Wednesday, February 23, 2022 | Kaiser Health News

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Kaiser Health News Original Stories

An $80,000 Tab for Newborns Lays Out a Loophole in the New Law to Curb Surprise Bills

The insurance company said that the birth of the Bull family’s twins was not an emergency and that NICU care was “not medically necessary.” The family’s experience with a huge bill sent to collections happened in 2020, but it exposes a hole in the new No Surprises law that took effect Jan. 1.(Jay Hancock,)

Targeted by Politicians, Trans Youth Struggle With Growing Fear and Mental Health Concerns

Transgender young people and their parents have stepped up to testify against legislation targeting them. But as rhetoric escalates in the political fray, what does the anti-trans legislative push mean for their mental health?(Sandy West,)

Other States Keep Watchful Eye on Snags in Washington's Pioneering Public-Option Plan

Washington was the first state in the U.S. to introduce a public option for health insurance, but the rollout hasn’t been smooth. Other states with public options in the works are taking notice.(Markian Hawryluk,)

Political Cartoon: 'A Death Drive?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'A Death Drive?'" by Clay Bennett.

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Summaries Of The News:

Covid-19 Crisis

Covid Cases Down An Encouraging 90% From 5 Weeks Ago

Around 84,000 new cases per day on average are now being reported, as compared to the pandemic-high of 800,000 infections reported on Jan. 15. Hospitalizations are also in decline in most places. But conditions remain dangerous for young kids and people who are immunocompromised.

CNBC:Covid Infections Plummet 90% From U.S. Pandemic High, States Lift Mask MandatesU.S. health officials are optimistic, albeit cautiously, the country has turned the corner on the unprecedented wave of infection caused by the omicron Covid variant as new cases plummet 90% from a pandemic record set just five weeks ago. As the nation emerges from the omicron wave, U.S. and state leaders are trying to mentally move past the crisis that has gripped everyone since the pandemic began two years ago. Public health leaders have begun rolling out plans to deal with the virus as a persistent but manageable risk in the future. (Kimball and Rattner, 2/22)

AP:Indiana Hospitals Less Stressed As COVID-19 Surge PassesOfficials at Indiana’s largest hospital system said Tuesday that its hospitals have weathered the worst of the latest COVID-19 surge although they are still treating hundreds of patients with the illness. The update from IU Health officials came as Indiana has seen steep declines in the past month in COVID-19 deaths, hospitalizations and new infections from the surge brought on by the delta and omicron variants. (Davies, 2/22)

But though covid is down, it's not out ... and worries for children remain —

Milkwaukee Journal Sentinel:Milwaukee Health Official Cautions Against Calling End To PandemicMilwaukee County's chief health policy adviser is cautioning the public on calling an end to the pandemic, citing high COVID-19 hospitalizations and waning vaccination levels. "Though many of us want to be done with the pandemic, the pandemic is likely not done with us," Ben Weston, chief health policy adviser with Milwaukee County, said in Tuesday's COVID-19 briefing. (Bentley, 2/23)

New Orleans Times-Picayune:Three Louisiana Children Died Of COVID Over The Past Week; Total Now At 21Three more Louisiana children died of COVID-19 in the last week, bringing the total number of kids who have been lost to the pandemic to 21, state officials said Tuesday. Two of the recent deaths were in children under 5 years old, a group that is too young to be vaccinated. The third death was in a child between the ages of 5 and 17. (Woodruff, 2/22)

CNN:As Omicron Cases Fall, Doctors Anxiously Await Possible Surge Of Dangerous Child Complication MIS-C After the Omicron coronavirus variant made a record number of US children sick in January, children's hospitals across the United States braced for what has come with every other spike in the Covid-19 pandemic: cases of a rare but dangerous condition called multisystem inflammatory syndrome in children, commonly known as MIS-C. But a number of hospitals say the expected surge in cases hasn't showed up -- at least not yet. MIS-C can follow Covid-19 even some weeks after infection. It can cause parts of the body to become inflamed, and it can affect major organs including the kidneys, brain, lungs and heart. (Christensen, 2/22)

Braced For Future Variants, WHO Worried About Scaled Back Testing

With the omicron subvariant BA.2 still "of concern," and other potential mutations on the horizon, the World Health Organization tells nations that now is not the time to reduce testing.

The Washington Post:Reduced Testing Is Concerning, WHO Official SaysA World Health Organization official on Tuesday expressed concern about reduced testing and surveillance of the coronavirus in countries around the world, saying monitoring remains critical. “We need to be strategic about this, but we cannot abandon it,” said WHO epidemiologist Maria Van Kerkhove during an online question-and-answer session. “And what we do not want to see is the dismantling of these surveillance systems that have been put in place for covid-19.” (Cheng, Timsit and Shammas, 2/22)

AP:WHO: New COVID Cases Fall For The 3rd Week, Deaths Also DropThe number of new coronavirus cases around the world fell 21% in the last week, marking the third consecutive week that COVID-19 cases have dropped, the World Health Organization said Tuesday. In the U.N. health agency’s weekly pandemic report, WHO said there were more than 12 million new coronavirus infections last week. The number of new COVID-19 deaths fell 8% to about 67,000 worldwide, the first time that weekly deaths have fallen since early January. (2/22)

Newsweek:Stealth Omicron BA.2, Found In 48 States, Should Remain Variant Of Concern Says WHOThe Omicron BA.2 sub-variant should continue to be considered a variant of concern (VOC) and remain classed as part of the Omicron family of variants, the World Health Organisation (WHO) has said.BA.2 has been the subject of interest and concern after it started spreading rapidly in some countries earlier this year, despite of the wider Omicron wave. (Browne, 2/23)

On vaccinations, and an unexpected global surplus —

Reuters:COVID Vaccine Supply For Global Programme Outstrips Demand For First TimeThe global project to share COVID-19 vaccines is struggling to place more than 300 million doses in the latest sign the problem with vaccinating the world is now more about demand than supply. Last year, wealthy nations snapped most of the available shots to inoculate their own citizens first, meaning less than a third of people in low-income countries have been vaccinated so far compared with more than 70% in richer nations. As supply and donations have ramped up, however, poorer nations are facing hurdles such as gaps in cold-chain shortage, vaccine hesitancy and a lack of money to support distribution networks, public health officials told Reuters. (Guarascio and Rigby, 2/23)

Politico:Africa CDC To Ask World To Pause Covid-19 Vaccine DonationsThe Africa CDC will ask that all Covid-19 vaccine donations be paused until the third or fourth quarter of this year, the director of the agency told POLITICO. John Nkengasong, director of the Africa Centres for Disease Control and Prevention, said the primary challenge for vaccinating the continent is no longer supply shortages but logistics challenges and vaccine hesitancy — leading the agency and the African Vaccine Acquisition Trust to seek the delay. (Payne, 2/22)

Bloomberg:Moderna Inks Latin America Deal in Bid to Expand Vaccine ReachModerna Inc. has signed a deal with a Uruguayan pharmaceutical company in a bid to expand its reach across Latin America. The Covid-19 vaccine maker announced the distribution deal Tuesday with Adium Pharma SA to market the shots in 18 countries in the region including Brazil and Mexico. The shots will be supplied from Moderna’s plants in the U.S. and Europe, said Roman Saglio, head of commercial alliances for Latin America. (Navarro, 2/22)

Also —

The New York Times:‘Our Life And Our Freedom Are Not As Important’: High-Risk People In England React To The Rules LiftingThe government has said that it is ending the remainder of virus restrictions to help the country shift to more of an approach of living with the virus. But some critics say the move is premature and overlooks those who are most clinically vulnerable, especially the hundreds of thousands who are immunocompromised. In the United States, many immunocompromised and higher-risk people have also felt left behind by the flurry of lifted restrictions. “What happened yesterday has been very concerning for the people we work with,” said Gemma Peters, the chief executive of Blood Cancer UK, a charity that funds research into blood cancer. (Bubola, 2/22)

Idaho Statesman:Chemical In COVID Test Kits Can Cause Sickness If Ingested, Experts SayWhile at-home COVID-19 tests are considered safe and effective when used properly, a chemical found in some popular kits is leading to an increase in calls to poison control centers. Sodium azide is potentially deadly in large amounts, but only small quantities are present in testing kits — enough to cause low blood pressure, heart palpitations, headache and dizziness if ingested, or burning and irritation to exposed skin, experts say. (Willetts, 2/22)

Pandemic Policymaking

Mask Mandates Dropped In Every State But One; More Cities Relax Rules

As covid cases dramatically dip, state-ordered public masking requirements only remain in Hawaii. Los Angeles and Chicago are also moving to lift some restrictions. But how to handle masks in schools remains a point of contention in many districts.

The Washington Post:Mask Mandates Have Ended In All But One State As Retailers And Cruises Follow SuitAs coronavirus cases continue to decline across the country, all states but one — Hawaii — have dropped their mask mandates or have made plans to do so in the coming weeks. This week, Target and Apple stores joined other retailers in pulling back their own mandates. In recent days, some cruise lines — including Norwegian and Royal Caribbean International — said they are relaxing mask requirements for vaccinated passengers after putting stricter rules in place during the omicron surge. The industry was hit hard early in the pandemic as horror stories of onboard outbreaks made international headlines. (Cheng and Timsit, 2/23)

Los Angeles Times:L.A. County Could Relax Mask Rules In Some Places, Officials SayVaccinated Los Angeles County residents may soon be able to go maskless in indoor settings that check for proof that they’ve received their doses, county officials said Tuesday. Details of that forthcoming shift remain scarce, but such a change would be a potentially significant loosening of rules in a region that has been more reluctant to relax such requirements even as the Omicron wave recedes. (Money and Lin II, 2/22)

The New York Times:Chicago Will End Its Mask Mandate For Many Public SpacesChicago will end its mask and vaccine mandate for some public places such as restaurants starting on Monday after a recent plunge in cases of the Omicron variant, the city’s mayor said on Tuesday. The move aligns with Illinois’s plan to end a statewide indoor mask mandate that same day.The announcement by Mayor Lori Lightfoot does not apply to some spaces — notably health care settings and public transit, where masks will still be required. (Patel, 2/23)

Masking in schools remains a controversial matter —

The New York Times:Most N.Y. Voters In Poll Want More Data Before School Mask Mandate EndsWhile New York State officials have begun lifting certain coronavirus pandemic restrictions, not all residents are happy to see them go, according to a new poll released Tuesday by the Siena College Research Institute. Forty-five percent of registered voters in the survey said the state should have kept in place its rule requiring masks or proof of full vaccination in indoor public places, which was recently rescinded. Some 31 percent said the mandate should have been ended earlier, and 20 percent said it ended at the right time, the poll found. (Fadulu, 2/23)

The Wall Street Journal:Masks In Schools: Districts Get Caught Between Health Authorities And Parent PushbackSchools have once again become a battleground over pandemic masking, with districts facing rising public pressure to drop mandatory mask requirements even as public-health agencies largely advise keeping students and teachers in face coverings. As the latest Covid-19 wave wanes, more states are lifting mask mandates for restaurants and businesses, but many school requirements remain. Disagreements are leading to heated school board meetings and divided communities, just months after similar tensions flared up during the return to in-person learning in the fall. (Randazzo, 2/23)

AP:Maryland Board Votes To Let Local Schools Decide On MasksThe Maryland State Board of Education voted Tuesday to allow local school districts to decide whether students must wear face coverings in school, sending the proposal to end an emergency order to a legislative committee to make a final decision. Citing improvements in COVID-19 health metrics, the board voted 12-2 to rescind the order on March 1. Still, the Maryland General Assembly’s Joint Committee on Administrative, Executive, and Legislative Review has the last say on the matter. (Witte, 2/22)

Bangor Daily News:Maine Teachers And School Board Members Seek Legal Protection As They Face HarassmentMaine educators are lobbying to be legally recognized as public servants as a protection against harassment as administrators, teachers and school boards have faced backlash over policies from COVID protocols to school curricula. Sen. Cathy Breen, D-Falmouth, introduced a bill, L.D. 1939, that would add school superintendents, principals, teachers and school board members to the definition of “public servants” in Maine’s criminal code. Public servants are currently defined as government officials, officers or employees and any person “participating as juror, advisor or consultant…in performing a government function.” Russell, 2/23)

Supreme Court Won't Consider Health Worker Bid For Religious Vaccine Exemption

The Supreme Court has again refused to hear a group of Maine health workers' objection to their state's covid vaccine mandate, that does not include a religious exemption. Other vaccine news focuses on "passports," child vaccination rates and boosters.

AP:Supreme Court Won't Hear Challenge To Maine Vaccine MandateThe U.S. Supreme Court has declined to hear arguments in a lawsuit that sought to challenge Maine’s COVID-19 vaccine mandate for health workers. Justices did not explain their decision in court papers on Tuesday. The court had already turned down two emergency applications that sought to stop the mandate from going into effect. The vaccine requirement in Maine went into effect in October. Unnamed workers sued the state to try to require religious exemptions from the vaccine law. (2/22)

Bloomberg:U.S. Supreme Court Spurns Bid For Religious Opt-Out From Covid Vaccine Rule Maine is one of three states, along with New York and Rhode Island, that require vaccination of health-care workers and allow exemptions only for medical reasons. Although the Supreme Court has limited the federal government’s power to require Covid shots or tests, the justices have allowed state and local mandates, even without religious exemptions. The court left in force New York’s requirement in December. The Supreme Court had already rejected the Maine challengers in October, when over three dissents the justices refused to intervene on an emergency basis. (Stohr, 2/22)

Politico:More GOP States Now Wagering On Vaccine ‘Passports’ TechnologySeveral Republican-leaning states that eschewed so-called vaccine passports over concerns that they limited freedom are now embracing the technology behind them so that their residents can travel and get their immunization and health records online. The technology — which allows proof of Covid-19 vaccination to be digitized and often includes a QR code — had been touted by supporters, largely in Democratic-leaning states, as a way to facilitate safer reopening after pandemic-related shutdowns. (Leonard, 2/23)

Deseret News:Utah Vaccine Passport Ban Advances Despite Concerns It Could Hurt Future Pandemic ResponseA bill to prohibit the use of vaccine passports by employers or governments passed the House despite fears that it takes an overly broad approach that could hamstring future public health efforts. HB60 would essentially make vaccination status a protected class — similar to race, sex and religion — and prevent employers from requiring vaccination as a term of employment. The bill comes amid pushback against COVID-19 vaccination requirements but isn’t limited to the current pandemic. (Beal-Cvetko, 2/22)

USA Today:Experts Worry A Lack Of Data Is Obscuring Which Kids Aren't Getting The COVID-19 ShotExperts worry a lack of data may be obscuring where to target strategies for vaccinating kids of color, who disproportionately suffer severe illness from COVID-19 but may lack access to the shot. Just shy of a third of children ages 5 to 11 nationwide have received at least one dose of COVID-19 vaccine and a quarter are fully vaccinated, Centers for Disease Control and Prevention data shows. About 67% of kids 12 and older have received one dose, and only 57% are fully vaccinated.But the CDC does not report children’s COVID-19 vaccination rates by race, and inconsistencies and variations remain in the ways figures are broken down and reported from state to state. (Hassanein, 2/23)

A fourth covid shot is still being considered —

Axios:America Prepares For A Potential 4th COVID Shot Even as the Omicron wave winds down, federal health officials, experts and the vaccine makers are already preparing for a potential fourth COVID shot to protect against whatever may come next. It's not yet clear whether another booster shot will be needed. And if it is, there are even more questions around who should receive one and what kind of shot would be most effective. ​​"The potential future requirement for an additional boost or a fourth shot for mRNA or a third shot for J&J is being very carefully monitored in real time. And recommendations, if needed, will be updated according to the data as it evolves," NIAID director Anthony Fauci told reporters last week. (Owens, 2/23)

Capitol Watch

Washington State's Public Option Insurance Plan Is Slow Out Of The Box

When Congress failed to add a government-sponsored insurance plan to those sold on the insurance marketplaces, Washington state opted to offer its own. But the initiative has been hampered by hospitals' hesitancy to participate.

KHN:Other States Keep Watchful Eye On Snags In Washington’s Pioneering Public-Option Plan With prospects dim for the U.S. to adopt a single-payer “Medicare for All” program, health care reform advocates turned instead to an insurance plan designed by the government that could compete with private insurance plans sold on the health care exchanges. The idea behind this “public option” is that it could ultimately expand health care access by making a lower-cost plan available to consumers. ... Washington state, in its second year of offering the nation’s first public-option health insurance plan, has learned an important lesson: If you want hospitals to participate, you’re probably going to have to force them. (Hawryluk, 2/23)

More protests against covid restrictions are coming —

The Hill:Pentagon Approves Request For National Guard Deployment Ahead Of DC Trucker ConvoyDefense Secretary Lloyd Austin has approved hundreds of unarmed National Guard troops to be deployed in Washington, D.C., ahead of a truck convoy protest against pandemic restrictions that is expected to coincide with President Biden's first State of the Union address. The Department of Defense (DOD) said that Austin had approved a request that had been made by the D.C. Metropolitan Police Department (MPD) and U.S. Capitol Police (USCP) for assistance from National Guard members. (Choi, 2/22)

AP:National Guard To Help DC Control Traffic For Truck ConvoysThe Pentagon has approved the deployment of 700 unarmed National Guard troops to the nation’s capital as it prepares for trucker convoys that are planning protests against pandemic restrictions beginning next week. ... It remains to be seen if any of the U.S. convoys would seek to actively shut down Washington’s streets, the way their Canadian counterparts did in Ottawa. Some convoy organizers have spoken of plans to briefly roll through the city, then focus on shutting down the Beltway, which encircles the capital. (Khalil and Baldor, 2/22)

Los Angeles Times:Truckers Set To Gather In California As People's Convoy Heads To D.C.A group of truckers similar to those whose defiant blockades have shut down border crossings into the U.S. and Canada for weeks are bringing their protests over COVID-19 mandates to California. Organizers are hoping to have 1,000 semi-truck drivers in their ranks by Wednesday, when a group calling itself the People’s Convoy leaves Adelanto to begin a scheduled 11-day trek to Washington, D.C. The convoy is expected to arrive in early March, which could disrupt traffic near the Capitol around the March 1 State of the Union address. (Winton, 2/22)

Also —

Stat:FDA Asks Congress For More Power To Regulate Certain Diagnostic TestsThe Food and Drug Administration is asking Congress for more power to regulate prenatal tests that help identify genetic issues during pregnancy. The agency’s request came in response to a letter from nearly 100 Republican lawmakers who probed how the FDA was regulating these tests after a New York Times investigation found the five most common prenatal tests frequently provided inaccurate results. In a new letter to lawmakers obtained by STAT, the FDA admits that it has only limited powers to regulate such products — so limited that for the most part, it doesn’t review them at all. The agency goes on to urge Congress to pass legislation giving the agency greater oversight powers in the sphere. (Florko, 2/23)

The Wall Street Journal:Push To Relax Marijuana Laws Hits RoadblocksFacing a tough midterm election and divisions in Congress, the Biden administration is sidestepping the politically sensitive issue of loosening marijuana laws even as the idea has gained support of most Americans. More than half of U.S. states have legalized cannabis use for some purposes. Lawmakers have proposed decriminalizing marijuana, which would entail reduced penalties for users, and have pushed for giving the industry access to banking services. Those promoting changes include a diverse range of political figures, from former Republican House Speaker John Boehner to progressive Rep. Alexandria Ocasio-Cortez (D., N.Y.). (Leary, 2/22)

Meanwhile, global health groups are seeking more funding —

Reuters:Fund Tackling AIDS, TB, Malaria Seeks $18 Bln To Reverse COVID DisruptionsAt least $18 billion is needed to get the fight against malaria, tuberculosis and AIDS back on track from disruptions caused by the COVID-19 pandemic, a global health fund said on Wednesday. The target for 2024-2026 is $4 billion more than the Global Fund to Fight AIDS, Tuberculosis and Malaria raised in its previous fund raising session in 2019. The $18 billion aims to reverse setbacks in its global efforts on disease testing, prevention and treatment caused by the pandemic, the Geneva-based aid body said. (Maddipatla, 2/22)

Women’s Health

Florida, S.D., Indiana Lawmakers Move To Tighten Abortion Laws

A Florida House panel approved a bill banning abortions after 15 weeks; a South Dakota House committee endorsed a bill requiring people getting medical abortions to see a doctor three times and the Indiana Senate passed a bill seeking to thwart "coerced" abortions.

Health News Florida:Committee Approves Florida's 15-Week Abortion Limit, Sending The Measure To The Senate FloorAfter the House passed the measure last week, a bill that would prevent abortions after 15 weeks of pregnancy is poised to go to the full Senate. The Senate Appropriations Committee on Monday voted 13-6 to approve the bill (HB 5), which is similar to a Mississippi law that is being reviewed by the U.S. Supreme Court. Committee Chair Kelli Stargel, a Lakeland Republican who is the Senate sponsor of the bill, said viability of babies has gotten earlier since the landmark Roe v. Wade abortion rights ruling in 1973. “This is about what we as a state should be responsible for and how we as a state should move forward and looking at within the confines of law,” she said. (2/22)

AP:S. Dakota Governor, Fellow Republicans Target Abortion PillsGov. Kristi Noem’s proposal to make South Dakota one of the hardest places in the country to get abortion pills gained support Tuesday from Republicans in the state House, even though a federal judge has halted a similar rule from taking effect there. Every Republican on the South Dakota House‘s Health and Human Services committee voted to advance the bill for a vote in the full chamber this week. The bill would require women seeking an abortion to make three separate trips to a doctor in order to take abortion pills. Women in South Dakota can currently get both drugs in the two-dose regimen during a single visit and take the second dose at home. (Groves, 2/22)

Indianapolis Star:Senate Votes to Criminalize Coerced Abortion. Opponents Say It Stigmatizes the Procedure.The Indiana Senate approved new abortion regulations on Tuesday by a 38-10 vote in an attempt to limit "coerced" abortions. ... Under House Bill 1217 any pregnant woman seeking an abortion would have to be informed both orally and in writing that no one can coerce the pregnant woman to have an abortion. If an abortion clinic employee suspects someone is being coerced — a Level 6 felony under the bill — they clinic must report it to law enforcement, who must then investigate. (Lange, 2/22)

On pregnancy and childcare matters —

AP:Pregnancy-Related Deaths Climbed In Pandemic's First YearPregnancy-related deaths for U.S. mothers climbed higher in the pandemic’s first year, continuing a decades-long trend that disproportionately affects Black people, according to a government report released Wednesday. Overall in 2020, there were almost 24 deaths per 100,000 births, or 861 deaths total — numbers that reflect mothers dying during pregnancy, childbirth or the year after. The rate was 20 per 100,000 in 2019. Among Black people, there were 55 maternal deaths per 100,000 births — almost triple the rate for whites. (Tanner, 2/23)

Bloomberg:U.S. Black Maternal Mortality Rate Triple That Of White, Hispanic Women In 2020The U.S. maternal mortality rate — already high compared to other wealthy countries — has increased, with Black women faring far worse than their White peers, according to new data. In 2020, 861 women died of maternal causes in the U.S., up from 754 in 2019, according to a report released Wednesday by the U.S. Centers for Disease Control and Prevention. That puts the 2020 maternal mortality rate at 23.8 deaths per 100,000 live births, a figure that is more than double the rate in countries including the U.K., Canada or France. (Butler, 2/23)

KHN:An $80,000 Tab For Newborns Lays Out A Loophole In The New Law To Curb Surprise BillsWhen Greg and Sugar Bull were ready to start a family, health challenges necessitated that they work with a gestational surrogate. The woman who carried and gave birth to their twins lived two states away. The pregnancy went well until the surrogate experienced high blood pressure and other symptoms of preeclampsia, which could have harmed her and the babies. Doctors ordered an emergency delivery at 34 weeks’ gestation. Both infants had to spend more than a week in the neonatal intensive care unit. (Hancock, 2/23)

Bloomberg:Infant Formula Survey Shows ‘Pervasive, Aggressive’ MarketingInfant formula makers are systematically targeting women through social media and health-care professionals to gain influence over feeding decisions, according to a study the World Health Organization says is the largest ever. More than half of the parents and pregnant women surveyed said they’ve been targeted with formula-milk marketing, according to the report. The study was commissioned by Unicef and the WHO, which has been trying for years to rein in such promotions, calling them disruptive to efforts to increase the rate of breastfeeding around the world. (Gretler, 2/22)

Science And Innovations

In A First, Scientists Capture Electrical Signals From A Dying Brain

The new results were gained in a coincidental EEG procedure during which the patient suffered a heart attack. The results may prompt a rethink about death process, and even impact organ harvesting practices. Obesity, human gene regulation, an RSV vaccine, and more are also in the news.

Press Association:First Ever Recording Of Dying Brain May Shed Light On Our Final MomentsScientists may be closer to answering an age-old question about what happens to the human brain as we die. Neuroscientists accidentally recorded a dying brain while they were using electroencephalography (EEG) to detect and treat seizures in an 87-year-old man and the patient suffered a heart attack. It was the first time ever that scientists had recorded the activity of a dying human brain. The rhythmic brain wave patterns which were recorded during the man's time of death were observed to be similar to those occurring during dreaming, memory recall and meditation. (2/23)

ScienceDaily:Obesity: What Does Immunity Have To Do With It? New Findings May Represent A Promising Approach For Obesity Treatment And Its Complications As organisms grow, older cells can undergo a phenomenon called senescence. This process defines a cell state where cells permanently stop dividing but do not die. Senescent cells secrete toxic pro-inflammatory factors contributing to the development of many diseases. Researchers from Boston University School of Medicine (BUSM) have shown that obesity in experimental models led to senescence of macrophages, an immune cell subtype within fat or adipose tissue. (Boston University School of Medicine, 2/22)

ScienceDaily:A Study Uncovers The 'Grammar' Behind Human Gene Regulation: The Logic That Controls Gene Regulation In Human Cells A research group has discovered the logic that controls gene regulation in human cells. In the future, this new knowledge can be applied to, for example, investigating cancers and other genetic diseases. (University of Helsinki, 2/22)

Reuters:Moderna Begins Late-Stage Study Of RSV Vaccine Using MRNA TechnologyModerna Inc said on Tuesday it had begun a late-stage study of its vaccine for Respiratory Syncytial Virus (RSV) based on the same technology used to develop its COVID-19 shots. The only approved product using messenger RNA (mRNA)is COVID-19 vaccine, but Moderna and rival Pfizer are rushing to tap the potential of the technology to target diseases such as shingles and cancer. Moderna is developing a vaccine for flu using mRNA technology and said on Friday it would develop three more shots, including one for viral infection shingles. (2/23)

CIDRAP:VA Study Finds Most Dental Antibiotic Prophylaxis Prescriptions ImproperAnother study of antibiotic prescribing by Veterans' Affairs (VA) dentists found that five of every six prescriptions for antibiotic prophylaxis were inconsistent with guidelines, researchers reported today in Infection Control & Hospital Epidemiology. The cross-sectional study of visits to VA dentists from 2015 through 2019 examined all antibiotics prescribed within 7 days of a visit in the absence of an oral infection. In the primary analysis, antibiotic prophylaxis was considered appropriate only if it was associated with a visit that involved manipulation of gingival tissue and if the patient had a cardiac condition at the highest risk of an adverse outcome from infective endocarditis according to guidelines. (2/22)

Study Shows Vaccine Protections Weaker Against Omicron

New research also shows that though omicron caused higher rates of infection, hospitalization, and death for fully-vaccinatedpeople, shots did provide significant protection against severe cases needing hospital stays. Other studies show reinfections with the new BA.2 omicron subvariant are possible but rare.

CIDRAP:3 COVID Vaccine Doses 99% Effective Against Omicron, Delta HospitalizationThree doses of the Moderna mRNA COVID-19 vaccine were more effective against infection with the SARS-CoV-2 Delta variant than against Omicron but were highly protective against hospitalization with either subtype, according to a study yesterday in Nature Medicine. A team led by Kaiser Permanente Southern California researchers conducted a test-negative case-control study among 26,683 COVID-19 cases caused by the Delta or Omicron variants in December 2021. Of all cases, 16% were Delta, and 84% were Omicron. The incidence of Omicron infections in Southern California increased from 1.2% to 94.1% from Dec 6 to 31. (Van Beusekom, 2/22)

The Washington Post:Covid Vaccine Protection Was Much Weaker Against Omicron, Data ShowsWhile coronavirus shots still provided protection during the omicron wave, the shield of coverage they offered was weaker than during other surges, according to new data from the Centers for Disease Control and Prevention. The change resulted in much higher rates of infection, hospitalization and death for fully vaccinated adults and even for people who had received boosters. The decline in protection continued a pattern driven by coronavirus vaccines’ reduced effectiveness over time, combined with the increasing contagiousness of the delta and omicron waves. (Keating and Ahmed, 2/22)

CIDRAP:Study Highlights Rare BA.2 Subvariant Reinfections After Omicron COVID-19Infection with the SARS-CoV-2 Omicron BA.2 subvariant shortly after an initial infection with the Omicron BA.1 subvariant—the original Omicron strain—is rare, occurring mostly in young, unvaccinated people with mild symptoms, according to a non–peer-reviewed Danish study. In the study, published today on the medRxiv preprint server, researchers at the Statens Serum Institut in Denmark analyzed the subgenomic and genomic RNA of viruses responsible for a randomly selected group of 263 paired samples from more than 1.8 million COVID-19 patients. The study period was Nov 22, 2021, when Omicron was first identified in that country, to Feb 11, 2022. The BA.2 variant now accounts for most COVID-19 cases in Denmark. (2/22)

Reuters:Reinfections With Omicron Subvariants Are Rare, Danish Study FindsGetting infected twice with two different Omicron coronavirus subvariants is possible, but rarely happens, a Danish study has found. In Denmark, a more infectious sublineage of the Omicron coronavirus variant known as BA.2 has quickly dethroned the "original" BA.1 variant, which is the most common worldwide, but it has remained unclear whether a person could get infected by both variants. A new study, led by researchers at Denmark's top infectious disease authority, Statens Serum Institut (SSI), shows that people infected with BA.1 can get infected with BA.2 shortly afterwards, but that it is a rare occurrence. (2/23)

Also —

Wednesday, February 23, 2022 | Kaiser Health News

CIDRAP:COVID-19 Patient ZIP Codes May Affect Disease SeverityA pooled cross-sectional study in the Annals of Internal Medicine finds that COVID-19 patients' ZIP codes may affect clinical outcomes, with patients from high-vulnerability neighborhoods more likely to be hospitalized for infections. The study is based on data from 2,309 patients hospitalized with COVID-19 at 38 Michigan hospitals. Medical history was compared with patients' social vulnerability index (SVI), which takes into account the local area's average income, education level, household density to percentage of households led by single parents, and homes in which English is the not the primary language. (2/22)

Fox News:Relatives Of Patients With Severe COVID-19 More Likely To Experience PTSD: StudyFamily members of patients hospitalized in the intensive care unit (ICU) for COVID-19 were more likely to have symptoms of post-traumatic stress disorder (PTSD) than those of patients with acute respiratory distress syndrome (ARDS) from another illness, according to researchers. In a study published in JAMA Network, a team of French authors conducted a prospective cohort study in 23 ICUs in France from January to June 2020 – and a final follow-up in October 2020. (Musto, 2/22)

Reuters:Very Small Blood Clot Risk After First AstraZeneca COVID Shot - UK StudiesA large study into rare blood clots linked with AstraZeneca's (AZN.L) COVID-19 vaccine found between just one and three cases per million, and only after the first dose, shedding fresh light on the side-effects from the shot. Researchers have sought to analyse any link between COVID-19 vaccines and rare blood clots in the brain, arteries or veins - sometimes accompanied by low platelets, reports of which led many nations last year to pause use of the AstraZeneca shot, which was developed with Oxford University. (Aripaka, 2/22)

CIDRAP:US Researchers Confirm SARS-CoV-2 Alpha, Delta Variants In DeerA new preprint study describes detection of both Alpha and Delta SARS-CoV-2 variants in white-tailed deer in Pennsylvania—the first known detections of those strains in deer—with 18 of 93 nasal swab samples (19.3%) testing positive, adding to growing evidence that deer are a reservoir for the virus in the United States. The study was published on medRxiv and has not been peer-reviewed. (2/22)

On long covid —

CNN:People With Covid-19 May Face Long-Term Cardiovascular Complications, Study Says As the Covid-19 pandemic enters its third year, scientists are finding that the coronavirus has far-reaching effects on health beyond the acute phase of illness. One recent study has found that people with Covid-19 are at an increased risk for cardiovascular diseases for at least a year after recovery. The study, published this month in the journal Nature Medicine, used data from US Department of Veterans Affairs national health care databases to follow over 153,000 veterans with a history of Covid-19 infection for up to a year after their recovery. Compared with those who were never infected, people who had a coronavirus infection were more likely to have symptoms including inflammatory heart disease, heart failure, dysrhythmia, heart attacks, strokes and clotting in the long term. (Ahmed, 2/22)

The Washington Post:Five Months Post-Covid, Nicole Murphy’s Heart Rate Is Still Doing Strange ThingsFive months after being infected with the coronavirus, Nicole Murphy’s pulse rate is going berserk. Normally in the 70s, which is ideal, it has been jumping to 160, 170 and sometimes 210 beats per minute even when she is at rest — putting her at risk of a heart attack, heart failure or stroke. No one seems to be able to pinpoint why. She’s only 44, never had heart issues, and when a cardiologist near her hometown of Wellsville, Ohio, ran all of the standard tests, “he literally threw up his hands when he saw the results,” she recalled. Her blood pressure was perfect, there were no signs of clogged arteries, and her heart was expanding and contracting well. (Eunjung Cha, 2/21)

Health Industry

Little Progress Made In Stamping Out Racism In Medical Care

A report in Stat covers concerns over inaction over racism in medical care, despite an older, scathing report about its impact on people of different backgrounds. Separately, the World Health Organization released a guide for programs to protect health workers at all levels of the industry.

Stat:Report Spotlighted Racism In Medicine. Why Has So Little Changed? The 764-page report minces no words about the inequality rife throughout medical care: “Racial and ethnic minorities experience a lower quality of health services, and are less likely to receive even routine medical procedures than are white Americans.” Those words might have been written recently, amid a pandemic that has disproportionately sickened and killed people of color. In fact, they were written two decades ago. (McFarling, 2/23)

Fox News:WHO Unveils New Guide To Help Protect Health Workers Who Are Burned OutThe World Health Organization (WHO) and the International Labour Organization (ILO) have published a new guide on developing and implementing stronger occupational health and safety programs for health workers. In a news release, the WHO said the agencies recommended programs at the national, sub-national and health facility levels – with all programs covering infectious, ergonomic, physical, chemical and psycho-social occupational hazards. (Musto, 2/22)

WUFT:Emergency Services In North Central Florida Slammed After Record High Responses Alachua County emergency medical personnel responded to a record number of incidents in 2021, over 2,000 more than its next highest count in 2018. Sumter County Fire Rescue witnessed a similar trend. And in Marion County, Ocala Health, which includes five freestanding emergency rooms and two hospitals, is now searching for more nurses to serve the ever-increasing number of patients. (Will, 2/22)

Chicago Tribune:Should Doctors Who Spread COVID Misinformation Lose Their Medical Licenses? Revolution MacInnes believes that disinformation about COVID-19 killed his father. In recent years, MacInnes’ dad began subscribing to conspiracy theories. His father spent a lot of time on Facebook, and believed posts that claimed COVID-19 vaccines were harmful and lining the pockets of government officials, MacInnes said. He believes his father may have been mentally ill, and the conspiracy theories helped him feel engaged. His dad refused to get vaccinated. In late January, the Oswego man began having trouble breathing. Within a few days, he was in the hospital with COVID-19. Soon after, he had a heart attack, his lung collapsed and he was on a ventilator, MacInnes said. He died Feb. 8 at the age of 76. (Schencker, 2/22)

In news on financial matters in the health industry —

Connecticut Public:Advocates Warn Hospital Merger Could Be ‘Bad News’ For CT PatientsEarlier this month, Yale New Haven Health officials announced plans to buy two other health systems, including three hospitals in central Connecticut, pending state approval. Hospital representatives said the acquisition, the largest in recent years, would bring high-quality, cost-effective care to more residents throughout the state by expanding YNHH’s coverage area and leveraging its academic affiliation with Yale School of Medicine. Consumer advocates and public health analysts say residents and insurance payers have a reason to be concerned about the deal. They say research is clear: A merger in which patients benefit the most is the exception, not the rule. (Leonard, 2/22)

The New York Times:To Fill Empty Retail Space, Landlords Tap Doctors And DentistsThe next time you get your teeth cleaned or blood pressure checked, you may be doing so in a space once outfitted with face creams and frying pans. Health care providers are increasingly choosing former stores for their offices and clinics, in a trend known as medtail — a reflection of the medical industry’s migration to retail properties. The pandemic has accelerated their embrace of retail space. Taking advantage of depressed rents, medical providers are opening facilities in storefronts on city streets and moving into malls and shopping centers in suburban and rural areas, sometimes occupying the hulking shells vacated by big-box and department stores. (Margolies, 2/22)

Stat:Pfizer To Halt Controversial Contracting With Dutch HospitalsIn response to a probe by Dutch authorities, Pfizer (PFE) has agreed to end a controversial practice of reducing discounts to hospitals that cut back on purchases of a medicine, which regulators said unfairly discouraged health systems from switching to lower cost versions. After the patent expired nearly seven years ago for the active ingredient in Enbrel, which is used to treat rheumatoid arthritis and other autoimmune disorders, a pair of rival medicines became available. Until then, Enbrel was the second most widely prescribed therapy for such maladies. Eventually, Pfizer began reducing discounts if hospital purchases of Enbrel declined more than a pre-specified percentage. (Silverman, 2/22)

The Wall Street Journal:Rise In Non-Covid-19 Deaths Hits Life InsurersU.S. life insurers, as expected, made a large number of Covid-19 death-benefit payouts last year. More surprisingly, many saw a jump in other death claims, too. Industry executives and actuaries believe many of these other fatalities are tied to delays in medical care as a result of lockdowns in 2020, and then, later, people’s fears of seeking out treatment and trouble lining up appointments. Some insurers see continued high levels of these deaths for some time, even if Covid-19 deaths decline this year. (Scism, 2/23)

Stat:California Officials Win An Empty Victory As They Try To Salvage A Pay-To-Delay Law In a closely watched battle, California officials convinced a federal judge to modify a temporary hold on a law that bans so-called pay-to-delay deals between pharmaceutical companies, a contentious issue that has factored into the larger debate over the cost of prescription medicines. But as a practical matter, the ruling likely amounts to an empty victory for the state, because little may change. At issue is a law that went into effect in the fall of 2019 that made California the first state in the nation to outlaw pay-to-delay deals, a step California officials said was necessary to prevent drug companies from thwarting competition and maintaining higher prices. The move was also significant because California is generally seen as a bellwether state. (Silverman, 2/22)

The Wall Street Journal:Investors Inject Over $325 Million In Kidney-Care Provider SomatusSomatus Inc., which partners with insurers and medical practitioners to provide preventive kidney disease care, has raised a new round of capital in a deal that values the business at more than $2.5 billion. (Cooper, 2/22)

As GlaxoSmithKline prepares to split-off its consumer health unit —

Bloomberg:Glaxo Names Consumer-Health Unit Haleon Ahead of SplitGlaxoSmithKline Plc has given its consumer-health unit a new name -- Haleon -- as the U.K. pharmaceutical company prepares to spin off the maker of Panadol painkillers and Sensodyne toothpaste this summer. The company is nearing its biggest shakeup in two decades following the rejection of Unilever Plc’s multiple bids for the consumer arm in recent months. Glaxo plans to update investors on the unit’s strategy, finances and growth ambitions on Feb. 28. (Paton, 2/22)

Public Health

Trans Health In Spotlight As Texas AG Calls Minors' Gender Surgery 'Abuse'

Reports cover how political actions impact the lives of transgender youths. Among the moves, a bill is introduced in the Idaho House to make gender confirmation surgery on minors illegal. In Texas the attorney general declared such surgery could constitute child abuse under state law.

KHN:Targeted By Politicians, Trans Youth Struggle With Growing Fear And Mental Health ConcernsCharlie Apple had experienced people calling into question his humanity, suggesting he was just a confused kid or even a moral aberration. As a transgender teen, he had accepted that his future could include discrimination, verbal abuse, and violence. The sense of peace he said he felt in transitioning physically, however, was worth the risk. Still, it was especially painful last year, Apple said, when Texas lawmakers used the same sort of dehumanizing language he’d heard on the playground as they debated whether to deny trans kids everything from participation in sports to gender-affirming medical care. (West, 2/23)

AP:Bill To Ban Youth Gender Confirmation Surgery IntroducedLegislation that would make it illegal to perform gender confirmation surgery on juveniles was introduced in the Idaho House State Affairs Committee on Tuesday. Rep. Bruce Skaug, a Republican from Nampa, said the bill, if approved, would modify the state’s current law against female genital mutilation to include boys and make it clear that performing gender confirmation surgery on a child is a felony. The proposal includes exceptions for birth defects and “verifiable chromosomal disorders,” he said. “The types of surgeries and actions proscribed in the bill are often irreversible, or at the very least cause permanent damage on a child that I believe is too young to be making those decisions,” Skaug told the committee. (2/22)

Bloomberg:Texas Attorney General Declares Sex-Change Procedures For Trans Kids Child AbuseTexas Attorney General Ken Paxton declared that sex-change procedures involving transitioning minors constitute child abuse under state law. Paxton cited measures including gender-reassignment surgery and the prescribing of so-called puberty blockers in the order released on Monday. “There is no doubt that these procedures are ‘abuse’ under Texas law, and thus must be halted,” Paxton said in a statement. “I’ll do everything I can to protect against those who take advantage of and harm young Texans.” (Carroll and Ceron, 2/21)

Meanwhile, in Florida some controversial plans were withdrawn —

The Hill:Amendment In Florida Bill To 'Out' Students Is WithdrawnFlorida state Rep. Joe Harding (R) on Tuesday withdrew an amendment to his Parental Rights in Education act – known to its critics as “Don’t Say Gay” – that would have required school principals to inform a student’s parents of their sexual orientation within six weeks of learning they were not straight. Harding had introduced the amendment Friday, and removed it just before a House question and answer session on Tuesday. The amendment had instructed school principals “to develop a plan, using all available governmental resources, to disclose such information within 6 weeks after the decision to withhold such information from the parent.” (Migdon, 2/22)

Avian Flu Found In Several Florida Bird Species

Meanwhile, CDC advisers are considering whether to recommend a high-dose flu shot for seniors to help combat the illness. The increased costs of child care during the pandemic, and a settlement from Firestone over toxic sulfur emissions are also reported.

Miami Herald:Scientists Confirm Cases Of Avian Flu In Florida Bird SpeciesFederal scientists have confirmed cases of an infectious avain flu strain in several species of Florida birds, the state announced Tuesday. The Florida Fish and Wildlife Conservation Commission said it is investigating bird mortalities in Brevard, Indian River and Volusia counties that are believed to be caused by “Highly Pathogenic Avian Influenza.” The agency was notified of the presence of the disease by the National Veterinary Services Laboratory, according to an FWC statement released Monday. The affected species include the lesser scaup, black vulture “and other species,” the FWC said. (Goodhue, 2/23)

Axios:Sanofi Pasteur Pushes For High-Dose Flu Shot Recommendation Advisors to the CDC will consider today whether to clarify flu vaccine guidelines and for the first time recommend a "high dose" shot over a standard dose for seniors. Even amid the pandemic, flu remains a major public health threat, especially for adults older than 65. to state a "clear preference" for its Fluzone high-dose vaccine products for adults over 65 in time to factor into federal guidance for the 2022-23 flu season. (Reed, 2/23)

Anchorage Daily News:For Low-Income Parents, No Day Care Often Means No PayAn analysis of census survey data shows low-income parents lost both child care and income at much higher rates than their wealthier counterparts during this winter’s covid surge. (Bhattarai and Fowers, 2/22)

New Orleans Times-Picayune:Firestone Polymers Of Sulphur To Pay More Than $3.35M To Settle Air Pollution ComplaintsSynthetic rubber manufacturer Firestone Polymers of Sulphur will pay a $3.35 million fine to settle allegations that it emitted illegally excessive amounts of toxic chemicals, federal and state officials said Tuesday. Acting on behalf of the federal Environmental Protection Agency and the state Department of Environmental Quality, the federal Department of Justice filed a complaint in U.S. District Court against Firestone in September, accusing it of emitting large amounts of nitrogen oxides, carbon monoxide and other hazardous chemicals, officials said. Those emissions ran afoul of the federal Clean Air Act and other anti-pollution laws. (Schleifstein, 2/23)

State Watch

A Cultural Shift In Southeast Could Come From Medical Marijuana

The Mississippi Clarion Ledger reports on progress toward legalizing medical marijuana, and how it may prompt a big change in ideology in the South. Other news includes a Maryland program to help HIV patients pay for meds, and New York City starts its program to clear homeless people from the subway.

Mississippi Clarion Ledger:Launch of Medical Marijuana in Mississippi Could Bring 'Cultural Change in the Southeast'The future of Mississippi’s medical marijuana program stood at a standstill for months as a court and a legislative battle played out. But now many entrepreneurs including Steve Merritt, the chief operating officer of Southern Sky Brands, say they hope the creation of a new and potentially thriving industry in the state is imminent. In November 2020, 74% of Mississippians voted in favor of Initiative 65, a more expansive version of the current program. But the vote was overturned last May by the state supreme court, which said the state's ballot initiative process was invalid and had to be rectified through the legislative process. Then state lawmakers had to craft the framework of the program, delaying its launch for months. Gov. Tate Reeves signed the program into law on Feb. 2, but businesses, patients and medical practitioners can't apply for licenses until June. (Clark, 2/22)

Health News Florida:Administrative Law Judge Weighs Penalties Against A Tallahassee Marijuana Physician State health officials are asking an administrative law judge to permanently ban a Tallahassee physician from ordering medical marijuana for patients, suspend his medical license for five years and impose a $10,000 fine, after an investigation that included undercover agents posing as patients. The Department of Health’s proposed penalties against physician Joseph Dorn – who has practiced in Florida for more than three decades – date back to a 2019 complaint alleging that the physician violated state law by failing to conduct physical examinations of “Patient O.G.” and “Patient B.D.” The complaint also accused Dorn of employing a “trick or scheme” in the practice of medicine. (Kam, 2/22)

In HIV news —

The Baltimore Sun:Maryland Program To Help HIV Patients Pay For Medication Still Hampered Months After Health Department Cyberattack A liver transplant recipient who’s HIV positive, Morris Murray checks each month for confirmation that his insurance premiums are paid. Any interruption in care could jeopardize his health. So when the state program helping people like him pay for HIV medications and insurance was shut down by the Dec. 4 cyberattack at the Maryland Department of Health, he waited and worried. (Cohn, 2/23)

New Hampshire Public Radio:Free Testing For HIV And Hep C Available In Claremont Granite Staters in the Claremont area can get free testing for HIV and hepatitis C on Wednesday, Feb. 23 at the TLC Family Resource Center. Appointments and insurance are not required to get tested at the event, which runs from 4 to 6 pm. Gail Moeller, TLC Center's assistant program manager, says testing takes about 20 minutes. People who get tested at the event can get connected with the next steps to get treatment for any positive results. It’s important for Granite Staters to know their status, the earlier the better, she said. (Hoplamazian, 2/22)

Other news from across the states —

North Carolina Health News:NC Experts Explain How Safe Smoking Kits Reduce Harm From Drug Use In December, the federal Substance Abuse and Mental Health Services Administration announced something that could change many lives: for the first time ever, the agency planned to distribute $30 million in grants to fund harm reduction services nationwide. Harm reduction practices aim to reduce some of the negative impacts of drug use. The theory goes that by providing people who use substances with certain things, they can use drugs more safely, and hopefully, stay alive. (Donnelly-DeRoven, 2/23)

Anchorage Daily News:Girdwood’s Fluoridation System Has Been Offline For Months And Won’t Be Fixed Until 2024, Water Utility SaysAnchorage’s water utility didn’t notify the Girdwood Board of Supervisors over the last year “because we believed the situation would be temporary,” a spokeswoman for the utility said. Goodykoontz, 2/23)

Bloomberg:NYC Begins Plan To Move Homeless From Subway As Crime SurgesNew York City began its push to remove subway riders using the transit system for shelter, part of a strategy to reduce crime and restore confidence in the nation’s largest public transportation network. Teams from the departments of homeless services and of health and mental hygiene went out early Tuesday to talk with riders who lacked housing and help them find shelter, Jason Wilcox, the New York City Police Department’s transit chief, said duringMetropolitan Transportation Authority committee hearings on Tuesday. The outreach “went fairly seamlessly,” according to Wilcox, who didn’t say how many individuals have been removed. (Kaske, 2/22)

AP:California Proposal Would Require School COVID Testing PlansProposed legislation in California would require all K-12 public schools to develop COVID-19 testing plans for students and staff and the funding for schools to do it, Sen. Richard Pan said in announcing it Tuesday. “It’s really important that schools know what’s going on in their school sites when it comes to COVID,” said Pan, a pediatrician. “COVID testing allows schools to identify positive cases and then quarantine those who are sick, helping to reduce the spread of the virus.” The legislation would also apply to pre-schools, childcare centers and afterschool programs. (2/22)

Des Moines Register:Iowa Supreme Court To Rule On COVID Insurance Claims By Wakonda ClubTwo cases before the Iowa Supreme Court could decide whether Iowa restauranteurs are in line for millions of dollars to compensate them for business lost in the first months of the COVID-19 pandemic. Lawyers for the Wakonda Club, the landmark Des Moines golf course and country club, claimed in oral arguments Monday that the club's insurer should cover hundreds of thousands of dollars in income lost during a state-ordered closure in spring 2020. (Morris, 2/22)

Global Watch

Europe Plans To Soften Restrictions For Vaccinated Travelers

In a further sign that the pandemic's current peak has likely passed, the European Union agreed that member states should relax restrictions placed on incoming foreign visitors. Meanwhile, concerns swell over the covid situation in North Korea, and South Korea reports a huge surge in new cases.

AP:EU Advises Further Relaxing Travel Rules For ForeignersEuropean Union member countries agreed Tuesday that they should further facilitate tourist travel into the 27-nation bloc for people who are vaccinated against the coronavirus or have recovered from COVID-19. The European Council is recommending that EU nations next month lift all testing and quarantine requirements for people who received vaccines authorized in the EU or approved by the World Health Organization. (2/22)

In covid news from North and South Korea —

Reuters:World Should Send 60 Mln COVID-19 Vaccines To N.Korea, U.N. Investigator SaysThe international community should form a strategy to provide North Korea with at least 60 million doses of COVID-19 vaccines to head off humanitarian disaster, an independent U.N. human rights investigator said on Wednesday. The vaccines could be a way to persuade the country to ease lockdowns that have left some of its 26 million people on the verge of starvation, Tomas Ojea Quintana, U.N. special rapporteur on human rights in the Democratic People’s Republic of Korea, told a briefing in Seoul. (Smith, 2/23)

Reuters:S.Korea Prime Minister Calls For Calm As COVID Cases Hit New RecordSouth Korea's prime minister on Wednesday called on people not to panic about a major increase in coronavirus infections as new daily cases surged past 170,000 for the first time. Serious cases and deaths are at manageable levels despite record cases caused by the highly infectious Omicron variant, Prime Minister Kim Boo-kyum told a pandemic response meeting. "Although our awareness and implementation of anti-COVID rules should not be loosened, there is no reason at all to fear or panic about the numbers of new cases as in the past," he said, according to a transcript. (Shin and Smith, 2/23)

... And from around the globe —

The Wall Street Journal:New Zealand Targets Protesters Camped Outside Parliament With Lawn Sprinklers, Blaring Barry ManilowFor two weeks, antigovernment protesters camped outside this South Pacific country’s Parliament have held group hugs, planted vegetable gardens and renamed a footpath “No Booster Lane” as authorities tried everything to disperse them without violence. A top official turned on lawn sprinklers, soaking the around 1,000 people protesting issues including vaccine mandates. Music, including Barry Manilow songs, was blasted, and regular loudspeaker announcements urged protesters to end the occupation. When none of that worked, authorities adopted another approach: installing concrete barriers to limit a blockade of vehicles and making some arrests. (Wright, 2/22)

AP:Hong Kong Orders Mandatory COVID-19 Tests For All ResidentsHong Kong will test its entire population of 7.5 million people for COVID-19 in March, the city’s leader said Tuesday, as it grapples with its worst outbreak driven by the omicron variant. The population will be tested three times in March, Hong Kong Chief Executive Carrie Lam said. She said testing capacity will be boosted to 1 million a day or more. “Since we have a population of some 7 million people, testing will take about seven days,” she said. (Soo and Fung, 2/22)

Stat:South African Government Sued Over Access To Covid-19 Vaccine ContractsA patient advocacy group in South Africa has filed a lawsuit accusing the government of failing to disclose Covid-19 vaccine contracts amid concerns the country may have overpaid or agreed to terms that limit the ability to freely distribute the shots elsewhere, among other things. In its suit, the Health Justice Initiative cited various media reports over the past year indicating that South African officials may have purchased vaccines at inflated prices, agreed to restrictions that prohibit exports, sales, or donations to other countries, indemnified manufacturers against injuries or negligence, and also agreed not to seek refunds for any down payments. (Silverman, 2/22)

Prescription Drug Watch

Three Doses Of Moderna Vaccine Prove Extremely Effective

Read about the biggest pharmaceutical developments and pricing stories from the past week in KHN's Prescription Drug Watch roundup.

CIDRAP:3 COVID Vaccine Doses 99% Effective Against Omicron, Delta Hospitalization Three doses of the Moderna mRNA COVID-19 vaccine were more effective against infection with the SARS-CoV-2 Delta variant than against Omicron but were highly protective against hospitalization with either subtype, according to a study yesterday in Nature Medicine. (Beusekom, 2/22)

The Lancet:Duration Of Effectiveness Of Vaccines Against SARS-CoV-2 Infection And COVID-19 DiseaseKnowing whether COVID-19 vaccine effectiveness wanes is crucial for informing vaccine policy, such as the need for and timing of booster doses. We aimed to systematically review the evidence for the duration of protection of COVID-19 vaccines against various clinical outcomes, and to assess changes in the rates of breakthrough infection caused by the delta variant with increasing time since vaccination. (Felkin, MD, et al, 2/21)

JAMA Network:Risk Of Second Allergic Reaction To SARS-CoV-2 Vaccines: A Systematic Review And Meta-Analysis In this systematic review and meta-analysis of 22 studies including 1366 patients revaccinated under the supervision of an allergist, there was a low incidence (0.16%) of immediate severe allergic reactions associated with receiving a second dose of SARS-CoV-2 mRNA vaccine among individuals who had an immediate allergic reaction to their first dose. There were no deaths. (Chu, M.D., Ph.D., et al, 2/21)

The Lancet:Real-World Serological Responses To Extended-Interval And Heterologous COVID-19 MRNA Vaccination In Frail, Older People The use of COVID-19 vaccines has been prioritised to protect the most vulnerable—notably, older people. Because of fluctuations in vaccine availability, strategies such as delayed second dose and heterologous prime-boost have been used. However, the effectiveness of these strategies in frail, older people are unknown. We aimed to assess the antigenicity of mRNA-based COVID-19 vaccines in frail, older people in a real-world setting, with a rationed interval dosing of 16 weeks between the prime and boost doses. (Vinh, et al, MD, 2/21)

Cambridge Core:Antibiotic Prophylaxis Prescriptions Prior To Dental Visits In The Veterans’ Health Administration (VHA), 2015–2019 Of every 6 antibiotic prophylaxis prescriptions, 5 were inconsistent with guidelines. Improving prophylaxis appropriateness and shortening duration may have substantial implications for stewardship. Guidelines should state whether antibiotic prophylaxis is indicated for extractions, implants, and immunocompromised patients. (Suda, et al, 2/22)

CIDRAP:Previously Approved Antibiotic Could Be Used Against Plague, MelioidosisThe UK government says its scientists, working in collaboration with industry and academia, have found that a fluoroquinolone antibiotic used to treat ear infections may also work against plague and melioidosis. The antibiotic, finafloxacin, was approved by the US Food and Drug Administration in 2014 for the treatment of acute otitis externa (infection of the outer ear canal) and is also in clinical trials for use in patients with complicated urinary tract infections. But German pharmaceutical company Merlion Pharma says finafloxacin has also demonstrated efficacy against Burkholderia pseudomallei, the bacterium that causes melioidosis, and Yersinia pestis, which causes plague, in mouse models of infection. (2/17)

New England Journal of Medicine:EDP-938, A Respiratory Syncytial Virus Inhibitor, In A Human Virus Challenge Respiratory syncytial virus (RSV) infection causes substantial morbidity and mortality among infants, older adults, and immunocompromised adults. EDP-938, a nonfusion replication inhibitor of RSV, acts by modulating the viral nucleoprotein. (Ahmad, Ph.D, et al, 2/17)

New England Journal of Medicine:Biologic And Clinical Efficacy Of LentiGlobin For Sickle Cell Disease Sickle cell disease is characterized by the painful recurrence of vaso-occlusive events. Gene therapy with the use of LentiGlobin for sickle cell disease (bb1111; lovotibeglogene autotemcel) consists of autologous transplantation of hematopoietic stem and progenitor cells transduced with the BB305 lentiviral vector encoding a modified β-globin gene, which produces an antisickling hemoglobin, HbAT87Q. (Kanter, M.D, et al, 2/17)

Nature:An Outdated Loophole Is Letting Faulty Lab Tests Hit The Market OP/edIt is time to close a loophole that allows certain types of diagnostic lab tests to be exempt from regulatory oversight, putting people at risk of making consequential medical decisions on the basis of unreliable results. (2/22)

Perspectives: New Ideas For Treating Long Term Opioid Patients

Read recent commentaries about drug-cost issues.

New England Journal of Medicine:Inherited Patients Taking Opioids For Chronic Pain — Considerations For Primary CarePatients who have taken opioids for years for chronic pain must be treated differently from those who have not because such therapies cause profound physiological and neurologic changes. Reflexive approaches to tapering or discontinuing opioids should be avoided. (Drs. Phillip O. Coffin and Antje M. Barreveld, 2/17)

Tallahassee Democrat:Stepping Up Efforts To Fight Prescription Drug Fraud There’s an old saying that an ounce of prevention is worth a pound of cure. That’s just as true in law enforcement as it is in medicine – and it’s badly needed here in Florida. Every year, prescription drug fraud committed by independent pharmacists costs patients, taxpayers and businesses billions of dollars in the form of higher prescription drug costs. This problem is serious, and lawmakers need to take real action to prevent and crack down on it. (Jim Maxwell, 2/21)

New England Journal of Medicine:A New Antiviral Against Covid-19The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this audio interview conducted on February 15, 2022, the editors discuss long-awaited trial results for nirmatrelvir, a new antiviral against Covid-19, as well as new studies of the protection offered by previous infection with SARS-CoV-2. (Dr. Eric J. Rubin, Dr. Lindsey R. Baden and Stephen Morrissey, 2/17)

Editorials And Opinions

Viewpoints: Texas Takes On Opioids; Gender-Affirming Care Needs Broader Scientific Analysis

Editorial writers weigh in on these public health issues, as well as a look back on the life of Dr. Paul Farmer.

Dallas Morning News:The Opioid Crisis Is Changing And Texas Needs A Syringe Services ProgramIn early February, the state of Texas announced two massive settlements from drug manufacturers and distributors related to their role in the opioid crisis. The total amount of funding secured for Texas in these settlements now tops $1.7 billion, and the question of how that money will be spent has never been more vital. Interventions that fit the rapidly changing landscape of substance use, addiction and overdose in Texas must be prioritized. (Lucas Hill and Scott Walters, 2/23)

Newsweek:What Both Sides Are Missing About The Science Of Gender-Affirming CareLast April, Arkansas became the first state to ban what's known as "gender-affirming care," a protocol that affirms a child's transgender identity and allows for medical transition with puberty blockers, cross-sex hormones and, in some cases, surgeries like mastectomies or orchiectomies. The ACLU, which is now suing the state on behalf of four transgender young people, their families and two doctors, noted that "Gender-affirming care is life-saving care for our clients" and that banning it "runs counter to science and medicine." There have been as many as 25 such bills floated, mostly in right-leaning states. (Lisa Selin Davis, 2/22)

Stat:A Preacher's New Calling: Diversifying Neuroscience Research When I was the pastor of a large Baptist church, people often came to me asking me for help. These requests tended to be about domestic relationships, trauma from grief, or spiritual counseling. But an appeal from a young woman in my congregation about becoming a cancer researcher resonates with the new work I am doing since giving my last sermon as pastor in August 2021. At the time, the woman was a student at Hampton University, a historically black school in Hampton, Virginia. She told me she wanted to become a cancer researcher, but wasn’t sure how to enter the field. (Rev. Alvin C. Hathaway, Sr., 2/23)

The Washington Post:Protecting Women’s Reproductive Rights In Maryland In 1992, Maryland voters overwhelmingly voted to codify Roe v. Wade into statute, affirming that Marylanders have the legal right to choose an abortion. But having the legal right does not equate to access to abortion care. In many ways, access to abortion care depends on the same factors as access to other health-care services. People need enough providers in their area, sufficient insurance and the means to navigate barriers such as transportation, leave from work and child care. (Ariana B. Kelly and Delores G. Kelley, 2/21)

Stat:Biopharma Needs Digital Portfolios For Its Future In Disease ManagementBiopharma companies have long been early adopters of technologies such as cloud infrastructure, big data analytics, artificial intelligence, and machine learning. But the intersection of biopharma and health care remains largely undigitized. Some biopharma companies have recognized this and are now racing to adopt and apply a variety of targeted apps to help digitize this intersection through patient portals, beyond-the-pill solutions, data analytics, and digital therapeutics. (Abhinav Shashank and Smriti Khera, 2/23)

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The Boston Globe:Paul Farmer Taught Us Not To Accept The Status Quo In Public Health Paul Farmer never accepted the status quo. That’s what made him so remarkable. And it’s why his untimely death this week, at age 62, is such an enormous loss for the world. Inequality is status quo. Racism is status quo. The notion that the poor will live in misery and die from diseases that are eminently treatable — that’s status quo too. And Paul would have none of it. (Michelle A. Williams, 2/22)

NPR:Poignant Memories Of Dr. Paul Farmer In His Last Days The last time I saw Paul Farmer was less than a week ago. I had traveled to Rwanda to teach the inaugural medical school class at the University of Global Health Equity in Butaro, a rural village. It is a place Paul Farmer helped dream and blossom into reality, a gorgeous, pristine medical campus arising in a very rural area among the beautiful hills of Rwanda. (Sriram Shamasunder, 2/22)

The New York Times:Paul Farmer: Tracy Kidder Remembers The Compassionate Doctor More than two decades ago, I had the great good fortune to spend parts of several years traveling with Dr. Paul Farmer, to Haiti, Peru, Cuba, Russia and Mexico for my book about his life. He was a good companion, funny and talkative and when I got sick from a night of too much rum in Cuba, he took care of me. (Tracy Kidder, 2/22)

Different Takes: Results Of Covid Misinformation; Covid Is Here For The Long Haul

Opinion writers examine these covid issues.

The Washington Post:Covid-19 Vaccine Misinformation Continues To Erode Confidence “Freaking miracle.” That’s how health journalist Helen Branswell recently described the vaccines that have saved millions of lives in the coronavirus pandemic. The vaccines, offered to the U.S. population, have proved to be 90 percent effective against infection. Ready within a year of the outbreak, they have proved to be safe. And they are widely available and free. There is no parallel in modern times. (2/22)

USA Today:Is COVID Over? No. The Pandemic Will Be With Us For YearsMandates are lifting. Employers are calling us back to offices. And even some of the strictest and most vigilant among us have decided that enough is enough. Americans are moving on from COVID-19, and I can’t fault them for it if I'm being honest. It has been a horrible two years as we watched this pandemic pillage the world of life and common sense. And while I will be one of the last to take off my mask and get near people again, I understand why many of you are rushing back to “normal.” (Louie Villalobos, 2/22)

The Washington Post:DeSantis’s Latest Brilliant Florida Pandemic Idea? A Mask-Shunning, Vaccine-Skeptical, Ivermectin-Promoting Surgeon GeneralAs physician Joseph A. Ladapo nears a final Florida Senate vote in his confirmation as state surgeon general, you can’t help but wonder why anyone would take the job. Not after what happened to the last guy. The former titleholder, Scott A. Rivkees, all but vanished after reportedly being hustled out of a public meeting about the coronavirus in April 2020 by the communications director of Florida’s Republican governor, Ron DeSantis. (Lizette Alvarez, 2/22)

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