First Edition: Feb. 27, 2023

KHN: After Capping Insulin Copays, Colorado Sets Its Sights on EpiPens
Almost four years after becoming the first state to cap insulin prices, Colorado may limit what consumers pay for epinephrine autoinjectors, also known as EpiPens, which treat serious allergic reactions. A proposed state law would cap out-of-pocket copayments at $60 for a two-pack of epinephrine autoinjectors. In 2007, the wholesale price of a single EpiPen was about $47. Today, two brand-name autoinjectors cost just under $636 at a Walgreens in Denver, according to GoodRx. At some pharmacies a generic pen sells for $100 to $200, which is still expensive for many people. (Santoro, 2/27)

KHN: California Explores Private Insurance For Immigrants Lacking Legal Status. But Is It Affordable? 
A doctor found cysts in Lilia Becerril’s right breast five years ago, but the 51-year-old lacks health insurance. She said she can’t afford the imaging to find out if they’re cancerous. Becerril earns about $52,000 a year at a nonprofit in California’s Central Valley, putting her and her husband, Armando, at more than double the limit to qualify for Medi-Cal, the state’s Medicaid program for people with low incomes and disabilities. Private insurance would cost $1,230 a month in premiums, money needed for their mortgage. (Bluth, 2/27)

KHN: Dementia Care Programs Help, If Caregivers Can Find Them
There’s no cure, yet, for Alzheimer’s disease. But dozens of programs developed in the past 20 years can improve the lives of both people living with dementia and their caregivers. Unlike support groups, these programs teach caregivers concrete skills such as how to cope with stress, make home environments safe, communicate effectively with someone who’s confused, or solve problems that arise as this devastating illness progresses. (Graham, 2/27)

KHN: Readers And Tweeters Urgently Plea For A Proper ‘Role’ Call In The ER 
KHN gives readers a chance to comment on a recent batch of stories. (2/27)

The New York Times: Lab Leak Most Likely Caused Pandemic, Energy Dept. Says
Some officials briefed on the intelligence said that it was relatively weak and that the Energy Department’s conclusion was made with “low confidence,” suggesting its level of certainty was not high. While the department shared the information with other agencies, none of them changed their conclusions, officials said. Officials would not disclose what the intelligence was. But many of the Energy Department’s insights come from its network of national laboratories, some of which conduct biological research, rather than more traditional forms of intelligence like spy networks or communications intercepts. (Barnes, 2/26)

The Wall Street Journal: A Lab Leak In China Most Likely Origin Of Covid Pandemic, Energy Department Says
The U.S. Energy Department has concluded that the Covid pandemic most likely arose from a laboratory leak, according to a classified intelligence report recently provided to the White House and key members of Congress. The shift by the Energy Department, which previously was undecided on how the virus emerged, is noted in an update to a 2021 document by Director of National Intelligence Avril Haines’s office. (Gordon and Strobel, 2/26)

NBC News: U.S. Energy Department Assesses With 'Low Confidence' Covid May Have Originated From Chinese Lab Leak
Sen. Dan Sullivan, R-Alaska, called Sunday for “extensive public hearings” if the U.S. intelligence community conclusively determines that Covid-19 leaked from a Chinese laboratory. Asked on NBC News’ “Meet the Press” what the consequences should be if the U.S. makes that determination and then discovers it was covered up by the Chinese government, Sullivan said lawmakers must first “have public hearings on this and really dig into it.” (Tsirkin, Alba, Roecker, Talbot and Edelman, 2/26)

The Hill: Republicans Jump On ‘Lab Leak’ Report, Call For Action Against China
Republicans are seizing on a new Energy Department conclusion pointing to a “lab leak” as causing the COVID-19 outbreak to call for swift action against the Chinese government, which has refused to cooperate with global probes into the pandemic’s origin. The Wall Street Journal and The New York Times reported Sunday that the Energy Department had determined with “low confidence” that the virus was leaked from a lab, though it is unclear what new intelligence that was based on. (Sforza, 2/26)

The Hill: What We Know About Energy Department’s COVID Lab Leak Conclusion 
White House national security adviser Jake Sullivan on Sunday responded to the WSJ report, saying the intelligence community hasn’t come up with a “definitive answer” on the question. “There is a variety of views in the intelligence community. Some elements of the intelligence community have reached conclusions on one side, some on the other. A number of them have said they just don’t have enough information to be sure,” Sullivan said.  (Mueller, 2/26)

NPR: FDA Authorizes The First At-Home Test For COVID And The Flu
The Food and Drug Administration issued an emergency use authorization on Friday for the first at-home test that can simultaneously detect both COVID-19 and the flu. With a shallow nasal swab, the single-use kit can provide results within 30 minutes indicating whether a person is positive or negative for COVID, as well as influenza A and influenza B, which are two common strains of the flu. (Kim, 2/25)

Stat: The FDA Has Cleared The First Home Flu And Covid Test — But Its Maker Just Declared Bankruptcy
On Friday, the Food and Drug Administration issued an emergency authorization for the first at-home test that can detect flu and Covid-19 — but for the test’s maker, Lucira, the long-anticipated authorization may have taken too long. The company filed for bankruptcy on Feb. 22, directly blaming the “protracted” FDA authorization process for the over-the-counter combination test for its financial troubles. (Trang, 2/26)

NBC News: Nasal Covid Vaccine Shows Promise In Early Clinical Trial
The vaccine, developed by a startup called Blue Lake Biotechnology Inc., was found to reduce the risk of symptomatic Covid infections by 86% for three months in people who received it as a booster dose. Existing booster shots in the United States reduce symptomatic infections by 43% in people 18 to 49 over one to two months, according to a study published in November by the Centers for Disease Control and Prevention. (Chow, 2/24)

Fox News: CDC Advisory Group Finds Insufficient Evidence To Recommend More Than One COVID-19 Booster A Year
A US Centers for Disease Control and Prevention (CDC) advisory group said Friday it isn’t recommending more than one annual coronavirus vaccine booster. The working committee, which is part of the CDC’s Advisory Committee For Immunization Practices, found insufficient evidence that more than one shot a year would benefit older or immunocompromised people. (Stimson, 2/24)

Reuters: Pfizer/BioNTech Apply For Full FDA Approval Of Updated COVID Vaccine 
Pfizer Inc and its German partner BioNTech SE said on Friday they filed an application to the U.S Food and Drug Administration (FDA) for a full approval of their Omicron-adapted COVID-19 vaccine. The companies are seeking approval of the updated vaccine both as a primary course and a booster dose for individuals 12 years of age and above. (2/24)

The Washington Post: Doctors Who Touted Ivermectin As Covid Fix Now Pushing It For Flu, RSV
First, the group of doctors championed ivermectin as a covid panacea. It failed to live up to the hype. Now, they’re promoting the anti-parasitic to prevent and treat the flu and RSV. The Front Line Covid-19 Critical Care Alliance, formed in 2020 to “prevent and treat covid,” is touting ivermectin for common respiratory infections amid a dramatic drop in prescriptions for the drug as clinical trials undermined claims of its efficacy against covid. (Weber, 2/26)

San Francisco Chronicle: XBB.1.5 Now Makes Up 85% Of U.S. Cases
The Centers for Disease Control and Prevention estimates that the XBB.1.5 omicron subvariant made up about 85% of U.S. COVID-19 cases in the week through Feb. 25, up from 74.7% of cases sequenced in the week ending Feb. 11. The BQ.1.1 and BQ.1 omicron subvariants together accounted for 12% of new cases, down from 20.4% two weeks ago. (Vaziri, 2/24)

San Francisco Chronicle: Nearly 80% Of U.S. Counties Have Low Virus Levels
About 77.58% of all U.S. counties have low COVID-19 community levels, according to updated figures from the U.S. Centers for Disease Control and Prevention. That is the largest proportion of people in that tier in nearly nine months. Another 20.34% have medium levels, and 2.08% have high levels. (Vaziri, 2/24)

ABC News: Drug-Resistant Strain Of Shigella Bacteria Prompts Warning From CDC
The Centers for Disease Control and Prevention issued a health advisory Friday about an increase in an antibiotic-resistant strain of the Shigella bacteria. Shigella is highly infectious and causes around 450,000 infections in the U.S. every year, according to the CDC. (Grant, 2/27)

The Washington Post: CDC Issues Warning About Rise In Highly Drug-Resistant Stomach Bug 
The Centers for Disease Control and Prevention is warning clinicians and public health departments about a sharp rise in serious gastrointestinal infections caused by bacteria that are resistant to common antibiotics. In a health advisory issued Friday, the CDC said the agency has been monitoring an increase in people infected with strains of Shigella bacteria that are highly resistant to available drugs. Shigella infections, known as shigellosis, usually cause diarrhea that can be prolonged and bloody, as well as fever and abdominal cramps. (Sun, 2/25)

Stat: A Dozen States Sue The FDA In Hopes Of Easing Abortion Pill Restrictions
In the latest flare up over access to the abortion pill, a dozen states filed a lawsuit to force the U.S. Food and Drug Administration to ease restrictions on how mifepristone is prescribed and made available to patients. At issue is a risk mitigation program, which is used to ensure certain prescription medicines considered to carry significant risks are prescribed and taken safely. (Silverman, 2/24)

Reuters: Texas Prosecutors Can't Target Groups That Fund Out-Of-State Abortions, Judge Says
Local prosecutors in Texas cannot use state laws that are more than 60 years old to prosecute organizations that help fund and arrange travel for Texans to obtain abortions in other states where it is legal, a federal judge ruled Friday. U.S. District Judge Robert Pitman in Austin said that 1961 state abortion laws, which were rendered unconstitutional by the U.S. Supreme Court's 1973 ruling in Roe v. Wade establishing a nationwide right to abortion, were not revived when the Supreme Court overturned Roe last June. (Pierson, 2/24)

Roll Call: FDA Plans Oversight Changes After Critical Tobacco Report
The Food and Drug Administration on Friday announced a series of actions meant to improve its oversight of tobacco and nicotine products, most notably e-cigarettes. FDA Commissioner Robert Califf outlined plans for better communication and transparency on product reviews, increased use of the tobacco advisory committee and intra-agency meetings on enforcement. (Clason, 2/24)

Fox News: Biden Admin To Limit Telehealth Prescriptions For Some Controlled Drugs
The Biden administration is moving to require patients to be evaluated by a physician in person before receiving prescriptions for some controlled medications, including Adderall and OxyContin. The proposal would reverse a policy enacted during the coronavirus pandemic that allowed doctors to prescribe these medications through telehealth appointments. The move will make it more difficult for Americans to access some drugs used for treating pain and mental health disorders. (Mion, 2/26)

Stat: Antitrust Officials Consider Letting Physician-Owned Hospitals Expand
Some government antitrust regulators are hinting at their support for expanding physician-owned hospitals, another sign of the Biden administration’s increasing scrutiny of consolidation among the nation’s health systems. (Wilkerson, 2/27)

The New York Times: Rural Hospitals Are Shuttering Their Maternity Units
Three days before Christmas, the only hospital in this remote city on the Yakama Indian Reservation abruptly closed its maternity unit without consulting the community, the doctors who delivered babies there or even its own board. At least 35 women were planning to give birth at Astria Toppenish Hospital in January alone, and the sudden closure — which violated the hospital’s commitment to the state to maintain critical services in this rural area — threw their plans into disarray. (Rabin, 2/26)

AP: NTSB Says Medical Plane Apparently Broke Apart Before Crash 
A medical transport flight that crashed in a mountainous area in northern Nevada, killing five all five people aboard the plane including a patient, apparently broke apart before hitting the ground, authorities said Sunday. The National Transportation Safety Board has sent in a seven-member team of investigators to the site of Friday night’s crash near Stagecoach. (2/27)

USA Today: Nonalcoholic Fatty Liver Disease Is Rising In Hispanic People, Kids
Two years ago, Allison Grainger went to her doctor after feeling constant fatigue and nausea. A quick trip to the grocery store would exhaust her. The lethargy was so intense, the 26-year-old quit her job working as a spa concierge. Her primary care doctor sent her to a specialist, who found abnormal levels on her liver function tests. A liver biopsy later showed she had nonalcoholic steatohepatitis, or NASH, a more severe form of nonalcoholic fatty liver disease that occurs when there’s too much fat in the liver. (Hassanein, 2/25)

The New York Times: Why Aren’t Doctors Screening Older Americans For Anxiety? 
Susan Tilton’s husband, Mike, was actually in good health. But after a friend’s husband developed terminal cancer, she began to worry that Mike would soon die, too. At night, “I’d lie down and start thinking about it,” recalled Ms. Tilton, 72, who lives in Clayton, Mo. “What would I do? What would I do?” The thought of life without her husband — they’d married at 17 and 18 — left her sleepless and dragging through the next day. (Span, 2/26)

Bloomberg: Photodisinfection Uses Lasers To Cut Post-Surgery Infections
Surgery is one of the leading ways patients acquire infections in hospitals, and their noses are a major part of the problem. Germs in the nasal passages can travel to the site of an incision and cause minor skin infections or even sepsis and death. To reduce the risk, a company based in Vancouver is commercializing a way to zap those bugs right before an operation. (Pham, 2/24)

USA Today: ChatGPT And Medicine: How Will It Affect Medical Diagnosis, Doctors?
Now, ChatGPT and similar language processing tools promise to upend medical care again, providing patients with more data than a simple online search and explaining conditions and treatments in language nonexperts can understand. For clinicians, these chatbots might provide a brainstorming tool, guard against mistakes and relieve some of the burden of filling out paperwork, which could alleviate burnout and allow more facetime with patients. (Weintraub, 2/26)

CIDRAP: Cancer Screenings In US Didn't Rebound From COVID Disruptions In 2021 
Two years into the COVID-19 pandemic, US cancer screening rates still hadn't recovered to pre-crisis levels, putting millions at risk for missed diagnoses, according to a study published yesterday in the Journal of Clinical Oncology. (Van Beusekom, 2/24)

Stateline: Addiction Treatment May Be Coming To A Pharmacy Near You
Despite an overdose epidemic that killed 107,000 people last year, nearly 9 in 10 Americans who need medication to treat their addiction to deadly opioids aren’t receiving it. Surprising new results from a first-of-its-kind study in Rhode Island could hold a key to getting addiction medication to more people who need it: allowing patients to get prescriptions at their local pharmacy rather than a doctor’s office. The change would particularly help those with low incomes who lack housing and transportation, the study found. (Vestal, 2/24)

NBC News: Residents Near Ohio Derailment Diagnosed With Bronchitis Due To Chemicals
Residents and workers near the site where a train carrying hazardous chemicals derailed this month have been diagnosed with bronchitis and other conditions that doctors and nurses suspect are linked to chemical exposure. (Bendix and Victoria Lozano, 2/25)

The Washington Post: Ohio Train Derailment Waste Grows As EPA Struggles To Find Disposal Sites
Following a one-day pause for federal authorities to take over operations, officials announced Sunday they can continue removing contaminated waste from the site of the toxic train derailment in East Palestine, Ohio — a city with residents eager for this nightmare to be over. Since the train derailed three weeks ago, Norfolk Southern has handled the disposal of contaminated materials. That changed Friday when the Environmental Protection Agency paused shipments to ensure all the sites receiving waste were certified by the EPA and that travel routes adhered to federal law, said Debra Shore, the EPA’s regional administrator. (Brasch, 2/26)

Houston Chronicle: EPA Pausing The Disposal Of Toxic Waste Headed To Houston Area
The disposal of toxic waste from the East Palestine, Ohio, train derailment fire into Houston and Harris County will be paused, U.S. Rep. Sheila Jackson Lee announced Saturday afternoon. The federal Environmental Protection Agency is pausing the disposal of an estimated 1.1 million gallons of hazardous waste into a disposal facility in Harris County days after local leaders reassured residents they were monitoring the situation. (Limehouse, 2/25)

AP: After Ohio Train Wreck, Biden Orders Door-To-Door Checks 
President Joe Biden on Friday directed federal agencies to go door-to-door in East Palestine, Ohio, to check on families affected by the toxic train derailment that has morphed into a heated political controversy. Under Biden’s order, teams from the Centers for Disease Control and Prevention, Environmental Protection Agency and Federal Emergency Management Agency will visit homes beginning Saturday. Workers will ask how residents are doing, see what they need and connect them with appropriate resources from government and nonprofit organizations, the White House said. (Daly and Amiri, 2/24)

San Francisco Chronicle: HHS Chief Becerra Tours Laguna Honda, Says ‘Stay Tuned’ On Its Fate
Like adversaries seeking detente, both sides in the conflict over the fate of San Francisco’s Laguna Honda nursing home met Friday and walked together through the beleaguered facility that is home to 550 frail and low-income city residents. (Asimov, 2/24)

The Boston Globe: ‘It’s Flooding An Already Completely Congested Market.’ Nursing Home Closures In Western Mass. Leave Families And Hospitals Scrambling
The abrupt announcement that four nursing homes in Western Massachusetts will be closing this spring has forced hundreds of people to scramble to find alternative facilities for their fragile family members. (Lazar, 2/25)

Fortune: Daily Marijuana Users Are More Likely To Take This Health Hit, A New Study Finds
Those who use marijuana daily are about a third more likely to develop coronary artery disease than those who’ve never used the recreational drug, according to a new study. “There are probably certain harms of cannabis use that weren’t recognized before, and people should take that into account,” Dr. Ishan Paranjpe, a physician at Stanford University and lead author, said in a news release about the study, which will be presented in early March at the American College of Cardiology conference. (Prater, 2/24)

Reuters: Viruses In Cambodian Bird Flu Cases Identified As Endemic Clade 
The viruses that infected two people in Cambodia with H5N1 avian influenza have been identified as an endemic clade of bird flu circulating in the country, the U.S. Centers for Disease Control and Prevention (CDC) said. The cases reported last week had raised concerns they were caused by a new strain of H5N1, clade 2.3.4.4b, which emerged in 2020 and has caused record numbers of deaths among wild birds and domestic poultry in recent months. But work so far suggests this is not the case. (2/26)

Reuters: Analysis: Why Public Health Officials Are Not Panicked About Bird Flu 
The very changes that have allowed the virus to infect wild birds so efficiently likely made it harder to infect human cells, leading disease experts told Reuters. Their views underpin global health officials' assessments that the current outbreak of H5N1 poses low risk to people. The new strain, called H5N1 clade 2.3.4.4b, emerged in 2020 and has spread to many parts of Africa, Asia and Europe as well as North and South America, causing unprecedented numbers of deaths among wild birds and domestic poultry. (Steenhuysen, 2/24)