CBS News: All U.S. Adults Now Eligible For COVID-19 Vaccine: How To Find A Shot
American adults in all 50 states as well as the District of Columbia and Puerto Rico are now eligible for the coronavirus vaccine as of Monday, meeting President Biden's goal of April 19 eligibility. Mr. Biden set the April 19 goal earlier this month, although the vast majority of states had already expanded eligibility to all adults earlier than that. The U.S. is nearing Mr. Biden's updated goal of providing 200 million shots by his 100th day in office, despite the federal government's decision to pause the Johnson & Johnson vaccine after a small number of women who had received the shot developed a rare blood clot disorder. Dr. Anthony Fauci told CBS News' "Face the Nation" on Sunday that he expects a decision on whether to resume that particular vaccine by Friday. (Watson, 4/19)

The New York Times: All U.S. States Have Met Biden's Vaccine Expansion Deadline 
All adults in every U.S. state, Washington, D.C., and Puerto Rico are now eligible for a Covid-19 vaccine, meeting the April 19 deadline that President Biden set two weeks ago. “For months I’ve been telling Americans to get vaccinated when it’s your turn. Well, it’s your turn, now,” Mr. Biden said Sunday on a program called “Roll Up Your Sleeves” on NBC. “It’s free. It’s convenient and it’s the most important thing you can do to protect yourself from Covid-19.” (Anthes, Ngo and Sullivan, 4/19)

NBC News: Map: These States Are Opening Up Vaccinations To People From Out Of State
Is your Covid-19 vaccination just across state lines? In addition to making every adult eligible for the shots Monday, several states lifted their residency requirements, meaning that providers will vaccinate even nonresidents. As of Monday, 18 states and one territory, including California, Pennsylvania, Michigan and Puerto Rico, no longer have residency requirements. Check the map below to see if your state is on the list. (Chiwaya, 4/19)

Roll Call: White House Fears Bumpy Rollout Deterring People From Vaccine Shots
Top White House health officials are concerned that the COVID-19 vaccination campaign’s slow rollout early on could be deterring people from getting their first shots and are emphasizing that every American adult is now eligible for a vaccine. “Things are about to get a whole lot easier,” Andy Slavitt, White House senior adviser on COVID-19, said Monday. (Kopp, 4/19)

AP: AP Source: Guantanamo Prisoners Now Getting COVID-19 Vaccine
Prisoners at the Guantanamo Bay detention center can now begin getting the COVID-19 vaccine, a senior defense official told The Associated Press on Monday, months after a plan to inoculate them was scuttled over outrage that many Americans weren’t eligible to receive the shots. The new timing coincides with President Joe Biden’s deadline for states to make the vaccines more widely available across the U.S. Beginning Monday, anyone 16 and older qualifies to sign up and get in a virtual line to be vaccinated. (Fox, 4/19)

Reuters: U.S. Will Boost ‘Do Not Travel’ Advisories To 80% Of World 
The U.S. State Department said on Monday it will boost its “Do Not Travel” guidance to about 80% of countries worldwide, citing “unprecedented risk to travelers” from the COVID-19 pandemic. The State Department already listed 34 out of about 200 countries as "Level 4: Do Not Travel," including places like Chad, Kosovo, Kenya, Brazil, Argentina, Haiti, Mozambique, Russia and Tanzania. (Shepardson, 4/19)

AP: US Warns Against Travel To 80% Of World Due To Coronavirus
The advice issued by the department isn’t a formal global advisory. Instead, it says the State Department will start using Centers for Disease Control and Prevention standards as it prepares health and safety guidelines for individual countries. Because of those standards, about 80% of countries will be classified as “Level 4” or “do not travel.” Travel is also discouraged for the remaining 20%, though not as emphatically. It says people with plans to visit those countries should reconsider before proceeding. (4/19)

In other news related to travel or being outside —

The Boston Globe: Could Outdoor Mask Mandates Get Dropped In The Coming Weeks? One Expert Thinks So
Dr. Ashish K. Jha, dean of the Brown University School of Public Health, says that states may soon drop their outdoor mask-wearing mandates — and it makes sense. “Outdoor infections are rare and occur when large groups gather in packed spaces, such as rallies,” Jha said in a tweet on Sunday. “Outdoor mask mandates are likely to be lifted in upcoming weeks. Indoor masking should stay for a bit longer,” he said. In an interview on CNN’s Inside Politics earlier Sunday, Jha said, “I think it’s pretty safe to be out and about walking around without a mask, especially in large parts of the country where infection numbers are under reasonable control.” (Finucane, 4/19)

The Atlantic: Are Outdoor Mask Mandates Still Necessary?
Perhaps a bit of weirdness should be expected. Rising vaccinations and burbling variants make for an awkward transition period in which it’s legitimately confusing to know when masking is a necessary and considerate act, and when it’s no more epidemiologically protective than, say, wearing a hat. Government rules aren’t doing much to help clarify the situation. In places such as D.C., outdoor masking is mostly mandatory and limited indoor dining is permitted, leading to masks in the streets and bare faces in the bar seats. Several dozen states have similar mask mandates for public spaces while also allowing various levels of indoor dining. (Thompson, 4/19)

CNN: Is It Safe To Go To Concerts In A Pandemic? A Guide 
As more people get Covid-19 vaccines, you may be wondering whether hearing live music in person again is safe. Coronavirus can spread when an infected person coughs or sneezes and others breathe in those droplets, and by accumulating in or flowing through air. You can get coronavirus from contaminated surfaces, too, but this isn't the primary mode of transmission, according to the US Centers for Disease Control and Prevention. (Rogers, 4/19)

CNN: Disinfecting Surfaces To Prevent Covid Often All For Show, CDC Advises 
The risk of surface transmission of Covid-19 is low, the US Centers for Disease Control and Prevention said Monday. Far more important is airborne transmission -- and people who obsessively disinfect surfaces may be doing more harm than good. "CDC determined that the risk of surface transmission is low, and secondary to the primary routes of virus transmission through direct contact droplets and aerosols," Vincent Hill, Chief of the Waterborne Disease Prevention Branch, said on a CDC-sponsored telephone briefing. (Langmaid, 4/19)

In other covid research news —

CIDRAP: COVID-19 Damages Brain Without Infecting It, Study Suggests 
Although SARS-CoV-2 probably does not infect the brain, it can damage it significantly, a new study of autopsies of 41 COVID-19 patients finds. Researchers at Columbia University say that they found no signs of virus inside the patients' brain cells but saw many brain abnormalities that could explain the confusion and delirium seen in some patients with severe coronavirus and the lingering "brain fog" in those with mild disease. (Van Beusekom, 4/19)

CIDRAP: Study: Indoor School Sports Most Likely To Spread COVID-19
A study in an Atlanta school district revealed that the highest secondary COVID-19 attack rates were in indoor, high-contact sports settings (23.8%), staff meetings or lunches (18.2%), and elementary school classrooms (9.5%), and that staff were more susceptible to COVID-19 than students were. The study, published late last week in Clinical Infectious Diseases, tracked COVID-19 cases and case contacts from Dec 11, 2020, through Jan 22, 2021, in a district that included eight elementary schools, two middle schools, and one high school. Students were in-person 4 days per week and wore masks, and desks were spaced 3 to 6 feet apart. (4/19)

Fox News: Oxford Challenge Trial Assessing Coronavirus Reinfection, Immune Responses
The University of Oxford announced Monday it launched a challenge trial intentionally re-infecting participants with the novel coronavirus to better understand how the immune system mounts a response the second time around, and potentially pave the way for improved vaccines and treatments. Britain marked the first country worldwide to greenlight "challenge trials" in February, Reuters reports, which generally involves "a carefully controlled study that involves purposefully infecting a subject with a pathogen or bug, in order to study the effects of that infection," per a related university release posted Monday. (Rivas, 4/19)

Fox News: Coronavirus Antiviral Drug Shows Promise In Hamsters, Enters Human Testing
An experimental antiviral treatment against the virus causing COVID-19 showed promise in animal studies and has entered human clinical trials, according to the National Institutes of Health (NIH). The drug, MK-4482, was said to drop viral levels and reduce damage from the disease in the lungs of hamsters treated for infection, per an NIH release. The treatment works by preventing the virus from replicating, with benefits seen when the drug was given 12 hours before or 12 hours after infection. Researchers from the National Institute of Allergy and Infectious Diseases published findings in the Nature Communications journal. (Rivas, 4/19)

Boston Globe: Adagio Raises $336 Million To Advance Covid-19 Antibody Treatment
Waltham-based Adagio Therapeutics announced on Monday that it has raised $336 million in new funding to rapidly advance its Covid-19 antibody treatment, which aims to treat and prevent the disease and all of its known variants. Last week the Waltham biotech began recruitment for global clinical trial to test the drug’s efficacy as a treatment for high-risk individuals with mild or moderate Covid-19. The goal: to determine whether a single intramuscular dose could prevent hospitalizations and deaths. (Gardizy, 4/19)

Also —

AP: Learning To Breathe: German Clinic Helps COVID Long Haulers
Located in Heiligendamm, a north German seaside spa popular since the late 18th century, the clinic specializes in helping people with lung diseases such as asthma, chronic bronchitis and cancer. Over the past year it has become a major rehabilitation center for COVID-19 patients, treating 600 people from across Germany, according to its medical director, Dr. Joerdis Frommhold. (Jordans and Sopke, 4/20)

CBS News: Some Long-Haul COVID Patients Report Vaccines Are Easing Their Lingering Symptoms
A Facebook group called "Survivor Corps" polled 962 COVID-19 long haulers and found 39% said they saw mild to full resolution of their lingering symptoms after they were vaccinated. 46% of people said they remained the same after their shot, 14% said they felt worse. "For me, this is a miracle," COVID long-hauler Kimberly Willis-Rinaldi told CBS News senior medical correspondent Dr. Tara Narula. "The viral conjunctivitis specifically in my right eye is gone. The rash that was on my back and on my arms and my neck, that's gone." (4/19)

Stat: We Know A Lot About Covid-19. Experts Have Many More Questions
Less than a year and a half ago, the world was blissfully, dangerously ignorant of the existence of a coronavirus that would soon turn life on earth on its head. In the 16 months since the SARS-CoV-2 virus burst into the global consciousness, we’ve learned much about this new health threat... But many key questions about SARS-2 and the disease it causes, Covid-19, continue to bedevil scientists. (Branswell, 4/20)

ABC News: Over-The-Counter COVID-19 Rapid Tests To Be Sent To Major Pharmacies This Week 
Store shelves at pharmacies across the county will soon be filled with affordable, quick, at-home coronavirus test kits. BinaxNOW, a rapid COVID test made by Abbott Laboratories, was shipped Monday to major pharmaceutical chains, including Walgreens, CVS and Walmart, to be sold over the counter. The tests will be sold in two-count packs for $23.99. (Pezenik and Pereira, 4/19)

USA Today: COVID-19: No-Prescription Tests To Be Sold At Walmart, CVS, Walgreens
Consumers will be able to buy rapid coronavirus tests without a prescription this week at three national chain retailers, an expansion that comes as the nation's vaccination effort accelerates and states relax distancing requirements and mask mandates. Abbott Laboratories' BinaxNOW coronavirus self-test kits will be shipped to CVS Pharmacy, Walgreens and Walmart locations and also will be sold online. The two-test kit, which last month received Food and Drug Administration emergency-use authorization for serial screening, will cost $23.99, the company said. (Alltucker, 4/19)

Related News From KHN: Backed by Millions in Public and Private Cash, Rapid Covid Tests Are Coming to Stores Near You

In other news about covid testing —

Fox News: Otters Test Positive For COVID-19, Georgia Aquarium Says
The Georgia Aquarium announced on Sunday that its Asian small-clawed otters tested positive for COVID-19. While it was unclear how many of the animals had tested positive, officials said in a news release that the otters are already showing signs of improvement and are expected to make "a full recovery." "Our Asian small-clawed otters are under very close monitoring by veterinarians and animal care team members," Dr. Tonya Clauss, vice president of animal and environmental health at Georgia Aquarium, said in a news release. "They have displayed only mild symptoms and we expect them all to make a full recovery. We are providing supportive care as needed so they can eat, rest and recover." (Hein, 4/19)

The Star Tribune: Questions Surface Over State's COVID-19 Testing Contract
Minnesota public health officials talk with pride of the free statewide COVID-19 testing system they set up last year, but questions are mounting about the cost of the no-bid contract they negotiated and a key pricing amendment still in the works. The Minnesota Legislative Auditor's Office confirmed Friday that it has received multiple complaints about the rates billed to the state for COVID testing and is conducting "preliminary inquiries" into the issue, said Joel Alter, director of special reviews for the office. (Carlson, 4/18)

AP: PGA Tour Tells Golfers To Get Vaccinated Or Pay For COVID Tests
The PGA Tour is telling its players they will not have to be tested for the coronavirus if they are vaccinated, and those who aren’t will have to pay for their own tests starting this summer. In a memo sent to players Monday, the tour strongly encouraged them to get vaccinated. It stopped short of saying it would require players to be vaccinated to compete in tournaments. (4/19)

The Guardian: The Obscure Math Theorem That Governs The Reliability Of Covid Testing 
Maths quiz. If you get a positive result on a Covid test that only gives a false positive one time in every 1,000, what’s the chance that you’ve actually got Covid? Surely it’s 99.9%, right? No! The correct answer is: you have no idea. You don’t have enough information to make the judgment. This is important to know when thinking about “lateral flow tests” (LFTs), the rapid Covid tests that the government has made available to everyone in England, free, up to twice a week. (Chivers, 4/18)

The Wall Street Journal: Covid-19 Cases Rise In Parts Of U.S. Even As Vaccinations Pick Up 
The CDC reported Monday that the seven-day average of new Covid-19 cases is at more than 67,443, up 1% from the prior seven-day average of 66,702. Four weeks ago, the seven-day average was 53,000 cases a day, said Dr. Rochelle Walensky, director of the CDC, during a press briefing Monday. The U.S. is in a “complicated stage” of the pandemic, Dr. Walensky said. (West, 4/19)

USA Today: US Reporting More Than 400K Coronavirus Cases Per Week
“While we’re making extraordinary strides in the number of people vaccinated, we still have an extraordinary amount of disease out there,” Centers for Disease Control and Prevention director Dr. Rochelle Walensky said at a White House news conference Monday. The U.S. has reported 33% of adults are fully vaccinated and over 50% of the U.S. adult population has received at least one vaccine dose, according to data from the CDC. But while cases and hospitalizations have fallen since January, the United States is still reporting more than 400,000 cases per week. And the US is reporting more than 21,000 cases of the variants found in the U.K., Brazil and South Africa. The U.K. variant has become the prominent strain in the U.S., according to the CDC. (Aspegren, 4/20)

Philadelphia Inquirer: COVID-19 Still Spreading Through Philly Region As More Can Get Vaccine, But Pa. And N.J. See Different Trends
Pennsylvania and New Jersey added more new coronavirus cases per capita than almost any other state last week, according to the Centers for Disease Control and Prevention, with only Michigan notching a higher case rate. But while New Jersey’s COVID-19 metrics appear to be plateauing or trending downward from recent weeks, Pennsylvania’s cases are on the rise, along with hospitalizations. (Steele, 4/20)

But some positive signs emerge —

WLRN 91.3: COVID Hospitalizations Plunge Among Seniors As Immunity Takes Hold
The number of Florida seniors entering the hospital for COVID-19 dropped sharply over the past month, an indication that the vaccination campaign begun in December has been effective in protecting the group most vulnerable to the disease. According to the South Florida Sun Sentinel, hospitals have registered a 46% drop in admissions for COVID patients aged 70 or over since mid-February, an encouraging sign in the fight against the pandemic. 4/19)

Roll Call: Tribes See Progress In COVID-19 Fight 
Last summer, the Navajo Nation had the highest per capita COVID-19 infection rate in the country. The nation’s largest Native American reservation reported 2,304 cases per 100,000 people in mid-May, compared to the U.S. average in mid-May of 8 per 100,000. On Nov. 21, Navajo Nation daily cases peaked at 401 — over 1.5 times the number of cases on the worst day of May. But on March 22, the reservation had good news. There were no deaths or even new cases to report. (Raman, 4/19)

In updates on covid variants —

Houston Chronicle: Texas A&M Researchers Discover A New COVID-19 Variant In College Station
College Station is best known as the home of Texas A&M University, but as of this month, researchers have confirmed it’s now the birthplace of a new COVID-19 strain. Only one student has tested positive for BV-1, named for the Brazos Valley. They were diagnosed with COVID-19 on March 5 and experienced mild respiratory symptoms. A second test on March 25 turned up positive results, worrying researchers the variant would cause a longer infection in young adults. (Wu, 4/19)

CNN: How To Stay Safe From Coronavirus Variants 
The coronavirus variant that first originated in the United Kingdom is now the dominant variant in the United States. The B.1.1.7 variant of SARS-CoV-2 is present in all 50 US states and is contributing to the surges of coronavirus infection, according to the US Centers for Disease Control and Prevention. Not only does it appear to be more transmissible; some research also suggests it can cause more severe disease, which puts more people at risk for hospitalization and death. (Hetter, 4/20)

Detroit Free Press: Duggan Announces Detroit Walk-In COVID-19 Vaccine Locations
Appointments are no longer needed to get a vaccine in the city of Detroit, starting Tuesday, Mayor Mike Duggan announced Monday. The move is intended to encourage more people to get the COVID-19 shot, since vaccination rates have dropped throughout the United States, Duggan said. He suspects it is due to publicity about  the Johnson & Johnson vaccine pause. (Rahal, 4/19)

Houston Chronicle: As COVID-19 Vaccine Supply Increases In Texas, Clinics Say No Appointments Needed
Walk-in COVID-19 vaccine clinics are now all the rage in Houston, as larger allocations and dwindling demand change the scarcity-fueled dynamic of the past several months. “Now, there is more supply than there is demand,” said Harris County Judge Lina Hidalgo during a Monday afternoon news conference at NRG Park. “That means we have more vaccines than we have people willing to get them.” (Wu, 4/19)

In other news on the vaccine rollout —

AP: Arizona Governor Orders 'Vaccine Passport' Ban For The State
Gov. Doug Ducey used his executive powers Monday to prohibit local and regional governments from making “vaccine passports” a requirement for people to enter businesses or get services, calling it an encroachment on the private medical information of Arizona residents. The Republican governor signed an executive order that also bans state agencies or businesses that contract with state government from requiring the vaccine passports that prove people have been vaccinated against the coronavirus. (Tang, 4/19)

The Hill: Alaska To Allow Prison Visits For Fully Vaccinated Inmates, Family Members
Alaska's Department of Corrections (DOC) will allow family members to visit fully vaccinated inmates starting on Wednesday, Alaska Public Media reported. It will be the first time public visitations are open for the state’s prisons in more than a year, as corrections officials closed all nonessential access in March 2020 amid to the COVID-19 pandemic. Only facilities in Anchorage and Ketchikan will remain closed due to recent outbreaks. (Oshin, 4/19)

AP: California Allows Fans For US Opens If Vaccinated Or Tested
A limited number of spectators will be allowed at the U.S. Women’s Open in San Francisco and the U.S. Open in San Diego in June provided they are vaccinated or can show proof of a negative test for the coronavirus. The USGA announced the policy Monday after consulting with California health officials. (Ferguson, 4/19)

AP: A Jab On The Job: Companies, Unions Offer COVID-19 Vaccines
Marie Watson wanted to be among the first in line when she and other essential workers became eligible for the coronavirus vaccine — and with good reason. The maintenance parts buyer for a Mission Foods tortilla plant in Pueblo, Colorado, had lost her father to COVID-19 in the fall and was told by a doctor last year that she herself almost certainly had the virus. So when her union, the United Food Workers and Commercial Workers, secured appointments for the plant’s 200 workers, she jumped in her car and drove to a nearby drive-thru clinic for the first of two doses. (Olson, 4/19)

The Washington Post: New Jersey Couple Offers Free Rides To Coronavirus Vaccination Sites Aboard ‘Joe’s Covee Car’ 
When Joseph Cicchetti rolls up to strangers’ driveways in his black hatchback, he is instantly recognizable. There aren’t many Fiat 500s covered in handcrafted red spikes intricately designed to resemble the coronavirus protein. Cicchetti had a good reason to turn his car into a mobile virus: The 58-year-old will take anyone in his suburban New Jersey neighborhood to their coronavirus vaccine appointment aboard “Joe’s Covee Car.” (Salcedo, 4/19)

Axios: Where Seniors Remain Unvaccinated And Vulnerable To The Coronavirus 
More than 80% of Americans 65 and older have received at least one dose of a coronavirus vaccine, per the CDC, but millions across the country remain unvaccinated — particularly in the South. Seniors who have yet to receive their shot remain highly vulnerable to the virus even as the country overall becomes safer. (Owens, 4/20)

AP: The Latest: Yale Requiring Students Get Vaccine Before Fall
Yale has joined a growing list of universities that are requiring students to be vaccinated against COVID-19 before returning in the fall. The university’s president and provost made the announcement Monday in an email to the Yale community. They urged students to get their shots as soon as possible, calling inoculation “the strongest tool for preventing transmission of the virus.” (4/19)

FOX 5 Digital Team: Clark Atlanta, Morehouse, Spelman Requiring COVID-19 Vaccinations For Fall Semester
A group of Atlanta universities that includes Clark Atlanta University, Morehouse College, and Spelman College will require all students, faculty members, and staff to be vaccinated for the upcoming 2021 fall semester. The Atlanta University Center Consortium (AUCC), which includes the three historically Black colleges and universities as well as Morehouse School of Medicine and the AUC Robert W. Woodruff Library, made the announcement that employees and students will need to be fully vaccinated on Monday. (4/19)

The CT Mirror: Bill That Would Eliminate CT’s Religious Exemption From Mandatory Vaccines Clears House
The state House of Representatives approved a bill early Tuesday that would remove Connecticut’s religious exemption from mandatory school vaccinations, a major step for a hot-button proposal that has been raised three years in a row with no vote in either chamber until this week. “Because we’re in the middle of a health crisis, we need to take a firm stand on the efficacy of vaccinations,” said Rep. Henry Genga, an East Hartford Democrat. “We need to keep our most vulnerable residents in our decision making, always. This policy will help prevent the spread of illness and disease to those who are most vulnerable – those who have diabetes, autoimmune diseases, who make up many of our neighbors. While they cannot be vaccinated, we must do what we have to do to protect them.” (Carlesso, 4/19)

New Hampshire Union Leader: Bye-Bye Lockdown, Hello Friends: Teens Getting Vaccinated For COVID-19 In NH 
Twins Rese and Kendall Jaggars say they cannot wait for sleepovers again. The 16-year-old girls from Greenland are students at Portsmouth High School and received their first Pfizer COVID-19 vaccination on Monday. Their mother, Stephanie, was in the school’s gymnasium with them to oversee the process. “I’m excited that we’re getting it and I hope a lot of other people will get it to protect themselves,” Kendall Jaggars said. (Haas, 4/19)

In other news on adolescent health care —

Crain's Cleveland Business: How The Role Of School Health Programs Might Expand Because Of The Pandemic
More than ever, the past year has shown how health and education go hand in hand and provided an opportunity to deepen the relationships between the two fields, said Katie Davis, director of the Center for Health Outreach, Access and Prevention at MetroHealth’s Institute for H.O.P.E. "The more that we partner together and support each other with bringing the health experts to the field and the education experts to the field, we really can impact the whole child and that community so that these students can be successful," she said. "I'm just hopeful that we continue to deepen the relationships that were already there that have gotten stronger this past year." (Coutré, 4/19)

WUSF 89.7: Mental Health Resources Can Help Kids Cope With Pandemic Anxiety 
Adolescence is a time when young teenagers are supposed to be growing independent and developing social connections outside of their own families. But the pandemic has limited those opportunities to spend time with friends and for kids to build their self-esteem. It’s no surprise then, that many parents say their teen has shown signs of a new or worsening mental health condition since the beginning of the pandemic. (Carter, 4/19)

WUSF 89.7: Coronavirus Pandemic Takes Toll On Teen Mental Health
When the pandemic shut down Florida schools last year, it was thought to be a short-term precaution to get the spread of the virus under control. So Maya, a 17-year-old student at Sarasota High School, reacted to the closure like a typical teenager. "At first, it was actually kind of fun because it was something we've never done before," she said. But as weeks turned into months, Maya became very depressed. (Carter, 4/19)

The Washington Post: During The Pandemic, Viewers Have Turned To Content Creators For Mental Health Support
During a recent live stream hosted by Abdallah Elayan, an official Nintendo Brand Ambassador with 884,000 subscribers, a viewer donated $5 along with an accompanying message. “I’m gonna take my life now,” the viewer wrote. Elayan, who makes YouTube videos under the name AbdallahSmash, said he immediately erased the message from the live chat so other viewers wouldn’t see it. On a side monitor, he instructed his team of moderators to check in with the viewer. He kept his stream going. It wasn’t his first time handling this kind of situation. Elayan trains his moderators to move concerning comments to private chats where they can listen, and most importantly, deliver professional recommendations for therapists or hotlines. (Hood, 4/19)

New York Post: CDC Probing ‘Handful’ Of New Potential J&J Vaccine Reactions
The CDC is investigating a "handful" of potential additional cases of severe side effects involving the Johnson & Johnson COVID-19 vaccine, the agency’s chief said Monday. Use of the single-dose COVID-19 vaccine was halted in the US last week amid reports that six women in the country developed dangerous blood clots — including one who died — after receiving the immunization. CDC chief Dr. Rochelle Walensky — asked at a White House press briefing if there were any more reports of "severe adverse effects" involving J&J doses in the US — replied, "There have been a handful of cases — not an overwhelming number of cases. (Sheehy, 4/19)

The Baltimore Sun: Baltimore Plant Pauses COVID Vaccine Production Amid FDA Inspection After Johnson & Johnson Mistake 
Emergent BioSolutions confirmed Monday that it has temporarily stopped production of the Johnson & Johnson COVID-19 vaccine at its East Baltimore plant at the request of government regulators looking into a mistake at the facility that led to the disposal of millions of doses. The news is the latest setback for the plant, for Rockville-based Emergent BioSolutions and for one of three vaccines crucial to helping end the coronavirus pandemic. (Cohn, 4/19)

AP: EU Drug Regulator Prepares To Issue Advice On J&J COVID Shot
Experts at the European Medicines Agency are preparing to present the conclusions of their investigation later on Tuesday into possible links between the Johnson & Johnson coronavirus vaccine and very rare cases of unusual clotting disorders detected in the U.S. Last week, J&J halted its European rollout of its one-dose vaccine after the U.S. Food and Drug Administration recommended officials pause its use while the rare blood clot cases are examined. Officials identified six cases of the highly unusual blood clots among nearly 7 million people who were immunized with the shot in the U.S. (Cheng, 4/20)

In related news about Johnson & Johnson —

The Washington Post: The Race To Untangle The Secrets Of Rare, Severe Blood Clots After Johnson & Johnson Vaccination
When an otherwise healthy 48-year-old Nebraska woman arrived at an emergency room after three days of abdominal pain and malaise, doctors discovered a life-threatening puzzle. Her platelets, the colorless blood cells that clump to form clots, had plummeted. But a CT scan of her abdomen and pelvis revealed extensive blood clots. Her medical team raced to untangle the seemingly paradoxical combination of symptoms. Even as they treated the patient with a common blood thinner, more clots appeared — in her brain and in the blood vessels around her liver and spleen. (Johnson, 4/19)

Las Vegas Review-Journal: Woman Had 3 Brain Surgeries For Clots After J&J Vaccine Shot
An 18-year-old Clark County woman who became critically ill after receiving the Johnson & Johnson COVID-19 vaccine has undergone three brain surgeries related to dangerous blood clots, a spokesman for the patient’s family said on Monday. The young woman, Emma Burkey, began to feel ill about a week after being vaccinated on or about April 1, eventually experiencing seizures that sent her to the hospital, spokesman Bret Johnson said. Burkey was first treated at St. Rose Dominican Hospital, Siena campus, in Henderson before being airlifted to Loma Linda University Medical Center in Southern California for specialized care. Her parents, Russ and Kathy, are at her bedside, but only for a brief period each day due to COVID-19 restrictions. (Hynes, 4/19)

Axios: Axios-Ipsos Poll: Americans Say J&J Pause Was The Right Call 
Most Americans support the pause in distribution of the Johnson & Johnson COVID-19 vaccine, and so far there's no evidence that it's leading to broader vaccine hesitancy, according to the latest installment of the Axios/Ipsos Coronavirus Index. In our weekly national survey, 91% of respondents were aware of the temporary pause recommended by the Food and Drug Administration and the Centers for Disease for Control and Prevention. Of those, 88% said the pause was a responsible decision. (Talev, 4/20)

CBS News: Illinois And OxFam Ask Shareholders To Reject Johnson & Johnson CEO's $30 Million Payday 
The fight over Johnson & Johnson CEO Alex Gorsky's $30 million payday is heating up. The state of Illinois, charitable organization OxFam and several religious organizations have filed letters with the Securities and Exchange Commission opposing his pay. The letters urge shareholders to vote no on a "say on pay" proposal set for consideration at J&J's annual shareholder meeting on April 22. Officials in Illinois, which owns J&J stock in its municipal retirement fund, take issue with how the company computed Gorsky's 2020 pay. They said it is unfair to exclude the billions of dollars the pharmaceutical company has paid to settle legal claims related to its role in the opioid epidemic. Illinois is asking J&J to cut Gorsky's pay by at least $2 million. (Gandel, 4/19)

The Wall Street Journal: Biden Administration Considering Rule To Cut Nicotine In Cigarettes
The Biden administration is considering requiring tobacco companies to lower the nicotine in all cigarettes sold in the U.S. to levels at which they are no longer addictive, according to people familiar with the matter. Administration officials are considering the policy as they approach a deadline for declaring the administration’s intentions on another tobacco question: whether or not to ban menthol cigarettes. (Maloney, 4/19)

CNBC: Tobacco Stocks Drop On Report Biden Is Planning To Limit Cigarette Nicotine
Tobacco stocks tumbled Monday on a report that the Biden administration is considering whether to cap nicotine levels in cigarettes. The report, which cited people familiar with the matter, was published in the Wall Street Journal. The paper said the discussion came as public officials approach a deadline to say whether they plan to seek a ban of menthol cigarettes or not. (Tsai, 4/19)

In other news about cigarettes and e-cigarettes —

The Washington Post: Civil Rights And Black Health Organizations Press Biden Administration To Ban Menthol Cigarettes 
Civil rights organizations and African American health groups ramped up pressure on the Biden administration to ban menthol cigarettes, accusing the tobacco industry of targeting Black communities for decades and demanding government action on what they said was an urgent social justice issue. In a letter Friday to Health and Human Services Secretary Xavier Becerra, 10 groups demanded that the Food and Drug Administration start the regulatory process to ban menthol, saying such a move was long overdue. (McGinley, 4/16)

Los Angeles Times: Tobacco Giant Philip Morris Sees Future Without Cigarettes 
The maker of Marlboro and other cigarette brands has a new mission: getting the world’s 1 billion smokers to quit smoking. You read that right. Philip Morris International is trying to persuade customers to switch to its heated tobacco products, which it says are better alternatives because they are smoke-free. Eventually, the company hopes, governments will regulate cigarettes out of existence altogether. (Chang, 4/16)

The Highlander: Fourth Generation Electronic Cigarettes Are Just As Harmful As Older Models 
A new UCR study published in March of this year indicates that in spite of evolving differences in design aesthetics, fourth generation electronic cigarettes pod atomizers are actually similar to those from previous generations and can leak harmful substances that lead to potentially serious health and environmental issues. (Garcia, 4/19)

Stat: Biden Officials Met With 3M, PhRMA, Others On Shoring Up The Stockpile
The Biden administration met privately this month with some of the nation’s biggest health care companies and lobbying organizations to discuss how to rework the health care supply chain. Some 30 companies, including 3M, AmerisourceBergen, and Dupont were invited to a private “workshop” held via WebEx on April 5, along with lobbying groups representing drug makers, hospitals, pharmacists and drug distributors, according to an invite obtained by STAT. (Florko, 4/20)

CNN: Biden Administration To Provide $150 Million To Boost Covid Response In Underserved And Vulnerable Areas
The Biden administration on Monday will allocate $150 million from the American Rescue Plan to community-based health care providers across the nation to help boost their coronavirus response for underserved communities and vulnerable populations, senior White House Covid-19 response adviser Andy Slavitt said Monday. "To get resources to health care providers serving at-risk populations and to promote equitable distribution of vaccines, today (the Department of Health and Human Services) is making $150 million available to community-based health care providers to strengthen their efforts to get shots in arms and care for patients with Covid-19," Slavitt said at a White House Covid-19 briefing. (Collins and Sullivan, 4/19)

KHN: Public Health Experts Worry About Boom-Bust Cycle Of Support
Congress has poured tens of billions of dollars into state and local public health departments in response to the covid-19 pandemic, paying for masks, contact tracers and education campaigns to persuade people to get vaccinated. Public health officials who have juggled bare-bones budgets for years are happy to have the additional money. Yet they worry it will soon dry up as the pandemic recedes, continuing a boom-bust funding cycle that has plagued the U.S. public health system for decades. If budgets are slashed again, they warn, that could leave the nation where it was before covid: unprepared for a health crisis. (Smith, Weber and Recht, 4/19)

In other news from the federal government —

The Washington Post: White House Closes In On $1 Trillion Plan Centered On Child Care, Pre-K, Paid Family Leave 
White House officials are closing in on a large spending plan centered on child care, paid family leave and other domestic priorities, according to two people aware of internal discussions. The package could amount to at least $1 trillion of new spending and tax credits, though details remain fluid. The American Families Plan, the second part of the administration’s Build Back Better agenda, is expected to be unveiled ahead of President Biden’s address to a joint session of Congress on April 28, the people said. (Stein and Pager, 4/19)

NPR: Not 'Illegal Alien," But 'Undocumented Noncitizen' Under New Immigration Policy
The Biden administration is ordering U.S. immigration enforcement agencies to change how they talk about immigrants. The terms "illegal alien" and "assimilation" are out — replaced by "undocumented noncitizen" and "integration." The new guidance is laid out in a pair of detailed memos sent Monday by the heads of U.S. Immigration and Customs Enforcement and Customs and Border Protection, part of a broader effort by the Biden administration to roll back the previous administration's hard-line policies and build what they call a more "humane" immigration system. (Rose, 4/19)

AP: Groups Push For Easier Student Loan Relief For The Disabled
Advocates for the disabled are pressing the Biden administration to cancel student debt for hundreds of thousands of Americans who have disabilities that make them eligible for federal debt forgiveness but who have not applied for the benefit. Using a rarely pursued federal petition process, three federal advocacy groups on Monday asked the U.S. Education Department to consider erasing debt for nearly 400,000 people with severe disabilities and to overhaul a debt forgiveness program that critics say is overly burdensome. (Binkley, 4/19)

And news from the Trump administration-era —

Washington Post: Federal Turf Wars Over Coronavirus Rescues Created ‘Health And Safety Risks,’ Watchdog Concludes
A chaotic effort to return hundreds of Americans to the United States in the earliest days of the coronavirus outbreak — including bureaucratic infighting over whether flights out of Wuhan, China, were an “evacuation” or “repatriation” — put the evacuees, federal officials, and even US communities at risk, a government watchdog concluded. The US government-led missions, which included an operation to evacuate Americans from a virus-stricken cruise ship off the coast of Japan in February 2020, were plagued by “serious fundamental coordination challenges,” the Government Accountability Office concluded in a report requested by Congress and released Monday. (Diamond, 4/19)

Georgia Health News: Trump Officials Thwarted EPA Action On Cancer-Causing Gas, Report Says 
On August 22, 2018, the citizens of Willowbrook, Ill., had just one hour to learn that local EPA officials were investigating high levels of a toxic gas in the neighborhoods near their homes. Then those officials, who were staffers in the EPA’s Region 5 office, got a call from their bosses in D.C. with an order: Take down the webpage on the investigation. When the page was eventually reposted, key parts had been removed, including important context about a facility run by the company Sterigenics that used the chemical ethylene oxide to sterilize disposable medical equipment and other goods. (Goodman and Miller, 4/19)

The New York Times: Officer Attacked In Capitol Riot Died Of Strokes, Medical Examiner Rules
Officer Brian D. Sicknick of the U.S. Capitol Police had multiple strokes hours after sparring with a pro-Trump mob during the Jan. 6 riot and died of natural causes, Washington’s medical examiner said on Monday. The determination is likely to complicate the Justice Department’s efforts to prosecute anyone in the death of Officer Sicknick, 42; two men have been charged with assaulting him by spraying an unknown chemical on him outside the Capitol. (Goldman, 4/19)

Houston Chronicle: Biden 'Has All The Cards' As He Pushes Texas To Expand Medicaid. But It May Take Time.
Texas Republicans have been swift to condemn the Biden administration for rescinding early approval of a multibillion dollar Medicaid program that would help fund emergency care for the state’s booming uninsured population through 2030. Gov. Greg Abbott said the federal government was “deliberately betraying Texans.” Attorney General Ken Paxton vowed to “use every legal tool available to regain the assistance Texans need.” (Blackman, 4/20)

Austin American-Statesman: Abbott Blasts Biden Administration Decision To Block Health Care Safety Net For Uninsured Texans
Gov. Greg Abbott on Friday said the Biden administration is “obstructing healthcare access for vulnerable Texans” after officials rescinded approval for a waiver that delivers billions in federal dollars to hospitals in Texas. In a letter to the state, federal Medicaid officials said the Trump administration’s decision to fast-track approval of the $100 billion waiver in January was made in error, without enough time for public comment. (Mekelburg, 4/17)

In other Medicaid news from Illinois, Mississippi and Arkansas —

News-Gazette: House Bill Would Free Up Medicaid Spending For Autism Treatment
In Illinois, private insurance has covered applied behavior analysis, or ABA, therapy for only about 10 years. Low-income families covered by Medicaid aren’t eligible for the service to be covered, even though ABA therapy is the only evidence-based therapy proven to help children with autism. ... Help might be on the way from Springfield. Legislation filed in the Illinois House would free up millions of dollars in Medicaid coverage for autism treatment after a previous bungled attempt in 2019. (Valley, 4/19)

Mississippi Center for Investigative Reporting: Mississippi Investigating Medicaid Drug Services Provider Centene
The state auditor and Mississippi attorney general are investigating whether Centene Corp., as a provider of Medicaid drug services, failed to disclose discounts on pharmacy services, inflated dispensing fees and received reimbursements for amounts already paid. Ohio Attorney General Dave Yost made similar allegations in a lawsuit. “Corporate greed has led Centene and its wholly owned subsidiaries to fleece taxpayers out of millions,” he said. “Centene has broken trust with the state of Ohio, and I intend to hold this company accountable for its deceptive practices.” (Mitchell, 4/18)

Arkansas Democrat-Gazette: Medicaid-Funding Bill Falls Short On 4th Try
For the fourth time in the past week, a bill to grant spending authority for Arkansas' Division of Medical Services in the next fiscal year fell short of obtaining the required three-fourths vote for approval in the Arkansas House of Representatives. According to legislative leaders, the difficulty in passage last week was connected to conflicting proposals to reduce the tax on the sale of used cars. Furthermore, if the Medical Services appropriation fails to pass, then lawmakers will have to rework a different bill that sets spending priorities for general revenue. That bill must pass if the Legislature is to recess by April 30. (Moritz, Wickline and Herzog, 4/20)

In Medicare news —

KHN: Humana Health Plan Overcharged Medicare By Nearly $200 Million, Federal Audit Finds
A Humana Inc. health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were, according to a new federal audit, which seeks to claw back the money. The Health and Human Services Office of Inspector General’s recommendation to repay, if finalized, would be “by far the largest” audit penalty ever imposed on a Medicare Advantage company, said Christopher Bresette, an HHS assistant regional inspector general. (Schulte, 4/20)

Modern Healthcare: 10% Of Prescription Drugs Make Up Majority Of Medicare Drug Spending, Study Finds
New data suggest that a targeted approach to negotiating the most expensive Medicare drugs could significantly impact federal drug spending. A Kaiser Family Foundation study has found that the top selling 7% and 8.5% of drugs covered by Medicare, part D and B respectively, take up the majority of the federal government's Medicare spending. The 250 top selling drugs, each with one manufacturer and no competitive products on the market, account for 60% of net total Medicare part D spending. The top 50 selling drugs, also with one manufacturer each and no competitors, account for 80% of total Medicare part B spending. (Gellman, 4/19)

Fierce Healthcare: AHA Counters Site-Neutral Medicare Payments With Study Highlighting Hospitals' More Complex Outpatients
The American Hospital Association (AHA) is reinforcing its longstanding position against the Department of Health and Human Services’ (HHS') site-neutral payments with new research suggesting hospital outpatient departments are treating poorer, more complex Medicare patients than independent physicians' offices are. The study, which was conducted for the AHA by KNG Health Consulting and published on its website, reviewed claims from a 5% sample of Medicare beneficiaries who had at least one visit to an outpatient setting between Jan. 1, 2012, and June 3, 2019. (Muoio, 4/19)

The Wall Street Journal: Drugmakers Accused Of Causing Opioid Addiction In Trial 
A lawyer for several large California communities accused four drugmakers of causing a deadly wave of opioid addiction with their aggressive marketing of pain pills, while defense attorneys said the firms followed the law, on the opening day of a trial closely watched by the pharmaceutical industry. “Without an avalanche of prescription opioids, there wouldn’t be an opioid epidemic,” said Fidelma Fitzpatrick, a plaintiffs’ lawyer hired to represent the counties of Los Angeles, Orange and Santa Clara and the city of Oakland. (Randazzo, 4/19)

Bloomberg: J&J, Teva Opioid Trial May Signal Cost of Drug Maker Accords
A California judge may soon provide a clearer picture of what it will cost drug makers including Johnson & Johnson and Teva Pharmaceutical Industries Ltd. to resolve liability for their role in the U.S. opioid epidemic. The first trial against opioid companies in almost two years started Monday in Santa Ana, where four California municipalities are demanding at least $50 billion for what they claim was the illegal marketing of pain pills. The case, which will be decided without a jury and tried virtually, may be a road map for thousands of similar claims pending against drug makers, distributors and pharmacies. (Feeley, 4/19)

Stat: A New Book Traces The Roots Of The Opioid Crisis Through The Sackler Family
The family behind the OxyContin maker Purdue Pharma was already under intense legal and public scrutiny when they learned in 2019 that comedian John Oliver was planning to do a segment about them on his show, “Last Week Tonight.” But being the target of a social commentary like Oliver’s struck a chord for at least one member of the Sackler family. (Joseph, 4/20)

In other pharmaceutical industry news —

Stat: A PBM Offered A $500 Gift Card To Persuade Patients To Switch Drugs
Dozens of patient advocacy groups are angry over an unusual move by a health insurer that recently began offering $500 debit cards to people who agree to switch psoriasis medicines after it removed a widely used drug from several of its formularies. At issue is a decision by Cigna (CI) to offer the debit cards as an incentive to psoriasis patients to try alternatives to a Novartis (NVS) treatment called Cosenytx. (Silverman, 4/19)

North Carolina Health News: Behind Needle Exchange Bill, A Spat Between Asheville Site And Its New Neighbors 
Proposed state legislation filed in response to a years-long feud between an Asheville neighborhood and a local needle exchange could threaten syringe exchanges across North Carolina. Senate Bill 607 seeks to ban mobile exchanges, require engraved needles, background checks, forced treatment and more. Meanwhile, opioid overdose deaths are at an all-time high. (Knopf, 4/20)

Bloomberg: Parexel’s Owner Is Said To Weigh Sale Of Drug-Trial Company
The owner of Parexel International Corp., which helps drugmakers run clinical trials, is working with an adviser on a potential sale that could value the company at several billion dollars, according to people familiar with the matter. Private equity firm Pamplona Capital Management is also considering taking Parexel public, said one of the people, who asked to not be identified because the matter isn’t public. It has drawn takeover interest from private equity firms and other companies, the people said. (Davis, Baigorri and Porter, 4/19)

The Hill: Senate Aims To Pass Anti-Asian Hate Crimes Bill This Week
The Senate is working to wrap up an anti-Asian hate crimes bill this week as senators near a deal on changes to the legislation. The bill, introduced by Sen. Mazie Hirono (D-Hawaii), will likely come up for a vote as early as Wednesday, a Senate Democratic aide confirmed to The Hill. "I'm optimistic we can finish our work on the anti-Asian hate crimes bill later this week in the same manner we started it, with an overwhelming bipartisan vote. And let me say it's needed," Senate Majority Leader Charles Schumer (D-N.Y.) said from the Senate floor on Monday.  (Carney, 4/19)

AP: Asian Americans Wary About School Amid Virus, Violence
A Chinese American mother in the Boston suburbs is sending her sons to in-person classes this month, even after one of them was taunted with a racist “slanted-eyes” gesture at school, just days after the killings of women of Asian descent at massage businesses in Atlanta. In the Dallas area, a Korean American family is keeping their middle schooler in online classes for the rest of the year after they spotted a question filled with racist Chinese stereotypes, including a reference to eating dogs and cats, on one of her exams. (Marcelo, 4/20)

AP: Older Korean-Americans In LA Fearful Amid Anti-Asian Attacks
Yong Sin Kim, an 85-year-old Korean immigrant living in a senior apartment complex in downtown Los Angeles, says he rarely leaves home these days. When he does, he carries a whistle with him; at least he could call for help if he’s attacked. Three floors up in the same building, Hyang Ran Kim, 74, waits for her daughter to pick her up. She is temporarily moving into her daughter’s place in a quieter neighborhood in the suburbs. Kim says her daughter is worried about her safety. Amid a surge of anti-Asian violence, fear creeps in and alters the daily life of vulnerable Asian seniors. (Hong, 4/20)

In other news about health and racism —

CBS News: Racism's Corrosive Impact On The Health Of Black Americans 
When the Centers for Disease Control declared last week that racism is a serious public health threat in America, it acknowledged something that researchers have found for decades: on nearly every measure of health, African Americans are more prone to serious disease and premature death. The coronavirus pandemic has provided devastating evidence of this: Black Americans have died of COVID-19 at twice the rate of Whites, and so far are being vaccinated at a dramatically lower rate. Poverty and unequal access to high-quality health care play a role in these disparities, but this is not a matter of genetics. Harvard researcher David Williams has spent his career showing what the CDC now recognizes: racism itself can be a killer. (Whitaker, 4/18)

ABC News: Universities Provide Mental Health Support To Students As Derek Chauvin Trial Continues 
Several universities and colleges across the country have reached out to students to provide campus support and resources as deliberations continue in the Derek Chauvin trial. Universities including Princeton University, Penn State, Syracuse, Boston University, Northwestern University, Grinnell College, Binghamton University and Columbia College Chicago have reached out to their student communities, listing mental health resources and virtual community spaces to help students and faculty process a trial that has sent shockwaves across the country. (Arancio, 4/20)

AP: Did Mask Hamper Chauvin's Image At Murder Trial?
The mask that former Minneapolis police Officer Derek Chauvin was required to wear during most of his trial in George Floyd ’s death hid his reaction to testimony, including any signs of sympathy or remorse that legal experts said could make a difference to jurors. As his attorney delivered closing arguments in his defense, his mask came off. Coronavirus concerns forced Chauvin and other participants to wear masks except when they were addressing the court. Chauvin, wearing a light gray suit with a blue shirt and blue tie, removed his mask Monday while his defense attorney presented his closing arguments to jurors. While prosecutors made their case, though, he kept his mask on with his eyes mostly focused on taking notes. (Groves, 4/19)

Modern Healthcare: Digital Health Funding Hit $7.2B In Q1
Digital health companies globally raised a collective $7.2 billion in this year's first quarter, a sizeable jump from both the previous quarter and 2020's first quarter, according to a new report from market research firm Mercom Capital Group. Here are four funding trends to take away from the quarter: 1. Q1 2021 represented a massive jump from previous quarters. In terms of funding dollars, 2021's first quarter marked a 60% rise quarter-over-quarter from $4.5 billion raised in 139 funding deals in 2020's fourth quarter. It also marks a 100% rise year-over-year from $3.6 billion raised in 142 deals in 2020's first quarter. (Kim Cohen, 4/19)

Bloomberg: Women’s Digital Health Startups Reap Record VC Funding On Covid Surge
Once considered too niche or risky by the venture capital community, women’s health startups have seen a surge in investments as the Covid-19 pandemic pushed more services online. Funding for women-focused digital-health startups rose 105% last year to $418 million and was spread across 22 companies, nearly twice the number from a year earlier, according to Rock Health, a San Francisco-based seed and early-stage venture fund. The firm tracks deals of $2 million or more among U.S.-based digital-health companies. It counts 55 companies in the "femtech" category, which includes those that tackle issues such as reproductive health, maternal care and chronic disease. (Davalos, 4/19)

In other health care industry news —

Modern Healthcare: HHS Allocates $145 Million To Health Center Look-Alikes To Fight COVID-19
Community-based healthcare providers will get $145 million from HHS to support their response to the COVID-19 pandemic, the agency said Monday. The funding is for so-called "health center look-alikes," providers that deliver primary care services to underserved communities and vulnerable populations but don't get health center grants from HHS. They can use it to slow the spread of the virus, strengthen vaccine efforts and improve healthcare services and related infrastructure. The new spending is part of the $7.6 billion that Congress gave HHS to help community health centers fight COVID-19 under the American Rescue Plan. (Brady, 4/19)

Atlanta Journal-Constitution: ETSU Offering Online Forensic Nurse Certificate
East Tennessee State University’s College of Nursing has added a forensic nurse certificate to its lineup of online programs. The post-baccalaureate certificate is for nurses who want to expand their knowledge beyond the training acquired as a sexual assault nurse examiner — or SANE — nurse. The course examines how intentional human violence intersects with health care and the criminal justice system, while integrating forensic science and social services, ETSU’s website states. (Clanton, 4/19)

Stat: The Future Of Voice Tech In Medicine Is Here. Can It Live Up To The Promise?
Microsoft’s high-profile of acquisition of Nuance Communications is a seeming win for patients and providers. The voice recognition company, which sells artificial intelligence solutions that can listen to clinical conversations and auto-populate electronic health records, has the potential to dramatically improve care by removing frequent sources of digital friction. (Palmer, 4/20)

Modern Healthcare: Stanford Alleges Anthem Owes $1.9 Millon Under Implied Contract
Stanford Health Care sued Anthem in federal court on Friday, alleging the insurer's failure to pay nearly $2 million owed under a national, reciprocal claims network violates an implied contract between the two. The not-for-profit health system claimed its physicians cared for six patients insured under Blue Cross and Blue Shield of Indiana plans from 2018 to 2020, but they still haven't received full reimbursement for their "usual and customary" rates. Anthem operates Blue Cross and Blue Shield plans in 14 states, including Indiana. (Tepper, 4/19)

KHN: UVA Health Will Wipe Out Tens Of Thousands Of Lawsuits Against Patients
University of Virginia Health System, which for years has sued thousands of patients annually for unpaid bills, said Monday it will cancel a massive backlog of court judgments and liens resulting from those lawsuits dating to the 1990s. Combined with reforms UVA announced in 2019, the move is likely to benefit tens of thousands of families and make UVA Health’s collections policies much more generous than those of many hospital systems, said scholars who study health care finance. The decision to wipe out liens that can drain home equity years after a hospital visit is extremely rare, they said. (Hancock, 4/20)

The Wall Street Journal: Strains, Sprains And Pinched Nerves: Injuries At Home Are On The Rise 
For more than a year, some of us have been working in makeshift offices, hunched over computers on beds, floors or coffee tables. Stuck at home, we’ve taken on projects and have been climbing ladders, painting walls and using tools that once collected dust in the basement. Some of us stopped exercising entirely—or launched into fitness routines without proper preparation. The result, doctors say, is more injuries among people hunkered down during the pandemic. “I’ve seen neck strains, rotator cuff injuries, low-back strains,” says Carlo Milani, a physiatrist at the Hospital for Special Surgery in New York City. That’s not all. Dr. Milani also is seeing “lumbar disc injuries, cervical spine disc injuries, pinched nerves in the neck, pinched nerves in the lower back.” (Reddy, 4/19)

The Washington Post: The Big Number: A Major Pandemic Weight Gain 
Since the pandemic began, about 42 percent of U.S. adults have gained weight — 29 pounds, on average, according to the American Psychological Association’s latest “Stress in America” report. About half of the weight-gainers reported adding more than 15 pounds; 10 percent, more than 50 pounds. Men have put on more weight than women (37 vs. 22 pounds, on average), and younger adults have gained more than older people (millennials averaging 41 pounds vs. baby boomers at 16 pounds). (Searing, 4/19)

The New York Times: Emerging From The Pandemic With Acne, Facial Hair And Body Odor 
Dr. Chanelle Coble, an adolescent medicine specialist at N.Y.U. Grossman School of Medicine, said that young people are experiencing the body changes of puberty without the supports they would usually get from their peer group, and that is part of the general stress of the pandemic year. In her New York City practice, Dr. Coble said that she has seen higher than usual rates of severe anxiety and depression, as well as disordered eating, including among 11-, 12- and 13-year-olds. (Klass, 4/19)

KHN: From Rotten Teeth To Advanced Cancer, Patients Feel The Effects Of Treatment Delays
With medical visits picking up again among patients vaccinated against covid-19, health providers are starting to see the consequences of a year of pandemic-delayed preventive and emergency care as they find more advanced cancer and rotting and damaged teeth, among other ailments. Dr. Brian Rah, chair of the cardiology department at Montana’s Billings Clinic, was confused in the early days of the covid pandemic. Why the sudden drop in heart attack patients at the Billings Clinic? And why did some who did come arrive hours after first feeling chest pains? (Alpert, 4/20)

In other public health news —

CIDRAP: Review Finds Increased MRSA Risk From Dog Ownership
A review and meta-analysis of previously published studies has identified dog ownership as a risk factor for methicillin-resistant Staphylococcus aureus (MRSA) colonization, German researchers reported last week in the Journal of Antimicrobial Chemotherapy. ... The data suggest that transmission occurs primarily from humans to dogs, who then may serve as a reservoir for reinfection and transmission to other household members. In addition, dogs may be a vector for livestock-associated strains of MRSA. (4/19)

The New York Times: Authorities Did Not Try To Use ‘Red Flag’ Law For Indianapolis Gunman
In Brandon Hole’s case, prosecutors considered his immediate mental health crisis — his mother told them he had talked of killing himself — to be the priority, and after his gun was taken away, they considered the crisis averted. Research has shown that red flag laws do prevent gun suicides, and some of those who have studied gun violence say that suicide prevention should be seen as the primary purpose of such laws. (Robertson, 4/19)

The Washington Post: A 73-Year-Old With Dementia Took $14 Of Items From Walmart. Police Broke Her Arm In A Violent Arrest.
Karen Garner was plucking purple wildflowers and strolling back to her home in Loveland, Colo., last year when the police spotted her. A few minutes earlier, the 73-year-old with dementia had walked out of a Walmart without paying for some items worth roughly $14 before returning them to employees outside. Now, as the officer tried to arrest her, she appeared confused and frightened. “I’m going home,” she pleaded, still clutching the flowers as he wrestled her into handcuffs. (Elfrink, 4/20)

KHN: After A Deadly Year On The Roads, States Push For Safety Over Speed 
As more Americans start commuting to work and hitting the roads after a year indoors, they’ll be returning to streets that have gotten deadlier. Last year, an estimated 42,000 people died in motor vehicle crashes and 4.8 million were injured. That represents an 8% increase over 2019, the largest year-over-year increase in nearly a century — even though the number of miles driven fell by 13%, according to the National Safety Council. (Bluth, 4/20)

In news about marijuana and other drugs —

AP: Should States Set Pot Policy By Its Potency? Some Say Yes
As marijuana legalization spreads across U.S. states, so does a debate over whether to set pot policy by potency. Under a law signed last month, New York will tax recreational marijuana based on its amount of THC, the main intoxicating chemical in cannabis. Illinois imposed a potency-related tax when recreational pot sales began last year. Vermont is limiting THC content when its legal market opens as soon as next year, and limits or taxes have been broached in some other states and the U.S. Senate’s drug-control caucus. (Peltz, 4/20)

Cincinnati Enquirer: Ohio Plans To Double Number Of Medical Marijuana Dispensaries
Businesses can apply for 73 new dispensary licenses this summer, bringing the total allowed to 130 statewide. The Ohio Board of Pharmacy approved the expansion Monday afternoon. Under the plan, applicants would have to apply by the same rules as the initial 2017 application process, including security and business plan requirements. Applicants that meet the qualifications would be entered into a lottery to allocate licenses by dispensary district, which is typically one county or a group of two or three smaller counties. Licensees would be limited to five dispensary licenses total statewide, including licenses they have now. (Borchardt, 4/19)

New Hampshire Union Leader: Three Years After Law, The Right To Try Experimental Drugs Still Eludes Dying Patients 
Lisa Stockman-Mauriello is dying. She has one last ambition: to live long enough to see her three sons graduate this year — from middle school, high school and college. She and her doctor believe she needs a new experimental drug to hold on. She’s unlikely to get it. (LaVito and Bloomberg, 4/19)

The Advocate: John Bel Edwards Won't Support Bills That Ban Transgender Athletes, Restrict Medical Treatment
Gov. John Bel Edwards said Monday he will not back bills that would place curbs on transgender athletes and other proposals that would restrict minors pursuing transgender treatments. "I am concerned about emotionally fragile people," Edwards told reporters. The brief comments could signal the death knell of the bills at the start of the second week of Louisiana's two-month session. (Sentell, 4/19)

Oklahoman: Despite NCAA Rebuke, Oklahoma House Advances Transgender Sports Bill
Despite a warning that legislation limiting transgender participants in sports could keep future NCAA events out of Oklahoma, the state House advanced a bill that would prevent transgender athletes from competing in women's sports. Following more than two hours of fierce discussion and debate Monday, the Oklahoma House passed legislation aimed at preventing "male-bodied athletes” from participating in female sports at K-12 schools, colleges and universities. The GOP-controlled House passed Senate Bill 2, which states: "Athletic teams designated for 'females,' 'women' or 'girls' shall not be open to students of the male sex."  (Forman, 4/19)

Dallas Morning News: Texas Business Leaders Urge Lawmakers To Oppose Anti-Transgender Legislation
Texas employers are urging state lawmakers not to pass legislation that is considered anti-transgender, including bills that would exclude transgender children from competing in sports and from accessing health care. Amazon, American Airlines, Facebook and IBM Corp. were just some of the more than 40 employers opposing the bills in a letter released Monday by Texas Competes, a coalition of Texas businesses in support of a more inclusive Texas. (Thompson, 4/19)

The Boston Globe: Activists See Political Motivations Behind Wave Of GOP Bills Targeting Transgender Kids
What does a wave of legislation targeting transgender children in state houses across the country have in common with the recent furor among Republicans over “cancel culture” and Dr. Seuss? More than you might think — at least according to LGBTQ rights’ advocates, who are working to fend off the bills. They argue that Republicans are targeting transgender youth now as a way to score political points with a segment of their base at a time when the party is out of power at the federal level and squabbling over some of the fundamental policies that used to unite them — from fiscal conservatism to cozying up to big business. (Goodwin, 4/19)

In other news from the states —

Anchorage Daily News: A 50-Year Data Trove Shows Alaska Native People Are Getting Cancer At Higher Rates. It Also Shows Opportunities To Save Lives
Data in a new report published by the Alaska Native Tribal Health Consortium shows that Alaska Natives currently have the highest recorded incidence from at least one type of cancer — colorectal cancer — in the world. It also shows that while rates of colorectal cancer among white people in the U.S. have declined over the last 50 years, those rates have remained high among Alaska Natives, representing a growing disparity. Cancer has long been a leading cause of death among Alaska Native people, since at least the late 1980s. But the new report includes over 50 years of data that will ultimately be used to track long-term cancer trends, and that can help save lives, researchers say. (Berman, 4/19)

AP: North Dakota Backs Health Care For Fallen Officers' Families
North Dakota Gov. Doug Burgum signed bipartisan legislation Monday that will cover the cost of health insurance for the surviving spouses and children of emergency responders killed in the line of duty. The bill, sponsored by Grand Forks Democrat Rep. Zac Ista, covers law enforcement, corrections officers, firefighters and other public-employed emergency workers. Ista said 17 other states, including neighboring Minnesota, offer similar benefits to surviving families. (MacPherson, 4/19)

Fox News: Los Angeles Mayor Proposes $24M Pilot Basic Income Program In Budget
Eric Garcetti, the Democrat mayor of Los Angeles, outlined the city’s budget that takes effect on July 1 and includes $24 million earmarked for a Guaranteed Basic Income pilot program that will provide 2,000 low-income families with $1,000 a month for the year. Fox 11 reported that Garcetti called the program the largest in the country and said the families will receive the funds, "no questions asked." "We’re betting that one small but steady investment for Angeleno households will pay large dividends for health and stability across our city and light a fire across our nation," he said. (DeMarche, 4/20)

The Washington Post: He Raised Over $40,000 On Facebook To Feed Hungry Neighbors During The Pandemic. Now He Owes $16,000 In Taxes.
When Louis Goffinet, a middle school science teacher in Connecticut, first started buying groceries for struggling families, he never expected to be handling tens of thousands of dollars. Determined to help a few elderly or laid-off neighbors last April, he appealed to his Facebook friends to throw him a few bucks on an online fundraiser. Much to his surprise, that effort quickly drew hundreds of donors from around the world. By July, Goffinet had raised more than $30,000, using the money to buy and deliver bags of food — as well as gas and rental assistance — for more than a hundred families in Mansfield Center, Conn. The bad news came in January, in an envelope from the Internal Revenue Service: He owed about half that amount in taxes. (Armus, 4/19)

Stat: For-Profit Nursing Homes Are A Bad Deal For Older Americans 
Nursing homes and hospice care are supposed to provide safe refuges for older people and those near the ends of their lives. During the Covid-19 pandemic, they have been just the opposite. Many nursing homes and hospice care organizations are now for-profit institutions. There is ample evidence they are putting profits ahead of people and that is taking a deadly toll during the pandemic. (Haider J. Warraich, 4/19)

The Philadelphia Inquirer: Telemedicine Doesn’t Need To Fade Away After The Pandemic 
This past year, telemedicine has been a critical alternative to in-person visits. They’ve helped doctors like me stay connected to patients, a lifeline for some. Many patients, particularly those with mental health struggles, have told me how much easier it is to see me from home, avoiding the hassle of traveling to “see me” in person. Other doctors — psychiatrists, sleep specialists, neurologists, and dermatologists –—have told me similar stories and use telemedicine to manage many conditions remotely, providing needed access for many and sorting out who should be seen in person. However, it’s at risk of fading away. Telemedicine visits have dropped off since the initial peak early in the pandemic. This was expected. Some diseases need in-person evaluations and some patients prefer in-person visits. But now, many doctors have scaled back further, in some cases advocating for in-person visits first. (Krisda H. Chaiyachati, 4/19)

Modern Healthcare: Data Is The Key To Repairing The Nation's Healthcare System
Demand for innovation designed to improve healthcare delivery—and resilience during difficult times such as the COVID-19 pandemic—reflects a number of key challenges: rising healthcare costs, suboptimal outcomes, deaths of despair, declining longevity and post-pandemic challenges to behavioral health. Healthcare information technology and the power of providers, payers and government agencies sharing and analyzing data can illuminate the path to better care and improve outcomes for all. (Reed Hartley, 4/20)

San Diego Union-Tribune: CDC Declares Racism A Public Health Threat. Researchers Weigh In On Why. 
It isn’t really news to hear that experiencing racism, both interpersonal and structural, is bad for a person’s health. Any member of a racial or ethnic minority in this country has understood that racism is harmful to their health, in some form, since this mass of land was first called the United States. What is news is the acceptance of the anecdotal with the scientific evidence, and taking measurable steps to track and repair the harm to public health that has come from racism. “What we know is this: racism is a serious public health threat that directly affects the well-being of millions of Americans,” Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said in a recent statement. (Lisa Deaderick, 4/18)

Stat: The FDA Should Embrace Remote Inspection Technology 
While pharmaceutical regulatory authorities in other countries are employing creative ways like video-based remote inspections to fulfill their obligations to the public, the U.S. Food and Drug Administration remains committed to conventional on-site inspections. By September 2020, the Covid-19 pandemic had precipitated a virtual pause in drug inspections: Roughly 85% of inspections had been curbed within U.S. borders and 99.5% outside the country. (Patrick McLaughlin and Tyler Richards, 4/19)

Los Angeles Times: Does Your Doctor Speak Your Language? 
Imagine that you woke up with weakness in your right arm and difficulty speaking. You’re a Spanish speaker and you go to the emergency room, where the doctor attending to you took Spanish in high school. Because the ER is busy, he decides he can get by without an interpreter. You tell him about your symptoms, and that you are worried you might be having a stroke. The doctor understands the Spanish word for “arm” but is not clear about the rest. After a quick physical exam, he sends you to get X-rays to rule out a broken arm. Meanwhile, your condition worsens. Research suggests that it’s not uncommon for doctors to overestimate their own language abilities. In one study, researchers compared medical residents’ self-reported Spanish proficiency with their proficiency as measured by an objective test. They found that 1 in 3 residents who classified themselves as proficient did not test as such. Despite this, residents at all proficiency levels reported sometimes discussing clinical care with patients and families in Spanish without the aid of an interpreter. (Mimi Zheng, 4/19)

NPR: In COVID Vaccine Talks, Doctors Should Be More Candid With Patients 
Back in December, I spent what felt like every moment agonizing over whether or not I should get vaccinated against COVID-19. I was early in my second trimester of pregnancy, and I'm also a family physician, which meant I was eligible to get my shot as soon as the vaccines were authorized for use in the U.S. At the time — it feels like a lifetime ago, even though it's only been a few months — we didn't have any direct data on the safety of COVID-19 vaccines in pregnant people, since no one who was pregnant had been enrolled in those first clinical trials. I wasn't sure it was a good idea. (Mara Gordon, 4/18)

The Atlantic: Are Outdoor Mask Mandates Still Necessary? 
Last week, I covered my nose and mouth with close-fitting fabric like a good citizen and walked to a restaurant in Washington, D.C., where I de-masked at a patio table to greet a friend. I sat with my chair facing the entrance and watched dozens of people perform the same ritual, removing a mask they’d worn outside and alone. It seemed like the most normal thing in the world. Until, suddenly, it seemed very weird. The coronavirus is most transmissible in poorly ventilated indoor spaces, where the aerosolized virus can linger in the air before latching onto our nasal or bronchial cells. In outdoor areas, the viral spray is more likely to disperse. One systematic overview of COVID-19 case studies concluded that the risk of transmission was 19 times higher indoors than outside. That’s why wearing a mask is so important in, say, a CVS, but less crucial in, say, the park. At the restaurant, however, I saw an inversion of this rule. Person after person who’d dutifully worn a mask on the uncrowded street took it off to sit still, in close proximity to friends, and frequently inside. I felt like I was watching people put on their seatbelts in parked cars, then unbuckle them just as they put the vehicle in drive. (Derek Thompson, 4/19)

Bloomberg: We Have Good News And Bad News About Covid Vaccines
The Covid-19 pandemic hasn’t brought out the very best in either consumers or producers of news. Marginal factoids keep getting blown out of proportion both in headlines and in our minds because they speak to our relentless fears, which the headlines often make worse. No wonder so many of us are swinging in the other direction and pretending the bad thing has gone away. (Mark Gongloff, 4/19)

CNN: Vaccine Passports -- A Technical, Not An Ideological Issue
Forgive me for thinking that the midst of a global pandemic that cost millions of lives and trillions of dollars in economic loss is not an ideal moment to parse the fine points of individual rights. Covid has already sparked political fires over how to rein it in. Privacy advocates have undercut contact tracing apps' use. This technology would have permitted us to go about our business -- unless we were unfortunate enough to contract infection. Then we would have been alerted to isolate. That was certainly preferable to the alternative we were left with -- most everyone stuck at home in lockdown. (Peter Baldwin, 4/19)

The New York Times: No, We Don't Know If Coronavirus Vaccines Affect Periods
It took a pandemic to get people to talk about menstruation. A spate of reports from women stating that their periods changed after they got their coronavirus vaccines has left many women worried that the jab is affecting their cycle. So far, there’s no data linking the vaccines to changes in menstruation. Even if there is a connection, one unusual period is no cause for alarm. There is a long list of triggers that can cause changes to the menstrual cycle, including stress, illness and changes in diet and physical activity. (Alice Lu-Culligan and Randi Hutter Epstein, 4/20)

The Philadelphia Inquirer: To Vaccinate More Latino Philadelphians, Community-Led Clinics Are Key
My mom always made sure my little sister and I received all our vaccinations. She taught us the importance of getting vaccinated as a way of keeping ourselves and our community safe. So when she told me in early March that she didn’t want to receive the COVID-19 vaccine, I was shocked. I never expected my mom to be one of many Hispanic adults hesitating to get vaccinated. Vaccine hesitancy has been discussed time and again by health-care professionals since the beginning of the vaccine rollout. While hesitancy isn’t unique to any particular group of people, its effects are most damaging to communities of color that are already struggling to access vaccines. As eligibility requirements expand, and shots reach more Americans, vaccine hesitancy remains a pressing issue among Hispanic and Latino communities. And it will be a lasting one, since the Pfizer and Moderna vaccines may need a follow-up booster shot. (Wendy Lliguichuzhca, 4/19)

The Washington Post: This Is The Most Dangerous Moment To Be Unvaccinated 
If covid-19 has taught us anything, it’s that nothing is straightforward. We know that people who are fully vaccinated are greatly protected against infection and serious illness and are far less likely to transmit covid-19 to others. The vaccines truly are a miracle. But here’s the bad news: Life has become even riskier for unvaccinated people, particularly those who have never had covid-19. (People with prior infections fall into a middle category, since they are at least partly protected but still require vaccination to increase the level and durability of immunity.) The reasons that the unvaccinated are at higher risk are biological, behavioral and political. (Robert M. Wachter, 4/19)