Morning Briefing
Summaries of health policy coverage from major news organizations
From 吃瓜不打烊 - Latest Stories:
吃瓜不打烊 Original Stories
Colorado Moves Toward Statewide Coverage of Wastewater Surveillance
Colorado was among the first states to embrace wastewater testing to track the coronavirus, an important public heath intervention that can give early warning of outbreaks.
California Sees Dramatic Decline in Child Homicide Victims. What鈥檚 Changed?
Bucking the alarming spike in overall homicides in recent years, the homicide rate involving young children is down 70% in California from three decades ago. The nation has seen a parallel, albeit slower, decline.
Here's today's health policy haiku:
WHAT 'LIVING WITH COVID' LOOKS LIKE
Grab your masks again 鈥
鈥 Anonymous
cases are going back up;
This is 'new normal'
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to an original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of 吃瓜不打烊 or KFF.
Summaries Of The News:
Administration News
Biden Administration Targets Growing Burden Of Medical Debt
The White House is seeking to help lessen Americans鈥 medical debt burden, Vice President Kamala Harris announced Monday. In its latest effort to help people deal with increased costs amid skyrocketing inflation, the White House laid out a four-point plan to help protect consumers. It builds on President Joe Biden鈥檚 recent executive order on increasing access to affordable health care coverage. (Luhby, 4/11)
The administration is asking federal agencies to erase medical debt as an underwriting factor in credit programs for certain consumer and small businesses whenever possible, the White House said Monday. For example, the rural housing loans that run through the U.S. Department of Agriculture are going to stop incorporating medical debt loads when devising borrower repayment plans, the White House said. Meanwhile, the Department of Veteran Affairs is looking at its guidelines after taking other steps to curb medical debt reporting. The Small Business Administration is reviewing its lending programs to spot ways to pull medical debt out of the equation when it comes to accessing capital, the White House said. (Keshner, 4/11)
Vice President Kamala Harris announced new steps designed to reduce the cost of federal home loans for Americans saddled with medical debt and make it easier for veterans to have health care bills forgiven during an event Monday at the White House. 鈥淚 have met so many people in so many communities in our nation who are struggling with this burden, many of whom are managing an illness or an injury at the same time, and who stay up at night staring at the ceiling, wondering if they will ever be able to pay off their medical debt,鈥 Harris said. 鈥淣o one in our nation should have to endure that.鈥 (Sink and Cook, 4/11)
The federal government will be taking action against 鈥渂ad actors鈥 who break the law when attempting to collect medical debt, Vice President Kamala Harris said on Monday. 鈥淥ur administration is also taking action against the bad actors. The folks who violate consumers rights to force people to pay medical debt,鈥 Harris said during a speech announcing the new action to be taken by the Consumer Finance and Protection Bureau. (4/11)
But an increasing number of insured Americans can't afford deductibles, copayments or other out-of-pocket costs that are rising with the underlying cost of care. More than 40% of households don't have enough liquid assets to pay typical private plan cost-sharing, according to a recent KFF analysis. Taking some of the bite out of medical debt doesn't prevent it from accruing in the first place, and it could have unintended consequences. "Policymakers should be cognizant of potential unintended consequences that could undermine some of their goals. Lenders may find ways to proxy for the hidden medical debt or try to avoid consumers likely to have them," said the American Enterprise Institute's Ben Ippolito. (Owens, 4/12)
Also 鈥
The Health and Human Services Department will soon request data from more than 2,000 providers related to medical debt, the White House announced Monday. Providers may be asked to submit information on their medical bill collection practices, lawsuits against patients, financial assistance, financial product offerings and third-party contracting or debt-buying practices. HHS will use the information when making grantmaking decisions. The department also will make some of the data public and share potential violations with enforcement agencies. (Goldman, 4/11)
Pandemic Policymaking
Philadelphia To Impose Mask Mandate Again
Philadelphia has become the first major U.S. city to reimpose an indoor mask mandate. The city said Monday it鈥檚 reached the Level 2: Mask Precautions stage of its four-tiered COVID-19 response system, and that it will reimpose the mask mandate on April 18. Health Commissioner Dr. Cheryl Bettigole said the city will provide businesses with a one-week educational period before the mandate goes back into effect. (4/11)
In related news about mask mandates 鈥
Universities nationwide are reinstating mask mandates amid an uptick in COVID-19 cases. The American University announced Monday it would reinstate its mask mandate in all Washington, D.C., campus buildings starting April 12. It joins Columbia, Georgetown, Johns Hopkins and Rice universities, which have also recently reinstated mask policies, according to the New York Times. The highly transmissible BA.2 subvariant of Omicron has sparked concerns about a possible surge. (Shapero, 4/11)
Extending the federal transportation mask mandate that applies to airplanes, buses and trains is "absolutely on the table," Ashish Jha, the White House's new COVID-19 response coordinator, said Monday on the Today Show. The transportation mask mandate was extended last month but is currently set to expire on April 18. Jha stressed that the decision to extend the transportation mandate lies with Centers for Disease Control and Prevention director Rochelle Walensky. (Saric, 4/11)
In other updates on pandemic restrictions and relief 鈥
The Biden administration on Monday asked a federal appeals court to clear a procedural hurdle that remained after a key legal victory last week and allow the administration to quickly resume enforcement of its COVID-19 vaccine mandate for federal employees.聽聽The request to the U.S. Court of Appeals for the 5th Circuit, if granted, would effectively reinstate the public health policy after it was put on hold across the country in January by a federal judge in Texas. (Kruzel, 4/11)
State Sen. Donzella James鈥 voice isn鈥檛 as strong as it used to be. In January 2021, James tested positive for COVID-19. She thought it was just her chronic bronchitis, but the next morning, she found herself in a crowded emergency room. After subsequent bouts of pneumonia and blood clots, she finally left the hospital in May. James, an Atlanta Democrat, remains vigilant about COVID-19 today. 鈥淚 saw people every day dying all around me,鈥 she said. 鈥淚 am concerned because I know far well what that COVID can do to you.鈥 (Voytek, 4/11)
Public health advocates are calling on Congress to extend a waiver program that was implemented early in the coronavirus pandemic to provides free meals to students, including millions of children in Florida. The waivers are set to expire at the end of this school year. The federal government gave schools more flexibility in how and where they could deliver meals and increased reimbursement rates to cover more kids and in some cases healthier food options. If the waivers expire at the end of June, children could lose out on an important source of nutrition, according to Jamie Bussel, senior program officer with the Robert Wood Johnson Foundation. (Colombini, 4/11)
Covid-19
Covid Cases Are Rising In Many Places, But Americans Are So Over It
As COVID-19 cases continue to tick up in the United States, the Northeast appears to be fueling the increase. Four of the five states with the highest seven-day case rates per 100,000 are in the Northeast. In the 10 states with the highest seven-day rates, seven are Northeastern, according to data from the Centers for Disease Control and Prevention. Rhode Island currently has the highest seven-day case rate at 172.4 cases per 100,000 people. (Kekatos, 4/11)
Wastewater testing shows a significant spike in COVID-19 in Bangor, with the city reporting among the highest virus concentrations among U.S. samples measured through the same testing method in the past six weeks. COVID-19 levels in the wastewater in Maine鈥檚 third-largest city are still lower than they were in January and early February during the winter omicron spike. But the rise is another indication that the virus may again be on the rise in Maine, as the state鈥檚 top public health official warned last week. It comes as the more contagious 鈥渟tealth omicron鈥 variant has become the dominant strain聽here over the past month. (Piper, 4/11)
Coronavirus cases are once again on the rise in Los Angeles County, according to data released Monday, prompting officials to urge residents to keep up safety protocols as the spring break holiday season arrives. Data show that for the seven-day period that ended Monday, an average of 960 new cases were reported daily countywide, which equates to 67 cases a week for every 100,000 residents. That鈥檚 up 23% from the previous week, when L.A. County reported an average of 783 cases a day. (Money and Lin II, 4/11)
COVID-19 cases are showing signs of rising again, even as many Americans are eager to move on. ... While there are now upticks in the Northeast, there are not yet signs of the massive spike that hit over the winter. That omicron variant-fueled spike already infected many people, helping provide them some immunity against the current outbreak, in addition to the immunity provided by vaccines and booster shots. (Sullivan, 4/11)
But a poll finds most Americans aren't concerned 鈥
Less than one in 10 Americans now describe COVID-19 as a crisis 鈥 with about three in four calling it a manageable problem and one in six saying it's no problem at all 鈥 according to the latest installment of the Axios/Ipsos Coronavirus Index. These sentiments 鈥 and the public's growing desire to be done with mask mandates and other restrictions 鈥 raise significant challenges for public health officials in managing new surges, and could create real political headwinds ahead of the midterms. (Talev, 4/12)
And more on the spread of covid 鈥
Children older than 5 years and those with high concentrations of ferritin in the blood鈥攁n indicator of inflammation鈥攚ere at highest risk for intensive care unit (ICU) admission for COVID-19鈥搑elated multisystem inflammatory syndrome in children (MIS-C), finds a study today in the Canadian Medical Association Journal (CMAJ). (4/11)
No week of the omicron wave saw more deaths than the week of Jan. 30 to Feb. 5. More than 18,400 deaths were recorded, according to NBC News鈥 tally, more deaths in a single week than in all of June and July 2021 combined. The death toll 鈥斅爓hich occurred two weeks after cases peaked across the United States 鈥 made the week the deadliest thus far of 2022 and one of the deadliest weeks of the pandemic.聽(Chiwaya, 4/7)
Since the pandemic arrived in March of 2020, the COVID-19 virus has officially killed just more than聽38,000 Ohioans. In Kentucky,聽the number is nearing 15,000. Cincinnati has recorded 565 deaths, with nearly 5,000 for the eight-county Greater Cincinnati region. Later this spring or early this summer, the national death toll, now just more than 980,000, will hit 1 million. It is likely to be a muted milestone. 鈥淧eople seem to have moved on and stopped paying attention," said Josh Nelson, a Kennedy Heights resident who works as a political and nonprofit consultant. (Gallagher Newberry, 4/12)
Speaker Nancy Pelosi (D-Calif.) announced on Monday that she has tested negative for COVID-19 and will exit isolation on Tuesday. She tweeted: "Today, happily I tested negative for COVID. Tomorrow, I will be exiting isolation at the direction of the Capitol鈥檚 Attending Physician and consistent with CDC guidelines for asymptomatic individuals. Many thanks to everyone for their good wishes, chocolates and chicken soup." (Schnell, 4/11)
KHN: Colorado Moves Toward Statewide Coverage Of Wastewater Surveillance
On a Sunday morning in March 2020, right at the start of the pandemic, an article in Popular Mechanics caught engineer Pieter Van Ry鈥檚 eye. It had a catchy title: 鈥淗ow Poop Offers Hints About the Spread of Coronavirus.鈥 鈥淎t the end of that article, it said, 鈥業f you have a wastewater facility and you鈥檙e interested in participating in this study, please contact us,鈥欌 he said. As a matter of fact, Van Ry did have a wastewater facility. He is the director of South Platte Renew, a wastewater treatment plant in Englewood, Colorado, that serves 300,000 people. He filled out the form, and South Platte joined the first facilities in the nation to start testing wastewater for covid-19. (Daley, 4/12)
Vaccines and Covid Treatments
Experimental Drug Halves Covid Deaths Among Critically Ill, Company Says
An experimental drug halved the death rate among critically ill Covid patients who were receiving supplemental oxygen and were at high risk for serious lung disease and death, the drug鈥檚 developer announced on Monday. ... The new drug, sabizabulin, reduced deaths among hospitalized Covid-19 patients so drastically in a clinical trial that independent safety monitors recommended stopping it early, officials at Veru Inc., the drug鈥檚 maker, said. The trial was halted on Friday. The results of that trial have not been peer-reviewed or published in a medical journal. (Rabin, 4/11)
And Evusheld is going unused in some places 鈥
Thousands of doses of COVID-19 therapeutics and preventive treatments sit unused in Michigan because doctors haven't been prescribing them, the state's top doctor聽told the Free Press last week.聽"The issue in the beginning had been that we thought demand would outpace supply and that didn't really happen in the state of Michigan or in most of the country,"聽said Dr. Natasha Bagdasarian, the state's chief medical executive.聽"What we really saw was the clinicians were a little bit hesitant to prescribe it ...聽because they were still learning about it." (Jordan Shamus, 4/11)
In updates on the vaccine rollout 鈥
CVS Pharmacy has reached a settlement with federal prosecutors that will ensure the company鈥檚 online vaccination scheduling portal remains fully accessible to people with disabilities, officials said Monday. The U.S. attorney鈥檚 office in Rhode Island alleged the company, which operates nearly 10,000 retail pharmacies nationwide, was in violation of the Americans with Disabilities Act because the portal was not accessible to people who use screen reader software designed for the visually impaired, and to those who have difficulty using a mouse. (4/11)
How much worse could the US COVID-19 pandemic have been if vaccinations hadn鈥檛 arrived in the nick of time in December 2020? Unimaginably worse, according to a study released last week. The researchers estimated that vaccinations by the end of last month had averted more than 2.2 million deaths, more than 17 million hospitalizations, and more than 66 million infections.鈥 Our findings highlight the profound and ongoing impact of the vaccination program in reducing infections, hospitalizations, and deaths,鈥 said the study released Friday by the Commonwealth Fund, a venerable nonprofit that focuses on improving health care, particularly for society鈥檚 most vulnerable. (Finucane, 4/11)
Pfizer and Moderna hire new CFOs 鈥
Vaccine makers Pfizer Inc. and Moderna Inc. named company outsiders as chief financial officers as they look to deploy some of the cash they have generated during the Covid-19 pandemic. New York-based Pfizer on Monday said David Denton will take over as CFO on May 2. Mr. Denton has served as finance chief of home-goods retailer Lowe鈥檚 Cos. since 2018. Before that, he led the finances of CVS Health Corp. , the Woonsocket, R.I.-based drugstore and health-services chain. (Broughton, 4/11)
David M. Denton was named the next CFO and EVP at Pfizer, effective May 2. Prior to joining Lowe鈥檚 in 2018 as CFO, Denton served as CFO and EVP at CVS Health. He helped guide the transformation of CVS from a retail pharmacy to a health solutions provider and led the full integration of Caremark into CVS, according to Pfizer. Denton also negotiated the terms and financing for CVS鈥檚 acquisition of Aetna in December 2017. The $70 billion deal closed in November 2018. (Estrada, 4/11 )
Medicare
Medicare Plans To Cut Payments To Nursing Homes
Nursing homes may see a $320 million cut to their Medicare Part A payments in fiscal 2023 under a proposed rule the Centers for Medicare and Medicaid Services issued Monday. The proposed rule also seeks feedback on how to establish minimum staffing requirements for nursing homes, as directed by President Joe Biden, and includes a plan to add three measures to the Skilled Nursing Facility Value-Based Purchasing Program. (Goldman, 4/11)
In other news about Medicare聽 鈥
Biogen and other drugmakers have already hinted they might sue Medicare over its decision to limit coverage for the controversial new drug, Aduhelm 鈥 a legal challenge that could have massive implications for patients and pharmaceutical companies that extend far beyond those focused on Alzheimer鈥檚 disease. Even before Medicare officials made their limits on the drug official last week, Biogen had said it didn鈥檛 believe such restrictions would hold up in court. Other drugmakers potentially impacted by the decision, like pharmaceutical giant Eli Lilly, raised similar objections. (Florko, 4/12)
Patient advocates fear the Montana State Hospital could fall further into a tailspin as the state-run facility is poised to lose federal funding for services starting Tuesday because of repeated failures to maintain health and safety standards. In interviews Monday, mental health professionals gave a grim picture of the availability of beds elsewhere in the state for patients who may have to relocate from the state-run hospital due to the loss of funding. Because of the end of reimbursement for services by the federal Centers for Medicare and Medicaid for people covered by either of those insurance programs, state officials said Monday they are exploring transfers for some patients. CMS will continue making payments for 30 calendar days for patients admitted on or before April 11. (Larson, 4/12)
Becker's calculated which U.S. hospitals have the highest share of their patients covered under Medicare. The 2019 data released April 5 is from the coverage, cost and value team at the National Academy for State Health Policy in collaboration with Houston-based Rice University's Baker Institute for Public Policy. (Emerson, 4/11)
And in news on Medicaid --
The deadline set by Florida lapsed for its largest Medicaid payment vendor to challenge a nearly $9.1 million fine over the company鈥檚 failure for nearly three months to pay tens of thousands of health care claims for the state鈥檚 sickest and neediest children. Sunshine State Health Plan Inc. of Tampa had until 5 p.m. Thursday to dispute the large fine imposed last month by its government regulator, the Agency for Health Care Administration, leaving the company with only the option to concede to pay. 鈥淪unshine waives any dispute not raised within 21 days,鈥 the government had warned the company March 17. (Bausch, 4/11)
Pharmaceuticals
FDA Exploring Route To Cheaper Drugs Through Imports
The FDA has started discussions with states over creating a way to import drugs from Canada 鈥 a policy the Biden and Trump administrations both embraced to bring down health costs but which experts regard as having limited impact. With President Biden's drug pricing agenda stalled, importation could allow states to take advantage of lower drug prices abroad without the need for direct action to limit prices in the U.S. Under one pathway, states, wholesalers and pharmacies submit importation proposals to HHS, which would be subject to safety and cost conditions. (Bettelheim, 4/12)
And more FDA news 鈥
The chairs of two powerful committees in the House and Senate that oversee FDA are demanding answers in response to a POLITICO investigation into the agency鈥檚 failure to act on a slew of pressing food safety and nutrition issues. Sen. Patty Murray (D-Wa.), who leads the Senate Committee on Health, Education, Labor and Pensions, sent a strongly-worded letter to FDA Commissioner Robert Califf Monday afternoon seeking 鈥渋mmediate action to ensure the FDA is doing all it can to fulfill all aspects of its mission to protect the health and safety of the American people.鈥 (Evich, 4/11)
The U.S. Food and Drug Administration has scolded Bausch Health for a video and webpage that made misleading claims about a plaque psoriasis treatment, the second time this year the agency has tagged a big drugmaker for overlooking the risks and benefits of a medicine in promotional materials. In a March 22 letter, the FDA wrote that a Bausch video failed to say that its Duobrii topical cream can cause birth defects. The video, which had been visible on YouTube but has since been taken down, failed to note that women should get a pregnancy test before applying the cream and should use contraception. The video, which can still be seen here, also lacked warnings about photosensitivity and the risk of sunburn. (Silverman, 4/11)
In updates on insulin pricing 鈥
A bipartisan group of four key lawmakers unveiled a long-shot policy that aims to alleviate one of the American health care industry鈥檚 most embarrassing problems: mind-bogglingly high prices for insulin, a drug millions of Americans need to survive. The policy outline released Monday is a reboot of a three-year-old bill introduced by Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine). It would dangle a carrot for drugmakers to lower their list prices. Insurers and middlemen wouldn鈥檛 get to keep fees for diabetes drugs 鈥 but only if drugmakers lower list prices for drugs back to 2006 levels. It would also make sure patients with Medicare or private insurance don鈥檛 pay more than $35 per month for their insulin, though it would not offer the same protection to the uninsured. (Cohrs, 4/11)
Insulin prices are sky high. High enough, now, that Human Rights Watch is declaring that insulin鈥檚 price tag contributes to human rights abuse. The international advocacy organization best known for investigating war crimes, genocides and dictatorships is out with a new report that argues that the human rights of people with diabetes are being violated when they鈥檙e unable to afford their insulin. That makes insulin makers, who set those high prices, complicit in human rights abuses, according to Matt McConnell, the lead author. 鈥淒rug companies鈥 drug pricing practices聽 鈥 are contributing to human rights abuses,鈥 he told STAT. (Florko, 4/12)
In other pharmaceutical industry news 鈥
Johnson & Johnson must pay $302 million in penalties to the state for many years of deceptive marketing to doctors and female patients about pelvic mesh implants that could cause serious vaginal pain and physical damage, a state appeals court ruled Monday. A San Diego County judge had assessed $344 million in penalties against Johnson & Johnson subsidiary Ethicon in January 2020, finding after a non-jury trial that the company had made misleading and potentially harmful statements in hundreds of thousands of advertisements and instructional brochures for nearly 20 years. The Fourth District Court of Appeal said $42 million of that amount, penalties for the company鈥檚 spoken sales pitches to doctors, was unjustified because the state had no evidence of what the sales representatives had actually said. (Egelko, 4/11)
When the coronavirus pandemic first hit the U.S., sales of window coverings at Halcyon Shades quickly went dark. So the suburban St. Louis business did what hundreds of other small manufacturers did: It pivoted to make protective supplies, with help from an $870,000 government grant. But things haven鈥檛 worked out as planned. The company quit making face shields because it wasn鈥檛 profitable. It still hasn鈥檛 sold a single N95 mask because of struggles to get equipment, materials and regulatory approval. (Lieb, 4/11)
Health Industry
JAMA's New Editor-In-Chief Is A Health-Equity Researcher
A year after the prestigious medical journal JAMA was embroiled in controversy over a podcast seen as racist by critics, the American Medical Association has appointed a prominent health-equity researcher as the publication鈥檚 new editor-in-chief 鈥 the first person of color to hold the position. Kirsten Bibbins-Domingo, a Black internist, epidemiologist, and health-equity researcher from the University of California, San Francisco, who has been a leading voice for equitable health care during the Covid-19 pandemic, will lead the Journal of the American Medical Association and the JAMA network of journals, the AMA announced Monday. (McFarling, 4/11)
Dr. Kirsten Bibbins-Domingo, a physician-scholar from the University of California, San Francisco, has been named the next editor-in-chief of the Journal of the American Medical Association. She is the first person of color to lead the medical journal and only the second woman to serve as editor-in-chief, AMA Chief Communications Officer Rodrigo Sierra said during a press conference today. Bibbins-Domingo will take the reins on July 1. The last permanent editor, Howard Bauchner, left the position following a controversy over a podcast and associated tweet that called into question the existence of systemic racism in the medical profession. Dr. Phil Fontanarosa has served as interim editor-in-chief since March 2021. (Asplund, 4/11)
In other health industry news 鈥
The action by Service Employees Union International-United Healthcare Workers West members comes after their contract with the not-for-profit hospital ended March 31. Contract bargaining began March 21, according to the union. Workers are demanding the hospital negotiate in "good faith" over staffing levels, patient and employee safety, and wages, a news release said. Ninety-three percent of the employees voted in favor of approving a three-day strike if talks don't progress, the union announced Monday. (Christ, 4/11)
When Governor Charlie Baker signed legislation in January 2021 mandating insurance coverage for telehealth appointments, the move seemed to resolve years of debate about how to pay for and adopt 21st-century health care technology. But delays in releasing regulations for that law have thrown insurers and doctors back into debate about which visits should be fully covered, and some say the resulting uncertainty could undo gains the industry has made in adopting telehealth over the course of the pandemic. 鈥淚t makes it much more difficult at a practice level to make sure you are getting care to people in the way that they need it,鈥 said Dr. Chris Garofalo, a co-owner of a private family medicine practice in North Attleborough and Attleboro. (Bartlett, 4/11)
Vermont regulators have rejected a 10% mid-year rate increase for two hospitals, including the state鈥檚 largest, that administrators sought to cover what they called historic inflationary pressures. Regulators instead approved much smaller increases for the University of Vermont Medical Center in Burlington and Central Vermont Medical Center in Berlin. The Green Mountain Care Board approved a rate increase of 2.5% for the UVM Medical Center and 2.7% for Central Vermont in a 3-2 vote on Friday, Vermont Public Radio reported. (4/11)
Hall Ambulance will honor its emergency medial dispatchers during National Public Safety Telecommunicators Week, which begins Sunday and runs through Saturday. 鈥淲hen someone falls victim to sudden illness or injury, these dispatchers are there to answer the call,鈥 Lavonne C. Hall, president and CEO of Hall Ambulance, said in a statement. 鈥淲e are grateful for their dedication and commitment to the communities we serve.鈥 (4/9)
Also 鈥
When Delta Air Lines created the chief health officer role in 2021, it was facing an acute, existential threat to its business and still reeling from COVID-19. Fast-forward to 2022; though the pandemic is on its way to becoming endemic, the airline is immortalizing the CHO role to navigate future health crises and workplace challenges that will inevitably emerge long after the pandemic has receded. (Wahba, 4/11)
Opioid Crisis
Florida's Opioids Trial Against Walgreens Begins
In Florida, the state鈥檚 case hinges on accusations that as Walgreens dispensed more than 4.3 billion total opioid pills in Florida from May 2006 to June 2021, more than half contained one or more easily recognized red flags for abuse, fraud and addiction that the company should have noticed and acted upon. 鈥淭he evidence will show Walgreens knowingly profited from the opioid crisis,鈥 said attorney Jim Webster for the state in an opening statement, which was attended by Florida Attorney General Ashley Moody. 鈥淲algreens wasn鈥檛 just greedy. It was fueling the opioid crisis that was killing people.鈥 (Anderson, 4/11)
Walgreens Boots Alliance Inc. supplied billions of opioid pills to drug addicts and criminals, contributing to an addiction epidemic in Florida, a lawyer for the state said on Monday in a civil trial against the pharmacy chain. Walgreens filled one in four opioid prescriptions in Florida between 1999 and 2020, and failed to investigate red flags that could have prevented drugs from being diverted for illegal use, the state's lawyer Jim Webster said as jurors heard opening statements in the trial held in New Port Richey. (Knauth, 4/11)
The effort to hold drug companies, pharmacies and distributors accountable for their role in the opioid crisis has led to a whirlwind of legal activity around the U.S. that can be difficult keep tabs on. Three trials are underway now, in Florida, West Virginia and Washington state. New legal settlements are being reached practically every week to provide governments money to fight the crisis and in some cases funds for medicines to reverse overdoses or to help with treatment. (Mulvihill, 4/12)
In updates from Ohio 鈥
The defense attorney for an Ohio doctor accused of overprescribing pain medication to multiple patients near death asked for a mistrial in the case Monday, saying certain remarks from prosecutors during closing arguments implied the defense has to meet a burden of proof. Defense attorney Jose Baez argued prosecutors have the burden to prove guilt and the defense doesn't have to prove anything. The defendant, William Husel, faces 14 counts of murder related to the allegations he prescribed the opioid fentanyl in doses "designed to hasten the death of the patients that were being treated," prosecutors said when Husel was indicted in June 2019. He was initially indicted on 25 counts of murder, but in January -- about a month before the trial began -- 11 of the 25 counts against him were dismissed. Husel has pleaded not guilty. (Casarez, 4/12)
A former Ohio hospital physician on trial in the deaths of critically ill patients was portrayed Monday in closing arguments as a "terrible doctor" with no medically justifiable reason for his actions and as a "caring man" easing the pain of those dying. The jury, which was expected to begin deliberations Tuesday, is tasked with determining whether William Husel, 46, committed murder by purposefully hastening 14 patients' deaths when, prosecutors say, he ordered excessive doses of fentanyl, a powerful opioid used to blunt pain, while he was employed at Mount Carmel Health System in Columbus. (Ortiz, 4/11)
In news about marijuana and psilocybin 鈥
A year and a half after New Jersey residents voted to legalize cannabis, the state on Monday gave seven medical-marijuana companies approval to start selling their products to all adults, opening the door to the first legal marijuana sales in the New York City region within a month. In a meeting held by videoconference, the five-member Cannabis Regulatory Commission ushered in a seismic cultural change, making New Jersey the second state on the East Coast to fully authorize sales of cannabis to all adults. (Tully, 4/11)
A Republican-authored bill to legalize medical marijuana in Wisconsin will be getting its first public hearing next week, achieving one goal of backers and the latest sign of progress for those who want to loosen the state鈥檚 laws. The bill won鈥檛 become law this year because Legislature has adjourned and won鈥檛 be back until 2023. But the April 20 Senate committee hearing on the medical marijuana bill will give supporters their highest profile chance to make the case for loosening Wisconsin鈥檚 marijuana laws. (Bauer, 4/11)
Psychedelic compounds like LSD, Ecstasy and psilocybin mushrooms have shown significant promise in treating a range of mental health disorders, with participants in clinical studies often describing tremendous progress taming the demons of post-traumatic stress disorder, or finding unexpected calm and clarity as they face a terminal illness. But exactly how psychedelics might therapeutically rewire the mind remains an enigma. (Jacobs, 4/11)
Magic mushrooms connect regions of the brain that are more segregated in people with depression, paving the way to treat the condition differently than with conventional medications. Psilocybin, a hallucinogenic compound present in fungi, helped 鈥渙pen up鈥 and improve communication within the brain for up to three weeks, researchers from Imperial College London found. The result was a liberating effect not seen with the traditional antidepressant Lexapro, according to the study published in the journal Nature Medicine.聽(Hernanz Lizarraga, 4/11)
Public Health
Report Finds Black Babies Can Expect 5 Years Less Life Than White Babies
The National Urban League released its annual report on the State of Black America on Tuesday, and its findings are grim. This year鈥檚 Equality Index shows Black people still get only 73.9 percent of the American pie white people enjoy. ... Among dozens of health measures, one stands out: Life expectancy has declined slightly for African Americans, so a Black child born today can expect to live to 74.7, four years less than a white baby. And lifelong inequities loom: Black women are 59% more likely to die as a result of bearing a child, and 31% more likely to die of breast cancer. Black men are 52% more likely to die of prostate cancer. (Warren, 4/12)
In environmental health news 鈥
In the western United States, where massive wildfires have fouled the air with smoke and hazardous levels of pollutants, Santosh Pandipati, an obstetrician in California, counsels pregnant patients to always check air quality before they venture outside to exercise. 鈥淵ou need to plan your outdoor activities when the air quality is better,鈥 he tells them. In other parts of the country, where hurricanes and floods have displaced pregnant residents, obstetrician Nathaniel DeNicola has advised patients, including those he saw in New Orleans, to pack a preparedness kit. (Kam,m 4/11)
When the pediatrician recommended Lisa Pascoe have her then-toddler tested for lead poisoning, she thought there was no way he could be at risk. Everything in her South St. Louis home had been remodeled. But then the nurse called to say her son's blood lead level was dangerously high 鈥 five times the level federal health officials then deemed elevated. Pascoe said she was "completely shocked." "After you hang up on the phone, you kind of go through this process of 'Oh my gosh, my kid is lead poisoned. What does that mean? What do I do?'" she said. (Kite and Savage, 4/11)
What recent research makes clear so far is that microplastics are ubiquitous, that these particles enter peoples鈥 bodies regularly during inhalation or through consumption of food or drinks, and that they find their way into vital body systems.聽Some studies of laboratory animals and cells grown outside the body suggest that there are reasons for concern about how these minuscule pieces of plastics affect our physiology.聽(Bush, 4/11)
In mental health news 鈥
The United States is experiencing an extreme teenage mental-health crisis. From 2009 to 2021, the share of American high-school students who say they feel 鈥減ersistent feelings of sadness or hopelessness鈥 rose from 26 percent to 44 percent, according to a new CDC study. This is the highest level of teenage sadness ever recorded. The government survey of almost 8,000 high-school students, which was conducted in the first six months of 2021, found a great deal of variation in mental health among different groups. More than one in four girls reported that they had seriously contemplated attempting suicide during the pandemic, which was twice the rate of boys. Nearly half of LGBTQ teens said they had contemplated suicide during the pandemic, compared with 14 percent of their heterosexual peers. Sadness among white teens seems to be rising faster than among other groups. (Thompson, 4/11)
Educators working聽in low-income schools reported that 53% of students struggle with mental health issues, a problem that聽was worsened by the COVID-19 pandemic,聽according to a new聽survey from聽educational nonprofit First Book and Nationwide Children鈥檚 Hospital鈥檚 On Our Sleeves alliance. Yet only 20% of the 967 educators surveyed feel prepared to support those struggling students, the study found.聽By assessing the severity of the COVID-19 pandemic's impact聽on students and providing guidance for educators, the two organizations聽hope to address what they say is an聽urgent聽need聽for mental health聽support in low-income聽schools, said Becki Last, First Book's聽chief programming officer.聽(Wright, 4/11)
Doing regular mindfulness exercises on a mobile app helped a group of Fox Valley adolescents banish stubborn negative thoughts, new research from a Lawrence University professor has found.聽The results add to a field with little prior examination and聽can help shed light on which kinds of tools help teens feel better, said Lori Hilt, an associate professor of psychology at Lawrence who led the study.聽"We don't have very much research on mindfulness interventions for kids, especially mobile apps," Hilt said. "So I think this study is really important as kind of a proof of concept that these things can work."聽(Hilton and Heim, 4/11)
State Watch
San Diego To Experiment With Sending 911 Calls To Nurses
Several years ago in the nation鈥檚 capital, a few hundred people who dialed 911 were not taken to a hospital. The next year, nearly 2,900 calls didn鈥檛 lead to an emergency room. The year after, it was more than 7,000, according to city data. Since 2018, more than 16,000 calls that once might have resulted in trips to the hospital were instead transferred to nurses, who could still help people find doctors or schedule rides to urgent cares. (Nelson, 4/11)
In other health news from across the U.S. 鈥
About 125,000 Connecticut kids didn鈥檛 have enough to eat in the fall of 2021, according to a new statewide report on the financial hardships faced by families with children. The report, conducted through a partnership between Connecticut United Way and United for ALICE, examines a group of people referred to as ALICE 鈥 the acronym for Asset Limited, Income Constrained, Employed. The people designated to be in this group earn enough to put them above the federal poverty level but not enough to make ends meet. ALICE is often comprised of people who work lower-paying hourly jobs, such as cashiers, for example. (Monk, 4/11)
A bill that would allow terminally ill patients to access life-ending medication won鈥檛 advance beyond the legislature鈥檚 Judiciary Committee this year, and proponents said they don鈥檛 expect the measure to pass this legislative session. Senators on the committee voted 5-4 against the bill Monday after members asked for a divided vote. Because the bill failed to win enough support among senators, House members on the committee did not take a vote. (Carlesso, 4/11)
The family of a Las Vegas man who was denied health insurance coverage for a specific type of lung cancer treatment, then later died, has won a $200 million civil verdict against his health insurance provider, according to court records. The family of William George 鈥淏ill鈥 Eskew sued Sierra Health and Life Insurance in 2019. A jury trial led to an initial $40 million verdict a week ago, along with another $160 million in punitive damages against Sierra Health in the courtroom of District Judge Nadia Krall. Sierra Health is a UnitedHealthcare company, which is owned by UnitedHealth Group. The company plans to appeal, a spokeswoman said. 鈥淲e are disappointed by the jury鈥檚 verdict,鈥 United HealthCare spokeswoman Maria Gordon Shydlo said in an email to the Las Vegas Review-Journal. (Puit, 4/11)
Indiana鈥檚 hospitals and insurers are assuring聽state lawmakers they are taking steps to reduce Indiana's health care costs, which are among the highest in the nation,聽but some business leaders say they have yet to create聽a plan to do so.聽Several industry leaders and executives laid out their ideas in letters to lawmakers last week. They were聽sent in response to a December directive from the Statehouse聽telling the two industries to bring Indiana鈥檚 health care costs in line with the national average. (Rudavsky, 4/12)
As voters went to the polls last month in the Texas primary, the voting rights hotline lit up at the nonprofit advocacy agency Disability Rights Texas. Molly Broadway, the group鈥檚 training and technical support specialist, heard from some frustrated voters with disabilities who had not received their mail-in ballots on time. Others had their ballots rejected several times because of signature and personal identification requirements or fretted that new rules banning ballot assistance could make criminals out of their friends and loved ones. (Vasilogambros, 4/12)
KHN: California Sees Dramatic Decline In Child Homicide Victims. What鈥檚 Changed?聽
The stunning climb in homicide rates in recent years in California and big cities across the nation obscures a remarkably good-news trend involving young children: The number of child homicide victims fell dramatically in California over the past decade, the latest death certificate data shows, a pattern mirrored to a lesser extent nationwide. In 1991, California鈥檚 coroners officially classified 133 deaths of children ages 9 and younger as homicides. By 2011, that figure had fallen to 81.In 2020, it stood at 40. (Reese, 4/12)
Global Watch
Shanghai Covid Surge Prompts Partial US Government Pullout
The U.S. State Department has ordered all non-emergency government staff and their family members in Shanghai to leave as Covid surges and told U.S. citizens to reconsider travel to China, according to an announcement dated April 11. 鈥淩econsider travel to the People鈥檚 Republic of China (PRC) due to arbitrary enforcement of local laws and COVID-19-related restrictions,鈥 the State Department said. 鈥淒o not travel to the PRC鈥檚 Hong Kong Special Administrative Region (SAR), Jilin province, and Shanghai municipality due to COVID-19-related restrictions, including the risk of parents and children being separated,鈥 the statement said. 鈥淩econsider travel to the PRC鈥檚 Hong Kong SAR due to arbitrary enforcement of local laws.鈥 (Cheng, 4/11)
South African scientists have discovered two new sublineages of the Omicron coronavirus variant, said Tulio de Oliveira, who runs gene-sequencing institutions in the country. The lineages have been named BA.4 and BA.5, he said by text message and in a series of tweets. Still, de Oliveira said, the lineages have not caused a spike in infections in South Africa and have been found in samples from a number of countries. (Sguazzin, 4/12)
The U.N. official spearheading global vaccination efforts against the coronavirus said Monday the number of countries where 10% or less of the population has been vaccinated dropped from 34 to 18 since January and called for accelerated progress to end the pandemic. Assistant Secretary-General Ted Chaiban told the U.N. Security Council that with over 6 million lives lost to COVID-19 and just over 1 million new coronavirus infections reported to the World Health Organization in the last 24 hours, it is urgent to increase vaccinations in countries where it wasn鈥檛 possible to boost rates in 2021. (Lederer, 4/12)
The specter of particulates has forced another recall鈥攖his time on Moderna鈥檚 massively successful COVID-19 vaccine Spikevax鈥攁nd the latest pull isn鈥檛 contract manufacturer Rovi鈥檚 first brush with contamination, either. Moderna on Friday said it was recalling one Spikevax lot in Europe. The batch contains 764,900 doses made by CDMO Rovi that were deployed across Norway, Poland, Portugal, Spain and Sweden between Jan. 13 and Jan. 14. Moderna yanked the shots because of a 鈥渇oreign body鈥 found in one vial of the batch made at Rovi鈥檚 site in Spain, the partners said in a release. (Kansteiner, 4/11)
Germany鈥檚 health ministry said Monday that the country may have to discard 3 million doses of expired COVID-19 vaccine by the end of June. Ministry spokesman Hanno Kautz told reporters in Berlin that 鈥渘ot many doses鈥 have been destroyed so far, though he couldn鈥檛 give an exact figure. (4/11)
Editorials And Opinions
Viewpoints: Focusing On Who Can Perform Abortions Is A Smokescreen; Police With PTSD Deserve Treatment
The essential question raised by the Abortion Care Access Act, the controversial legislation enacted by the Maryland General Assembly last Saturday with House (90-46) and Senate (29-15) votes to override Gov. Larry Hogan鈥檚 veto, was this: Should abortions be performed by 鈥渜ualified鈥 health care providers who are not physicians? Opponents of the bill would have Marylanders believe that standard pregnancy termination could not safely be conducted by, for example, a nurse practitioner or a physician assistant who has been specially trained in this procedure. This would be news to the medical community. It was none other than the American College of Obstetricians and Gynecologists that found non-physicians can be trained to conduct this procedure. And when did the organization that represents 90% of the nation鈥檚 board-certified ob-gyns first make that determination? (4/11)
A growing number of police officers in Minnesota have been diagnosed with post-traumatic stress disorder (PTSD) during the past two years and are receiving millions in payments through workers' compensation settlements and state disability pensions. Though Minneapolis has the largest portion of cases from public safety workers, mostly police, with 43%, St. Paul has 9% and about 48% come from elsewhere in the state, according to the Public Employees Retirement Association (PERA). In addition to the high cost for state and local governments, the current system doesn't offer training or treatment options. (4/11)
Affordable reproductive health and family planning resources shouldn鈥檛 be controversial, but in recent years these vital services have become collateral damage in the culture wars. That鈥檚 why U.S. Sen. Patty Murray鈥檚 effort to restore federal Title X family planning funding is so important. Until abortion opponents tire of using the grant program as proxy in their fight against safe, legal abortion, it will take champions like Murray to protect funding for low-income women鈥檚 access to contraception, testing and treatment for sexually transmitted infections, cancer screenings and other care. (4/11)
When I was 19, I had surgery for sex reassignment, or what is now called gender affirmation surgery. The callow young man who was obsessed with transitioning to womanhood could not have imagined reaching middle age. But now I鈥檓 closer to 50, keeping a watchful eye on my 401(k), and dieting and exercising in the hope that I鈥檒l have a healthy retirement. (Corinna Cohn, 4/11)
Over the past 14 years I have been either incarcerated, on parole, or under community supervision. In 2019,聽 just prior to COVID-19 pandemic, I transitioned back into the community, where I struggled with finding a job, acclimating to 鈥渞eal life,鈥 and addressing my mental and physical health. Although given an overall clean bill of health, I learned that my egg quality was severely deteriorated, and I could never carry a baby to term. Studies show that vitamin D deficiency, a common occurrence among incarcerated people who have irregular access to sunlight, causes fertility issues and depression among women. I always thought that I would have a chance to be a mother. Unfortunately, that is no longer the case. I consider myself lucky that this is the only health problem I bear from my time in prison. Some people are left with life-altering complications and others did not even survive. (Marisol Garcia, 4/11)
On covid 鈥
America鈥檚 attempt to vaccinate the world against Covid is about to come to an end. 鈥淲e are at a point now where without additional funding we are going to have to start winding down our programming,鈥 said Jeremy Konyndyk, the leader of the United States Agency for International Development鈥檚 Covid-19 task force. Such funding does not appear to be forthcoming. Our gruesomely dysfunctional politics are going to lead to more illness and death across the globe, and we鈥檙e increasing the odds that a new viral mutation will once again upend American life. If it does, we might call it the filibuster variant. (Michelle Goldberg, 4/11)
The war in Ukraine has had an unexpected side effect noted by many health care workers on Twitter: 鈥渁 bot holiday鈥 鈥 the sudden decline of social media accounts espousing anti-vaccine views and attacking health care workers and scientists trying to correct their disinformation. While disinformation campaigns are not new, they were once spread through rather primitive vehicles, ranging from door-to-door snake oil peddlers or mass printing of propaganda leaflets. The advent of the internet and social media have transformed the battlefield for disinformation. The army of bots deployed on social media enables false information to be deliberately and widely spread around the world at the speed of light. While there is global consensus from the World Health Organization, the U.S. Surgeon General, and others that disinformation is a problem, how to best solve it remains uncertain. (Shikha Jain, Vineet Arora and Eve Bloomgarden, 4/10)
As former elected officials from Midwestern states, we are heartsick watching farmers across the region destroy millions of chickens infected with highly pathogenic avian influenza because, frankly, they have no other choice. The last time this disease struck the United States in 2015, our country detected infections in 21 states, spent $879 million to respond to the epidemic and depopulated more than 50 million birds on 232 farms. (Tom Daschle And Susan Brooks, 4/11)