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Thursday, March 24, 2022 | Kaiser Health News

KHN Morning Briefing

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Kaiser Health News Original Stories

Health Officials See Bright Future in Poop Surveillance

Sewage surveillance is proving so useful in mapping covid trends that many public health officials say it should become standard practice in tracking infectious diseases. Whether that happens will depend on the nation’s ability to make it viable in communities rich and poor.(Anna Maria Barry-Jester,)

Can Melatonin Gummies Solve Family Bedtime Struggles? Experts Advise Caution

Throughout history, parents have searched for the secret to getting fretful children to sleep through the night. The latest strategy involves giving children melatonin-infused gummies and tablets, a trend that concerns some doctors.(Jenny Gold,)

In Nurse's Trial, Investigator Says Hospital Bears 'Heavy' Responsibility for Patient Death

Nashville nurse RaDonda Vaught is charged with reckless homicide for giving the wrong medication to a patient at Vanderbilt University Medical Center.(Brett Kelman,)

Political Cartoon: 'Burned Out?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Burned Out?'" by Bob and Tom Thaves.

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Summaries Of The News:

Reproductive Health

Idaho Governor Signs Near-Total Abortion Ban Despite Fears It Is 'Unwise'

Gov. Brad Little, a Republican, voiced reservations over the civil enforcement clauses — modeled after the controversial Texas law that has survived court challenges so far — in the legislation that bans a surgical abortion after 6 weeks of pregnancy. In Oklahoma, lawmakers advance a bill that is even more restrictive than the laws in Texas or Idaho.

The New York Times:Idaho Governor Calls Abortion Law ‘Unwise’ But Signs It AnywayGov. Brad Little of Idaho signed a strict new abortion bill into law on Wednesday, even as he expressed grave concerns about the wisdom and constitutionality of the measure and warned that it could retraumatize victims of sexual assault. ... “While I support the pro-life policy in this legislation, I fear the novel civil enforcement mechanism will in short order be proven both unconstitutional and unwise,” Mr. Little wrote in a message to Lt. Gov. Janice McGeachin, who is also president of the State Senate. The state attorney general’s office had previously issued an opinion saying that the bill would effectively prohibit all abortions and that it would most likely be found unconstitutional. (Baker, 3/23)

ABC News:Idaho Governor Signs Bill Banning Abortion After 6 Weeks Modeled After Texas Law The new law also allows the father, grandparents, siblings, uncles or aunts of the fetus to sue a medical provider who performs the procedure. ... Although the Idaho law is the first in the nation to be modeled after the Texas law, there are a few differences. Both allow for exceptions in the case of a medical emergency, but the Texas law does not allow for exceptions in cases of rape or incest. In contrast, the Idaho bill does allow for such exceptions. However, women who want an abortion under those exceptions in Idaho are required to file a police report and show it to the medical provider before the abortion. (Kekatos, 3/23)

AP:Idaho Governor Signs Abortion Ban Modeled On Texas LawThe law in the conservative state is scheduled to take effect 30 days after the signing, but court challenges are expected. Opponents call it unconstitutional, and note that six weeks is before many women know they’re pregnant. Advanced technology can detect a first flutter of electric activity within cells in an embryo as early as six weeks. This flutter isn’t a beating heart; it’s cardiac activity that will eventually become a heart. An embryo is termed a fetus after the eighth week of pregnancy, and the actual heart begins to form between the ninth and 12th weeks of pregnancy.(Ridler, 3/23)

In abortion updates from Oklahoma and Texas —

Oklahoman:Oklahoma GOP Advances Nation's Most Restrictive Anti-Abortion LawOklahoma is one step closer to copying a restrictive anti-abortion law implemented in Texas. But legislation advanced Tuesday by the Oklahoma House is even more restrictive than the law adopted in Texas that has forced hundreds, if not thousands, of women to seek abortions in neighboring states. Republican House legislators passed House Bill 4327 that would effectively ban most abortions by allowing private citizens to sue anyone who performs an abortion or "aids or abets" someone who pursues the procedure. (Forman, 3/23)

Newsweek:Oklahoma's Abortion Ban Would Be Even Stricter Than TexasThe Oklahoma House voted on Tuesday to ban all abortions unless it is necessary for saving the pregnant woman's life. In a 78-19 vote, the House sent HB 4327 to the Republican-controlled state Senate. If signed into law, it would surpass Texas' six-week abortion ban to become the most restrictive in the nation. Like the Texas law, the bill would allow private citizens to pursue civil actions of up to $10,000 against doctors and others who aid a woman in obtaining an abortion. (Rahman, 3/23)

The Texas Tribune:Texas Abortion Law Faces New Legal Challenge From Advocacy Groups Two Texas abortion advocacy groups are trying a new legal strategy to strike down the state’s restrictive abortion law, which has proven very difficult so far to challenge in court. They’ve filed four lawsuits, including two in federal court, challenging the law’s constitutionality. But rather than focusing on abortion itself, the suits argue that the law is unconstitutional in other ways — violating the right to due process, free speech and equal protection under the law. Texas’ abortion law, passed last year as Senate Bill 8, empowers private citizens to sue anyone who “aids or abets” an abortion after about six weeks of pregnancy. (Klibanoff, 3/24)

And from Colorado and South Dakota —

AP:Colorado Democrats Send Abortion Access Bill To GovernorColorado’s Democrat-led Legislature on Wednesday sent the governor a bill to codify the right to abortion in state law in a party-line response to efforts in other states to limit abortion access as well as pending constitutional challenges to the procedure. Democratic Gov. Jared Polis has said he will sign the bill into law. (3/23)

AP:Noem Signs Bill Aiming To Restrict Abortion Pill Access South Dakota Gov. Kristi Noem on Wednesday signed a bill that would make the state one of the most difficult places to get abortion pills, though most of the law will not be enacted unless the state prevails in a federal court battle. The Republican governor pushed the legislation this year to enshrine a similar rule from her administration that attempted to require abortion-seekers to make three separate visits to a doctor to take abortion pills. But a federal court issued a preliminary injunction against that rule last month, and the bill Noem signed contains language that says the restrictions are not enforceable unless the state convinces a federal court to overturn that order. (Groves, 3/23)

Planned Parenthood

Planned Parenthood Gifted $275 Million By Philanthropist MacKenzie Scott

The largest single-donor contribution to Planned Parenthood and 21 affiliates comes at a critical time when its reproductive health services and government funding sources are under threat over the abortion debate.

BuzzFeed:MacKenzie Scott Just Made The Single Largest Donation In Planned Parenthood's HistoryMacKenzie Scott donated $275 million to Planned Parenthood and 21 of its affiliates, making it the largest gift from a single donor in the organization's history, Planned Parenthood announced Wednesday. The donation from Scott, who received a 4% stake in Amazon in her divorce settlement with founder Jeff Bezos, comes at a crucial time for Planned Parenthood. Sexual and reproductive health rights are under attack across the country as conservative lawmakers are rushing to introduce and pass anti-abortion legislation in anticipation of the Supreme Court rolling back Roe v. Wade. (Skinner, 3/23)

The Wall Street Journal:MacKenzie Scott Donates $3.86 Billion To 465 Organizations In Less Than A Year MacKenzie Scott said she has given $3.86 billion to 465 groups over the past nine months, marking the latest round of funding for the billionaire philanthropist who has pledged to donate the majority of her fortune to charity. Ms. Scott, one of the richest women in the world, said she aimed to support the needs of underrepresented groups. The hundreds of recipients that received funds varied widely in their focus, including organizations working in education, climate change and criminal justice.(De Avila, 3/23)

Where some of the money will be directed —

St. Louis Post-Dispatch:Philanthropist Gives St. Louis-Based Planned Parenthood $9 Million, Its Largest Donation EverPlanned Parenthood of the St. Louis Region and Southwest Missouri has received its largest single donation — $9 million — from author and philanthropist MacKenzie Scott, the abortion and reproductive health care provider announced Wednesday. The gift to the Planned Parenthood regional affiliate is part of $225 million Scott gave to the Planned Parenthood national office as well 21 other Planned Parenthood affiliates across the country. (Munz, 3/23)

Milwaukee Journal Sentinel:Planned Parenthood Of Wisconsin, Milwaukee Habitat For Humanity Receive Historic DonationsTwo nonprofits that work to serve Wisconsinites in need will benefit from "transformational" gifts made by billionaire philanthropist MacKenzie Scott this week. ... "I really immediately thought about what this would mean and especially (in terms of) the political winds that constantly blow at us," said Tanya Atkinson, Planned Parenthood of Wisconsin President and CEO. "And while those political winds won't go away, I thought about how a transformational gift like this offers us (the ability to) be there for our patients and communities." (Shastri, 3/23)

Sioux Falls Argus Leader:Planned Parenthood North Central States receives $20M gift from billionaire MacKenzie Scott“We are honored and deeply thankful to receive this historic and incredibly generous gift to fund Planned Parenthood’s work on behalf of the people we serve,” Sarah Stoesz, president and CEO of Planned Parenthood North Central States, said. “Every single person deserves to have sexual and reproductive health care, no matter what. Our mission changes lives and this gift will help us grow our impact during a pivotal time for reproductive health care in our country.” (Matzen, 3/23)

Capitol Watch

After 3 Days, Hearings Shed Little Light On KBJ's Stance On Roe, ACA, More

Questioning has ended, but the public heard little of substance about how Supreme Court nominee Ketanji Brown Jackson would rule on pressing health matters that would affect most Americans.

ABC News:Ketanji Brown Jackson Clears Major Hurdle In Historic Supreme Court BidThe nation's first Black woman nominated to the U.S. Supreme Court, Judge Ketanji Brown Jackson, cleared 19-hours of grueling questioning at the Senate Judiciary Committee on Wednesday, appearing headed toward confirmation as a justice with support from all Democrats and a small number of Republicans. "In my capacity as a justice, I would do what I've done for the past decade," Jackson told the committee on her third day of testimony, "which is to rule from a position of neutrality, to look carefully at the facts and… to render rulings that I believe and that I hope that people would have confidence in." (Dwyer, 3/23)

AP:AP FACT CHECK: Senators Misrepresent Jackson On Abortion Republican senators painted Supreme Court nominee Ketanji Brown Jackson as hostile to anti-abortion views, twisting words from a legal brief she co-signed years ago as evidence she would rule broadly against abortion opponents. That’s a misrepresentation. (Yen and Woodward, 3/24)

Slate:The KBJ Hearings Show Marriage Equality Is The Next Target After Roe.For several decades, Republicans used Supreme Court nomination hearings to sharpen their knives against Roe v. Wade. They have long seized the opportunity to make their case against Roe, railing against the decision as a paragon of judicial activism and overreach. During Ketanji Brown Jackson’s hearings this week, GOP senators have, predictably, condemned Roe—but not as much as might be expected. Instead, many senators have turned their attention to a different precedent that’s likely next on their hit list once Roe likely falls this summer: Obergefell v. Hodges, the 2015 decision recognizing same-sex couples’ constitutional right to marry. (Stern, 3/23)

ABC News:Ketanji Brown Jackson Highlights Challenge Of Being A Working Mom In Supreme Court Confirmation Hearings If Judge Ketanji Brown Jackson is confirmed to the U.S. Supreme Court, she will set precedent as not only the first Black woman to sit on the nation's high court, but also as the second-consecutive working mother to be confirmed. Jackson, 51, is the mother of two school-age daughters, Talia and Leila. The most recent justice confirmed to the Supreme Court, Justice Amy Coney Barrett, is a mother of seven children, five biological and two who were adopted from Haiti. ... On Tuesday, in response to a question from Democratic Sen. Cory Booker, of New Jersey, Jackson opened up more about juggling her career and motherhood. She spoke about missing events in her daughters' lives because of her job, and said that she "didn't always get the balance right." (Kindelan, 3/23)

The Washington Post:Takeaways From Day 3 Of Supreme Court Pick Ketanji Brown Jackson’s HearingSen. Thom Tillis (R-N.C.) asked her about a ruling on the issue of releasing inmates during the coronavirus pandemic, in which she had written, “The obvious increased risk of harm that the COVID-19 pandemic poses … reasonably suggests that each and every defendant that is currently in the D.C. Department of Corrections custody and thus cannot take individual measures to control their own hygiene and distance themselves from others should be released.” Tillis asked her, “Do I read that statement to say that you felt, given the circumstances of the time, they should all be released?” Jackson responded, “No, senator, you don’t read it correctly.” (Blake, 3/23)

Also —

The Hill:Dems Plow Toward Supreme Court Vote After Testy Hearing Democrats are barreling forward with Judge Ketanji Brown Jackson's Supreme Court confirmation after she emerged from two days of high-profile questioning largely unscathed. How far above 50 votes Jackson will ultimately get is unclear. Republicans are skeptical she’ll get more than one or two of their members, as GOP senators harden their lines of attack against her nomination. (Carney, 3/24)

The New York Times:Confirmation Hearings, Once Focused On Law, Are Now Mired In Politics One senator asked Judge Ketanji Brown Jackson, President Biden’s Supreme Court pick, how religious she was “on a scale of 1 to 10.” Another asked her to define the word “woman.” A third wanted to know if babies are racist. Supreme Court confirmation hearings have long been criticized as empty rituals, or worse. But the complaints have mostly focused on nominees’ failure to answer questions about how they would rule. (Liptak, 3/23)

And questions linger about the health of Supreme Court Justice Clarence Thomas —

The Washington Post:Clarence Thomas Misses Supreme Court Arguments Because Of Hospitalization Justice Clarence Thomas missed oral arguments at the Supreme Court this week because of his hospitalization for treatment of an infection. A court spokeswoman declined to provide an update on Thomas’s condition. He was admitted to Sibley Memorial Hospital in Washington Friday night, complaining of flu-like symptoms. Sunday night, the court said in a new release that he had been diagnosed with an infection and was being treated with intravenous antibiotics. ... Justices decide for themselves how much health information they will release to the public, and there has been no additional guidance. (Barnes, 3/23)

Marketplace

Record 14.5 Million Americans Enrolled In ACA Plan This Year

And CNN reports that some low-income Americans are now eligible for special enrollment with $0 premiums through healthcare.gov. Marking the 12th anniversary of the Affordable Care Act becoming law, President Joe Biden also announced that over 18.7 million people across 39 states are now insured under Medicaid expansion criteria set by Obamacare.

Reuters:U.S. Signs Up More Than 14.5 Mln People For Obamacare Health Insurance More than 14.5 million Americans signed up for Obamacare health insurance for 2022, a 21% jump over last year and the highest since the Affordable Care Act was signed 12 years ago, the U.S. government said on Wednesday. About 10.3 million people enrolled from the 33 U.S. states that use the online marketplace funded by the federal government and about 4.3 million people from states that sell the insurance directly to their residents. (2/23)

CNN:Obamacare: Low-Income Americans Now Can Sign Up For $0 Premium Plans On Federal Exchange Low-income Americans who missed signing up for 2022 Affordable Care Act coverage can now enroll in plans with $0 premiums through the federal exchange's website. Those with incomes less than 150% of the federal poverty level -- $19,320 for an individual and $39,750 for a family of four -- can select policies on healthcare.gov through a special enrollment period, the Centers for Medicare and Medicaid Services told CNN exclusively on Monday. Most people will be able to select plans with no premiums, while others may have to pay a few dollars. (Luhby, 3/21)

Also —

The Fiscal Times:Obamacare Turns 12 With Record Enrollment, But Trouble AheadWhen President Barack Obama signed the Affordable Care Act into law 12 years ago, Vice President Joe Biden was famously overheard telling his boss that the occasion was a “big f—ing deal.” Today, despite a rocky start, the ACA boasts record enrollment, thanks in no small part to President Joe Biden’s effort to expand coverage in the first year of his administration amid the Covid-19 pandemic. To top it off, Republican efforts to overturn the law seem to have run out of gas, a situation noted by the Kaiser Family Foundation’s Larry Levitt, who wrote that there are “no meaningful political or legal threats to its existence for the first time since its passage.” (Rainey, 3/23)

Politico:Joe Biden’s Never-Ending Campaign To Build On ObamacareIn the dwindling time Joe Biden has to revive his domestic agenda, one thing is clear: Even if he succeeds, it will be a far cry from completing one big unfinished task he promised to tackle. That task was delivering on the full promise of Obamacare, the national health care reform law enacted in 2010 while Biden was vice president. His vow to expand and strengthen it was a central theme of his presidential campaign, and part of how he distinguished himself from his challengers in the 2020 primary. (Kenen, 3/23)

In related news about President Biden's health care agenda —

Politico:With Democrats' Health Agenda Stalled, Lawmakers Turn To InsulinDemocrats who have hit a wall on achieving sweeping drug price reforms during what could be their final months controlling Congress are pushing a narrower policy fix they hope will bolster the midterm fortunes of key members. Sen. Chuck Schumer announced a plan on Tuesday to bring legislation to the floor just after Easter that would cap the out-of-pocket cost for insulin products at $35 per month and take other steps to extend relief to diabetics, a bumper-sticker-ready plan that would deliver on at least some of the Democrats’ promises to tackle health costs. (Ollstein, 3/23)

Houston Chronicle:Texas And Biden’s White House Locked In $30 Billion ‘Game Of Chicken’ Over Medicaid FundingNearly a year after the Biden administration revoked approval of billions in future Medicaid dollars for Texas, state and federal officials are at an impasse over the safety net funding, with a deadline looming Friday. The money, funneled through what’s known as an 1115 waiver, has brought more than $30 billion to Texas since its start in 2012 and now accounts for nearly a third of the state’s Medicaid budget. Those dollars primarily prop up hospitals for emergency care to patients without government or private insurance. (Blackman, 3/23)

Vaccines

Moderna Will Apply To FDA For Covid Vaccine Use In Kids Under 6

If approved, all children over the age of 6 months would be eligible to get vaccinated against covid. Moderna released data that showed two 25-microgram doses trigger a strong immune response to the virus, including the omicron variant.

Stat:Moderna To Ask FDA To Authorize Covid Vaccine In Kids 6 Months To 6 YearsModerna announced Wednesday that it will ask the Food and Drug Administration to authorize its Covid-19 vaccine for emergency use in children aged 6 months to 6 years, a group for which there are currently no authorized Covid vaccines. The company’s announcement came as it released interim data from two clinical trials of its vaccine in children under 6 years of age. Moderna said the studies — in children aged 6 months to 23 months and 2 years to 6 years — showed the vaccine generated similar immune responses as those seen in adults aged 18 to 25 who received two doses of Moderna’s adult Covid vaccine. (Branswell and Herper, 3/23)

NBC News:Moderna Says Covid Vaccine For Children, 6 Months To Age 6, Protects Against Severe OmicronModerna said Wednesday its Covid-19 vaccine generated a strong immune response and was generally well-tolerated in kids ages 6 months up to 6 years. The drugmaker said two 25-microgram doses of the vaccine, a quarter of the dose given to those 18 and older, produced an antibody response similar to what was seen in a clinical trial of adults. For the approximately 6,900 children in the trials, the majority of side effects were "mild or moderate," and no cases of a rare heart condition called myocarditis were reported, the company said. (Lovelace Jr., 3/23)

AP:Moderna Says Its Low-Dose COVID Shots Work For Kids Under 6 Moderna’s COVID-19 vaccine works in babies, toddlers and preschoolers, the company announced Wednesday — a development that could pave the way for the littlest kids to be vaccinated by summer if regulators agree. Moderna said that in the coming weeks it would ask regulators in the U.S. and Europe to authorize two small-dose shots for youngsters under 6. The company also is seeking to have larger doses cleared for older children and teens in the U.S. (Neergaard, 3/23)

Also —

NBC Chicago:When Could COVID Shots Begin For Children Under 5 And Which Vaccine Is Best? Parents may find it confusing that Moderna is seeking to vaccinate the youngest children before it's cleared to vaccinate teens. While other countries already have allowed Moderna’s shots to be used in children as young as 6, the U.S. has limited its vaccine to adults. The FDA hasn't ruled on Moderna's earlier request to expand its shots to 12- to 17-year-olds because of concern about a very rare side effect. Heart inflammation sometimes occurs in teens and young adults, mostly males, after receiving either the Pfizer or Moderna vaccines. Moderna is getting extra scrutiny because its shots are a far higher dose than Pfizer’s. (3/23)

Covid-19 Crisis

Omicron BA.2 On The Rise, Threatening Another Surge

Health officials in Washington state say the "stealth omicron" subvariant now accounts for 25% of local covid cases. The Fresno Bee covers the rise of BA.2 in California. Covid in children, safe organ transplants from covid patients, sewage surveillance, and more are also in the news.

AP:Omicron Subvariant Found In 25% Of Cases Tested At UW Lab Health officials say the subvariant of omicron known as BA.2 accounts for about one-fourth of COVID-19 cases sequenced in Washington. The Seattle Times reports the subvariant has steadily spread in the state, and across the country and Europe, but researchers are hopeful any potential wave of the new strain won’t cause as many infections, hospitalizations and deaths as the original version of the variant did. (3/23)

Fresno Bee:BA.2 COVID Subvariant Rising In California. Is Surge Coming? As a more contagious subvariant of omicron known as BA.2 represents a steadily climbing portion of COVID-19 cases in California, experts are still working to determine whether that means another surge is on the horizon — and if so, when and how severe it might be. For now, California has nestled into one of its lowest points of COVID-19 activity of the two-year pandemic. The only period with lower case rates and hospital numbers was spring 2021, after vaccines began to roll out but before the delta variant took hold. (McGough, 3/23)

And more news on the spread of the novel coronavirus —

Las Vegas Review-Journal:Nevada Surpasses 10K Total COVID-19 DeathsNevada this week crossed a major milestone in the COVID-19 pandemic, more than two years after the virus first caused shutdowns and restrictions around the world — 10,000 deaths. The state reported 82 deaths over the preceding week, with data updated through Monday. That increase was reported despite the 14-day moving average of daily deaths dropping from four to three. Divided by seven, the number of deaths reported over the last week represent an average of over 11 per day — well above the daily number on the dashboard. (Dylan, 3/23)

CIDRAP:Study: Kids' Antibody Responses After COVID-19 Greater Than Adults'US infants and toddlers previously infected with SARS-CoV-2 had significantly higher levels of antibodies against the virus than did adults, finds a prospective study yesterday in JCI Insight. Researchers with Johns Hopkins University and the Centers for Disease Control and Prevention compared concentrations of receptor binding domain (RBD) antibodies against the SARS-CoV-2 spike protein and neutralizing antibodies in serum samples from children 0 to 17 years old with those from adults aged 18 to 62. (3/23)

CNBC:Why Don't Kids Get Covid Badly? Scientists Are Starting To UnderstandOne of the enduring mysteries of the Covid-19 pandemic, a global health crisis that has led to over 6 million fatalities, is that children have been spared by the virus — for the most part — and have not experienced anywhere near the severity of illness that adults have. When Covid emerged in late 2019 and began to spread around the world, scientists scrambled to understand the virus and how to combat it, with hospitals trying different techniques to save the worst-off Covid patients in intensive care units. Mercifully, few of those patients were children, posing a mystery for public health experts as to why kids were not becoming severely ill or dying with Covid. (Ellyatt, 3/24)

HealthDay News:Organ Transplants From Donors Who Had COVID-19 Are Safe, Study ShowsFor those waiting during the pandemic for a new kidney or liver, new research is reassuring: Organs from deceased donors who had COVID-19 did not cause infection in recipients and posed no risk to healthcare workers. In a study that began in September 2021, the Duke University School of Medicine team assessed transplants in which two livers and two kidney/pancreas combinations from four donors who tested positive for COVID-19 were given to four recipients. (3/23)

CIDRAP:Simple Home Oxygen Monitors Signal When To Seek COVID CareCOVID-19 patients can safely use inexpensive pulse oximeters at home to watch for a drop in blood oxygen that signals they need to seek advanced care, according to a systematic review published yesterday in The Lancet Digital Health. ... "Remote monitoring reduced unnecessary contact of health-care professionals with patients with COVID-19, which could control the risk of infection transmission and enable resources to be redirected to those who need them the most," the study authors wrote. For example, one study found that only 5 of 162 remote patient monitoring participants required in-person assessment. Another study of 279 participants estimated savings of about $845,000 over 6 months. (Van Beusekom, 3/23)

KHN:Health Officials See Bright Future In Poop Surveillance One of Patrick Green’s first orders of business each day is to open a tap and fill a bottle with sludge. A utilities plant operator in Modesto, a city of nearly a quarter-million people in California’s San Joaquin Valley, Green helps keep the city’s sewers flowing and its wastewater treated to acceptable levels of safety. But in recent months, he and his colleagues have added covid-19 sleuthing to their job description. At the treatment plant where Modesto’s sewer pipes converge, larger items, ranging from not-supposed-to-be-flushed baby wipes to car parts, are filtered out. What remains is ushered into a giant vat, where the solids settle to the bottom. It’s from that 3-feet-deep dark sludge that researchers siphon samples in their search for SARS-CoV-2, the virus that causes covid. (Barry-Jester, 3/24)

Also —

NBC News:White House Once Again Urges Congress To Pass Funding For CovidThe White House on Wednesday continued to press Congress to provide emergency funding it says it needs to buy additional Covid-19 vaccines, treatments and other critical pandemic tools. Without the funds, the U.S. faces major cutbacks in its Covid response efforts, including a critical shortage of monoclonal antibody treatments and an insufficient supply of fourth vaccine doses that may be needed for the general public this fall, the White House coronavirus response coordinator, Jeff Zients, said at a briefing. (Lovelace Jr., 3/23)

Pandemic Policymaking

In New York, Unvaxxed Athletes Can Play Home Games

Pandemic restrictions continue to fall, including in New York City where the mayor is set to exempt athletes and performers from vaccine mandates. Vaccine requirements are also withdrawn at Los Angeles restaurants. Separately, L.A. terminates 24 city employees for violating shot requirements.

AP:New York City To Let Unvaccinated Athletes Play Home GamesNew York City’s mayor will announce Thursday that he’s exempting athletes and performers from the city’s vaccine mandate for private workers, a move that will allow Brooklyn Nets star Kyrie Irving to play home games and unvaccinated baseball players to take the field when their season begins. Mayor Eric Adams will make the announcement Thursday morning and it will be effective immediately, according to a person familiar with the upcoming announcement who was not authorized to discuss it publicly. The city’s sweeping vaccine mandate for workers will still apply to people with other types of jobs, including government employees. (Price, 3/24)

Los Angeles Times:L.A. Moves To End Vaccine Requirements At Restaurants, GymsLos Angeles on Wednesday took another step toward rolling back its COVID-19 vaccine verification requirements for indoor restaurants, gyms, movie theaters and other businesses even amid concerns that circulation of the “stealth” Omicron subvariant, BA.2, might fuel an increase in cases this spring. The City Council voted 13 to 1 to make it voluntary for such businesses to verify that people patronizing their indoor areas are vaccinated. The changes would also remove such requirements for big outdoor events. (Alpert Reyes, Money and Lin II, 3/23)

Los Angeles Times:L.A. Terminates 24 Employees Over COVID Vaccine RequirementsMonths after Los Angeles rolled out requirements for city workers to be vaccinated against COVID-19, the city said that as of last week, it had terminated 24 employees for violating those rules. The terminated employees include a dozen workers at the Los Angeles Fire Department, as well as smaller numbers of employees in the city attorney’s office, the Los Angeles Police Department, the parks department and Los Angeles World Airports, according to the city personnel department. (Alpert Reyes, 3/23)

Thursday, March 24, 2022 | Kaiser Health News

In updates on mask mandates —

CNN:Airline CEOs Urge Biden To End Mask Mandate, Testing RequirementsThe CEOs of 10 airlines and cargo carriers have signed a letter to President Joe Biden saying he should end the transportation mask mandate and testing requirements for international travelers. In a new letter, industry group Airlines for America wrote, "now is the time for the Administration to sunset federal transportation travel restrictions -- including the international predeparture testing requirement and the federal mask mandate -- that are no longer aligned with the realities of the current epidemiological environment." The CEOs of Alaska Airlines, American Airlines (AAL), Atlas Air Worldwide, Delta Air Lines (DAL), FedEx Express, Hawaiian Airlines, JetBlue Airways (JBLU), Southwest Airlines (LUV), United Airlines (UAL), and UPS Airlines signed the letter. (Muntean, 3/23)

The Washington Post:Judge Rules That A Dozen Virginia Students Can Ask For Mask Mandates — But No More A federal judge in Charlottesville ruled Wednesday that a handful of schools in Virginia could require face masks if necessary to protect a dozen immunocompromised children whose families sued over mask-optional policies. The ruling includes schools in the state’s largest districts, Loudoun and Fairfax. Judge Norman K. Moon emphasized repeatedly, though, that he is not undoing state law and an executive order that makes masks optional. His order is limited to the 12 families who sued in Charlottesville federal court, whose children attend 10 different school districts in Virginia and range in age from preschool to 11th grade. Those children, he ruled, can ask their schools to require masks as an accommodation for their disabilities. (Natanson and Weiner, 3/24)

Fox News:Howard Stern Distraught Over End Of Mask Mandates, Blames Republicans: 'The Wackos Are Winning'Longtime radio personality Howard Stern didn't hide his disappointment Wednesday that mask mandates were being lifted across the country, despite a drastic reduction in new coronavirus cases over the past few months. During Wednesday's broadcast of "The Howard Stern Show," Stern blamed Republicans for the lifting of the mandates, referred to them as "wackos" who were anti-mask and anti-vaccine, and declared that he missed the "old Republican Party." (Gillespie, 3/23)

In related news about pandemic rules —

AP:US Capitol Reopening For Limited Public Tours After 2 Years The U.S. Capitol will reopen to the public on Monday for guided tours for limited groups of people who have registered in advance, congressional officials said, two years after the coronavirus pandemic prompted the cessation of such visits. Officials said that the resumption would occur in phases, beginning on Monday for school groups and other groups of up to 15 people who would be led by lawmakers or their aides. Congressional offices would each be limited to leading one tour weekly. (Fram, 3/23)

Roll Call:Administration Faces Risks In Decision On Public Health Emergency More than two years into the country’s declared public health emergency, the Biden administration faces a dilemma about whether and when to end it. The administration is under pressure from the public and Republican lawmakers to lift the emergency this year as COVID-19 case counts come down and the virus becomes increasingly endemic. But the return to pre-pandemic normal could have downsides: Millions of Americans risk losing their health coverage and could find it harder to access care. (Cohen, 3/23)

The Atlantic:Americans Want To Return To Normal. But Also They Don’tRecent opinion surveys give mixed messages about how Americans perceive the current state of the pandemic, and what they think we should do about it. In a February Washington Post/ABC News poll, for example, 58 percent of Americans said that controlling the spread of the coronavirus is more important than loosening restrictions on normal activities. In a Yahoo News/YouGov poll conducted the same week, 51 percent said we need to learn to live with COVID-19 and get back to normal. These are two of several examples that show Americans have seemingly conflicting views about the pandemic. A natural question to ask is why—is it the polls or the American people who are confused? And what do Americans really think? (Jackson, 3/23)

Health Industry

Court Says Insurer Doesn't Have To Reconsider Thousands Of Claims

United Behavioral Health had been required to reconsider tens of thousands of denied claims for mental health, drug and alcohol care but an appeals court has now overturned the earlier rulings. Mount Sinai, the American Hospital Association, the NIH, and more are also in the news.

San Francisco Chronicle:Ninth Circuit Overturns Behavioral Health Care Rulings That Required Insurer To Reconsider Thousands Of ClaimsA federal appeals court has overturned rulings that would have required an insurer to reconsider its denials of tens of thousands of claims for mental health, drug and alcohol care. In decisions in 2019 and 2020, Chief U.S. Magistrate Judge Joseph Spero of San Francisco said United Behavioral Health, which manages mental health services for insurance giant UnitedHealthcare, had acted “to protect its bottom line” by using its own restrictive criteria to deny claims in multiple states from 2011 to 2017. He said the company then “lied to state regulators” and made misleading statements during a nonjury trial in his court. (Egelko, 3/23)

Modern Healthcare:United Behavioral Health Beats Landmark Coverage Class-ActionA federal appeals court on Tuesday reversed a landmark decision that required the nation's largest behavioral health insurer to adopt more stringent standards for mental health and substance abuse treatment and reprocess tens of thousands of claims. The 9th U.S. Circuit Court of Appeals ruled that United Behavioral Health adequately followed plan terms when it denied coverage by self-insured and fully insured employer health plans for residential and outpatient treatment from 2011 to 2017. (Tepper, 3/23)

In other health care industry news —

Modern Healthcare:Mount Sinai Opens Clinic To Support Pregnant Women And Prevent StillbirthMount Sinai Health System will launch a multidisciplinary clinic this month, focused on reducing stillbirths and supporting women and families who have experienced this pregnancy loss, the health system said Tuesday. The Rainbow Clinic at Mount Sinai is a collaboration with the organization PUSH for Empowered Pregnancy and will provide sensitivity training for clinicians and devise strategies for better pregnancy outcomes. It will offer clinical care and psychological support in post-stillbirth pregnancies as a way to prevent fear, anxiety and future perinatal losses. (Devereaux, 3/23)

Modern Healthcare:American Hospital Association's Latest Investments Emphasize Health EquityThe American Hospital Association is taking a direct approach to facilitating health equity by providing capital and support to investment outfits emphasizing personalized healthcare startups led by women and people from racial and ethnic minority communities. The AHA has invested in SteelSky Ventures, a women-led fund with a portfolio focused on maternal health, telehealth and in-home care services and artificial intelligence tools for managing chronic health conditions, the trade group announced Tuesday. (Hartnett, 3/23)

Stat:NIH Grapples With An Identity Crisis, After Covid And Collins’ DepartureUnder the reign of Francis Collins, the National Institutes of Health was untouchable. From virtually the moment President Obama appointed him in 2009, prominent figures in government and science have been enchanted by Collins, the Harley-riding, guitar-playing geneticist who brought newfound attention to the nation’s medical research agency. In less than a decade, his agency’s budget ballooned from $29 billion to $42 billion. In an era when Democrats and Republicans agreed on nothing, the NIH’s popularity served as a rare unifier under three presidents. (Facher, 3/24)

Also —

Salt Lake Tribune:50 Women Sue Provo OB-GYN, Alleging Sexual Battery And AbuseDozens more women have come forward in a lawsuit filed against a Provo OB-GYN who they say sexually assaulted them while he was their doctor. One woman said she “felt like she was not in control of her own body — that she was just a piece of meat on the exam table,” according to an amended complaint filed this month in 4th District Court. Another woman, who was nervous about getting a Pap test, remembers asking Dr. David H. Broadbent “to wait a minute so she could relax her body.” “Broadbent chuckled and said, ‘Oh, you need a minute to get ready to get assaulted?’” the complaint alleges. (Jacobs, 3/23)

KHN:In Nurse’s Trial, Investigator Says Hospital Bears ‘Heavy’ Responsibility For Patient Death A lead investigator in the criminal case against former Tennessee nurse RaDonda Vaught testified Wednesday that state investigators found Vanderbilt University Medical Center had a “heavy burden of responsibility” for a grievous drug error that killed a patient in 2017, but pursued penalties and criminal charges only against the nurse and not the hospital itself. Vaught, 38, was stripped of her nursing license and is now on trial in Nashville for charges of reckless homicide and abuse of an impaired adult. If convicted, she faces as much as 12 years in prison. Vanderbilt received no punishment for the fatal drug error. (Kelman, 3/24)

Public Health

Population Fell In Three Quarters Of US Counties In 2021

Media outlets cover Census Bureau data that shows that 2021 was the slowest year of population growth in U.S. history, and that nearly 75% of U.S. counties actually lost population numbers. Separately, a study links low cholesterol and glucose levels at 35 to later lowered Alzheimer's risks. And the CDC is monitoring bird flu cases.

The Washington Post:Nearly 75% Of U.S. Counties Lost Population Last Year As Deaths Outnumbered Births, Data Shows Almost three-quarters of all U.S. counties reported more deaths than births last year, a development largely caused by the pandemic, which contributed to a dramatic slowing in the nation’s overall population growth, according to data released Thursday by the Census Bureau. Low fertility rates, which have persisted since the end of the Great Recession, and the nation’s continuing demographic shift toward an older population also combined to create the smallest population increase in 100 years, said Kenneth M. Johnson, a sociology professor and demographer at the University of New Hampshire. He said he expected the data to show a natural decrease but was surprised at its scale. Natural decrease occurs when a population records more deaths than births. (Kunkle, 3/24)

The New York Times:Cities Lost Population In 2021, Leading To The Slowest Year Of Growth In U.S. History Substantial population loss in some of the nation’s largest and most vibrant cities was the primary reason 2021 was the slowest year of population growth in U.S. history, new Census data shows. Although some of the fastest growing regions in the country continued to boom, the gains were nearly erased by stark losses last year in counties that encompass the New York, Los Angeles and San Francisco metropolitan areas. (Gebeloff, Goldstein and Hu, 3/24)

In other public health news —

Boston Herald:Cholesterol And Glucose Levels At Age 35 Are Linked To Future Risk Of Alzheimer’s, Boston Researchers FindGetting your cholesterol and glucose levels in a healthy range at a young age could save you from an Alzheimer’s diagnosis later in life. That’s according to Boston University School of Medicine researchers, who found that lower HDL (high-density “good” cholesterol) and high triglyceride levels at age 35 are linked to a higher risk of Alzheimer’s. The Boston scientists in this new study also concluded that high blood glucose levels measured between ages 51 and 60 is associated with Alzheimer’s risk in the future. (Sobey, 3/23)

NBC News:Bird Flu Outbreak In The US: Human Risk Remains Low, CDC SaysFederal health officials are closely watching a highly lethal type of bird flu that’s devastated poultry farms along the East Coast and the Midwest in recent weeks. There are no signs the strain of avian influenza poses a danger to people yet, but experts are on the lookout for potential mutations of the virus that could make it more of a threat. Although the risk to humans remains low, the Centers for Disease Control and Prevention said it will monitor people who've been exposed to domestic and wild species infected with H5N1 — a highly pathogenic avian influenza virus that spreads easily among birds. (Lovelace Jr., 3/23)

USA Today:Researchers Warn Of Tick-Borne Heartland Virus In US. What To Know About The Viral PathogenThe Heartland virus is circulating in ticks in Georgia, researchers warn. A new study published in the journal Emerging Infectious Diseases last week and led by researchers from Emory University analyzed virus samples from ticks collected in central Georgia. But the Heartland virus, first identified in Missouri in 2009, has been documented in multiple states across the Midwest and Southeast. But what does that mean for your next hiking or camping trip? Is it time to be on the lookout for ticks that could carry the virus? (Pitofsky, 3/23)

Stat:Scientists Test Common Bacteria As A Weapon To Target Pancreatic TumorsPancreatic cancer has proved one of the most deadly forms of the disease, and the most difficult to crack. It shrugs off immunotherapy drugs and resists chemotherapy, and only about 10% of patients live longer than five years after diagnosis. But Albert Einstein College of Medicine immunologist and microbiologist Claudia Gravekamp is trying a new, unconventional approach: using Listeria bacteria to develop an immunotherapy that makes pancreatic tumors vulnerable to immune attacks. The results from her experiments in mice, published Wednesday in Science Translational Medicine, found the therapy can extend survival by 40% — a figure that experts said was very promising, though preliminary, and warranted further research in humans. (Chen, 3/23)

Bloomberg:U.S. Army Combat Fitness Test Ditches Gender- And Age-Neutral ScoringLeg tucks are out. The plank is in. And gone is the gender- and age-neutral scoring when the U.S. Army’s new combat fitness test becomes compulsory this fall. Even with the latest revisions, the Army is still banking on lean, mean fighting machines. But this time around, the largest U.S. military service doesn’t want to disadvantage any groups and kick out valuable soldiers because they couldn’t pass the new fitness test as it was initially envisioned. (Tiron, 3/23)

Houston Chronicle:Houston Expert Explains Why Your Allergies Are Worse Than UsualTexas is one of the most challenging places to live in America for people who deal with seasonal allergies, according to the Asthma and Allergy Foundation of America. And unfortunately for many, allergies are getting worse every year. Dr. Omar Ahmed, an otolaryngologist at Houston Methodist, says the hospital is seeing a trend toward longer and worse allergy seasons across the country and, in particular, Houston. "In Houston, we're expecting a bad season," Ahmed said, "and that's because we had a moderate to mild winter. You can track the allergy counts. Especially March and this coming April, it's going to be a bad season." (Nickerson, 3/23)

Fox News:Bella Hadid Speaks Out About The Perils Of Plastic Surgery In TeenagersBella means beautiful, but Bella Hadid didn’t think she was when she was a teenager. Supermodel Bella Hadid is finally coming clean about having plastic surgery, but she is speaking out on her regret of having it done when she was 14, according to a Vogue report last week. "I was the uglier sister. I was the brunette. I wasn’t as cool as [my sister] Gigi, not as outgoing," the twenty-five-year-old said. (Sudhakar, 3/23)

KHN:Can Melatonin Gummies Solve Family Bedtime Struggles? Experts Advise CautionFor three exhausting years, Lauren Lockwood tried to get her son Rex to sleep through the night. As an infant, he couldn’t sleep without a blanket over his carrier to drown out the world around him. At age 2, it sometimes took hours for him — and her — to fall asleep, only for him to be jolted awake from night terrors that left him shrieking in panic. Over the years, Lockwood, a nurse midwife who runs a group for new moms from her home in Oakland, California, experimented with a gamut of approaches to bedtime. When Rex was a baby, she let him “cry it out” so he could learn to put himself back to sleep. As he got older, she would lie beside him for hours each night. Finally, she hired a sleep consultant who created yet another plan that didn’t solve the problem. By the time Rex was 3, Lockwood, with another baby on the way, was worn out and desperate. (Gold, 3/24)

Also —

The Washington Post:Madeleine Albright Dies; First Female Secretary Of State Was 84Madeleine K. Albright, who came to the United States as an 11-year-old political refu­gee from Czechoslovakia and decades later was an ardent and effective advocate against mass atrocities in Eastern Europe while serving as U.S. ambassador to the United Nations and the first female secretary of state, died March 23 in Washington. She was 84.The cause was cancer, her family said in a statement. (Otis, 3/23)

Bay Area News Group:Bob Saget Said He Had Long COVID, Didn't Feel Well Before DeathTo add to the mystery of how Bob Saget fell in his Florida hotel room and suffered a fatal brain injury, the “Full House” star said he didn’t feel well and that his hearing was “off” before performing a comedy set the night before his death, according to a new report. Saget, 65, also told a showrunner at the Ponte Vedra Concert Hall near Jacksonville, Florida that he was suffering from “long-term COVID” and that it had taken “his body a long time to get over it.” That’s what the showrunner, Rosalie Cocci, told Orange County Sheriff’s investigators in an interview conducted after the actor’s death, according to audio obtained by Page Six. (Ross, 3/23)

NBC News:Disability Advocates Say Amanda Bynes' Conservatorship Case Isn't The NormAmanda Bynes' conservatorship was terminated Tuesday without public contention or fanfare. But disability advocates say her case is not the norm, and warn against using Bynes as evidence that conservatorships don't need to be reformed. Bynes' parents filed to place her in a conservatorship in 2013, following what the former child actor previously described as a dark period in her life. Her case has rarely played out in the public eye and draws a contrast to that of pop star Britney Spears, whose conservatorship was dissolved after a protracted, public court battle and has led to legal reform efforts in California. (Madani, 3/23)

State Watch

FDA Must Allow All Gay Men To Donate Blood, Massachusetts Doctors Say

Gay men can donate only if they have abstained from sex with other men for 90 days, according to a revised 2020 policy. The state's leading advocacy group for physicians says scientific advances that have improved blood screening — and the ongoing national blood shortage — should not be ignored.

The Boston Globe:State Physicians Urge FDA To Ease Restrictions On Blood Donation By Gay, Bisexual MenThe state’s leading advocacy group for doctors and a Boston-based health care center are urging the US Food and Drug Administration to further ease restrictions on blood donations by gay and bisexual men, calling the practice both discriminatory and problematic amid a national blood shortage. Massachusetts Medical Society and Fenway Health have partnered to press the federal government to adopt an enhanced screening process for blood donation, instead of excluding men who have sex with men. Gay men have been barred from donating blood since the 1980s, because of fears over HIV and AIDS. The FDA subsequently revised its policy in 2015 to allow gay and bisexual men to donate blood if they had abstained from sex with other men for a year. In 2020, the FDA again adjusted the abstention window to 90 days. (Bartlett, 3/23)

In news from Maine and Rhode Island —

AP:Lawmakers Approve Plan To Increase Dental Insurance Value Maine legislators are considering a law change to try to make dental insurance a better value for consumers in the state. The proposal is based on the Affordable Care Act rule that requires health insurers to have an 80% medical loss ratio. That means the insurers spend 80 cents of every dollar on customers claims and on items that improve care quality, lawmakers said. (3/23)

The Boston Globe:Families Push Lawmakers To Help Kids With Special Education NeedsOne family after another testified before the Senate Education Committee on Wednesday about their desperate, often fruitless, struggles to get schools to accommodate their children’s special needs and disabilities. Some of them held photos of their children as they spoke before lawmakers. Their words were emotional and, at times, heartbreaking. Lawmakers heard about Dillon, who has autism and sensory disorder, and started first grade by being sent to “an autism room” when teachers didn’t know what to do with him. When he misbehaved or took off his clothes, they called 911, said his mother, Renee Smith of Coventry, R.I.. She found another public school, just down the road, which had a comprehensive behavioral program that met his needs. She worries about what will happen next year, when he changes schools for sixth grade. (Milkovits, 3/23)

In news from Georgia, Kentucky, Kansas, and Texas —

Capitol Beat News Service:Georgia Senate Working To Finalize Its Version Of Medical Marijuana Bill Georgia senators are digging in their heels when it comes to how the state’s medical marijuana program should be operated. The Senate Health and Human Services Committee has essentially scrapped legislation the Georgia House of Representatives passed last week aimed at breaking a logjam that has sidetracked the program. Instead, the panel approved the same version the full Senate passed last week. Both bills would throw out the selection process a state commission created to oversee the program used to tentatively award licenses last summer to six companies to grow marijuana and convert the leafy crop to low-THC cannabis oil. The process left 16 losing bidders disgruntled and threatening to tie up the process in litigation. (Williams, 2/23)

AP:Lawmakers OK Bill Aimed At Reversing High Child Abuse Rates Kentucky lawmakers took aim Wednesday at reversing the state’s chronically high rates for child abuse and neglect, passing a sweeping measure to bolster prevention and oversight efforts. The bill won 94-0 final passage in the House, sending the measure to Gov. Andy Beshear. Child welfare advocates hailed the action, saying the legislation advances efforts to confront the Bluegrass State’s high national standing for its rates of child abuse and neglect. (Schreiner, 3/23)

AP:Kansas House Wants Age Limit For Tobacco, Vaping At 21The Republican-controlled Kansas House on Wednesday approved a bill that would increase the age to purchase or possess cigarettes and tobacco products from 18 to 21. The legislation also applies to electronic cigarettes and vaping products, and would prohibit them in school buildings. It would also make selling any tobacco or vaping products to someone younger than 21 or buying them for those under 21 a misdemeanor that can be punished with a $200 fine. (Field, 3/23)

Dallas Morning News:AG Paxton Appeals To Texas Supreme Court As State Halts Inquiries Into Parents Of Trans ChildrenAttorney General Ken Paxton is asking the Texas Supreme Court to allow the state to restart its abuse investigations into the parents of transgender children. Paxton filed his request with the state’s top court Wednesday afternoon. On Tuesday, the Texas Department of Child and Protective Services directed its employees to stop opening child abuse investigations based solely on allegations that parents are allowing their trans kids to access certain medical treatments after a court issued an injunction. “While this injunction is in place, [statewide intake] will not assess these matters as intakes unless independent grounds that warrant an investigation are reported,” Associate Commissioner Stephen Black said in an email obtained by The Dallas Morning News and verified by the agency. (McGaughy, 3/23)

And from Missouri, Michigan, and Montana —

Missouri Independent:Missouri Republicans Are Pushing Work Requirements To Get Health Care Under Medicaid Expansion When the Good Samaritan Care Clinic opened in 2006 in Mountain View, only about 5% of the free clinic’s clients were eligible for Medicaid. When it closed late last year, that number had risen to 70%, Dr. John Roberts, one of the clinic’s founders, told the Missouri Senate Appropriations Committee on Tuesday. Medicaid expansion means the clients without health insurance served by the clinic now can find paid care, Roberts said, but if it is taken away, they will have nothing. Roberts testified against a House-passed proposal that would add work requirements for people newly eligible because of Medicaid expansion and make portions of the Medicaid program subject to annual appropriations. (Keller, 3/23)

Detroit Free Press:Whitmer, Lawmakers Agree On $4.7 Billion Water And Infrastructure DealGov. Gretchen Whitmer and Michigan lawmakers have a deal to spend approximately $4.7 billion on an expansive plan to replace lead water pipes, improve dam safety, shore up the state's unemployment system and more. The compromise on a supplemental spending bill for the 2022 financial year was announced late Wednesday evening, marking another budget compromise between Republican legislative leaders and the Whitmer administration. "These are tough times for families, small businesses and communities, and this bipartisan supplemental will help grow our economy, create jobs and invest in every region of our state," Whitmer said in a joint statement issued after 10 p.m. on Wednesday. (Boucher and Egan, 3/23)

AP:EPA Moves To End Asbestos Cleanup Along Montana Railroad Environmental regulators are moving to end a years-long cleanup along dozens of miles of railroad in two northwestern Montana communities where lung-damaging asbestos from mining has been blamed in hundreds of deaths. The asbestos came from mining vermiculite that was processed and shipped by rail across the country for use as insulation, as a gardening soil additive and for other purposes. (Brown, 3/23)

AP:Blackfeet Tribe Declares Emergency After Drug OverdosesBlackfeet Tribal leaders declared a state of emergency on the northwestern Montana reservation following a string of fentanyl overdoses and drug-related deaths. There were four deaths tied to drugs and 17 overdoses over a one week period this month, the Blackfeet Tribal Business Council said Monday. Tribal leaders say they will set up a drug prevention task force to help combat the problem. (2/23)

Global Watch

Spotlight Falls On Mental Health Strains From Ukraine Invasion

News outlets cover concerns over mental health in Ukraine under traumatic circumstances, stresses experienced by refugees, and a lack of medical staff in the country. Separately, the European Society of Cardiology bans Russian doctors.

ABC News:'Nation Under Stress': Doctors Say Mental Health A Top Priority In Ukraine Since the war in Ukraine began, more than 3 million refugees have fled -- by bus, train, car and foot -- for neighboring countries. Some have destinations in mind, while others have no plan. But as these displaced citizens navigate different yet equally impossible conditions, doctors at the countries that border Ukraine say there's a common thread: mental health is the most often reported medical problem. ABC News interviewed doctors from the U.S. and Europe who flew to the border to volunteer. According to those doctors, among the millions of refugees, acute stress disorder has been reported as a common ailment. (Kondoleon, 3/22)

Reuters:500,000 Refugees From Ukraine Have Mental Health Issues, WHO Says About half a million refugees from Ukraine who have fled to Poland need support for mental health disorders, and 30,000 have severe mental health problems, the representative for the World Health Organisation in Poland said on Tuesday. Refugees arriving in Poland are suffering from a range of health problems, including diarrhea and dehydration, but the main need is for support due to trauma, Paloma Cuchi, WHO representative in Poland, told a briefing in Geneva. (3/22)

WRAL.Com:'Nurses Needed:' Duke Health Nurse Helps Infants In Ukraine As Bombs Fall NearbyA Duke Health nurse is back home in the Triangle after spending nearly a week at a hospital in Ukraine. Melissa Babb traveled to the war zone to treat infants in need of heart surgeries. She told WRAL News about her life-changing experience, and why she's willing to do it all over again. The idea began from the safety and comfort of her couch. Babb was watching TV with her husband Mitch when she noticed a Facebook post: Nurses needed. (3/22)

Fox News:European Society Of Cardiology Bans Russian Docs Amid Ukraine InvasionThe European Society of Cardiology (ESC), an international community of cardiologists, said in a statement sent to Fox News, that it paused the memberships of the Russian Society of Cardiology and the Belarussian Society of Cardiologists amid the ongoing invasion of Ukraine, which is also one of its member countries. Cardiologists in Russia or Belarus are also barred from any ESC event, including presenters, the statement said. "Please let us emphasize that this extraordinary measure is not at all directed against cardiologists, scientists, and other ESC members from the Russian Federation or Belarus. They are not to blame for the war. They are our friends and colleagues in the fight against cardiovascular disease." Stephan Achenbach, President of the ESC, said in the statement. (McGorry, 3/23)

Reuters:Ukraine Uses Facial Recognition To Identify Dead Russian Soldiers, Minister SaysUkraine is using facial recognition software to identify the bodies of Russian soldiers killed in combat and to trace their families to inform them of their deaths, Ukraine's vice prime minister told Reuters. Reuters exclusively reported that Ukraine's Ministry of Defense this month began using technology from Clearview AI, a New York-based facial recognition provider that finds images on the web that match faces from uploaded photos. It was not clear at that time how the technology would be used. (Dave, 3/23)

In global covid news —

CIDRAP:Global COVID-19 Cases Climb For Second Week In A Row Led mainly by surges in Asian hot spots, COVID-19 cases last week increased for the second straight week, though deaths continued to fall, the World Health Organization (WHO) said yesterday in its weekly pandemic update. Last week marked a turnaround in a 5-week decline in cases. In the continued rise this week, cases were up 7% compared to the week before, the WHO said. Cases were up 21% in the Western Pacific region, an area that includes locations experiencing surges, including South Korea, Vietnam, and Hong Kong. (Schnirring, 3/23)

Bloomberg:Sweden Jumps The Gun On Covid Strategist’s New WHO JobSweden’s announcement that Anders Tegnell, the mastermind behind the Scandinavian country’s controversial Covid-19 strategy, had been hired by the World Health Organization has turned out to be premature. The March 9 report by Sweden’s Public Health Agency FHM said that Tegnell had resigned as state epidemiologist to become a senior expert in a group that will coordinate the work between the WHO, the UN Children’s Fund UNICEF and vaccine organization Gavi. Svenska Dagbladet first reported that the announcement was met with “surprise and confusion” within the WHO. (Jungstedt, 3/23)

Health Policy Research

Research Roundup: Covid; Diabetes; Parkinson's; Alzheimer's

Each week, KHN compiles a selection of recently released health policy studies and briefs.

ScienceDaily:Natural COVID-19 Antibodies Lasts Seven Months For Children, According To New Study Children previously infected with COVID-19 develop natural circulating antibodies that last for at least seven months, according to a new study. (University of Texas Health Science Center at Houston, 3/18)

The Lancet:Risks And Burdens Of Incident Diabetes In Long COVID: A Cohort Study There is growing evidence suggesting that beyond the acute phase of SARS-CoV-2 infection, people with COVID-19 could experience a wide range of post-acute sequelae, including diabetes. However, the risks and burdens of diabetes in the post-acute phase of the disease have not yet been comprehensively characterised. To address this knowledge gap, we aimed to examine the post-acute risk and burden of incident diabetes in people who survived the first 30 days of SARS-CoV-2 infection. (Xie and Al-Aly, 3/21)

ScienceDaily:A Gene Could Prevent Parkinson's DiseaseParkinson's disease is a neurodegenerative disorder characterized by the destruction of a specific population of neurons: the dopaminergic neurons. A team has investigated the destruction of these dopaminergic neurons using the fruit fly as study model. The scientists identified a key protein in flies, and also in mice, which plays a protective role against this disease and could be a new therapeutic target. (Universite de Geneve, 3/17)

ScienceDaily:New Strategy Reduces Brain Damage In Alzheimer’s And Related Disorders, In MiceAlzheimer's disease is the most common and best known of the tauopathies, a set of neurodegenerative brain diseases caused by toxic tangles of the protein tau. A study has now shown that targeting astrocytes -- an inflammatory cell in the brain -- reduces tau-related brain damage and inflammation in mice. (Washington University School of Medicine, 3/18)

ScienceDaily:When The Brain Sees A Familiar Face: The Action Of The Eye Triggers Brain Waves To Help Remember Socially Important Information Researchers have uncovered new information about how the area of the brain responsible for memory is triggered when the eyes come to rest on a face versus another object or image. (Cedars-Sinai Medical Center, 3/18)

ScienceDaily:Large Study On Traumatic Brain Injury Highlights Global Inequality In Causes And Treatment Neurosurgery experts from Cambridge have led the largest ever study examining the surgical management of traumatic brain injuries, highlighting regional inequalities in both major causes and treatment of such injuries. (University of Cambridge, 3/17)

American Academy Of Pediatrics:The Plight Of Discontinued Pediatric Clinical Trials And What We Can Do About It While all peer-reviewed pediatric journals look forward to receiving well-done clinical trials, the number of pediatric trials is much smaller than the number of adult clinical studies. An important reality is that many studies are not completed. This could be due to the challenge of enrolling children, the relative low prevalence for high-priority conditions, and a lack of funding. What proportion of trials registered with ClinicalTrials.gov, one of the largest international databases of clinical trials, are completed and ultimately published?These were the questions that Brewster et al (10.1542/peds.2021-052557) explored in an interesting article being early-released this month in Pediatrics. (First, MD, MS, 3/22)

JAMA Network:Outcomes And Safety Of History-Based Screening For Medication Abortion: A Retrospective Multicenter Cohort Study Screening for medication abortion eligibility typically includes ultrasonography or pelvic examination. To reduce physical contact during the COVID-19 pandemic, many clinicians stopped requiring tests before medication abortion and instead screened patients for pregnancy duration and ectopic pregnancy risk by history alone. However, few US-based studies have been conducted on the outcomes and safety of this novel model of care. (Upadhyay, Phd, MPH, et al, 3/21)

Editorials And Opinions

Viewpoints: The Next Variant Could Come From North Korea; Slow Vaccine Trials Are Neglecting Youngest Victims

Opinion writers weigh in on covid and mental health.

The Washington Post:If The World Doesn’t Act, North Korea Could Become A Breeding Ground For Dangerous Covid Variants North Korea’s nuclear-tipped missiles are not the only threat from the rogue nation that demands the world’s attention. It is also at high risk of a runaway coronavirus outbreak, which could create a breeding ground for new, dangerous variants. For two years, North Korea has imposed a “zero covid” policy. Pyongyang claims that this has been successful in keeping the country covid-free, but it has also cut off critical food and medical supplies, resulting in severe shortages. It has also left its population of approximately 25 million people both unvaccinated (despite multiple offers from Covax, the United Nations-backed global vaccine initiative) and probably with minuscule immunity from prior infections. (Victor Cha, Katrin Fraser Katz and Stephen Morrison, 3/23)

Houston Chronicle:Moderna Finally Has Data On A COVID Vaccine For Kids Under 5. It Shouldn’t Take So LongParents of young children have some good news about COVID vaccines. Moderna announced its two-dose pediatric vaccine is safe for children under five and produces an immune response. The data, however, don’t yet give us a clear picture of how effective it is at preventing illness — a problem pediatricians and researchers foresaw in 2020. (Mark W. Klinne and Sophie Rosenblum, 3/23)

Also —

The CT Mirror:Mental Health Providers Need Support, TooThe legislature is to be applauded for their attention to the state’s mental health workforce. Senate bills SB1 and SB2, plus House Bill 5001 all offer positive incentives, programs, and funding meant to attract the next generation of mental health providers. Ideas such as loan forgiveness, grants to pay for licensing fees, grants for hiring of social workers, and assistance paying for license preparation courses are all wonderful ideas. The only problem is that we are not offering anything to the current mental health workforce to keep them in place. (Stephen Wanczyk-Karp, 3/24)

The Washington Post:Why Is This Mentally Ill Army Vet Stuck In Jail? In his State of the Union address on March 1, President Biden proposed a four-pronged “unity agenda,” including a shared commitment to delivering mental health services and to caring for our veterans. “Veterans,” the president said, “are the best of us.” While Biden spoke, one of our best — retired Army Spec. Scott Ryan Merryman — lay languishing in a jail cell, less than 20 miles from the Capitol, because of a mental health crisis. (Liz Oyer, 3/22)

Different Takes: Some Doctors Prescribe More Than Pills; What Will Happen If Roe Is Reversed?

Editorial writers examine these public health issues.

The Boston Globe:Take This Cash And Call Me In The Morning Nine years ago, Dr. Gordon Schiff, a physician at Brigham and Women’s Hospital, offered a patient a medicine that his textbooks had never mentioned: $30 in cash. Schiff had learned that his patient could not afford the out-of-pocket cost to fill his prescription and didn’t have the time to deal with insurance. So Schiff figured cash from his own pocket would help his patient find quicker relief. But the trainee shadowing Schiff disagreed, and reported him for being “unprofessional.” (Julia Hotz, 3/24)

CNN:Why A 'War On Abortion' Is Doomed To Fail Often, the fate of Roe v. Wade looms over the confirmation hearing of any prospective Supreme Court justice. This time feels different. This week, Ketanji Brown Jackson takes questions from the Senate Judiciary Committee as the Supreme Court continues to deliberate whether it will undermine the fundamental right to abortion when it rules on a Mississippi statute that bans abortions after 15 weeks of pregnancy. (Mary Ziegler and Aziza Ahmed, 3/23)

JAMA Network:It Is Time To Change The Standard Of Medication Abortion Before prescribing medication abortion, clinicians have been compelled to perform a pelvic examination or ultrasonography for gestational dating to adhere to the requirements of the US Food and Drug Administration (FDA) Risk Evaluation and Mitigation System (REMS) program for dispensing mifepristone. These examinations require an in-person clinic visit, which can be logistically burdensome and limit access to care. In this issue of JAMA Internal Medicine, Upadhyay et al1 provide evidence that medication abortion using mifepristone and misoprostol is safe and effective for pregnancy termination without requiring an in-person clinical evaluation. These data should reassure clinicians and FDA evaluators that allowing history-based screening in lieu of in-person examinations is appropriate and evidence based. (Jennifer Karlin, MD, PhD and Jamila Perritt, MD, MPH, 3/21)

Columbus Dispatch:How Can People With Disabilities Get Better Healthcare?Most people would agree that a well-trained physician — or nurse, patient care tech or any other healthcare professional — should be prepared to give people effective care regardless of gender, race or age. That’s Inclusivity 101. But for too many in healthcare, Inclusivity 101 leaves out a very large group: people with disabilities. With between 20% and 25% of Americans living with a disability, it’s time for medical education to become fully inclusive. (Kara Ayers, Karen Kostelac and Susan Havercamp, 3/23)

Stat:Private Equity, Health Care, And Profits: It's Time To Protect Patients In his State of the Union address, President Biden expressed concern with the growing — and troubling — trend of private equity ownership and operation of nursing homes and the inherent risk it presents to care of their residents. Between 2010 and 2019, such equity deals in health care nearly tripled in value, from $42 billion to $120 billion, totaling $750 billion over the last decade. That staggering number represents thousands of hospitals, nursing homes, travel nurse companies, behavioral health programs, and other health care settings in every state. The profit-making goals of private equity are, in many ways, at odds with the needs of patients and the rules of government-financed health care programs. In fact, since 2013, private equity-owned health care companies have paid more than $500 million to settle claims of overcharging government health care programs. (Jeanne A. Markey and Raymond M. Sarola, 3/24)

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