Friday, August 26, 2022 – Kaiser Health News

Kaiser Health News Original Stories
Unraveling the Interplay of Omicron, Reinfections, and Long Covid
The omicron variant has proved adept at finding hosts, often by reinfecting people who recovered from earlier bouts of covid. But whether omicron triggers long covid as often and severe as previous variants is a matter of heated study. (Liz Szabo, )
With More Sizzling Summers, Colorado Changes How Heat Advisories Are Issued
The National Weather Service is now gauging heat risk in a way that better suits Colorado as summers in the Centennial State get hotter and longer. (Markian Hawryluk, )
Hospitals Cut Jobs and Services as Rising Costs Strain Budgets
More than two years into the pandemic, hospital budgets are beginning to crack. One of the biggest drivers of financial shortfalls has been the cost to find workers. (Katheryn Houghton, )
KHN’s ‘What the Health?’: The Future of Public Health, 2022 Edition
A new report from the Commonwealth Fund Commission on a National Public Health System calls for a major overhaul of the way the U.S. organizes, funds, and communicates about public health, particularly in the harsh spotlight of the covid-19 pandemic. In this special episode of KHN’s “What the Health?” host Julie Rovner and KHN’s correspondent Lauren Weber interview the commission’s chair, Dr. Margaret Hamburg, former commissioner of the U.S. Food and Drug Administration, about how to fix what ails public health. ( )
Political Cartoon: 'Time Release Pills?'
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Time Release Pills?'" by Bob and Tom Thaves.
KHN’s Morning Briefing will not be published Aug. 29 through Sept. 5. Look for it again in your inbox on Tuesday, Sept. 6.
Government Policy
White House Issues Directive To Make Federally Funded Studies Free To Public
In a "historic" move, the Biden administration also says the research should be made available immediately, instead of being kept behind a paywall for a year. Speaking to Stat, the New England Journal of Medicine editor-in-chief said at least a third of the journal's roughly 200 yearly articles are connected to taxpayer funding.
The Chronicle for Higher Education: ‘A Historic Moment’: New Guidance Requires Federally Funded Research To Be Open Access
In a move hailed by open-access advocates, the White House on Thursday released guidance dictating that federally funded research be made freely and immediately available to the public. The Office of Science and Technology Policy’s guidance calls for federal agencies to make taxpayer-supported research publicly available immediately, doing away with an optional 12-month embargo. (Zahneis, 8/25)
The New York Times: White House Pushes Journals To Drop Paywalls On Publicly Funded Research 
In laying out the new policy, which is set to be fully in place by the start of 2026, the Office of Science and Technology Policy said that the guidance had the potential to save lives and benefit the public on several key priorities — from cancer breakthroughs to clean-energy technology. “The American people fund tens of billions of dollars of cutting-edge research annually,” Dr. Alondra Nelson, the head of the office, said in a statement. “There should be no delay or barrier between the American public and the returns on their investments in research.” (Patel, 8/25)
The Scientist Magazine: No More Paywalls On Federally Funded Research: White House
“The American people fund tens of billions of dollars of cutting-edge research annually. There should be no delay or barrier between the American public and the returns on their investments in research,” Alondra Nelson, acting head of the Office of Science and Technology Policy, says in a White House news release.  (Williams, 8/25)
Stat: White House Directs Agencies To Make Federally Funded Studies Free
“The devil’s in the details,” said New England Journal of Medicine Editor-in-Chief Eric Rubin, who told STAT at least a third of the journal’s estimated 200 articles a year are attached to federal funding, though other funding streams do require open access. “It does threaten the model of a carefully thought-out presentation and carefully getting research. We’re gonna have to think about how we can still do what we think is important.” (Owermohle, 8/25)
Vaccines
Pfizer's RSV Vaccine Found 86% Effective For Older Adults
The respiratory syncytial virus vaccine is experimental but has already been in clinical trials. Pfizer says there were no safety concerns. About 14,000 Americans die of RSV each year, reports say.
NBC News: Pfizer's RSV Vaccine Protects Against Severe Illness In Older Adults
Pfizer’s experimental vaccine for a respiratory virus called RSV was nearly 86% effective in preventing severe illness in a late-stage clinical trial of older adults, the company announced in a release Thursday. (Lovelace Jr., 8/25)
Reuters: Pfizer's RSV Vaccine Found Effective, Safe Among Older Adults In Study 
The vaccine, RSVpreF, was also found to be well-tolerated with no safety concerns in the study. Pfizer's shot is designed to target two strains of the respiratory virus. The company has so far enrolled about 37,000 participants aged 60 and above in its late-stage global study of the vaccine. (8/25)
Stat: Pfizer's Experimental RSV Vaccine Protects Older Adults In Study
Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, called the data exciting. “This vaccine will be of enormous benefit to the elderly in preventing severe and occasionally fatal respiratory tract infections,” Offit predicted. “The vaccine will also be important as a maternal vaccine to protect babies in the first six months of life.” (Herper, 8/25)
Self: Here’s Why Pfizer’s RSV Vaccine for Adults Is a Pretty Big Deal
Each year, about 177,000 older adults are hospitalized due to RSV infection in the US, and 14,000 of these infections lead to death, according to the Centers for Disease Control and Prevention (CDC). “RSV is a major burden of illness in elderly or immunocompromised adults,” Amesh A. Adalja, MD, infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security, tells SELF. Currently, there is only a monoclonal antibody injection, called Synagis, that is used to reduce the risk of severe RSV illness in some high-risk babies. But the FDA has not yet approved an RSV vaccine for adults, so Pfizer’s option is on its way to becoming the first to get there. (Miller, 8/25)
Covid-19 Crisis
No, Not Over: Covid Has So Far Killed 1 Million Worldwide This Year
The World Health Organization announced that global deaths have passed the "tragic milestone" of 1 million lost lives in 2022 due to covid.
CIDRAP: WHO: COVID Deaths For 2022 Pass 1 Million Worldwide
At a World Health Organization (WHO) briefing today, Director-General Tedros Adhanom Ghebreyesus, PhD, said COVID-19 deaths for 2022 alone passed 1 million this week, as he pressed countries to do more to vaccinate all healthcare workers, older people, and others at highest risk. Since the pandemic began in early 2020, 6,472,848 deaths have been reported, according to the Johns Hopkins online dashboard. Tedros said countries in Africa with the lowest rates are making progress with vaccine coverage, and many countries are making good strides in targeting high-priority groups. He said, however, that one third of the world is still unvaccinated, including two thirds of health workers and three quarters of older adults in low-income countries. (8/25)
UN News: World Reaches ‘Tragic Milestone’ Of One Million COVID-19 Deaths So Far In 2022
“We cannot say we are learning to live with COVID-19 when one million people have died with COVID-19 this year alone, when we are two-and-a-half years into the pandemic and have all the tools necessary to prevent these deaths,” said Tedros, speaking during his regular briefing from Geneva. (8/25)
The Guardian: Twice As Many People Died With Covid In UK This Summer Compared With 2021
Twice as many deaths involving Covid occurred this summer compared with last summer, according to analysis of new data – though rates have fallen in recent weeks as the latest wave decreases in severity in the UK. (Garcia and Duncan, 8/23)
In related news about the covid-19 pandemic —
Bloomberg: Dr. Anthony Fauci Expected Covid To Be ‘Behind Us’ A Year Into Biden’s Term
White House Chief Medical Adviser Anthony Fauci expected the US would have moved past the Covid-19 pandemic after the first year of the Biden administration, but the disruption from the virus has lingered longer than the infectious disease expert anticipated. (Baumann and Tozzi, 8/25)
KHN: KHN’s ‘What The Health?’: The Future Of Public Health, 2022 Edition 
It’s been nearly a year since KHN’s “What the Health?” podcast took a deep dive into public health, and much has changed. Covid, in various versions, is still infecting people around the world, along with other communicable diseases including monkeypox and even polio. Yet public health remains a divisive issue, with politicians and the public alike arguing over how best to protect the community without trampling on individuals’ rights. Earlier this summer, the Commonwealth Fund Commission on a National Public Health System called for a major overhaul of the way the U.S. organizes, funds, and communicates about public health. The report includes specific recommendations for the Biden administration, Congress, state and local public health agencies, and medical and public health professionals. (8/25)
Report Says Up To 4 Million Out Of Work Because Of Long Covid
This figure from a new survey is more than twice the number of earlier estimates. The cost of missed work hours may be around $170 billion a year. Also: variant covid rapid tests, covid in kids under 5, New Mexico's governor has covid, and more.
NBC News: Long Covid May Be Keeping Up To 4 Million People Out Of Work, Research Suggests
Up to 4 million people may be out of work because of long Covid in the U.S, according to a report published this week by the Brookings Institution. In lost wages, that could add up to at least $170 billion per year, the report suggests. (Bendix, 8/25)
Axios: Millions Out Of Work From Long COVID: Brookings
That figure, which incorporates four new questions about long COVID from the Census Household Pulse Survey, is more than twice an earlier estimate and could help explain the lingering labor shortages in America. (Reed, 8/25)
In other news about the spread of covid —
CIDRAP: Study: Two COVID-19 Rapid Tests Accurately Diagnose Variant Infections
Two COVID-19 rapid antigen tests produce accurate results for infections with the SARS-COV-2 pre-Delta, Delta, and Omicron strains, finds a study yesterday in JAMA Network Open. University of Washington and University of Nevada researchers tested 797 adults who had symptoms characteristic of COVID-19 within the previous 5 days. They assessed the SCoV-2 Ag Detect Rapid Self-Test and BinaxNow COVID-19 Ag Card at multiple sites in King County, Washington. Testing was done from Feb 17, 2021, to Jan 11, 2022. Average participant age was 37.3 years, 58.2% were women, and 52.9% were unvaccinated. (8/25)
USA Today: COVID In Kids Under 5: Vaccination Rates Low As Hospitalizations Rise
“We’ve seen a little uptick in hospitalizations across the board in children,” said Dr. Kathryn Moffett, chief of pediatric infectious diseases at West Virginia University Medicine Children’s Hospital. “The estimate is that there is a child every day dying of COVID in the U.S.” (Rodriguez, 8/25)
KHN: Unraveling The Interplay Of Omicron, Reinfections, And Long Covid
The latest covid-19 surge, caused by a shifting mix of quickly evolving omicron subvariants, appears to be waning, with cases and hospitalizations beginning to fall. Like past covid waves, this one will leave a lingering imprint in the form of long covid, an ill-defined catchall term for a set of symptoms that can include debilitating fatigue, difficulty breathing, chest pain, and brain fog. (Szabo, 8/26)
AP: New Mexico Governor Tests Positive For COVID
Gov. Michelle Lujan Grisham tested positive for COVID-19 on Thursday morning and was receiving an antiviral drug treatment. Lujan Grisham said in a statement that she was experiencing mild symptoms and is working in isolation from the governor’s mansion in Santa Fe. (8/25)
USA Today: Uranium Mining May Have Put New Mexico Indigenous Tribes At COVID Risk
As a young girl, Arlene Juanico would rush to gather the laundry before the explosions started. When the alarms sounded, Juanico would hustle to grab the clean garments off the clothesline before she was enveloped by dust clouds. But Juanico’s little legs usually couldn’t get her back to shelter in time. (Cahan, 8/26)
Updates on the covid vaccine rollout —
San Francisco Chronicle: Fewer Than 15,000 Novavax Shots Have Been Given In U.S.
The U.S. has administered 14,559 of its 626,900 available doses of the Novavax COVID-19 vaccine since the shots were cleared for use in mid-July, according to data published Thursday by the U.S. Centers for Disease Control and Prevention. (Vaziri, 8/25)
Anchorage Daily News: Alaska Sees Sharp Drop In Child Vaccinations, Prompting Concern About Future Outbreaks Of Preventable Diseases
The percentage of Alaska children who are up to date on their routine vaccinations has fallen considerably since the beginning of the pandemic, prompting concern among health experts about the return of certain serious illnesses that had been all but eradicated in the U.S. until recently. (Berman, 8/25)
AP: NYPD Detective Asks Supreme Court To Block Vaccine Mandate
A New York City police detective has asked the U.S. Supreme Court to stop the city from firing him and other workers for refusing to get vaccinated against COVID-19. Lawyers for Detective Anthony Marciano asked the court Thursday for an emergency injunction that would block the city from enforcing a rule requiring all municipal employees to get vaccinated. (Matthews, 8/25)
After Roe V. Wade
Abortion Access Shrinks With New Restrictions In Effect In 4 More States
Abortion "trigger laws" were enacted in Idaho, North Dakota, Tennessee and Texas this week. And a judge rejected a request for a temporary injunction on Florida's 15-week ban. News outlets report on the barriers patients face even in states where abortion is still allowed.
Politico: Abortion Access Crumbles: 4 More States Enact New Restrictions This Week 
The erosion of abortion access in the United States accelerated this week with four more state trigger laws taking effect — in Idaho, North Dakota, Tennessee and Texas. While three of those states had significant restrictions on the procedure already in place, the new laws carry narrower exemptions and harsher criminal penalties, all but eliminating abortion in broad swaths of the U.S. (Messerly and Ollstein, 8/25)
AP: Three More GOP-Led States Enact Abortion 'Trigger Laws'
The change will not be dramatic. All of these states except North Dakota already had anti-abortion laws in place that largely blocked patients from accessing the procedure. And the majority of the clinics that provided abortions in those areas have either stopped offering those services or moved to other states where abortion remains legal. (Kruesi, 8/25)
The Washington Post: North Dakota Judge Blocks Abortion Ban From Going Into Effect Friday 
The day before a near-total abortion ban would have taken effect in North Dakota, a judge put that law on hold Thursday afternoon, pending the conclusion of a legal challenge being mounted by the state’s former sole abortion clinic. Burleigh County District Judge Bruce Romanick granted a preliminary injunction in a legal challenge brought by Red River Women’s Clinic, which was North Dakota’s only abortion clinic until it moved just across state lines earlier this month. Although the trigger ban has been blocked, the state will have no abortion clinic for the foreseeable future. (Shepherd, 8/25)
Health News Florida: An Appeals Court Rejects A Injunction Request That Would Have Blocked Florida's Abortion Law 
An appeals court Wednesday tossed out a temporary injunction that would have blocked a new Florida law preventing abortions after 15 weeks of pregnancy. (Saunders, 8/25)
The Biden administration vows to take more action —
The Hill: White House Says More Abortion Actions Coming 
“Americans across the country and of all backgrounds agree that women should have the right to make their own personal health care decisions and to receive life-saving medical care, without interference from politicians, and the President will continue to take action to protect women’s access to lifesaving health care,” Jean-Pierre said Thursday.   Jean-Pierre did not specify what further actions President Biden could take. (Sullivan, Weixel and Choi, 8/25)
More on abortion and reproductive rights —
CBS News: Google To Label Clinics That Provide Abortions In Effort To Increase Transparency 
Google has updated its features to better assist those using its tools to seek abortion-specific care, according to a letter released by Sen. Mark Warner that the company sent to him and Rep. Elissa Slotkin on Thursday. (Mandler, 8/25)
The Washington Post: New Restrictions From Major Abortion Funder Could Further Limit Access
New restrictions from one of the country’s largest abortion funding organizations could add new obstacles for many patients in antiabortion states seeking the procedure elsewhere. The National Abortion Federation and its NAF Hotline Fund will now require patients who receive their funding to take both abortion pills in a state where abortion is legal, according to emails sent on Aug. 22 and obtained by The Washington Post. The nonprofit, which is backed largely by billionaire Warren Buffett, helped fund at least 10 percent of all abortions in the U.S. in 2020. The new rules could impact thousands of patients a year, providers say. (Kitchener, 8/25)
AP: Oregon: Surge In Out-Of-State Abortion Patients
Planned Parenthood leaders in Oregon on Thursday said there has been a surge in the number of people traveling from out of state for abortions, including from neighboring Idaho, where most of a near-total abortion ban has taken effect. “We are definitely seeing an uptick as more and more trigger bans are being put into effect and laws are being enacted,” said Anne Udall, president and CEO of Planned Parenthood Columbia Willamette. “We’re seeing people from all over,” Udall said. “Louisiana, Texas, Mississippi, Idaho, Florida.” (Rush, 8/26)
Atlanta Journal-Constitution: Georgia Abortion Clinics Stay Open, But Visits Shift To NC, Florida
Local abortion clinics remain open and their phones are ringing off the hook. But a bit more than a month after Georgia’s strict new abortion law went into effect, the clinics are turning more patients away. (Malik and Prabhu, 8/26)
Axios: Report: Pregnant People Face "Systemic" Barriers In States With Abortion Restrictions
States that have enacted abortion restrictions or bans also have "systemic" barriers in place that impede "the health and economic security of pregnant and birthing people and their families," according to a new report from the nonpartisan and nonprofit National Partnership for Women & Families first shared with Axios. (Chen, 8/25)
In related election news —
The Washington Post: Viral Video Reinforces Growing GOP Political Dilemma On Abortion 
At a hearing, state Rep. Neal Collins (R) recounted the arduous journey faced by a 19-year-old thanks to an abortion ban he himself supported. Collins said the woman’s fetus was not viable, but that attorneys told her doctor they couldn’t extract it because it still had a heartbeat — the standard set in the bill supported by Collins that had gone into effect just the week before. “They discharged that 19-year-old,” Collins said. “The doctor told me at that point there is a 50 percent chance — well, first she’s going to pass this fetus in the toilet. She’s going to have to deal with that on her own. There’s a 50 percent chance — greater than 50 percent chance that she’s going to lose her uterus. There’s a 10 percent chance that she will develop sepsis and herself, die.” Collins added: “That weighs on me. I voted for that bill. These are affecting people.” (Blake, 8/25)
The Boston Globe: After Dobbs, Most New Voters In Kansas Are Women 
In the week after the court’s decision, more than 70 percent of newly registered voters in Kansas were women, according to an analysis of the state’s registered voter list. An unusually high level of new female registrants persisted all the way until the Kansas primary this month, when a strong Democratic turnout helped defeat a referendum that would have effectively ended abortion rights in the state. (8/25)
Outbreaks and Health Threats
Monkeypox Case Trends Hint At Progress In Curbing Spread
Globally, new reported cases declined 21% in the last week, though the World Health Organization says that numbers are still steeply climbing in the Americas. Officials in San Francisco and Los Angeles are also seeing signs that the outbreak is slowing in those areas.
AP: WHO: Monkeypox Cases Drop 21%, Reversing Month-Long Increase
The number of monkeypox cases reported globally dropped 21% in the last week, reversing a month-long trend of rising infections and signaling that Europe’s outbreak may be starting to decline, the World Health Organization said Thursday. The U.N. health agency reported 5,907 new weekly cases and said two countries, Iran and Indonesia, reported their first cases. To date, more than 45,000 monkeypox cases have been reported in 98 countries since late April. (8/25)
San Francisco Chronicle: Monkeypox: SF ‘Cautiously Optimistic’ Outbreak Is Slowing Down
After about two months of rapid spread, San Francisco appears to be turning a corner on monkeypox, with early data showing the local epidemic may be slowing down. The number of new cases reported each week hit a high of 143 the week of July 24 and has tapered each week since, first to 87 cases, then 54 and then, last week, to fewer than five, according to figures provided by the San Francisco Department of Public Health. (Ho, 8/24)
Los Angeles Times: Monkeypox Cases Begin To Slow In L.A. County
“Although a month ago we were seeing a doubling of monkeypox cases in as few as nine days, we are now seeing a leveling in the number of new cases per week. And our doubling time has increased to 16 days,” said Dr. Rita Singhal, chief medical officer for the L.A. County Department of Public Health. (Toohey, Lin II and Money, 8/25)
More on the spread of monkeypox —
CIDRAP: Monkeypox Epicenter Moves From Europe To Americas 
Today World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus, PhD, said monkeypox transmission has dropped in Europe, which was the initial epicenter of the current outbreak, but now rising cases are rising in the Americas, making the region the main hot spot. … Following the United States, Spain, Brazil, Germany, the United Kingdom, France, Canada, the Netherlands, and Peru have the most cases, accounting for 88.9% of the global case count. (Soucheray, 8/25)
Bloomberg: Monkeypox Virus Mushrooms Into Global Contagion In Just Four Months
From just a handful of infections in early May, monkeypox has escalated into a global public health emergency, with more than 45,000 cases scattered across 100 or more countries, mostly in Europe and North America. (Gale and Pong, 8/26)
Columbus Dispatch: Ohio Launches Monkeypox Case Dashboard
The Ohio Department of Health launched an online monkeypox dashboard on Thursday showing where cases are around the state. The map and data is at odh.ohio.gov (Wu, 8/25)
Richmond Times-Dispatch: Women, Heterosexual Men Now Eligible For Monkeypox Vaccines In Virginia 
The Virginia Department of Health announced Thursday that it would expand eligibility for the Jynneos shot to women and heterosexual men, aligning its policy with the Centers for Disease Control and Prevention. (Kolenich, 8/25)
Dr. Fauci weighs in on the monkeypox epidemic —
The Hill: Fauci Compares Monkeypox Outbreak To HIV Epidemic, Advises Against Making The Same Assumptions
The White House’s chief medical adviser Anthony Fauci advised against making the same assumptions about the current monkeypox outbreak that were made during the early days of the HIV/AIDS epidemic. Fauci and H. Clifford Lane, deputy director for clinical research and special projects at the National Institute of Allergy and Infectious Diseases (NIAID), published a piece in the New England Journal of Medicine on Thursday in which they reflected on the similarities between the monkeypox outbreak and the HIV/AIDS epidemic, which both men spent much of their careers studying. (Choi, 8/25)
New England Journal of Medicine: Monkeypox — Past As Prologue 
If one compares the situations at the start of the AIDS, Covid-19, and current global monkeypox outbreaks, certain interesting similarities and differences are apparent. (H. Clifford Lane, MD, and Anthony S. Fauci, MD, 8/25)
Also, a virus with blisters that resemble monkeypox is spreading in India —
The Washington Post: What Is Tomato Flu, The New Viral Infection Spreading In India?
A new, highly contagious viral infection that has been dubbed “tomato flu” is spreading among children in India, the country’s Health Ministry said this week. … The infection gets its name from the “eruption of red and painful blisters throughout the body that gradually enlarge to the size of a tomato,” according to an article published last week in the British medical journal Lancet. The blisters resemble those seen on young monkeypox patients. The disease — which appears to spread through close contact and is not considered life-threatening — could be an aftereffect of chikungunya or dengue rather than a viral infection, according to the article. (Jeong, 8/25)
CNBC: Tomato Flu: Indian Health Advisory For Rare Virus Infecting Children
The emergence of a rare, new viral infection afflicting young children has prompted health authorities in India to issue a health advisory after more than 100 cases were discovered in the country. (Gilchrist, 8/26)
Health Industry
CMS Pushes Back Controversial Radiation Oncology Model
Modern Healthcare says radiation oncologists oppose the model's design, and the Center for Medicare and Medicaid Innovation wants to test whether it will save money. Under the new federal government rule, once a decision is made CMS must propose a new start date 6 months ahead.
Modern Healthcare: Radiation Oncology Model Indefinitely Delayed
The federal government indefinitely delayed the start of the controversial radiation oncology model in a final rule published Thursday. The Centers for Medicare and Medicaid Services will propose a new start date at least six months in advance under the final rule. CMS proposed the extended delay in April after the agency and Congress pushed its start date back several times. The model was originally slated to roll out Jan. 1, 2021. … The Center for Medicare and Medicaid Innovation, which will manage the mandatory initiative, wants to test whether prospective, site-neutral, episode-based payments for radiotherapy can save money. (Goldman, 8/25)
In other health care and insurance news —
Modern Healthcare: DOJ Joins Cigna Medicare Advantage Fraud Case
The whistleblower lawsuit, filed in 2017 in a New York federal court by a former service provider for Cigna’s Medicare Advantage subsidiary HealthSpring, accuses Cigna of bilking the federal government out of $1.4 billion by submitting improper diagnostic codes from 2012 to 2019. The codes were allegedly based on health conditions that did not exist in the patient or were not found in any medical record. (Kacik, 8/25)
Modern Healthcare: California Medicaid Contracts With Molina, Centene, Elevance
California regulators intend to award coveted five-year Medicaid managed care contracts to Molina Healthcare, Centene subsidiary Health Net and Elevance Health's Anthem Blue Cross Partnership Plan, the state Department of Health Care Services announced Thursday. (Tepper, 8/25)
Modern Healthcare: Centene Washington State Medicaid Fraud Case Settled 
Centene will pay $33 million to settle allegations its now-defunct pharmacy benefit manager overcharged the Washington state Medicaid program for drugs. (Tepper, 8/25)
Tampa Bay Times: Florida Blue, BayCare Spar Over Health Care Coverage
Tens of thousands of Tampa Bay residents may have to find new doctors by October as two of the region’s major health care players are publicly sparring over a new insurance contract. (O'Donnell, 8/25)
Stat: Why Amazon And Others Are In A Bidding War For Home Health Tech 
The bidding war over Signify Health — a health technology business that could fetch multibillion-dollar offers from Amazon, CVS, and UnitedHealth Group — is not about its dazzling software or a blockbuster AI algorithm. The crush of corporate interest, experts said, stems from something much bigger: the opportunity to move medical services back into the home. (Ross and Palmer, 8/25)
Also —
Becker's Hospital Review: 10 States With Highest Coding Rates For Social-Determinants-Of-Health Diagnoses
The most used codes were those for homelessness; disappearance and death of family members; problems related to living alone; problems related to living in a residential institution; and problems in relationship with a spouse or partner. (Cass, 8/25)
Community Hospitals Hit Disproportionately By Covid: Study
A new study into "downstream" health care impacts of covid shows how community hospitals were more severely hit by central line-associated bloodstream infections and other care-associated infections during the pandemic. Also: Becker's reports on the best hospitals to work for in each state.
CIDRAP: Study Shows Outsized COVID Impact On Community Hospitals 
A new analysis of healthcare-associated infections (HAIs) at hospitals in the southeastern United States highlights some of the downstream healthcare impacts of COVID-19. The study, published this week in Clinical Infectious Diseases by a team of researchers from Duke University and the University of North Carolina, found that rates of central line-associated bloodstream infections (CLABSIs), ventilator-associated events (VAEs), and Clostridioides difficile infection (CDI) at hospitals in six southeastern states rose significantly during the pandemic compared with previous years. But the impact was most keenly felt in smaller community hospitals. (Dall, 8/25)
In other hospital news —
Becker's Hospital Review: Best Hospitals, Health Systems To Work For By State
Forbes released its "America's Best Employers by State" list Aug. 24, and 262 hospitals and health systems made the cut. Forbes, in collaboration with market research company Statista, surveyed 70,000 employees working for businesses with more than 500 employees. A total of 1,382 employers were ranked from varying industries, up to 101 per state. Employers could be ranked more than once if they operate in more than one state. (Kayser, 8/25)
Forbes: America's Best Employers By State 2022
The list is divided into 51 rankings—one for each of the 50 states, plus the District of Columbia—and was compiled by surveying 70,000 Americans working for businesses with at least 500 employees. Surveys were conducted anonymously, allowing participants to freely share their opinions. The final list ranks the 1,382 employers that received the most recommendations. (Baruch, 8/24)
Modern Healthcare: New Rural Hospital Model Draws Interest – And Questions
In July, the Centers for Medicare and Medicaid Services proposed payment methodology for rural emergency hospitals. Under the model, rural hospitals would eliminate their inpatient beds in exchange for a 5% Medicare reimbursement boost for covered outpatient services and an average facility fee payment of $3.2 million a year, according to estimates from the Healthcare Financial Management Association. (Kacik and Goldman, 8/25)
More on health care workers —
The Colorado Sun: Colorado Will Provide Free Education To Students Across Health Care Jobs
A state effort to ease Colorado’s dire shortage of health care workers will offer tuition-free training for several thousand students, providing a much-needed boost to hospitals and clinics. (Breunlin, 8/25)
Becker's Hospital Review: Vanderbilt, Public Schools Team Up To Mentor Future Nurses
Vanderbilt University Medical Center, based in Nashville, Tenn., will partner with Metro Nashville Public Schools to lead monthly conversations with high school seniors about what it takes to become a registered nurse. (Twenter, 8/25)
Houston Chronicle: Amid Health Care Worker Shortage, UTHealth Has A $10.5M Solution
The University of Texas Health Science Center opened a new public psychiatric hospital in March across the street from the Harris County Psychiatric Center, just east of Texas 288, to provide relief to the state’s overburdened mental health system by adding more beds. But building the hospital was the easy part. The real challenge was finding workers to staff it. (Carballo, 8/25)
KHN: Hospitals Cut Jobs And Services As Rising Costs Strain Budgets 
Bozeman Health had a problem, one that officials at the health system with hospitals and clinics in southwestern Montana said had been building for months. It had made it through the covid-19 pandemic’s most difficult trials but lost employees and paid a premium for traveling workers to fill the void. Inflation had also driven up operating costs. (Houghton, 8/26)
AP: Watson Case Revives Old Fight For Massage Therapy Industry
Michelle Krause still grapples with the challenge of acknowledging she’s a massage therapist when she first meets someone, dreading their reaction or misguided comments even after 18 years in the profession. … Krause was among hundreds of therapists from across the country who gathered for the American Massage Therapy Association’s three-day national convention, which began Thursday. It was an opportunity to talk about a job made more difficult amid the pandemic, the 2021 attack on three Atlanta-area massage businesses in which eight people were killed and the lingering stain of NFL quarterback Deshaun Watson’s ongoing case that has perpetuated the sex worker stigma around the industry. (Walker, 8/25)
From The States
Arkansas Blocked From Banning Trans Minors' Gender Care
A three-judge panel of the 8th U.S. Circuit Court of Appeals affirmed an earlier ruling that had temporarily blocked Arkansas from enforcing a 2021 law banning children's gender-affirming care. Also: A medical record issue in Utah prisons, parental leave in South Carolina, and other news.
AP: Court: Arkansas Can't Ban Treatment Of Transgender Kids
A federal appeals court on Thursday said Arkansas can’t enforce its ban on transgender children receiving gender-affirming medical care. A three-judge panel of the 8th U.S. Circuit Court of Appeals affirmed a judge’s ruling temporarily blocking the state from enforcing the 2021 law. A trial is scheduled for October before the same judge on whether to permanently block the law. (DeMillo, 8/5)
In other health news from across the U.S. —
Salt Lake Tribune: ‘Crisis’ In Utah Prisons As ‘Systemwide’ Glitch Causes Inmates To Miss Medications, Officials Say
Utah’s two state prisons are in the midst of a “crisis” after the rollout of a new medical records system this month resulted in inmates missing medication refills, officials announced Wednesday. (Peterson, 8/25)
AP: 6 Weeks Of Paid Parental Leave Coming Soon In South Carolina
Starting in October, state employees in South Carolina are entitled to six weeks of parental leave after giving birth or adopting children. Surrounded by Republican and Democratic lawmakers who worked together to pass the bill, Republican Gov. Henry McMaster held a signing ceremony Thursday for the law he put his signature to back in May. (Collins, 8/25)
AP: Court Loosens Rules On Where Malpractice Cases Can Be Filed 
Pennsylvania’s highest court on Thursday reversed its own two-decade-old rule that required medical malpractice cases to be filed in the county where the alleged harm occurred, a win for civil plaintiffs and the lawyers who represent them but a potentially costly change for health care providers. The decision by the state Supreme Court is likely to mean the number of such lawsuits will increase in Philadelphia and Pittsburgh, where jurors are considered to be more sympathetic to patients and more likely to produce larger verdicts. (Scolforo, 8/25)
Bangor Daily News: Bangor Dental Clinic Is Seeing More Patients After Expansion Of MaineCare Coverage
A Bangor dental clinic that serves low-income patients has seen a flood of new patients who previously only sought care for painful dental emergencies in the two months since the state’s Medicaid program expanded to cover routine dental care. (O'Brien, 8/26)
AP: Woman Sues Over Residency Requirement For Assisted Suicide
A Connecticut woman with cancer sued Vermont on Thursday for allowing only its own residents to take advantage of a state law that lets people who are terminally ill end their own lives. Lynda Bluestein, 75, of Bridgeport, Connecticut, who has terminal fallopian tube cancer, and Dr. Diana Barnard, of Middlebury, Vermont, argue in the lawsuit filed in U.S. District Court in Burlington that Vermont’s residency requirement violates the U.S. Constitution. (Ring, 8/25)
Detroit Free Press: Michigan’s Cannabis Testing Industry: It's Like The ‘Wild Wild West’
When consumers walk into one of the hundreds of legal marijuana dispensaries around Michigan, they have both the expectation that the product they will buy is safe, and that they will be able to view THC percentages on labels. This information is important to consumers for different reasons. (Roberts, 8/25)
In updates on West Nile virus —
Los Angeles Times: L.A. County Confirms First Human West Nile Virus Cases Of The Year
Public health officials on Thursday confirmed Los Angeles County’s first human cases of West Nile virus of the year. (Martinez, 8/25)
Lifestyle and Health
E. Coli Infection Count Hits 84; Whole Foods Sued Over Antibiotics In Beef
The bacterial outbreak source is still unknown, reports Reuters, but a majority of the infected people ate sandwiches at Wendy's. Separately, a lawsuit alleges Whole Foods beef labeled antibiotic-free contains traces. Plus, news on sleep, heat, and chronic disease.
Reuters: E.Coli Infections In Four U.S. States Rise To 84; Majority Wendy's Customers 
The E.coli bacteria outbreak in four Midwest states from an unknown source has affected 47 more people, the U.S. Centers for Disease Control and Prevention said on Thursday, with a majority of the total 84 reported to have sandwiches at Wendy's. The agency said 52 people of the 62 it interviewed reported to have eaten sandwiches with romaine lettuce at a Wendy's restaurant in the week before they fell ill. (8/26)
NPR: Consumers Sue Whole Foods For Allegedly Falsely Advertising Antibiotic-Free Beef
Several consumers are suing Whole Foods, claiming traces of antibiotics were found in their beef products labeled antibiotic-free, according to a lawsuit filed in California this week. Whole Foods uses the slogan, "Our Meat: No Antibiotics, Ever" in its marketing materials, such as on packaging, signs in the store and on its parent website, Amazon. (Archie, 8/26)
Fox News: Sleep Deprivation May Make You More Selfish, New Study Suggests
You might be less willing to help another person if you are deprived of quality sleep, according to a new study. Through three different experiments, Researchers at the University of California, Berkeley, found that a lack of sleep may affect how humans treat each other. The study, which was published Tuesday in the journal PLOS Biology, noted a selfish effect that altered behavior due to sleep deprivation. (Nieto, 8/24)
KHN: With More Sizzling Summers, Colorado Changes How Heat Advisories Are Issued 
For all the images of ski resorts and snow-capped peaks, Colorado is experiencing shorter winters and hotter summers that are increasingly putting people at risk for heat-related illnesses. Yet until this year, the National Weather Service hadn’t issued a heat advisory for the Denver metropolitan area in 13 years. That’s because the heat index commonly used by the weather service to gauge the health risks of hot weather relies on temperature and humidity. Colorado’s climate is so dry that reaching the thresholds for that kind of heat advisory is nearly impossible. (Hawryluk, 8/26)
Stat: Researcher Studying Life’s Complexities To Improve Chronic Disease Care
Having a chronic disease can feel like a full-time job. There are the symptoms, the flare-ups, the medications and therapies and appointments. And there are tiny adjustments to be made all the time — to a sitting position, a meal, a plan, an expectation. (Cueto, 8/26)
Weekend Reading
Longer Looks: Interesting Reads You Might Have Missed
Each week, KHN finds longer stories for you to enjoy. This week's selections include stories on the infant formula shortage, online medical data, mattresses-in-a-box, Dr. Anthony Fauci, and more.
Bloomberg: How Deadly Bacteria Spread In A Similac Factory—And Caused The US Formula Shortage
About 20% of the infant formula produced in the US comes from a plant on the edge of the city of Sturgis, in southern Michigan, where it’s been a presence for more than five decades. It’s owned by Abbott Laboratories and makes Similac, the country’s most popular brand. (Berfield and Edney, 8/25)
The New York Times: A Dad Took Photos Of His Naked Toddler For The Doctor. Google Flagged Him As A Criminal
Mark noticed something amiss with his toddler. His son’s penis looked swollen and was hurting him. Mark, a stay-at-home dad in San Francisco, grabbed his Android smartphone and took photos to document the problem so he could track its progression. … With help from the photos, the doctor diagnosed the issue and prescribed antibiotics, which quickly cleared it up. But the episode left Mark with a much larger problem, one that would cost him more than a decade of contacts, emails and photos, and make him the target of a police investigation. Mark, who asked to be identified only by his first name for fear of potential reputational harm, had been caught in an algorithmic net designed to snare people exchanging child sexual abuse material. (Hill, 8/21)
Los Angeles Times: How A Mattress In A Box Left One Family With Health Issues And $20,000 In Damages
Vanessa Gutierrez began to notice the sores and rashes on her 5-month-old in May 2019. Around the same time, her other daughter, 9, experienced asthma flare-ups. The administrative assistant from Sacramento was baffled about what could be harming her children. “The baby got the worst of it,” Gutierrez said. “I thought she was overactive, but it was because she was feeling the burning.… It looked like little paper cuts all over the back of her legs.” After hours of internet research, Gutierrez grew convinced the culprit is what many of us spend up to one-third of our lives on: a mattress. She is now the lead plaintiff in a lawsuit filed in Sacramento in July against the manufacturer of her mattress, Zinus Inc., alleging flame-resistant fiberglass fibers in the South Korean company’s products can escape and cause health problems, including skin and respiratory tract irritation, and persistent environmental contamination. (De Leon, 8/25)
The Wall Street Journal: Can This Snorer’s Marriage Be Saved? Yes, With Mouth Tape
Mouth tapers affix a not-too-sticky adhesive strip, such as surgical tape, either horizontally or vertically across their lips. Devotees including Mr. Gesualdi, a Rhode Island used-car-dealership owner, say that snuffs snoring, in part by rerouting breath through the nose. The believers have gotten mixed messages from the medical establishment and hard-nosed resistance from skeptics who think mouth taping is best left to hostage movies. The little-studied practice could be risky, say doctors including Dr. Aarti Grover, medical director of Tufts Medical Center’s Sleep Medicine Center in Boston. “Let’s say you have some medical issues like acid-reflux disease,” she says. “Having tape over your mouth might be detrimental.” (Woo, 8/22)
The Washington Post: When Kids Get Control Of Their Lunch, Healthy Options Get Easier 
One of the most effective ways to reach kids is to tap their desire for control. Putting them in the driver’s seat around food (with appropriate guidance, of course) gives them a sense of autonomy and investment, making them more likely to want and enjoy what they are eating. Gardening and cooking with kids are well known ways to foster such agency, but the possibilities don’t stop there. Every step of the meal process is an opportunity for engagement — the more hands-on the better. (Krieger, 8/18)
Politico: Congress Ordered Agencies To Use Tech That Works For People With Disabilities 24 Years Ago. Many Still Haven't
Ronza Othman, a lawyer with the Centers for Medicare and Medicaid Services in Baltimore, hasn’t been able to order a sandwich without help in her office cafeteria for a decade. Before the deli replaced workers with a touch screen in 2012, she would walk up to the counter and ask for a roast beef and cheddar sandwich with cucumbers, not pickles. But Ronza, who is blind, can’t work the touch screen as it doesn’t take voice commands. “I’m an attorney. I have a master’s degree in government and nonprofit management. I’ve raised children,” she said. “But I can’t get a damn sandwich by myself in my agency.” (Reader, 8/21)
The Washington Post: The History Of Polio And The Vaccines That Nearly Eradicated It
Photos and videos show the impact of the disease and the relief vaccinations brought. (Mellen, 8/20)
Also —
USA Today: Dr. Anthony Fauci Didn't Just Treat Infectious Diseases, Colleagues Say. He 'Served The Public For 50 Years.'
Dr. Anthony Fauci’s leadership and communication have always been “science-based, gracious, extraordinarily clear and offered with great diplomacy,” said Dr. William Schaffner, an infectious disease specialist at the Vanderbilt University School of Medicine in Nashville, Tennessee. Fauci's enlightened leadership, Schaffner said, was critical to a public health community that found itself under incredible strain and sometimes attack. “Tony was our guide star in all of this, modeling what many of us did locally in our own communities in attempting to educate and implement public health measures,” he said. (Alltucker, Weise and Voyles Pulver, 8/23)
Editorials And Opinions
Viewpoints: Smelly Sweat Turns Out To Be A Good Thing; CDC Making Headway With Monkeypox
Editorial writers delve into these public health topics.
NPR: Stinky Sweat Turns Out To Have A Surprising Health Benefit 
Back in college, I had an embarrassing moment that's forever etched into my memory. A girlfriend borrowed my backpack for a weekend trip. And when she came back, she handed me the backpack and said something I'll never forget: "Michaeleen, you must sweat a lot because your backpack stinks. The armstraps smell like onions. Ew." (Michaleen Doucleff, 8/25)
USA Today: US Monkeypox Response Improves As CDC Learns From COVID Mistakes
hanges are finally underway with our national approach to monkeypox, hopefully with more to come. Testing, vaccination and treatment efforts have been seriously delayed, reminiscent of public health shortcomings in response to the COVID-19 pandemic. (Dr. Marc Siegel, 8/25)
Stat: LGBTQ+ Community Needs Public Health Response To Monkeypox
I assumed I could get vaccinated against monkeypox fairly easily. But it took me weeks to do that. It’s even more difficult for people in my community with less time and fewer resources. What can be done to fix this? (David Stein, 8/26)
Los Angeles Times: I Am California’s Surgeon General And I Have Bipolar Disorder
In 2011 I was a third-year medical student at Harvard Medical School. I was on my psychiatry rotation — and I had a secret. My attending doctors remarked on how well I supported our patients. I was grateful but felt as though my familiarity with and deep empathy for their symptoms and medication side effects were like a neon sign that at any moment could out me. (Devika Bhushan, 8/26)
The Star Tribune: Smart Step To Help The Hard-Of-Hearing
As Americans age, they often run into one of the frustrating realities of the current health care system — the coverage gap when it comes to helping those who are hard of hearing. (8/25)
The New York Times: The Pernicious Myth Of Maternal Instinct 
New research on the parental brain makes clear that the idea of maternal instinct as something innate, automatic and distinctly female is a myth, one that has stuck despite the best efforts of feminists to debunk it from the moment it entered public discourse. (Chelsea Conaboy, 8/26)
The CT Mirror: Opinion: Psychiatric Hospitals Don't Aid Recovery. Public Policy Can.
When you go to the hospital for a physical health condition, you don’t expect to spend years or decades of your life in that hospital. If that were the case, we’d say that hospital is failing its patients. So why is that happening in our mental health system? (Jordan Fairchild, 8/26)
Different Takes: End Of Roe Has Negative Impact On IVF; Midwives Feel The Stress Of Post-Roe America
Opinion writers discuss reproductive rights, covid, and polio.
NBC News: I Want To Expand My Family. But Texas' Abortion Trigger Ban Stopped Me In My Tracks. 
When Roe v. Wade was overturned earlier this summer, I felt nearly as queasy as when I found out our in vitro fertilization treatment didn’t work. After months of injections, endless waiting and tens of thousands of dollars, the transfer of our sole genetically normal embryo had failed. (Shannon Perri, 8/25)
The Washington Post: In Post-Dobbs Alabama, Midwives Fight For Women’s Autonomy 
Stephanie Mitchell’s life’s work was at stake when she spoke last week at a meeting convened by Alabama’s Department of Public Health in Montgomery. (Karen Attiah, 8/25)
The Tennessean: Abortion Is Now Illegal In Tennessee, But It Took Decades To Get Here
I lead a major abortion provider in the South. Now that we’re forced to indefinitely suspend abortion care in our state, everyone keeps asking me, what’s next? (Ashley Coffield, 8/25)
The Washington Post: The New Covid Booster Is A Bit Of A Gamble-But One Well Worth Taking
For all the amazing benefits of the mRNA coronavirus vaccines, there are limitations. The effectiveness wanes. New variants evolve faster than shots can be adjusted. Destructive disinformation about their safety lingers. Yet, the vaccines are critical to battling disease and death — and that also goes for the next generation of boosters coming soon. (8/25)
Miami Herald: COVID Isn't Over. Congressional Funding For Testing In Florida Shouldn't Be Either
Funding for free COVID testing for low-income and uninsured Floridians through the Health Resources and Services Administration (HRSA) has officially lapsed. For many communities in our state, a lack of access to free testing means they are at risk. (Julio Fuentes, 8/25)
Scientific American: COVID Has Set Back Childhood Immunizations Worldwide 
Thanks to COVID vaccines, more people were immunized in 2021 than in any other year in history. Yet that same year, with tragic irony, more children ended up at risk of highly preventable infectious diseases than before the pandemic began. (Seth Berkley, 8/25)
Stat: Polio In New York: A Call To Action For U.S. Pediatricians, Public Health
A nightmare for pediatricians became a reality earlier this month: Polio, which was previously thought to be eliminated in the U.S., paralyzed an unvaccinated adult, and the virus was found in the wastewater in New York City and outlying counties. (Sallie Permar and Jay K. Varma, 8/26)
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A Disability Program Promised to Lift People From Poverty. Instead, It Left Many Homeless.
Journalists Look Into Wildfire Trauma and the South’s Monkeypox Response
With Polio’s Return, Here’s What Back-to-Schoolers Need to Know
New Abortion Laws Jeopardize Cancer Treatment for Pregnant Patients
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