First Edition: April 23, 2021

KHN: Michigan’s Outbreak Worries Scientists. Will Conservative Outposts Keep Pandemic Rolling?
When Kathryn Watkins goes shopping these days, she doesn’t bring her three young children. There are just too many people not wearing masks in her southern Michigan town of Hillsdale. At some stores, “not even the employees are wearing them anymore,” said Watkins, who estimates about 30% of shoppers wear masks, down from around 70% earlier in the pandemic. “There’s a complete disregard for the very real fact that they could wind up infecting someone.” Her state tops the nation by far in the rate of new covid cases, a sharp upward trajectory that has more than two dozen hospitals in the state nearing 90% capacity. The nation is watching. (Appleby, 4/23)

KHN: Only One Vaccine Is OK For Older Teens. It’s Also The Hardest To Manage In Rural America.
As states expand covid-19 vaccine eligibility to allow shots for 16- and 17-year-olds, teens in rural America may have trouble getting them. Of the three vaccines authorized in the U.S., currently only one can go to that age group: the Pfizer-BioNTech shot. That vaccine comes in 1,170-dose packages at minimum and expires after five days in a fridge, meaning too many doses on too tight a deadline for many rural communities to manage. (Houghton, 4/23)

KHN: Virtual Care Spreads In Missouri Health System, Home To ‘Hospital Without Beds’
When Tom Becker was diagnosed with an irregular heartbeat in March 2020, the 60-year-old EMS helicopter pilot from Washington, Missouri, worried he would never fly again. But his cardiologist, Dr. Christopher Allen, had served in the Air Force and knew aviation physiology. So Becker felt reassured when Allen told him he didn’t expect any problems, because Becker was still fairly young. (Berger, 4/23)

KHN: KHN’s ‘What The Health?’: Picking Up The Pace Of Undoing Trump Policies
The Biden administration is speeding up the pace of efforts to undo Trump administration health policies. The two most recent: overturning a ban on fetal tissue research funded by the National Institutes of Health and canceling a last-minute extension of a Medicaid waiver for Texas. (4/22)

CBS News: The CDC And FDA Are Leaning Toward Resuming Use Of The Johnson & Johnson Vaccine, Sources Say 
The Centers for Disease Control and Prevention and the Food and Drug Administration are leaning toward resuming use of the Johnson & Johnson vaccine with a warning about blood clots, sources told CBS News. A decision is expected Friday, more than a week after the vaccine's distribution was paused following reports of rare but dangerous blood clots in eight people under the age of 50. "I think too many people may be scared off by taking the vaccine. They shouldn't be, but perception is everything when it comes to vaccines," said Dr. Peter Hotez, who works at the Texas Children's Hospital Center for Vaccine Development. (Shamlian, 4/22)

AP: Feds Report Texas Woman With Clots After Getting J&J Vaccine
Federal health officials have informed state officials that a Texas woman has been hospitalized with possible blood clots associated with Johnson & Johnson COVID-19 vaccine recipients, a state spokesman said Thursday. The U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention informed the Texas Department of State Health Services of the situation Wednesday afternoon through the federal Vaccine Adverse Event Reporting System, said DSHS spokesman Chris Van Deusen. (4/22)

AP: Oregon: CDC Investigating Woman's Death After J&J Vaccine
Oregon health officials said Thursday that federal officials are investigating the death of a woman in her 50s who developed a rare blood clot and low platelets within two weeks of receiving the Johnson & Johnson vaccine against COVID-19.The Oregon Health Authority learned of the probe on Tuesday, two days after the U.S. Centers for Disease Control and Prevention began the investigation, the agency said. The woman, whose name was not released, received the dose before the CDC ordered a pause on the vaccine amid concerns it could cause dangerous clots. (Flaccus and Cline, 4/23)

Fox News: Walensky 'Hopeful' Johnson & Johnson COVID-19 Vaccine 'Can Be Used Again Soon'
A day before a Centers for Disease Control and Prevention (CDC) committee is set to meet regarding the Johnson & Johnson COVID-19 vaccine, the agency’s director said she is "really hopeful" that the one-shot jab "can be used again soon." Speaking to TODAY, Dr. Rochelle Walensky, whose agency along with the FDA recommended a pause in the vaccine’s rollout after six cases of a rare blood clot occurred in the more than 7 million vaccine recipients, said the agency will "need to make a decision quickly" regarding its use. (Hein, 4/22)

Politico: White House Writes Off Johnson & Johnson Vaccine After String Of Production Failures 
The Biden administration has stood by Johnson & Johnson as the vaccine maker struggled to deliver promised doses of its Covid-19 vaccine — but privately, frustrated senior health officials have largely written off the shot, according to seven people with knowledge of the matter. Johnson & Johnson, which has a long history of successful vaccine development, was one of the government’s first and biggest bets in the coronavirus vaccine race. But the company has faced an unrelenting series of setbacks, including a contractor mix-up that ruined 15 million doses and revealed serious safety and hygiene lapses, and concerns that the vaccine may be linked to recent reports of rare, severe blood clots among recipients. (Banco, Cancryn and Owermohle, 4/22)

The New York Times: South Africa Decides To Resume Use Of Johnson & Johnson Vaccines.
South Africa will resume the use of the Johnson & Johnson vaccine to inoculate health care workers next week, offering some relief to the country that has suffered a series of blows to its vaccination efforts in recent months, according to South African authorities. The country suspended an early-access Johnson & Johnson vaccination program last week after health officials in the United States put a pause on the vaccine amid concerns of rare blood clots that emerged in a handful of people who received it. (Goldbaum, 4/23)

NBC News: Senate Passes Hate Crime Bill Responding To Wave Of Violence Against Asian Americans
The Senate passed legislation Thursday targeting anti-Asian hate crimes after an uptick of incidents during the Covid-19 pandemic. Lawmakers approved the measure in a 94-1 vote. Sen. Josh Hawley, R-Mo., was the only member to oppose the bill. The legislation, introduced by Sen. Mazie Hirono, D-Hawaii, in March, would direct the Department of Justice to expedite the review of hate crimes related to Covid-19 that were reported to law enforcement agencies and help them establish ways to report such incidents online and perform public outreach. (Shabad, 4/22)

The Wall Street Journal: Senate Passes Hate-Crimes Legislation After Attacks On Asian-Americans
“I cannot tell you how important this bill is to the AAPI community, who often have felt very invisible in our country,” said Sen. Mazie Hirono (D., Hawaii), referring to the Asian American Pacific Islander community. “We in the Senate are going to stand with our AAPI community, and indeed any community that is discriminated against on the basis of race.” (Peterson, 4/22)

Politico: CDC Reassigns Official Who Drew Spotlight For Pandemic Warning
CDC respiratory disease chief Nancy Messonnier has been reassigned from her position heading the agency's Covid-19 vaccine task force, according to three people familiar with the move. Messonnier is being absorbed into an incident management response team headed by CDC Director Rochelle Walensky. But the situation remains fluid as CDC restructures teams under Walensky's leadership. (Owermohle, Banco and Cancryn, 4/22)

Politico: HUD Scraps Trump Proposal On Transgender Access To Single-Sex Homeless Shelters 
The Department of Housing and Urban Development is withdrawing a Trump-era proposed rule giving federally funded single-sex homeless shelters the choice to house only people whose biological sex, rather than gender identity, matches the sex of the shelter. The Trump rule, proposed last July, would have rolled back transgender protections included in HUD’s 2016 Equal Access rule, which mandated access to shelter based on a person’s self-expressed gender identity. (O'Donnell, 4/22)

Modern Healthcare: House Democrats Back Medicare Drug Price Negotiations In Infrastructure Talks
House Democrats introduced a bill Thursday that would allow the federal government to negotiate with pharmaceutical companies for lower prices on drugs covered by Medicare, a long-held goal for the party that has its best chance in passing Congress in years. Still, substantial drug pricing reform appears to be an uphill battle with Democrats' narrow majorities in the House and Senate, mixed signals on whether President Joe Biden is ready to back such legislation this year and lobbying by the powerful pharmaceutical industry. (Hellmann, 4/22)

Modern Healthcare: Molina To Pay $60 Million For Cigna's Texas Medicaid Plans
Through the acquisition, Molina will add approximately 50,000 Medicaid enrollees, including those from Cigna's STAR+PLUS program in the Hidalgo, Tarrant and Northeast service areas. It will also bump up the payer's revenue: In 2020, Cigna's Texas Medicaid contracts generated $1 billion in premium revenue. Molina currently operates six managed-care plans in the state and, at the end of the year, counted 357,000 members in Texas. Last year, it successfully protested its initial omission from the state's $10 billion Medicaid program and was able to keep its Medicaid contracts in Texas. (Tepper, 4/22)

Houston Chronicle: Texas House Republicans Snuff Out Growing Call For Medicaid Expansion
Thursday’s defeat sets up an uncertain year ahead for state health officials, who must now begin renegotiating a deal with the Biden administration for billions of dollars to cover the cost of emergency care for uninsured Texans. Federal health officials last week threw out an eleventh-hour approval by the Trump administration for that funding — money that does not promote routine care but has long given Republicans cover to forgo Medicaid expansion. (Blackman, 4/22)

Modern Healthcare: Most Broker Sites Advertise Less Than 50% Of Medicare Plans
Just 43% of available Medicare Advantage products, and 65% of Part D plans, were showcased on broker plan selection tools, according to a report released by The Commonwealth Fund on Thursday. Additionally, when researchers searched online for health coverage options, they found that web results primarily showcased information directly from health plans — not from neutral government, or third-party, sources. After looking through multiple large brokerage sites, researchers found one page that included information about Medigap plans, and only 18% of those available benefits were showcased. (Tepper, 4/22)

Axios: ACLU Files Suit Against Iowa Over Medicaid Payments For Gender Transition Surgery
The American Civil Liberties Union filed suit Thursday against the state of Iowa over a law that allows Medicaid to deny payments for gender transition surgery. Why it matters: The suit is the latest volley in nationwide fight over transgender rights, ranging from access to medical care to the ability to compete on sports teams. Details: The ACLU plans to argue that denying the surgery to transgender people violates equal protection rights, the Associated Press reports. (Reed, 4/22)

Modern Healthcare: Premier Asks CMS To Give ACOs More Time To Prep For New MSSP Quality Reporting Requirements
Accountable care organizations need more time to adjust to new quality reporting requirements for the Medicare Shared Savings Program set to take effect in 2022, group purchasing and consulting organization Premier told CMS in a letter last week. The organization, which serves about 4,100 hospitals and health systems, said the COVID-19 pandemic has made it difficult for providers to devote the time and resources necessary to make the required changes. (Brady, 4/22)

The New York Times: Vaccines Are Effective Against The New York Variant, Studies Find
For weeks, New Yorkers have witnessed the alarming rise of a homegrown variant of the coronavirus that has kept the number of cases in the city stubbornly high. City officials have repeatedly warned that the variant may be more contagious and may dodge the immune response. On that second point, at least, they can now breathe easier: Both the Pfizer-BioNTech and Moderna vaccines will effectively prevent serious illness and death from the variant, two independent studies suggest. Antibodies stimulated by those vaccines are only slightly less potent at controlling the variant than the original form of the virus, both studies found. (Mandavilli, 4/22)

Fox News: Hawaii Man Receives Third Pfizer COVID-19 Vaccine Dose In Booster Study: Report
A Hawaii man participating in a Pfizer-led study looking at third doses of its COVID-19 vaccine as booster shots said he joined the trial to help others, according to a local report. Gary Lahens of Honolulu took part in the company's vaccine trials for the safety of his family and community, he told news outlet KHON2. He rolled his sleeve before the cameras to show the bandage on his arm. "I did this study in the beginning because of my mom and my aunties, they’re all in their eighties," Lahens told the outlet. "I think it was a good thing for me to do." (Rivas, 4/22)

CNN:  New Study Shows Why Vaccinating Everybody Is Essential 
Although there's a growing sense that normalcy is within reach after the devastating Covid-19 pandemic, experts are continuing to push for more vaccinations -- particularly as new research details the long-term consequences for those who are diagnosed with the virus. In what the authors say is the largest study to date of the long-term impact, researchers from Washington University in St. Louis found that people who had Covid-19 seem to face a much greater risk of death and need more medical care in the six months after their diagnosis, even if they had a milder form of the disease. "We have to think about the burgeoning health crisis this is going to cause for years to come," CNN Chief Medical Correspondent Dr. Sanjay Gupta told Anderson Cooper on Thursday. (Holcombe, 4/23)

The New York Times: What Do Women Want? For Men To Get Covid Vaccines. 
Holly Elgison and Len Schillaci are a mixed vaxxed couple, and they are far from alone. “I was always going to get the vaccine, 100 percent,” said Ms. Elgison, a medical claims auditor in Valrico, Fla. Her husband, a disaster insurance adjuster, said he will pass. “To be honest with you, I think that the worst of Covid is behind us,” Mr. Schillaci said. “I’m good.” As the Biden administration seeks to get 80 percent of adult Americans immunized by summer, the continuing reluctance of men to get a shot could impede that goal. (Steinhauer, 4/22)

AP: US Drop In Vaccine Demand Has Some Places Turning Down Doses
Louisiana has stopped asking the federal government for its full allotment of COVID-19 vaccine. About three-quarters of Kansas counties have turned down new shipments of the vaccine at least once over the past month. And in Mississippi, officials asked the federal government to ship vials in smaller packages so they don’t go to waste. As the supply of coronavirus vaccine doses in the U.S. outpaces demand, some places around the country are finding there’s such little interest in the shots, they need to turn down shipments. (Willingham, Hollingsworth and Smith, 4/23)

The Washington Post: D.C., Maryland Have Vaccine Appointment Offers For All Who Register
Officials are shifting their attention to people who have yet to sign up for shots in an effort to reach vaccination levels needed to control the virus. Maryland has launched a “No arms left behind” initiative, with expanded walk-up options, mobile clinics and direct outreach to the elderly and college students. D.C. opened 10 walk-up clinics this week and is organizing a May 1 day of service that will focus on encouraging unvaccinated residents to get the shots. (Fadulu and Portnoy, 4/22)

Bloomberg: Covid Vaccine Battle Pivots To New Tactics To Get Shots To All Americans
Having made its way through those who lined up eagerly to get vaccinated for Covid-19, the campaign to inoculate every American is now slowing down with surplus supply and open appointments appearing in pockets nationwide. While 3 million shots a day are being administered, that’s down from a peak of 3.4 million. And only 75% of about 28 million doses being shipped out weekly will be used at the current pace. All of this suggests the vaccine effort is evolving, from the megasites that inoculated thousands a day toward a slower grind designed to reach the half of Americans who haven’t yet received a dose. (LaVito and Armstrong, 4/22)

NBC News: Divine Intervention: Pastors Tapped To Help Get Skeptical Churchgoers Vaccinated
The thrust of a new campaign to persuade mostly white born-again and evangelical Christians who have been unwilling to get Covid-19 vaccinations is a variation on the Golden Rule — do it for others if you won't do it for yourself. And the main driver behind the Christians and the Vaccine project backs up his contention that that is what Jesus would do by both citing the Bible and tapping the expertise of secular public health experts like Dr. Francis Collins, who heads the National Institutes of Health. (Siemaszko, 4/23)

CBS News: Cigna Offers Workers $200 And Paid Time Off To Get Vaccinated 
Cigna on Thursday joined other major corporations looking to coax workers into getting the COVID-19 vaccine by offering its roughly 65,000 U.S. employees $200 each and paid time off to get the shots. Fully vaccinated workers will get $200 in their health-spending accounts, along with emergency PTO to get vaccinated, according to the health insurance company, which is not requiring employees to get immunized. (Gibson, 4/22)

Houston Chronicle: Houston Methodist Says It Will Fire Hospital Workers Who Refuse To Take COVID Vaccine
Four out of five Houston Methodist employees are vaccinated against COVID-19. The sliver who are not will be suspended or fired if they refuse the shot, according to company policy. The hospital required managers to be vaccinated by April 15 and all other employees — about 26,000 workers in total — by June 7, said Stefanie Asin, a Houston Methodist spokesperson. With 84 percent of the staff vaccinated, the hospital is close to herd immunity, CEO Marc Boom wrote in a letter to employees this month. (Wu and Garcia, 4/22)

Politico: California Public Universities Plan To Require Covid-19 Vaccines
California's two public university systems announced Thursday they will require nearly 800,000 students to receive the Covid-19 vaccine as soon as this fall in the nation's most sweeping higher education testing requirement. California State University and University of California proposed the requirement for students, faculty and staff for the fall 2021 semester — contingent on full FDA approval. All told, the requirement could apply to more than 1 million people. (Mays, 4/22)

Bay Area News Group: California Vaccinations Decline At Turning Point In Rollout
The pace of vaccinations in California has declined for the first time in weeks, mirroring a national trend that has experts worried about slowing demand for the life-saving vaccine. On average last week, just over 360,000 doses were administered daily across California, an 8% drop from mid-April when the seven-day average peaked at about 391,000 doses, according to data compiled by this news organization. Nationwide, doses have dipped about 11% over the past week. (Kelliher, 4/22)

NBC News: In Michigan, A Record-Breaking Number Of Children Have Been Hospitalized With Covid
Among the many alarming consequences of Michigan’s recent Covid-19 surge is one that has doctors particularly concerned: a record-breaking spike in child hospitalizations. Data from the Michigan Health & Hospital Association shows that the number of children hospitalized with severe Covid-19 symptoms hit a high of 70 this week — twice as many as were hospitalized during the worst days of the wave that swept the state in November. (Einhorn, 4/22)

Axios: Washington State Enters 4th COVID-19 Surge, Says Governor
Washington state has entered its fourth wave of the COVID-19 pandemic, Gov. Jay Inslee (D) announced during a press conference on Thursday. Why it matters: Washington — like other states such as Michigan — is experiencing a surge in COVID cases driven largely by variants of the virus, predominantly the one first discovered in the U.K. What they're saying: "The virus is not done with us," warned Inslee. (Saric, 4/22)

Bloomberg: New York State Surpasses 2 Million Covid-19 Cases
New York state surpassed 2 million recorded Covid-19 cases, crossing a milestone for the pandemic in the state where the disease hit hard a year ago and became a worldwide center of infection. As of April 21, New York reported 2,012,806 cases. That puts it third behind Texas, with 2.9 million, and California with more than 3.7 million reported cases, according to Bloomberg data. (Goldman, 4/22)

Axios: Coronavirus Cases Aren't Budging — Even After Vaccinations Doubled
The U.S. is pumping out coronavirus vaccines by the millions, but the coronavirus isn’t slowing down. The big picture: This spring has seen a surge in vaccinations but almost no change in the coronavirus’ spread, leaving the U.S. with an outbreak that’s still too big. Where it stands: In the last week of February, the U.S. was averaging 65,686 new coronavirus cases per day. Now, eight weeks later, we’re averaging 64,814 new cases per day. And yet, over the same eight-week period, the U.S. has administered more than 65 million vaccine doses — roughly doubling the number of Americans who have gotten at least one shot. (Baker and Witherspoon, 4/22)

The Washington Post: First Covid-19 Cases Reported Among Climbers At Everest Base Camp 
When Nepal welcomed foreign climbers back to Mount Everest for the spring climbing season, many feared it was only a matter of time before the coronavirus made its way to the world’s highest peak. Sure enough, just weeks into the season, symptoms of the virus have been found at Everest’s base camp, sparking a renewed debate about whether Nepal’s reliance on the mountain as a source of revenue is getting in the way of safety. On Wednesday, Outside magazine first reported a climber at base camp had been evacuated by helicopter for what was believed to be high-altitude pulmonary edema and tested positive for the coronavirus upon arriving at a hospital in Kathmandu last week. The New York Times subsequently revealed that in fact there had been multiple climbers who tested positive after being flown out of base camp. (Farzan, 4/22)

Fox News: COVID-19 Antibodies Found In Dogs In Washington State, Officials Say
More than a dozen dogs in Washington state have tested positive for COVID-19 antibodies, indicating they were once exposed to SARS-CoV-2, the virus that causes a COVID-19 infection. Some 23 dogs tested as part of a study by the University of Washington were found to be positive for SARS-CoV-2 antibodies, marking the first instance among pets in the state, officials with the Washington State Department of Agriculture (WSDA) said in a news release. (Farber, 4/22)

Bloomberg: ‘Long Hauler’ Study Shows Covid Can Kill Months After Infection
One of the largest studies of Covid-19 “long haulers” has proved what many doctors suspected: Not only are many patients suffering a raft of health problems six months after infection, they’re also at significantly greater risk of dying. Survivors had a 59% increased risk of dying within six months after contracting the SARS-CoV-2 virus, researchers reported Thursday in the journal Nature. The excess mortality translates into about 8 extra deaths per 1,000 patients -- worsening the pandemic’s hidden toll amid growing recognition that many patients require readmission, and some die, weeks after the viral infection abates. (Gale, 4/22)

NPR: People With Severe COVID-19 Have More Long-Term Effects, Study Finds
Ziyad Al-Aly and his colleagues used the databases of the U.S. Department of Veterans Affairs to examine health outcomes in more than 73,000 people who'd had COVID-19 and were not hospitalized, comparing them with nearly 5 million users of the VA health system who did not have COVID-19 and were not hospitalized. Six months later, those who'd had COVID-19 were found to be at higher risk of new onset heart disease, diabetes, mental health disorders including anxiety and depression, substance use disorders, kidney disease and other problems. (Wamsley, 4/22)

NBC News: Is It Still Necessary To Wear Masks Outdoors? CDC 'Looking At' Revising Mask Guidance
On Thursday, the director of the Centers for Disease Control and Prevention told "TODAY" the agency is considering revising its mask guidance. “We’ll be looking at the outdoor masking question, but also in the context of the fact that we still have people who are dying of Covid-19,” Dr. Rochelle Walensky said. (Syal, 4/22)

The Washington Post: Should I Wear A Mask Outside? Experts Weigh In. 
As more Americans are vaccinated against the coronavirus and a growing body of scientific evidence suggests that the risk of outdoor transmission is low, many people are wondering: Do we need to keep wearing face masks outside? The short answer is that masking outdoors can be “optional,” says Paul Sax, clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital in Boston. While he says people should still generally don masks indoors, Sax believes statewide mandates for wearing masks outdoors may no longer be necessary. “The science of the viral transmission is advanced enough that we really don’t want to be kind of confusing people by forcing them to wear masks in places where really they’re at minimal risk,” he says. (Chiu, 4/22)

AP: Topless Clubs Among Businesses That Can Reopen In Vegas
Topless dancers can shed coronavirus restrictions next weekend in Las Vegas and get face-to-face with patrons again, under rules accepted Thursday by a state COVID-19 task force. But masks still will be required for adult entertainment employees and recommended for customers. Sin City strip clubs that went dark when Nevada Gov. Steve Sisolak ordered casinos, clubs and nonessential businesses closed in March 2020 will be able to open May 1 at 80% of fire code capacity under strict social distancing guidelines. (Ritter, 4/23)

Stat: As Pfizer Discontinues An Old Glaucoma Drug, Patients Struggle To Cope
Next month, an eye drop that Carol Vaghar has taken for the past few years to manage a rare form of glaucoma will no longer be available, leaving her little choice but to consider potentially risky surgery to maintain the pressure in her eyes. The 62-year-old real estate agent developed cataracts in both eyes many years ago and after surgery, developed aphakic glaucoma, which causes intraocular pressure to rise dramatically. Vaghar tried various medications, but only one — a decades-old eye drop called Phospholine Iodide — has been effective. But Pfizer (PFE), which is the only supplier, will soon stop distributing the product. (Silverman, 4/22)

Stat: Scientists Unlock The Key To Scar-Free Skin Healing, In Mice
Now, researchers at Stanford University have decoded the chemical and physical signals that trigger a particular type of skin cell to produce scars. And they have discovered a way to reprogram these cells, transforming them into another cell type capable of regenerating tissues intact. Mice that received this tweak healed from wounds with no scars, scientists reported Thursday in Science. The animals regrew hair, glands, and other critical structures. Their recovery was so complete that an image-classifying algorithm couldn’t tell the healed wound apart from the animals’ healthy, unmaimed skin. (Molteni, 4/22)

NBC News: Medical Debt Is Engulfing More People As Pandemic Takes Its Toll
Andréa Ceresa said she may have to declare bankruptcy soon. She has paid off about $23,000 in medical bills so far, but she faces $133,000 more for a nine-day hospital stay in November. Since she tested positive for Covid-19 a year ago, Ceresa has joined the ranks of those who still struggle with various manifestations of the coronavirus. She's also one of a growing number of Americans who can't afford their medical bills. (McCausland, 4/23)

The Washington Post: Children’s National Doctors Warn They’re Seeing More Children With Self-Harm-Related Injuries
There is no data showing that suicides among adults and teens have increased in the country during the pandemic, but mental health workers in Washington, D.C., say they are seeing a notable increase in children who are experiencing anxiety, depression and loneliness. Children’s National doctors told D.C. Council members last month at an education hearing that its emergency rooms are experiencing an uptick of children with self-harm-related injuries. They are seeing children experiencing panic attacks and admitting more patients with eating disorders, the doctors said.

AP: Texting Option Weighed For Upcoming '988' Suicide Hotline
Recognizing that many Americans rely on texting, U.S. regulators are weighing whether to require that phone companies allow people to text a suicide hotline. The Federal Communications Commission last summer voted to require a new “988” number for people to call to reach a suicide-prevention hotline. Phone companies have until July 2022 to implement it. (Arbel, 4/22)

NBC News: Tiny Smoke Particles Could Make Wildfires Particularly Harmful To Human Health
When the San Francisco Bay Area experienced a record 30 consecutive days of worrisome air quality alerts in August and September, Mary Prunicki began taking blood samples from firefighters. The sky had turned orange from nearby wildfires. Thousands of firefighters would spend months battling the blazes, which would eventually scorch more than 4 million acres and kill 31 people. (Chow, Patterson and Ryan, 4/23)

KQED: Doctors Find Wildfire Smoke May Damage The Skin
Wildfire smoke may not only be choking people’s lungs. It could also be irritating their skin, according to a new UCSF and UC Berkeley study published in JAMA Dermatology. Tiny particles floating in wildfire smoke can wreak havoc on the body, and it’s well documented that pollutants can trigger a scratchy throat, coughing fits or even a heart attack. Exposure to air pollutants contributed to 3.7 million to 4.8 million deaths across the globe in 2015. Previous research has found that skin conditions like eczema may be exacerbated by cigarette smoke or heavy air pollution in dense cities. Smoky days may also cause the skin to flare up. (McClurg, 4/22)

NBC News: Heavy Marijuana Use During Pregnancy Linked To Premature Birth, Early Infant Death
Women who use marijuana during pregnancy are putting their babies at risk, a study published Thursday finds. Babies born to women who were heavy cannabis users during pregnancy are more likely to have health problems, including premature birth and death within a year of birth, compared to babies born to women who did not use cannabis during pregnancy, according to an analysis of nearly 5 million California women who gave birth between 2001 and 2012. (Carroll, 4/23)

NPR: During Pandemic, Fentanyl's Spread Made Illicit Drug Use Far More Treacherous
Researchers gathered for a conference on addiction this week received a grim update on the growing spread of street drugs laced with deadly synthetic opioids including fentanyl. The trend contributed to a stark rise in overdoses that left more than 90,000 Americans dead during the 12-month period ending in September 2020, according to the latest data. "We've seen a very significant rise in mortality," said Dr. Nora Volkow, head of the National Institute of Drug Abuse, who spoke Thursday as part of an on-line gathering of the American Society of Addiction Medicine. (Mann, 4/22)

AP: California Senate OKs Supervised Sites For Drug Users
Instead of putting opioid-users in jail, a proposal moving through the California Legislature would give them a place to inject drugs while trained staff watch them to make sure they don’t die from accidental overdoses. The state Senate passed a bill on Thursday by just one vote that would allow the programs in Oakland, San Francisco and Los Angeles County. But the bill must still pass the state Assembly before it can go to Democratic Gov. Gavin Newsom, who would decide whether to sign it into law. (Beam, 4/22)

Philadelphia Inquirer: Fatal Overdoses Among Black Philadelphians Rose Through COVID Pandemic, New Data Show
Fatal overdoses among Black Philadelphians skyrocketed in the first three quarters of 2020, new data from the city health department show. And overdoses have risen at alarming rates in several communities outside the neighborhoods typically considered “hot spots” for drug deaths. City officials say the spike in deaths, noted in a city report on its Opioid Response Unit, was likely made worse by the effects of the COVID-19 pandemic. And the latest data show how Philadelphia’s overdose crisis is changing, affecting more people of color — who also have suffered the most from COVID-19 — across the city. (Whelan, 4/22)

AP: Florida Court Deals Blow To Marijuana Ballot Initiative
The Florida Supreme Court on Thursday dealt a potentially fatal blow to supporters of a proposed constitutional amendment aimed at legalizing recreational marijuana under certain circumstances. The justices ruled that the initiative's ballot summary is “misleading” in part because it does not spell out that recreational marijuana possession and distribution remains a federal crime. (4/22)

Philadelphia Inquirer: Pennsylvania 2022 Elections Show Marijuana Legalization Going From Fringe To Front-Runner
Not long ago, a candidate for statewide office in Pennsylvania would have been seen as fringe for backing the legalization of recreational marijuana. Now the issue looks like a winner for Democrats. The party’s major candidates for U.S. Senate and governor all favor legal weed. Lt. Gov. John Fetterman, the early Senate front-runner, flooded the internet with pro-pot messaging this week. He got on board after a 2019 statewide tour, where he spoke to voters about the issue. (Brennan, 4/23)

AP: Kansas Governor Vetoes Ban For Transgender School Athletes 
Democratic Gov. Laura Kelly on Thursday vetoed a Republican measure that would have made Kansas the latest state with a GOP-controlled legislature to ban transgender athletes from girls' and women's school sports. Kelly's action was widely expected because she had labeled the bill “regressive” and said it would hurt the state's ability to recruit businesses. Conservative Republican lawmakers did not have the two-thirds majorities necessary in both chambers to override a veto when they pushed it to passage earlier this month. (Hanna, 4/22)

AP: Feds Say California Jail Violates Rights Of Mentally Ill
Alameda County in Northern California violated civil rights by failing to provide proper mental health services, especially in a jail where dozens of people have committed suicide, according to federal report released Thursday. The U.S. Department of Justice took aim at conditions for people with serious mental health issues, specifically in the Santa Rita Jail, where a woman killed herself April 2. It was the second suicide at the jail this year and the 50th since 2014. (Jablon, 4/23)

Bay Area News Group: Kaiser Permanente To Pay Black Employees In $11.5 Million Settlement
Health care giant Kaiser Permanente has agreed to pay $11.5 million to settle claims going back 15 years that it illegally discriminated against thousands of Black employees — half of them in the Bay Area — by denying them equal pay and promotions. The 111-page settlement, which requires court approval, would resolve a class-action lawsuit claiming Kaiser’s alleged bias affected 2,225 Black workers in administrative support and consulting services in California. (Baron, 4/22)

AP: Ex-Michigan Health Chief Ordered To Testify About Departure
Former Michigan health director Robert Gordon will testify next week before a legislative committee about his abrupt departure from Gov. Gretchen Whitmer’s administration, following the panel’s vote to subpoena him Thursday. Gordon ordered coronavirus restrictions for more than three months after the Democratic governor lost powers in a court ruling. He resigned in January as director of the state Department of Health and Human Services and received $155,000 in a separation agreement signed by the chief lawyer in Whitmer’s office. (Eggert, 4/23)