The Hill: Democrats Press Trump Officials Over Drop In ObamaCare Signups Amid Website Problems
Congressional Democrats are pressing the Trump administration for answers on ObamaCare sign-ups, pointing to a dip in enrollment due to technical problems with the healthcare.gov website. The lawmakers pointed to an analysis from the group Get America Covered, run by former Obama administration health officials, which found that as many as 100,000 fewer people signed up on the first day of ObamaCare enrollment this year due to technical problems with healthcare.gov. (Sullivan, 11/21)

Kaiser Health News: It’s Obamacare Season. Here’s What You Need To Know.
During Wednesday night’s Democratic presidential debate, candidates touched on “Medicare for All,” “Medicare for all who want it” and other ways to reform the American health system.But in the backdrop, it’s once again Obamacare sign-up season. Despite repeated efforts by Republicans in Congress to undo the Affordable Care Act, the controversial law’s seventh open-enrollment period launched this month to relatively little fanfare. It ends Dec. 15. (Luthra, 11/22)

And in the states —

The CT Mirror: State's Health Exchange Reports Similar Enrollment Numbers As Last Year
Three weeks into open enrollment, the state’s insurance exchange has signed up about 20,000 people for 2020 health plans, roughly the same amount as this time last year, the group said Thursday. Another 77,000 who currently are enrolled have yet to be renewed. Of those, 67,500 are scheduled for automatic renewal by the end of next week and another 10,000 will have to do it manually, leaders at Access Health said. Reminders will be issued in the coming days. The open enrollment period runs through Dec. 15. (Carlesso, 11/21)

WZTV: CMS: Tennessee Experiencing More Than 22 Percent Decrease In Healthcare Enrollment
Tennessee is reportedly experiencing a decline of more than 22 percent for healthcare enrollment through the end of Week 3 in 2019 compared to 2018.Centers for Medicare & Medicaid Services released sign-up data for states that use the HealthCare.gov platform, according to a press release. Get America Covered compared the first three weekly snapshots from CMS (16 days of OE7 to the first 17 days of OE6). (Hall, 11/21)

The Associated Press: AG Barr To Unveil Plan On Missing, Murdered Native Americans
Attorney General William Barr will announce a nationwide plan on Friday to address the crisis of missing and murdered indigenous people as concerns mount over the level of violence they face. Barr will announce the plan, known as the Missing and Murdered Indigenous Persons Initiative, during a visit with tribal leaders and law enforcement officials on the Flathead Reservation in Montana. Native American women experience some of the nation’s highest rates of murder, sexual violence and domestic abuse. (Balsamo, 11/22)

In other news from the Department of Justice —

The Washington Post: Javaid Perwaiz: FBI Creates Hotline, Website For Potential Victims Of Needless Surgeries
In the two weeks since authorities accused Virginia gynecologist Javaid Perwaiz of performing unnecessary surgeries on women to collect insurance payments, hundreds of distraught former patients have contacted federal authorities, concerned they might be among the people who allegedly endured invasive procedures they did not want or need. (Mettler and Schmidt, 11/21)

NBC News: U.S. Seeks More Patients Of Virginia OB/GYN Accused Of Unnecessary Surgery
The Justice Department also said current or former patients seeking their medical records should email usavae.perwaiz.medical.records@usdoj.gov with their full names and dates of service. Not all records are available, it said. "The website and the hotline are all specifically established to ensure that we're doing our very best to reach out to current and former patients regarding this case," a spokesperson for the U.S. attorney's office said. "We would like to hear from all current and former patients of Dr. Perwaiz." (Kosnar, 11/21)

ProPublica: Under Trump, LGBTQ Progress Is Being Reversed In Plain Sight
When he campaigned for president, Donald Trump posed with the rainbow flag and became the first GOP nominee to mention LGBTQ citizens in his convention speech. In his first month as president, he signed an executive order stating he was “determined to protect the rights of all Americans, including the LGBTQ community.” Yet since taking office, Trump’s administration has acted to dismantle federal protections and resources for LGBTQ Americans, particularly those gained under President Barack Obama. (Berg and Syed, 11/22)

In other news —

The CT Mirror: Connecticut Communities Score High On LGBTQ Issues, Civil Rights Group Says
Connecticut cities and towns scored higher than average in a national assessment of laws and policies supporting the LGBTQ community, with Stamford and Hartford at the top in the state,  according to a report released Tuesday by the educational arm of the Human Rights Campaign. The campaign, which is the nation’s largest civil rights organization for LGBTQ people, partnered with the Equality Federation Institute to produce a “Municipal Equality Index” for 506 communities in 50 states assessing them on a scale of zero to 100 points. (Megan, 11/20)

Politico: Trump Pledge To Forgive Disabled Veterans' Student Loans Delayed — At Education Department
The Trump administration suspended the process of forgiving hundreds of millions of dollars in student loans owed by veterans with severe disabilities, despite a pledge by President Donald Trump in August that the debts would be easily erased. The holdup is centered at the Education Department, which in late October stopped processing automatic loan forgiveness for veterans who are "totally and permanently" disabled, according to an internal memo viewed by POLITICO. (Stratford, 11/21)

CBS News: 2 Runners Battle 500 Mile Marathon To Raise Awareness Of Veteran Suicides
Marathon enthusiasts Brian Tjersland and Josh Milich are on the longest run of their lives. They are running 500 miles in 12 days, from Massachusetts National Cemetery on Cape Cod to Arlington National Cemetery in Virginia. They're averaging more than 40 miles a day, braving rain, snow and injury, to raise awareness of veteran suicides. CBS News caught up with them in Philadelphia.  (Barnett, 11/21)

The Washington Post: Trump’s EPA Scales Back Obama Era Safety Rules Adopted After Deadly Chemical Explosion In West, Texas
The Environmental Protection Agency weakened a rule Thursday governing how companies store dangerous chemicals. The standards were enacted under President Barack Obama in the wake of a 2013 explosion in West, Tex., that killed 15 people, including 12 first responders. Under the new standards, companies will not have to provide public access to information about what kinds of chemicals are stored on their sites. (Eliperin, 11/21)

The Associated Press: EPA Prosecutions Of Polluters Approach Quarter-Century Lows
Justice Department figures show criminal prosecution and convictions of polluters have fallen to quarter-century lows under the Trump administration’s Environmental Protection Agency. The figures Thursday from a Syracuse University records-tracking program show the Justice Department filed 75 prosecutions, and secured 60 convictions, in EPA cases in the fiscal year ended this September. They are the lowest numbers since mid-1990. (Knickmeyer, 11/21)

And in more news on environmental health —

NPR: How New Cases Of Lung Damage Emerged In The U.S. Countertop Industry
Ublester Rodriguez could not have anticipated that his life would be profoundly changed by kitchen and bathroom countertops. He says that he grew up poor, in a small Mexican town, and came to the United States when he was 14. He spoke no English, but he immediately got a job. "In the beginning I was working in a Chinese restaurant, from 10 a.m. to 10 p.m. It was all day, so I never had time to go to school," he recalls. "I was a dishwasher." (Greenfieldboyce, 11/21)

New Hampshire Union Leader: Employees Treated At Hospitals Following Chemical Incident In Merrimack Were Released Within An Hour 
The 13 people who were transported to area hospitals following a chemical situation earlier this week at Spraying Systems Co. were quickly released, according to company officials. In a statement, Spraying Systems said the employees were transported as a precautionary measure where they were evaluated and released within an hour with no signs of exposure or other adverse health effects. Fire crews responded to Spraying Systems Co. Tuesday night to check the conditions at the site after employees received a package of powder from a vendor that “wasn’t labeled property,” fire officials said earlier. (Houghton, 11/21)

The New York Times: The Parents Passed A Drug Test. Should They Get Their Children Back?
Dylan Groves had suffered tremendously long before his tiny body was found in June at the bottom of a 30-foot well, decomposed and wrapped in plastic bags. He had been born a few months earlier with several drugs in his system, and had spent his first days in the care of a foster mother who had cuddled him while he shook and sweated through withdrawal. After 12 days, the foster mother, Andrea Bowling, was ordered to return Dylan to his father. “I begged and pleaded for more time,” she said she told the county’s child welfare agency. (Levin, 11/22)

Reuters: Bankrupt Insys Reaches Deal To Divvy Cash Among Opioid Victims
Drugmaker Insys Therapeutics Inc outlined a deal on Thursday to divide its dwindling cash among governments, insurers, hospitals and individuals who accused the company of fueling the U.S. opioid crisis. The company was largely adopting a plan it had filed in September, which now had the support of numerous groups that initially opposed it, said Brenda Funk, who represents the company, at Thursday's hearing before a U.S. bankruptcy judge Kevin Gross in Delaware. (Hals, 11/21)

The Wall Street Journal: Opioid Maker Insys Struggles To Quell Chapter 11 Plan Objections
The manufacturer, which manufactured an under-the-tongue formulation of the powerful painkiller Fentanyl, filed for chapter 11 protection in June after its former top leaders were convicted of racketeering. (Brickley, 11/21)

Los Angeles Times: Doctors Object To Plan To Help Prisoners Fight Opioid Addiction
A California company seeking to expand its role in battling opioid addiction has come under fire for an aborted plan to recruit prisoners with drug and alcohol problems to be human guinea pigs for its novel addiction recovery program. This week, the watchdog group Public Citizen asked the Food and Drug Administration to investigate the initiative launched by Anaheim-based BioCorRx, Inc. and Louisiana’s Department of Public Safety and Corrections on the grounds that it lacked the ethical, safety and legal protections that are commonplace in medical research studies involving human subjects. (Healy, 11/21)

The Baltimore Sun: Tuerk House In West Baltimore Marks Tenfold Increase In Inpatient Opioid Treatment Services 
Officials at a West Baltimore drug and alcohol treatment facility officially opened renovated and expanded space Thursday able to handle a tenfold increase of people for inpatient detoxification treatment, up from four to 40. Tuerk House has been operating for five decades and is among the city’s oldest treatment centers. It has embarked on a $10.2 million expansion at a time when drug overdose deaths are at historic highs. The new beds represent the first phase of the planned upgrades. (Cohn, 11/21)

Stat: Three CEOs Own Up To Biopharma’s Bad Reputation 
Biopharma’s reputation is, objectively speaking, the worst. And on Thursday, several biotech CEOs said in no uncertain terms that they believed that negative reputation was earned — particularly because of some drug pricing decisions. “Unfortunately, I think the industry has earned it. I think there has been and continues to be bad behaviors,” said Nick Leschly, the chief executive of Bluebird Bio, speaking at the STAT Summit on Thursday. (Sheridan, 11/21)

Stat: Machine Learning Will Yield New Drug Candidates Within Three Years 
An explosion of biological data will lead to the first drug candidates discovered by an artificial intelligence system within the next few years, a feat that promises to change the way pharmaceutical companies conduct research. That was a consensus opinion that emerged among experts in machine learning who spoke at the STAT Summit Thursday about the use of AI in the pharmaceutical industry. (Ross, 11/21)

Stat: Gene Therapy Pioneer: Field Is Behind, And Delivery Tech Is 'Embarrassing'
Gene therapy pioneer Dr. James Wilson is disappointed by the progress in his field — and expects current therapies and technologies to be soon surpassed by new approaches. “In five years, when we look back on the way we’re executing on gene therapy now, we’re going to realize that things are going to be very different,” Wilson said at the STAT Summit on Thursday. “The way in which we’re going to treat Duchenne muscular dystrophy, potentially cure it, is not the way in which it’s being evaluated in the clinic now.” (Robbins, 11/21)

Stat: Biogen’s Top Scientist Nearly Dares FDA Not To Approve Alzheimer’s Drug
Biogen’s top scientist offered unflinching support Thursday for the efficacy of the company’s controversial Alzheimer’s drug called aducanumab, shrugging off outside skepticism and almost daring regulators not to approve it. “I believe the drug works,” said Al Sandrock, Biogen’s head of research and development and chief medical officer, speaking at the STAT Summit. “I’m very excited about the prospect of getting the drug approved.” (Feuerstein, 11/21)

Stat: After Celgene Buy, Bristol-Myers CEO Ducks Questions About Rival
In his first appearance since Bristol-Myers Squibb completed its takeover last week of Celgene (CELG), Giovanni Caforio offered a predictably upbeat prognosis for the newly combined company but sidestepped questions about rival Merck’s ongoing dominance of immunotherapy, a key area that has been tinged with disappointment for the poker-faced executive. “I think we’re just at the beginning of a long journey. We’ve demonstrated immune-oncology  is extremely effective and changing the standard of care across a large number of tumors. … We are far from the end,” the Bristol-Myers chief executive officer told the crowd at the STAT Summit, an industry conference sponsored by STAT and held at MIT. (Silverman, 11/21)

Stat: As FDA Toils Over How To Regulate CBD, Frustration Builds On All Sides
Companies who want to make CBD are increasingly frustrated that the Food and Drug Administration hasn’t yet given them clear regulations for their work. So, too, are consumer advocates, who want the agency to rein in the wildly popular marijuana-adjacent product. Dr. Amy Abernethy, the FDA official leading that effort, has a simple but less than satisfying message: We’re trying. The FDA set out in earnest in April to figure out how to regulate CBD supplements. But following a closely watched public meeting in May, the agency has largely gone silent on when it will release a blueprint for how it plans to regulate the product — even blowing past self-imposed deadlines. (Florko, 11/22)

St. Louis Post Dispatch: In Missouri, People Who Can’t Speak And See Wait In Line For Help 
State lawmakers cut the budget for new Medicaid waivers from $31.4 million to $8.5 million, including both state and federal funds. That $8.5 million is enough to fund about 440 waivers this fiscal year — or roughly five new clients a month like Marcus who need residential care and 30 new clients a month who need less costly, specialized support services. That’s still far fewer than the 1,300 who the state estimated will need the services. (Bogan and Erickson, 11/21)

Columbus Dispatch: Ohio Medicaid Still “Hemorrhaging” Money To Pharmacy Middlemen, Expert Testifies - News - The Columbus Dispatch - Columbus, OH
A national drug-pricing consultant says that despite implementing a new pricing system and other efforts to rein in pharmacy middlemen, Ohio’s Medicaid program continues “hemorrhaging” tax dollars. “You are hemorrhaging money right now,” Linda Cahn, a critic of pharmacy benefit managers, or PBMs, told the Joint Medicaid Oversight Commission on Thursday. PBMs hired to oversee the $3 billion-a-year drug program have contracts that allow them to increase profits rather than keeping costs down, she said. (Candisky, 11/21)

The Colorado Sun: Colorado Hospitals Accuse Polis Administration Of Hurting Medicaid Patients, As Health Fight Grows Nastier
Executives at Colorado’s largest hospital systems on Thursday sent a blistering letter to Gov. Jared Polis and the leaders of the state Medicaid agency, saying they fear the state has “lost its focus on uninsured and Medicaid patients.” The executives accused the state Department of Health Care Policy and Financing, which administers Medicaid in Colorado, of creating cumbersome pre-approval processes and delays for Medicaid patients to receive care, of antiquated records-management practices, of denying patients needed care and of shorting hospitals more than $30 million on drug costs. (Ingold, 11/22)

Modern Healthcare: ProMedica Insurance Company Is Weighing Medicaid Exit In Ohio
Paramount, the insurance company owned by Toledo, Ohio-based health system ProMedica, is contemplating dropping out of Medicaid in the state after losing money in the program this year. Paramount reported an operating loss of $102.8 million in the nine months ending Sept. 30, driven by Medicaid losses which the company pinned on inadequate rates and enrollment errors. (Livingston, 11/21)

The Philadelphia Inquirer: Hahnemann Closure Puts $51 Million In Medicaid Funds In Play. Will The Money Stay In Philly?
After Hahnemann University Hospital went into bankruptcy and closed this summer, a group of state senators urged the Wolf administration to redistribute the Center City institution’s subsidies for the poor and uninsured to other hospitals that serve North Philadelphia .Moving the Hahnemann money to Einstein, Jefferson, and Temple — the shift sought by Philadelphia’s State Sen. Tina Tartaglione and others to prevent cascading losses at other hospitals as they picked up indigent Hahnemann patients — sounds simple. (Brubaker, 11/21)

The Associated Press: Medicare Drug Plan Finder Can Steer Seniors To Higher Costs 
Medicare’s revamped prescription plan finder can steer unwitting seniors to coverage that costs much more than they need to pay, according to people who help with sign-ups as well as program experts. Serving some 60 million Medicare recipients, the plan finder is the most commonly used tool on Medicare.gov and just got its first major update in a decade. (Alonso-Zaldivar, 11/21)

Bloomberg: Pricing Tactics Slow Uptake Of Generic Drugs By Medicare Plans 
Medicare prescription plans are much slower to cover new generic drugs than private plans, according to an industry study, a sign that many seniors may be overpaying for their medicines. A research report on Thursday from the Access for Affordable Medicines, or AAM, a lobbying group for the generic-drug industry, shows just 22% of generic drugs are covered by Medicare plans in their first year on the market, compared with the 46% of new copycat drugs covered by commercial drug plans. (Koons and Griffin, 11/21)

And The Wall Street Journal offers advice on navigating Medicare enrollment —

The Wall Street Journal: Tiny Tax Moves Can Save You Big On Medicare Premiums
Now is a good time for higher-earning Medicare recipients to check whether a small reduction in this year’s income could make a big difference in future premiums. Here’s why. Medicare premiums are based on income, and the formulas have “cliffs” that can raise premiums steeply if income rises by even one dollar. In addition, there’s a new inflation adjustment for 2020 that complicates the situation. These features are producing odd results. (Saunders, 11/22)

The Associated Press: Governor Vetoes Bill Outlawing Abortions Over Down Syndrome
A bill that would have prohibited abortions because of a prenatal diagnosis of Down syndrome was vetoed Thursday by Pennsylvania’s Democratic governor. One day after it passed the Republican-controlled Legislature, Gov. Tom Wolf made good on a promise and rejected the legislation. (11/21)

The Hill: Pennsylvania Governor Vetoes Bill Outlawing Abortions Over Down Syndrome
“This legislation is a restriction on women and medical professionals and interferes with women’s health care and the crucial decision-making between patients and their physicians,” Wolf wrote in an online statement. “Physicians and their patients must be able to make choices about medical procedures based on best practices and standards of care.” (Campisi, 11/21)

In other news on women's health —

The Associated Press: Man Admits Attempted Arson At Planned Parenthood Clinic
Federal prosecutors say a man has admitted he tried to burn down a Planned Parenthood clinic in Missouri because it provides reproductive services. Forty-two-year-old Wesley Brian Kaster, of Columbia, pleaded guilty Thursday to maliciously using explosive materials to damage a building owned by an organization that receives federal financial assistance and to violating the Freedom of Access to Clinic Entrances Act. (11/21)

The Washington Post: Canadian Teen May Have Suffered Popcorn Lung After Months Of E-Cigarette Use
A Canadian teenager who used e-cigarettes developed a near-fatal lung condition that does not resemble the vaping-related illnesses that have swept the United States. Doctors say the 17-year-old boy’s case looks more like “popcorn lung,” an injury once seen in factory workers who breathed in a chemical used to create a butter flavor. The previously healthy teen, whose case was reported Wednesday in the Canadian Medical Association Journal, had been vaping flavored e-cigarettes “intensively,” adding THC — the main component in marijuana — to his devices. After months of daily use, he was admitted to a London, Ontario, hospital with a fever, persistent cough and difficulty breathing. (Shammas, 11/21)

CBC News: Ontario Teen's Vaping Injury Consistent With 'Popcorn Lung,' Study Suggests
Medically known as bronchiolitis obliterans, popcorn lung is linked to diacetyl, a chemical that provides a buttery or caramel-like flavour. Although it's safe to eat, it is dangerous to inhale. The case emerged months ago, when the previously healthy 17-year-old turned up at the emergency room of a London, Ont., hospital with a severe cough, shortness of breath and a fever. He was initially diagnosed with pneumonia and sent home with antibiotics, but returned five days later with worsening breathing difficulties, fatigue and nausea. (11/21)

The Associated Press: Vape Debate: Are E-Cigarettes Wiping Out Teen Smoking?
In almost any other year it would be hailed as a public health victory: The smoking rate among U.S. high schoolers took its biggest hit ever this year, federal figures show, falling to a new low. Instead the milestone was relegated to a lone figure at the bottom of a government press release and went unremarked by anti-tobacco groups that have spent decades working to stamp out youth smoking. (Perrone, 11/21)

Reuters: U.S. Vaping-Related Deaths Rise To 47, Cases Of Illness To 2,290
U.S. health officials on Thursday reported 2,290 confirmed and probable cases and 5 more deaths from a mysterious respiratory illness tied to vaping, taking the total death toll to 47 so far this year. Last week, the Centers for Disease Control and Prevention (CDC) recorded 2,172 cases and 42 deaths from the illness. (11/21)

CNN: Vaping Lung Injury Cases Rise To 2,290, CDC Says
Meanwhile, according to the White House, President Donald Trump has scheduled a meeting for Friday related to a separate issue around e-cigarettes: the rise in youth use and how e-cigarettes should be regulated. "President Trump will hear from outside stake holders on the issue of youth usage of e-cigarettes and the government's role in regulation," White House deputy press secretary Judd Deere told CNN in a statement. (Erdman, 11/21)

The New York Times: After Deaths, Ban On Flavored Vapes To Be Passed By New York City
The New York City Council — in spite of a determined lobbying effort by the vaping industry — agreed on Thursday to ban flavored e-cigarettes amid heightened concerns about the use of such products. The ban, which would cover all flavored e-cigarettes and e-liquid vaping products, including ones that are menthol flavored, would make New York City the most populous jurisdiction in the country to ban flavored e-cigarettes. At least 30 members of the 51-member City Council have signed on as co-sponsors of the legislation. (Mays and Goodman, 11/21)

The San Francisco Chronicle: Juul, Shrinking And Under Fire, May Sell SF Office Tower It Just Bought
Juul is considering selling the San Francisco office tower it bought just five months ago for nearly $400 million. (Ho and Li, 11/21)

New Hampshire Public Radio: Dartmouth-Hitchcock Launches Anti-Vaping Campaign
Dartmouth Hitchcock Health is reaching out to teens and families as part of its new anti-vaping campaign. The campaign, called No Safe Vape, focuses on presenting facts about the dangers of vaping to kids and their families. It also aims to provide local and national resources people can access. Brian O’Sullivan is a pediatric pulmonologist at Dartmouth Hitchcock. (Allee, 11/21)

The Hill: Massachusetts Lawmakers Pass Flavored Tobacco, Vaping Products Ban 
Massachusetts lawmakers passed legislation Thursday to ban the sale of flavored tobacco and vaping products as well as menthol cigarettes. In addition to the ban, the bill would introduce a 75 percent excise tax on remaining vaping products and would force health care providers to pay for tobacco cessation counseling, according to The Associated Press. (Johnson, 11/21)

Arizona Republic: Arizona Board Of Regents Could Ban The Use And Sale Of E-Cigarettes
The Arizona Board of Regents is considering a ban on vaping and the sale of vaping devices on public university campuses and other university-owned properties across the state. The proposal comes amid mounting scrutiny of vaping, which has grown in popularity among young people despite health concerns about nicotine addiction and a wave of recent illnesses linked to black market THC vaping products. (Oxford, 11/21)

The New York Times: How Churches Fight The Stigma Of H.I.V.
The second Wednesday of the month is always crowded in the parking lot of Bible Way Ministries. That’s the day the church offers its community food bank — and as of this year, it’s also the day when an AIDS Healthcare Foundation mobile testing unit rolls up to provide H.I.V. testing to anyone who wants it. Bible Way had already been offering H.I.V. testing some Sundays and at special events for five years, said the senior pastor, the Rev. Dr. Monte Norwood, his voice barely audible over gospel music blaring from the black testing van. (Keren Landman, 11/21)

The Wall Street Journal: New York City Sees Decline In Number Of New HIV Cases
The number of new HIV diagnoses in New York City declined in 2018 to the lowest level since the city began reporting new cases in 2001, according to a report to be released Friday by the New York City Department of Health and Mental Hygiene. State and city officials have set a goal to end the HIV epidemic in New York by 2020, which has led to millions being funneled into prevention services and health care. (West, 11/22)

The Wall Street Journal: Dreading The Flu Shot? More Needles Might Help.
Fear of needles has been one of the medical industry’s most intractable problems. David Hoey thinks more needles may be the solution. The difference is that the needles that Mr. Hoey’s company, Vaxxas, are developing are tiny—each a fraction of the width of a human hair. Clustered on one side of a patch, they are invisible to the human eye and barely break the skin when pressed onto the arm—benefits that could lower anxiety levels of patients requiring a seasonal flu jab or other injection. (Winning, 11/21)

The Associated Press: Bacteria-Infected Mosquitoes Take Bite Out Of Deadly Dengue
They still bite, but new research shows lab-grown mosquitoes are fighting dangerous dengue fever that they normally would spread. Dengue infections appear to be dropping fast in communities in Indonesia, Vietnam, Brazil and Australia that are buzzing with the specially bred mosquitoes, an international research team reported Thursday. (11/21)

The New York Times: Early Menopause Increases Heart Risks
Early menopause, before age 40, may increase the risk for cardiovascular disease. Using a British health database, researchers studied records of 144,260 postmenopausal women, average age around 60. Among them, 4,904, or 3.4 percent, had reached menopause before 40 naturally; 644 had gone into early menopause because they had oophorectomies, or surgical removal of the ovaries. The study is in JAMA. (Bakalar, 11/21)

ABC News: Over 80% Of Adolescents Worldwide Don’t Get Enough Exercise, Putting Health At Risk
A vast majority of adolescents around the world are not participating in enough exercise, putting their current and future health at risk, according to a new study. The study, conducted by researchers from the World Health Organization and published in The Lancet medical journal on Thursday, found that more than 80 percent of children aged 11 to 17 worldwide did not meet current recommendations of at least one hour of physical activity per day. (Hanrahan, 11/22)

The Associated Press: Salad Product Recall Over E. Coli Bacteria Impacts 22 States
The U.S. Department of Agriculture says thousands of pounds of salad products are being recalled due to a possible E. coli contamination. The department says Missa Bay, LLC from Swedesboro, New Jersey, is recalling more than 75,000 pounds of salad products that contain meat or poultry because the lettuce may be contaminated with a strain of E. coli. (11/21)

CNN: Over 75,000 Pounds Of Salad Products Are Recalled After An E. Coli Outbreak Sickens 17 People In Eight States, CDC Says
The items in question were shipped to distribution locations in Alabama, Connecticut, Florida, Georgia, Illinois, Indiana, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Virginia, and Wisconsin. Public health officials will keep investigating the E. coli outbreak that has infected at least 17 people in eight states, the US Centers for Disease Control and Prevention announced Wednesday. (Nedelman and Johnson, 11/22)

The CT Mirror: Courtney Scores Win With House Approval Of Workplace Safety Bill
The U.S. House on Thursday approved a bill sponsored by Rep. Joe Courtney that aims to protect  nurses and other health care and social workers who are physically attacked by patients or their family members. The 251-158 vote on the “Workplace Violence Prevention for Health Care and Social Service Workers Act,” came after House Republican leaders urged GOP lawmakers to vote against it because they said Democrats have prioritized the impeachment inquiry into President Donald Trump over other critical issues. (Radelat, 11/21)

The Baltimore Sun: How MICA And Shock Trauma Are Using Virtual Reality To Help Patients Cope With Spinal Cord Injuries 
[Dr. Sarah] Murthi launched the Maryland Blended Reality Center with $2.4 million from MPower, a partnership between the University of Maryland’s College Park and Baltimore campuses to support innovative research and opportunities, in 2017. She had been in touch with MICA Game Lab’s director, Jason Corace, since around that time, when the Game Lab was also new. For Corace, the partnership provides access to otherwise difficult-to-obtain resources. Both Corace and Murthi noted that medical funding often involves rigorous standards for approval and reporting that can draw out the research and development process — great for adults in medical graduate programs, but prohibitive for undergraduate students. (Rao, 11/21)

Kaiser Health News: Drug Deals And Food Gone Bad Plague Corner Stores. How Neighbors Are Fighting Back.
The parking lot was dark when Marie Franklin and her husband, Sam, last stopped at a corner store near their home. The couple didn’t want much from the market that night. But they still strategized before Sam, 49, went inside. “My husband wouldn’t let me go in,” Marie Franklin, 57, recalled. “About four or five guys were hanging around the door.” For her, the scene felt all too familiar in a city where it’s getting harder to find a safe place to buy milk. In some neighborhoods across the country, such corner stores often stock more alcohol than food — and poor-quality groceries at that — amid a minefield of violence just outside their doors. (Anthony, 11/22)

The Wall Street Journal: Saugus High Shooter Used ‘Ghost Gun’ Built From Parts
The gun used in the Southern California high-school shooting last week was a “ghost gun” with no serial number, law-enforcement officials said Thursday. The .45 caliber handgun used by Nathaniel Berhow to kill two fellow students and wound three others at Saugus High School on Nov. 14 was built from parts that can be easily purchased online, the officials said. The 16-year-old shot himself as well and died the next day. (Elinson, 11/21)

Los Angeles Times: Santa Clarita Shooting: Weapon Used In Saugus High Attack A 'ghost Gun,' Sheriff Says
Sheriff’s homicide detectives are trying to determine who built the .45-caliber handgun, a 1911-model pistol. The weapon included a partially built receiver, meaning it did not contain a serial number. Police and witnesses said 16-year-old Nathan Berhow came to school the morning of Nov. 14, removed the handgun from his backpack and opened fire in the Santa Clarita high school quad. Five students were shot, two of whom later died, before Berhow turned the weapon on himself. He died from his injury a day later. (Winton, 11/21)

Health News Florida: NRA Renews Fight Over Florida's Age Restriction For Purchasing Guns
After dropping an attempt to keep secret the identities of two plaintiffs, the National Rifle Association has relaunched a federal court challenge to a Florida law that raised the age to purchase rifles and other long guns. The NRA filed the lawsuit last year, immediately following the passage of a sweeping school-safety law enacted in response to the mass shooting at Parkland’s Marjory Stoneman Douglas High School that killed 17 students and faculty members. (Kam, 11/21)

The Washington Post: Fatal Shooting After Patient’s Release, Bacteria In Water System Spark Changes At St. Elizabeths
The District’s mental health agency has made staff changes and created a new patient tracking system and plans to hire a consultant after a discharged psychiatric patient with a homicidal history allegedly killed a neighbor in an unprovoked shooting earlier this year. The changes announced Wednesday are the latest at the city-owned St. Elizabeths Hospital after recent incidents that include a potentially harmful bacteria found in its water supply and allegations of patient abuse. (Moyer, 11/21)

The Associated Press: Ohio State Vows ‘Monetary Resolution’ For Doctor’s Victims
Ohio State University is committed to a “monetary resolution” for men sexually abused decades ago by team doctor Richard Strauss, school leaders said Thursday, though no settlement has been reached in lawsuits alleging school officials ignored complaints and failed to stop him. The university has acknowledged its failure to prevent and investigate the abuse and has repeatedly apologized publicly. But prior to comments Thursday by the chairman of the board of trustees, it hadn’t made any commitments to compensation for those abused by the now-dead physician. (11/21)

The San Francisco Chronicle: California’s Juvenile Halls Are Supposed To Hold Just The Worst Young Offenders. The Truth Is A Different Story
Marie shivered beneath a thin blanket on her first night in juvenile hall, her only view an occasional glimpse of a guard checking on her through the window in her cell door. Her crime was minor: refusing to obey police officers who came into her bedroom to question her about skipping school. Three weeks earlier, the 16-year-old girl had been caught shoplifting a bottle of cognac. (Palomino and Tucker, 11/21)

The Associated Press: Suspected Norovirus Outbreak Closes 46 Colorado Schools
Thousands of students in Colorado were out of school Thursday because of a suspected outbreak of norovirus. All 46 schools in the district serving Grand Junction and the surrounding area were closed and won’t reopen until after the Thanksgiving break so custodians can disinfect surfaces. (11/21)

The New York Times: Virus Outbreak Closes Colorado Schools For More Than 20,000 Students
“We are taking this highly unusual action because this virus is extremely contagious and spreading quickly across our schools,” Tanya Marvin, the district’s nursing coordinator, said in the superintendent’s statement. The school district, stretching from the Utah border to Palisade, Colo., is the 14th largest in the state. (Padilla, 11/21)

The Washington Post: Former Baltimore Mayor Catherine E. Pugh Pleads Guilty To Fraud And Tax-Evasion Conspiracies Over Her Children's Books
Former Baltimore mayor Catherine E. Pugh pleaded guilty Thursday to fraud-and-tax-evasion conspiracies to illegally hide profits from sales of her children’s books to enhance her political and personal fortunes. Pugh’s acknowledgment of guilt came during a court hearing in downtown Baltimore, the city the disgraced 69-year-old once led. Her appearance followed the unsealing by federal prosecutors a day earlier of an indictment against Pugh following a three-year investigation into sales of the “Healthy Holly” book series that began when she was a state senator representing Baltimore in Annapolis. (Hermann and Bui and Marimow, 11/21)

Health News Florida: Judge Blocks Release Of Health Plan Information
A Leon County circuit judge has issued a permanent injunction to shield from public disclosure information that a Medicaid managed-care plan submitted to state regulators. Judge John Cooper this month approved a request by UnitedHealthcare of Florida to prevent the Office of Insurance Regulation from releasing certain information as part of a public-records request. Cooper agreed with the managed-care plan that the information included protected trade secrets. (11/21)

Milwaukee Journal Sentinel: Sixteenth Street Community Health To Open Behavioral Health Clinic
Sixteenth Street Community Health Centers is buying the building at 1635 W. National Ave. that now is the headquarters of Badger Mutual Insurance and plans to open a clinic that will provide behavioral health care and alcohol and substance abuse services. The expansion will be partly funded by a $3.7 million gift from Froedtert Health and is the second announced by the community health center in recent weeks. (Boulton, 11/21)

Health News Florida: Nonprofit Helps Low-Income Floridians Make Their Homes Safer For Asthmatic Children
A nonprofit program funded in part by local government entities helps low-income Floridians make modifications to their homes to improve health and safety. Part of the program focuses on making homes safer for children with severe allergies and asthma, like 5-year-old Tampa resident Mario Garcia. (Miller, 11/21)

Wyoming Public Radio: Report Highlights Corners Of The Mountain West Lacking Running Water
A report out this week shows a significant number of Americans don't have access to basic services like running water. And many of the places that lack plumbing are in the Mountain West. “Small pockets of communities without complete plumbing exist in every state,” write the researchers, who also say the gap isn’t driven by people who choose to live off-the-grid, but instead by a lack of basic infrastructure. (Bichell, 11/21)

The Associated Press: Parents Look For Answers After Autistic Son Chokes At School
A Maryland couple whose autistic teenager died after choking on a latex glove say they have concerns about the way the public school system handles students with special needs. The Capital Gazette reports 17-year-old Bowen Levy died on Nov. 10, five days after he choked on a glove at Central Special School, which serves children with disabilities in Anne Arundel County. (11/21)

Milwaukee Journal Sentinel: Bridges Nursing Home In Milwaukee Will Close, Cutting 71 Jobs
A Milwaukee nursing home notified state officials Thursday that it will close, adding to a growing number of nursing home closures in Wisconsin. The latest to announce it is shutting down is The Bridges of Milwaukee Rehab and Care Center, 6800 N. 76th St. The closing is expected to eliminate 71 full-time jobs, the facility said in its notification. The job cuts will begin on Jan. 20. (Romell, 11/21)

The CT Mirror: As Feds Eye Treatment Of Juveniles At Manson Youth Institution, Its Adult Population Falls
The number of young adults at Manson Youth Institution fell by 42% between March and November of this year after the Department of Correction closed two units at the Cheshire facility and transferred those inmates to other prisons. On March 1, there were 401 people between the ages of 18 and 21 incarcerated at Manson. The next month, there were 288. That number declined even further by Nov. 1, when there were only 233 young adults at the high-security penitentiary, an almost 42% decrease from March. (Lyons, 11/22)

NPR: 'Street Medicine' Clinic Brings Health Care To Atlanta's Homeless
Herman Ware sits at a small, wobbly table inside a large van that's been converted into a mobile health clinic. The van is parked on a trash-strewn, dead-end street in downtown Atlanta where homeless residents congregate. Ware is here for a seasonal flu shot. "It might sting," he says, thinking back on past shots. Ware grimaces slightly as the nurse injects his upper arm. (Whitehead, 11/21)

The New York Times: As Rents Outrun Pay, California Families Live On A Knife’s Edge
When Priscilla Fregoso and her family moved into their apartment in Van Nuys, a neighborhood in the San Fernando Valley, three years ago, she finally breathed a sigh of relief. They had bounced from home to home in Long Beach and Orange County and then in Pacoima, long known as a diverse working-class area of the Valley. But when their rent there increased by $220 a month, they found themselves living in their car. (Cowan and Gebeloff, 11/21)

Undark: Mental Illness Behind Bars: The Lessons Of Orleans Parish
In May of 2016, not long after his release from a psychiatric hospital, Colby Crawford, a 23-year old black man, was booked into the Orleans Justice Center (OJC) — a new $150-million-dollar jail opened a year earlier to replace the crumbling and now shuttered Orleans Parish Prison complex, and touted as a symbol of a more progressive approach to incarceration in New Orleans. Ten months later, he was dead. Prior to Crawford’s incarceration, he had been diagnosed with schizophrenia, bipolar disorder, and substance use disorder. A psychiatrist at OJC noted that he was prone to “seeing spirits and ghosts, insomnia, anxiety, paranoia, and bad dreams,” and prescribed an antipsychotic and anticonvulsant. A month after Crawford’s arrest on allegations that he hit his mother and sister, he was transferred about an hour outside of New Orleans to a state prison called the Elayn Hunt Correctional Center — the one place he received adequate mental health care while incarcerated, according to a wrongful death suit filed by his mother. (Chrastil, 11/20)

The Atlantic: Why People Support Medicare For All
How a socialist-seeming health-care policy became a rallying cry in the Democratic mainstream. (Khazan, 11/21)

The New York Times: She Had Two Heart Attacks, But Normal Arteries. What Was Going On?
The 56-year-old interior designer was at her desk, on the phone, when the now-unmistakable burning ignited her chest. Since her heart attack the year before, the pain, which her cardiologist called angina, would hit her at the strangest times. Just sitting or even sleeping, she’d get this sensation like terrible heartburn. She quickly got off the phone, knowing what was coming next — the rib-crushing pressure that made it hard to talk or even breathe. She made her way to the kitchen and bathroom, looking for nitroglycerin, the only medicine that relieved the pain. She couldn’t read the labels on the pill bottles — that’s when she knew she was in real trouble. She could feel her heart beating erratically as she called 911. She collapsed before she could even unlock the door. (Sanders, 11/20)

WIRED: PM2.5 Air Pollution Is Still Killing Thousands Of People In The US
Soot kills. Still! Even in America, even in 2019. Those suspended fragments and droplets smaller than 2.5 micrometers across, small enough to be inhaled into the deepest recesses of the lungs and slip into the bloodstream—that’s soot. Or PM2.5 in technical terms. Breathing it in can inflame airways, triggering respiratory troubles, heart problems, even dementia. And, as study after study have shown, these adverse health effects can trim years off a person’s life. (Molteni, 11/20)

The New York Times: Will Science Ever Give Us A Better Night’s Sleep? 
We humans spend a third of our lives asleep, oblivious to our surroundings and temporarily paralyzed. It’s a vulnerability that would seem to diminish our odds of survival, so evolutionarily speaking it must also somehow confer tremendous benefits. Yet our best guesses about what those benefits are tend to come from observing what happens when sleep is curtailed. As far as we know, all animals sleep in some way; deprive most of them of it for long enough, and they will die, but exactly why is unclear. (Tingley, 11/19)

The New York Times: When Mental Illness Is Severe
There‌ are‌ ‌some‌ ‌crimes‌ ‌that‌ ‌are‌ almost‌ ‌impossible‌ ‌to‌ ‌forget. ‌ ‌For‌ me, ‌they‌ ‌include‌ ‌the‌ ‌death‌ ‌in‌ ‌1999‌ ‌of‌ ‌Kendra‌ ‌Webdale, ‌an‌ ‌aspiring‌ ‌young‌ ‌journalist‌ ‌who‌ ‌was‌ ‌pushed‌ ‌in‌ ‌front‌ ‌of‌ ‌a‌ ‌New‌ ‌York‌ ‌subway‌ ‌train‌ ‌by‌ ‌a‌ ‌29-year-old‌ ‌man‌ ‌with‌ ‌schizophrenia‌ ‌who‌ ‌had‌ ‌stopped‌ ‌taking‌ ‌his‌ ‌medication. ‌That‌ ‌same‌ ‌year, ‌two‌ ‌mentally‌ ‌ill‌ ‌teenage‌‌‌ ‌boys‌ ‌massacred‌ ‌12‌ ‌students‌ ‌and‌ ‌one‌ ‌teacher‌ ‌at‌ ‌Columbine‌ ‌High‌ ‌School‌ ‌in‌ ‌Colorado. ‌ ‌Thirteen‌ ‌years‌ ‌later, ‌a‌ ‌seriously‌ ‌emotionally‌ ‌disturbed‌ ‌20-year-old‌ ‌man‌ ‌murdered‌ ‌20‌ ‌young‌ ‌children‌ ‌and‌ ‌six‌ ‌adults‌ ‌at‌ ‌Sandy‌ ‌Hook‌ ‌Elementary‌ ‌School‌ ‌in‌ ‌Connecticut. (Brody, 11/18)

Stat: Medicare's New Primary Care Payment Rule Is Good News For Patients
An announcement earlier this month offers good news for patients and their primary care physicians. The Centers for Medicare and Medicaid Services issued a rule to greatly improve payments for office visits — sometimes called evaluation and management services — and reduce the time physicians must spend on unnecessary documentation that takes away precious time from caring for their patients. (Robert McLean and Gary Leroy, 11/22)

St. Louis Post Dispatch: Black Infant Mortality, Uninsured Kids Suggests 'Pro-Life' Agenda Needs Work.
For a nation with arguably the most advanced health care system in the world, the United States still suffers an appallingly high rate of black infant mortality. Black infants in St. Louis County are more than twice as likely to die as white infants, according the county’s Department of Public Health. This gap is hardly limited to the county. Nationally, the disparity between black and white infant mortality is wider today than it was in 1850, The New York Times reported. Whatever advances the United States has seen in medical care for pregnant women and infants, the black population is seeing a smaller proportion of the benefits. At a time when the national conversation is focused on abortion and protecting the rights of the unborn, the evidence suggests that far too little emphasis is being placed on protecting black children once they’re born. (11/21)

The Washington Post: The One Health-Care Word I Wish Democrats Would Say During Debates
Democrats spent a lot of time during Wednesday’s debate discussing how to pay for health care when patients get sick. And when they finally branched out from the Medicare-for-all conversation to discuss their plans for tackling specific health policy issues, such as prescription drug affordability, marijuana legalization and abortion, there was one word I wish they had said: prevention. (Leana S. Wen, 11/21)

The Wall Street Journal: Warren’s Medicare Blunder
Sen. Elizabeth Warren admitted last Friday that she had made a colossal, potentially fatal, campaign error—and immediately proceeded to make it worse. If the Warren presidential bid flops, this will be the moment to mark. That admission didn’t come in so many words. It came instead in the form of a major update to Ms. Warren’s Medicare for All plan. The Massachusetts senator now proposes a two-year “transition” period, in which Americans would be able to opt in to Medicare. Put another way, Ms. Warren now calls for the same sort of public option as her “moderate” competitors. She says that she will wait until the third year of her presidency to abolish private insurance. (Kimberley A. Strassel, 11/21)

The Hill: Media Needs To Stop Wild Speculations About Trump's Health 
My grandmother was from the “old country” and she wisely told me never to wish bad health on your enemies, because you never know when that negative energy could come back around to you.I couldn’t help but think about this old wisdom last weekend when the news media began to speculate wildly about President Trump’s health, just because he paid a visit to Walter Reed National Military Medical Center and underwent a work-up, which was reported to be part of his yearly physical. (Marc Siegel, 11/21)

Stat: The Day I 'Declared Myself' — And Was In Surgery Just Hours Later 
I was about to begin rounds in the intensive care unit when I bumped into the liver specialist on call. My team had asked her about a patient with advanced liver disease who was not responding to treatment and was quickly deteriorating.“ If she’s infected, she will declare herself,” the hepatologist said, evoking a centuries-old diagnostic concept in medicine. It presumes that a sick-enough patient will eventually develop symptoms so distinct and profound that she or he will “declare” the mysterious illness at play, making it possible to readily identify the culprit disease. I didn’t realize it at the time, but that phrase would apply to me in just a few hours. (Jessica Lichter, 11/22)

Boston Globe: In A Small Vermont City: Heroin, Bullets, And Empathy
The bullets arrived before the dawn, announcing themselves with a loud crack that said this wasn’t some crank in a pickup popping off a couple of drunken, random rounds with a .22. That sound and the holes in the thick glass door at the Rutland Police Department told the officers inside that whoever fired those shots was wielding a high-powered rifle. Investigators quickly reviewed video from a security camera, zeroed in on a license plate, and thought they knew who they were looking for when, an hour and a half later, they spotted the white Ford Focus parked near the Walmart in a nearly deserted nearby shopping plaza. (Kevin Cullen, 11/21)

Dallas Morning News: A Man Was Found In His Apartment Three Years After His Death – And What It Can Teach Us About Loneliness
We’ve seen thousands of sad stories in our time, but the case of a man found in his DeSoto apartment three years after his death ranks right up there as one of the saddest.Ronald Wayne White, believed to be a Navy vet working as a defense contractor, was last in contact with his mother in New York three years ago. He apparently moved several times and traveled extensively so several police departments told his family they couldn’t treat him as a missing person, his family said.His body was recently discovered on the floor of his apartment when workers went investigating why some tenants weren’t using water for a while. Stunningly, the medical examiner ruled he had been dead three years. (11/21)