic keeping patients and medical buildings safe and clean. It’s an unassuming line of work that some people consider a calling. (Bluth, 10/21)
Also —
NBC News: Sexual Assault-Related ER Visits Increased 1,500% Since 2006, Study Finds
Emergency department visits related to sexual assault increased more than tenfold over a span of 13 years, according to a new study that experts and advocates say reflects a growing cultural shift around confronting sexual assault. (McShane, 10/20)
The Hill: Salmonella Outbreak Tied To Raw Salmon Sold In California, Arizona
So far 21 people in California, 11 in Arizona and one in Illinois are confirmed cases, according to the Food and Drug Administration, but the tainted product may have reached additional states. Thirteen of those who fell sick had to be hospitalized but all survived. (Tanner, 10/20)
AP: Concussion Lawsuit Against NCAA Could Be First To Reach Jury
Of the hundreds of wrongful death and personal injury lawsuits brought by college football players against the NCAA in the past decade, Gee’s is only the second to go trial alleging that hits to the head led to chronic traumatic encephalopathy, a degenerative brain disease, and could be the first to reach a jury. (Melley, 10/21)
Science And Innovations
Neurological Issues Found In Nearly 1 In 10 Kids Hospitalized With Covid
A team of researchers found 7% of young covid patients hospitalized from covid had neurological issues. Meanwhile, Moderna found its covid shot safe and quite effective in children younger than 5, but research showed vaccines weren't as effective at preventing hospitalization during the Summer.
CIDRAP: Study: 7% Of Children Hospitalized With COVID-19 Had Neurologic Problems
A team led by Children's Hospital at Vanderbilt researchers assessed length of hospital stay, intensive care unit (ICU) admission, 30-day readmission, death, and medical costs of 15,137 COVID-19 patients aged 2 months to 18 years released from 52 children's hospitals from March 2020 to March 2022. A total of 37.1% of the patients had a pre-existing complex chronic condition, and 9.8% had one or more neurologic complex chronic conditions. (10/20)
CIDRAP: Study: Moderna COVID Vaccine Safe, Comparably Effective In Preschoolers
Two doses of the Moderna COVID-19 vaccine were safe in children aged 6 months to 5 years and triggered similar immune response and protection against infection as that seen in young adults, according to preliminary results from a phase 2/3 clinical trial published yesterday in the New England Journal of Medicine. (Van Beusekom, 10/20)
San Francisco Chronicle: Vaccines Didn’t Prevent Hospitalization As Well During Summer Surge
The original mRNA vaccines from Pfizer and Moderna didn’t work as well in preventing hospitalization during the summer’s BA.4/BA.5 omicron surge as they had during the original BA.1/BA.2 omicron spike last winter, according to new research from the U.S. Centers for Disease Control and Prevention. (Vaziri, 10/20)
In research developments not linked to covid —
NPR: Health Department Medical Detectives Find 84% Of U.S. Maternal Deaths Are Preventable
For several weeks a year, the work of nurse-midwife Karen Sheffield-Abdullah is really detective work. She and a team of other medical investigators with the North Carolina public health department scour the hospital records and coroner reports of new moms who died after giving birth. (Dembosky, 10/21)
CIDRAP: Small Trial Supports Shorter Antibiotics For Kids' Pneumonia
A randomized clinical trial conducted in Canada found that 5 days of high-dose amoxicillin was non-inferior to 10 days in children with community-acquired pneumonia (CAP), researchers reported this week in the Journal of the Pediatric Infectious Diseases Society. (10/20)
CIDRAP: More Stewardship Needed For Postoperative Antibiotics In Kids, Study Finds
A multicenter observational study found that the use of antibiotics after nonemergent surgery in children varied widely across US hospitals but was not correlated with skin site infection (SSI) in children, US researchers reported yesterday in JAMA Surgery. (10/20)
NPR: Brain Cells In A Dish Play Pong And Other Brain Adventures
The world of brain research had two incredible developments last week. Researchers have taught a dish of brain cells to play the video game Pong to help develop more intelligent AI. Separately, scientists transplanted human brain organoids into a living animal with the hope of using them as models of human disease. (Scott, Hamilton and Cirino, 10/21)
State Watch
San Francisco To End Monkeypox State Of Emergency
The emergency declaration, now due to end October 31, has been in place for about three months and comes as case counts drop to fewer than one per day. But in Nevada, the first Clark County death from monkeypox was reported. Meanwhile, Seattle had the worst air in the world for a second day.
San Francisco Chronicle: Monkeypox: San Francisco To End State Of Emergency This Month
The change comes nearly three months after the emergency declaration was announced, at a time when case counts have slowed to fewer than one per day, officials said. The emergency declaration has allowed San Francisco to marshal resources and personnel to confront the virus. (Vainshtein, 10/20)
Las Vegas Review-Journal: Health District Reports 1st Death Of Clark County Resident With Monkeypox
The first death of a Clark County resident with monkeypox was reported Thursday by the Southern Nevada Health District. The patient, a man over the age of 50, had a compromised immune system, and his death was attributed to other causes, according to the district. (Hynes, 10/20)
Meanwhile, Seattle’s air quality continues to be a problem —
The Washington Post: Why Seattle Air Quality Is The Worst In The World Two Days In A Row
It was the second day in a row that the city had the worst air quality on earth, beating out famously polluted cities such as Beijing and Delhi. Seattle’s air quality index, or AQI, reached over 240 on Wednesday and Thursday — a level defined as “very unhealthy” for all groups. It was hard to see the top of a building a block away, and people wore masks to protect themselves from particulates in the air and the acrid smell of smoke. (Osaka, 10/20)
On “active shooter” drills in Texas’ schools —
KHN: Texas Revamps ‘Active-Shooter’ Drills At K-12 Schools To Minimize Trauma
After Britt Kelly’s son participated in a lockdown drill two years ago in his Lamar, Texas, kindergarten class, he had nightmares and wet his bed. Now 8, he can sleep only with a light on. In August, Mary Jackson’s daughter, a kindergartner in Leander, asked her mom to put a “special lock” on her bedroom door to “keep bad adults out” in the wake of a separate lockdown drill. (Rayasam and DeGuzman, 10/21)
In other news from across the country —
Reuters: U.S. Judge Blocks New York From Banning Guns In Church
A federal judge on Thursday barred the state of New York, at least for now, from enforcing the part of a closely watched gun law that bans firearms from churches or other places of worship. (Whitcomb, 10/20)
PBS NewsHour: How This New York Clinic Helped Transform Reproductive Health Care
In October of 1918, Margaret Sanger opened the first birth control clinic at 46 Amboy Street in Brooklyn, New York. Back then, as now in some ways, reproductive rights and abortion were hotly contested issues. (Markel, 10/20)
The Boston Globe: Amherst Mother And Son Had Life-Threatening Liver Damage After Eating Poisonous Wild Mushroom
An Amherst man was hospitalized and his mother needed a liver transplant after they mistakenly ate a highly poisonous mushroom they foraged from the wild, hospital officials said Thursday. (Sweeney, 10/20)
The New York Times: Former UCLA Gynecologist Is Convicted Of Sexually Abusing Patients
An obstetrician-gynecologist who worked for years at the University of California, Los Angeles, was convicted on Thursday of sexually abusing patients in a case that cost the university hundreds of millions of dollars in settlements and came amid similar accusations against doctors at other universities. (Levenson, 10/20)
Houston Chronicle: Houston Region Again Fails To Meet Federal Ozone Requirement Set 14 Years Ago
Texas officials are in even deeper trouble with federal officials for failing once again to protect Houston residents from dangerous ozone pollution. (Foxhall, 10/20)
Salt Lake Tribune: New Utah Bill Proposes To Ban Gender-Affirming Surgeries On Minors
A Utah legislative committee advanced a proposal to ban gender-affirming surgeries on minors in Utah, teeing up a debate on the contentious issue for the upcoming 2023 session. (Schott, 10/20)
AP: Worker Who Lowered Vermont Town's Fluoride For Years Resigns
Richmond water superintendent Kendall Chamberlin disclosed in his five-page resignation letter, submitted Monday, that fluoride levels have not been in the state-recommended range for over a decade — instead of nearly four years, as the state had recently disclosed. (Rathke, 10/21)
The Washington Post: Health Equity Grants Awarded To Groups Helping Low-Income D.C. Residents
Thirty-two nonprofit groups will receive $9.2 million in funding from the Health Equity Fund, which is managed by the Greater Washington Community Foundation. The fund was created last year, after the insurance company CareFirst agreed to pay $95 million to settle a 13-year legal battle between the insurer and the D.C. government. (Bahrampour, 10/20)
The New York Times: This Minnesota Race Will Show The Potency Of Crime Vs. Abortion
Keith Ellison, the incumbent attorney general and a Democrat, insists that his bid for re-election will hinge on abortion, which remains legal in Minnesota. But his Republican challenger, Jim Schultz, says the contest is about public safety and what he argues are “extreme” policies that Ellison endorsed after the 2020 murder of George Floyd in Minneapolis — the aftermath of which Minnesota is still wrestling with. (Hounshell, 10/20)
Weekend Reading
Longer Looks: Interesting Reads You Might Have Missed
Each week, KHN finds longer stories for you to enjoy. This week's selections include stories on hospital payment systems, psychedelics, the hypothesis of “depressive realism," and more.
Modern Healthcare: Hospitals Prepare For A Cash-Pay Future
For health systems that have long relied on payment from insurers, accepting money for services directly from patients requires modernizing their technology systems, educating staff and setting cash rates with an actuarial eye. It can still also mean negotiating with insurance companies. But some providers embracing the cash pay revolution say their bottom line benefits from faster reimbursement, lower administration costs and higher patient retention. (Tepper, 10/18)
Houston Chronicle: Kingwood Hospital Treats Most Snakebites In The Nation
Single mom April Speight is typically a cautious person, but a lapse in her overprotective nature almost cost her her life when she was bitten by a copperhead snake on Aug. 5. While hers was a mild case, Speight became one of more than 50 people treated for snakebites in 2022 at HCA Houston Healthcare Kingwood, according to the North American Snakebite Registry for 2022. (Taylor, 10/19)
The New York Times: Half The World Has A Clitoris. Why Don’t Doctors Study It? 
Some urologists compare the vulva to “a small town in the Midwest,” said Dr. Irwin Goldstein, a urologist and pioneer in the field of sexual medicine. Doctors tend to pass through it, barely looking up, on their way to their destination, the cervix and uterus. That’s where the real medical action happens: ultrasounds, Pap smears, IUD insertion, childbirth. If the vulva as a whole is an underappreciated city, the clitoris is a local roadside bar: little known, seldom considered, probably best avoided. “It’s completely ignored by pretty much everyone,” said Dr. Rachel Rubin, a urologist and sexual health specialist outside Washington, D.C. “There is no medical community that has taken ownership in the research, in the management, in the diagnosis of vulva-related conditions.” … This near-universal avoidance has consequences for patients. (Gross, 10/17)
Bloomberg: Psilocybin Mushroom: Scientists Seek To Find How They Become 'Magic' 
Scientists are using advanced genetic methods and behavioral experiments in a bid to uncover how mushrooms become magic and evolve psychedelic properties. Compounds found in so-called magic mushrooms are increasingly being recognized for their potential to treat health conditions including depression, anxiety, compulsive disorders and addiction. (Hayhurst, 10/17)
Stateline: Babies Kept Dying In This City. People Worked Together To Understand Why
The United States has a higher infant mortality rate than most other developed countries. And Baltimore’s success in the past decade may make it a model for other U.S. cities and counties working to keep more of their babies alive. Not long ago, Charm City’s infant mortality rate had been staggeringly high, among the worst in the country. In 2008, the city reported 120 infant deaths. The next year was even worse — 128 dead babies. That year, the city recorded 13.5 infant deaths for every 1,000 live births, the worst rate in at least five years. (Ollove, 10/19)
The New York Times: Sadder But Wiser? Maybe Not
The idea of “sadder but wiser” has been taught to decades of Intro Psych students and cited more than two thousand times by other scholars. It also percolated through our culture, introducing the idea that depression, for all its pain, may also provide its sufferers with some gifts. A study published this month in the journal Collabra: Psychology by Amelia S. Dev and others calls that conclusion into question. (Barry, 10/18)
AP: Arizona Farm Gives Refuge From Pain, For Man And Beast Alike 
The leader has the name of her dead baby spelled out in beads on her left wrist, and standing before her is a mother so grief-choked by her young son’s death that she flips on her side at one point in this creekside yoga class and sobs. In the next row, a woman whose daughter died by suicide goes through the poses next to a man with a tattoo of three little ducks, one for each of the children who was murdered .Just beyond, in the fields of this sanctuary for the grieving, is a sheep whose babies were snatched by coyotes, a goat saved from slaughter and a horse that was badly mistreated carrying loads at the Grand Canyon. … There is no talk at Selah Carefarm of ending the pain of loss, just of building the emotional muscle to handle it. (Sedensky, 10/20)
Editorials And Opinions
Viewpoints: Telemedicine Is Worth Keeping; Are We Prepared For The New Covid Variants?
Editorial writers weigh in on these public health topics.
NBC News: Telemedicine Works. But States Are Killing It Off.
Red tape and restrictions on telemedicine — health care services provided to patients remotely via the internet or telephone — need to be removed to make such care viable, particularly state licensing requirements and insurance reimbursement policies that require in-person visits. (Jessica Denson, Chris McGovern, and David Nunnally, 10/20)
Los Angeles Times: COVID Precautions Are Fading Just As Virus Is Strengthening
Winter is coming, and so are new COVID-19 variants. Based on the last two years, expect a botched national response when, not if, the winter surge comes. Highly transmissible new COVID variants such as BQ.1.1 and XBB are capable of overcoming immunity from prior Omicron infections and are resistant to antibody-based treatments, rendering two of our best defenses far less effective. (Dr. Dipti S. Barot, 10/20)
East Bay Times: Washington Is Neglecting A Key National Security Threat
At the Global Fund Seventh Replenishment Conference last month, President Joe Biden pledged $6 billion in U.S. funding to fight AIDS, tuberculosis and malaria, and strengthen health systems worldwide. The announcement is a welcome sign of the administration’s continued interest in global health as attention to the COVID-19 pandemic wanes. (Sam Fraser, 10/20)
The Tennessean: Mental Health And Substance Abuse Treatment Help Incarcerated People
Evidence-based treatment for mental health and substance use disorders delivered during incarceration reduces symptoms and disciplinary problems, improves post-release adjustment and decreases recidivism risk.  (Jeremy C. Kourvelas, 10/20)
Stat: Research Funding Is Broken. A Lottery Approach Could Fix It
Thirty years ago, Katalin Karikó had what was then an outlandish idea: use messenger RNA as a medicine. But getting funding to demonstrate that might be possible was impossible, despite three decades of trying. … Her outlandish idea has since provided the platform for the vaccines that are helping protect people around the world from Covid-19 and is being used to develop other treatments. … Karikó overcame the lack of funding with incredible dedication. But her story illustrates that the world has likely missed out on other revolutionary scientific ideas because funding systems are designed to reward those who are already successful, not necessarily those who work represents real innovation. (Lionel Page and Adrian Barnett, 10/21)
Stat: Supporting Family Caregivers Would Improve Clinical Trials
During the Covid-19 pandemic, America’s 53 million family caregivers gained some long overdue recognition for their vital role as unpaid extenders of an under-resourced health care workforce. The clinical trial enterprise, however, has yet to appreciate caregivers — and fully engage them — as critical partners in recruiting and supporting people who are older, disabled, or have Alzheimer’s disease, cancer, or other chronic medical conditions for research studies. (Sharon Inouye and Jason Resendez, 10/21)
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