Stat: Serotonin Levels Are Depleted In Long Covid Patients, Study Says, Pointing To A Potential Cause For ‘Brain Fog’
If you’ve been following the mystery of long Covid since it emerged in 2020, you’ll recall interferons and serotonin have been clues from the start as combatants in the body’s prolonged battles against the virus. Theories about why symptoms persist long after the acute infection has cleared often point to two suspects: viral reservoirs where SARS-CoV-2 lingers and inflammation sparked by the infection that doesn’t subside. (Cooney, 10/16)

The New York Times: Scientists Offer A New Explanation For Long Covid
A team of scientists is proposing a new explanation for some cases of long Covid, based on their findings that serotonin levels were lower in people with the complex condition. In their study, published on Monday in the journal Cell, researchers at the University of Pennsylvania suggest that serotonin reduction is triggered by remnants of the virus lingering in the gut. Depleted serotonin could especially explain memory problems and some neurological and cognitive symptoms of long Covid, they say. (Belluck, 10/16)

Bloomberg: Long Covid Study Links Lingering Virus With Bowel-To-Brain Havoc
Viral vestiges in the gastrointestinal tracts of a subset of long-Covid patients may drive chronic inflammation that interferes with a key chemical messenger involved in nerve activity, brain function and memory, researchers at the University of Pennsylvania reported Monday in the journal Cell. The findings provide an explanation for poor concentration, memory problems and other neurocognitive symptoms in long Covid, they said. Importantly, their experiments identified Prozac and other drugs that boost levels of the chemical messenger — serotonin — as promising targets for future study. (Gale, 10/16)

More on long covid —

MedPage Today: Mixed Signals For Paxlovid And Long COVID Risk In CDC Study
Use of nirmatrelvir-ritonavir (Paxlovid) during the acute phase of COVID-19 appeared to significantly reduce the risk of post-COVID conditions (PCCs) in older adults at high risk for severe disease, but may have increased the risk in adolescents, according to a large case-control study from the CDC. In adults ages 50 and up, the risk of PCCs was lower among those who received nirmatrelvir-ritonavir, with relative risks (RRs) of one or more PCC of 0.91 (95% CI 0.91-0.92) and two or more PCCs of 0.86 (95% CI 0.85-0.87), reported Alexandra Dalton, PhD, of the CDC's Coronavirus and Other Respiratory Viruses Division, during a late-breaking abstract session at the IDWeekopens in a new tab or window annual meeting. (Sullivan, 10/16)

Medscape: 6% of Workers' Comp Cases Are for Long COVID, But Many Can't Collect
Long COVID cases now account for 6% of all workers' compensation claims, according to a new study released by the Workers Compensation Research Institute (WCRI), a nonprofit research and trade group. But many who have filed such claims have been unable to collect, in part because of variations in how states administer the insurance program designed to protect people who get sick or injured on the job, experts say. Among the workers who are struggling to receive benefits are essential workers — hospital staff, medics, teachers, and others who were unable to work remotely during the early days of the pandemic, often putting themselves at higher risk for infection. (Ready, 10/16)

Psychology Today: Patients Are Desperate For Better Long COVID Treatments 
Ty Godwin loved marathons. The dedicated runner got COVID-19 in January 2020 and was diagnosed with long COVID a year later. Ty's journey in search of recovery has been recorded on the blog he originally started to document his frequent running with a child with special needs through Team Hoyt San Diego. ... Ty has had more than 200 doctors' appointments as he works to restore his health to what it was. Ty says that one of the primary blocks to his recovery is “gaslighters and deniers” in the medical profession. (Brewis and Mendenhall, 10/16)

CNN: Price Of Lifesaving Covid-19 Antiviral Paxlovid Expected To Rise Next Year, Raising Concerns About Access
The price of the lifesaving Covid-19 medication Paxlovid is likely to rise next year for most patients as the United States continues to transition out of the emergency phase of the pandemic, sparking concerns among doctors that it will become less accessible. ... The new price – the cost before insurance – hasn’t been set but is expected to be higher than the $530-per-course price paid by the US government. (Tirrell, 10/16)

On the spread of covid —

News Service of Florida: Florida's Reported COVID Cases Continue To Fall, But Deaths Pass 91,500 
The COVID-19 death toll continues to climb in Florida, while new COVID-19 cases have dropped in recent weeks. The state Department of Health on Friday released a report that showed 91,590 Florida residents had died with COVID-19 since the pandemic started in 2020. That was up from 91,178 deaths in a report issued two weeks earlier. (10/16)

WUSF: As Florida Hands Over COVID Data, What Impact Could It Have?
On June 4, 2021, Florida stopped delivering daily information on COVID-19 testing, infections and deaths. At the time, the spokesperson for Gov. Ron DeSantis said COVID cases had dropped significantly and Florida was “returning to normal,” noting the availability of vaccines. Instead of daily reports, it was going to release the data each week. Today, the information comes out every two weeks. At the time the state stopped its daily update, nearly 37,000 Floridians had died from COVID-19. This past week, the state agreed to hand over the statistics it originally said it did not have. It amounts to 25 gigabytes of data — more than two years of infection rates, vaccinations and deaths. (Miller, 10/16)

CIDRAP: COVID Infection Can Damage The Brains Of Dogs, Study Suggests 
Dogs experimentally infected with the SARS-CoV-2 Delta variant but not showing neurologic or respiratory signs of COVID-19 had evidence of degenerative brain disease on necropsy. The study, led by Konkuk University researchers in South Korea, was published late last week in Emerging Infectious Diseases. The research team intranasally infected six female beagle dogs with the SARS-CoV-2 Delta virus. The six dogs shared cages with six dogs that weren't experimentally infected. Three uninfected dogs inoculated with a placebo served as controls. (Van Beusekom, 10/16)

On the vaccine rollout and RSV —

Reuters: Pfizer CEO Expects 17% Of Americans Will Get New COVID Shots
Pfizer (PFE.N) CEO Albert Bourla said on Monday that he expects about 17% of the U.S. population to get updated COVID-19 vaccines during the current vaccination campaign, in-line with last year. (10/16)

NBC News: Covid, Flu, RSV Vaccines Urged During Pregnancy But Fewer Want Them, CDC Finds
"We are meeting more resistance than I ever remember," said Dr. Neil Silverman, a maternal-fetal medicine specialist at UCLA Health. "We didn't get this kind of pushback on this scale before the pandemic." "Now all vaccines are lumped together as 'bad,'" he said. ... However, a recent CDC report found growing doubts about vaccination during pregnancy. Among almost 2,000 women who were pregnant during the height of last year's cold and flu season or when the survey was conducted in March and April, almost a quarter said they were "very hesitant" about getting a flu shot. (Edwards and Weaver, 10/17)

CIDRAP: Analysis Shows 3% Prevalence Of RSV During Pregnancy
A new meta-analysis of 11 studies reveals a 3.4% estimated prevalence of respiratory syncytial virus (RSV) infection during pregnancy, but with a wide range in estimates, according to a study published yesterday in The Journal of Infectious Diseases. The analysis comes during a year in which RSV has been the target of new vaccines and monoclonal antibody therapies. Though a mild respiratory illness in most adults, the virus can be severe in infants under 6 months of age, the elderly, and pregnant women. (Soucheray, 10/13)

Also —

Bloomberg: End Of Covid Emergency Forces Vaccine Makers Like Pfizer, Moderna To Adapt
Covid-19 reshaped the health-care industry. The waning of the pandemic is reshaping it all over again. Vaccine makers and pharmacy chains are seeing a steep decline in the number of people getting Covid shots. Makers of at-home rapid tests are going belly-up. Companies that made personal protective equipment have shut down. (Smith, 10/17)

CNN: FDA Takes ‘Momentous’ Step Toward Banning Menthol Cigarettes And Flavored Cigars
The US Food and Drug Administration took a “momentous” step Monday toward banning menthol in cigarettes and banning flavored cigars, proposing a rule that public health experts say could save hundreds of thousands of lives. (Christensen, 10/16)

Stat: White House Moves Closer To A Ban On Menthol Cigarettes
The tobacco industry has already made clear its distaste for the ban, and its plans to sue if the ban is ever formalized. When the proposal was first released in draft form, Altria, the parent company of Marlboro cigarette maker Philip Morris USA, wrote that the policy would “create unregulated, illegal markets, encourage criminal activity, and threaten the integrity of the regulatory system,” “eliminate billions of dollars in tax revenues,” and “lead to the loss of thousands of jobs.” The proposal “​​would fail legal scrutiny if finalized,” the company added. (Florko, 10/16)

In other news about smoking —

Reuters: Big Tobacco Turns To Rooibos Tea To Counter Upcoming Ban 
Big Tobacco firms including British American Tobacco are selling heat sticks made from nicotine-infused substances such as rooibos tea, countering an incoming European Union ban on flavoured heated tobacco products. While the sticks mark a new way to inhale the addictive drug, health experts warn that their safety is unclear. The industry has produced "heat-not-burn" sticks containing tobacco for years, aiming to avoid the toxic chemicals released via combustion. (Rumney, 10/16)

Courtroom View Network: Philip Morris Prevails In Trial Over New Mexico Smoker's Death
Jurors early this month cleared Philip Morris and Allsup’s Convenience Stores, Inc. of liability for the oral cancer that killed a New Mexico man who smoked for decades. Waters/Youngers v. Philip Morris, et al. The New Mexico First Judicial Circuit State Court jury rejected design defect, negligent marketing, and conspiracy claims over the 2021 death of Edward “Eddie” Waters due complications related to mouth cancer. Waters was a pack-a-day smoker by the time he was 13 and continued to smoke for decades, favoring Philip Morris’ Marlboros during that time. (Crisco, 10/16)

Niagara-Gazette.Com: State Lawmaker Proposes Fines For Smoking Marijuana Near Children
A New York state lawmaker wants to make it illegal to smoke marijuana near children. Assemblyman Phil Steck, D-Schenectady, has introduced A.8025 to prohibit the use of cannabis within 30 feet of a child or 30 feet of any location in which children reside or attend for any recreational or educational purpose. Steck’s bill also includes additional penalties for those who are ticketed more than once. (Whittaker, 10/14)

KGOU: Oklahoma Smoking Prevalence Is Declining, But Still Exceeds National Average 
The percentage of adults who smoke in Oklahoma is declining, but the state is still above the national average. The number of adults who smoke in Oklahoma fell from 26.1% in 2011 to 15.6% last year. But Oklahoma is still considered part of the "Tobacco Nation,” which refers to states whose smoking prevalence exceeds 14%. (Taylor, 10/12)

Also —

New York Post: Renting Can Age You Faster Than Smoking, Obesity: Study
The stresses of renting a home can age people faster than if they are obese, smoked or were unemployed, a new study indicates. Struggling to pay rent, dealing with the hassles of moving and even the mere stigma of renting can cause tenants to age two and a half weeks faster for every year renting, according to The British Medical Journal’s Journal of Epidemiology & Community Health. (Bardolf, 10/14)

NPR: Medicare Shoppers Often Face A Barrage Of Unsolicited Calls And Aggressive Ads
One minute last December Leslie Montgomery was a medieval warlord pillaging a nearby kingdom. The next she was a retiree drowning in a flood of confusing Medicare sales calls. The 75-year-old had been deeply immersed in her favorite free online game when a banner ad appeared warning her that she might be missing out on money from the federal government. She clicked, and within minutes, she received an avalanche of calls with health insurance quotes she had never requested. ( Walker and Gorenstein, 10/16)

Forbes: The Inflation Reduction Act Has Made This Year’s Medicare Open Enrollment More Important Than Ever
Do an internet search on the Inflation Reduction Act. You’ll find several sites that mention deficit and carbon emissions reduction, investment in domestic energy production, and Medicare prescription drug negotiation. Buried somewhere in the text of the act is one change that will have an immediate impact in 2024: the elimination of the 5% coinsurance in the Catastrophic Coverage drug payment stage. Most probably have no idea what this means. Briefly: Those who take costly brand name drugs and spend about $3,300 out-of-pocket will reach Catastrophic Coverage, the fourth payment stage of a Part D drug plan. Once there, they will not pay another cent for prescription drugs in 2024. (Omdahl, 10/16)

KPBS: Some San Diego Medicare Advantage Customers Face A Tough Choice
Open enrollment for Medicare began on Sunday. But more than 30,000 Scripps Health clients who have Medicare Advantage plans are now facing a difficult choice: either get new doctors or different coverage. Scripps Health says its Scripps Coastal and Scripps Clinic Medical Groups will stop accepting Medicare Advantage plans in 2024. (Carroll, 10/16)

MarketWatch: How To Nail Down The Medicare Part D Plan That Will Save You The Most Money
Figuring out the savings may not be easy. Teresa Mears, the founder and CEO of Living on the Cheap, a group of 40 bargain-hunting websites nationwide, knows how to pinch pennies. But last year, she stumbled when she switched Part D plans. “Hah! I changed and didn’t save money,” she recalls. “I only take one drug. I changed plans thinking this drug was covered, based on the info online. But it was not. I fear for people who are trying to manipulate this system when they need a lot of drugs.” (Phipps, 10/17)

In other Medicare news —

Modern Healthcare: Aetna, Humana See Medicare Advantage Star Rating Boosts
In the aftermath of unwelcome but not surprising news for the health insurance industry about Medicare Advantage star ratings for next year, insurers cited stricter government standards as they look to move forward. On Friday, the Centers for Medicare and Medicaid Services revealed which Medicare Advantage plans earned four or five stars under the quality assessment program and confirmed months of anxiety among health insurers that expected lower scores—and the revenue hits that come from losing lucrative bonus payments. (Tepper, 10/16)

Fierce Healthcare: Reduced Post-Acute Care Rates Could Save Medicare Billions
A research brief out of think tank Urban Institute evaluates the prospect of reducing Medicare spending by reining in excessive post-acute care rates. Right now, there are different payment structures in place for post-acute care in its different settings including skilled nursing facilities, inpatient rehabilitation facilities, long-term care hospitals and home health. (Tong, 10/16)

Modern Healthcare: Healthcare Professionals Fleeing Industry, New Data Show
More than 145,000 healthcare practitioners left the industry from 2021 through 2022, threatening access and quality, according to a report published Monday. Physicians accounted for roughly half of the healthcare workers who retired or changed professions over the two-year span, according to an analysis of all-payer claims data from Definitive Healthcare, a healthcare commercial intelligence company. More than 71,000 physicians left the workforce from 2021 to 2022. (Kacik, 10/16)

Stat: Is There Really A Nursing Shortage In The U.S.? 
Hospitals are frustrated with a nationwide nursing shortage that’s only gotten worse since the pandemic. In 2022, the American Hospital Association quoted an estimate that half a million nurses would leave the field by the end of that year, bringing the total shortage to 1.1 million. At the same time, National Nurses United insists there isn’t a nurse shortage at all. There are plenty enough nurses for the country, they say — merely a shortage of nurses who want to work under current conditions. (Trang, 10/16)

In other health care industry developments —

Modern Healthcare: Prior Authorization Cuts From Cigna, UnitedHealth Meet Skepticism
Providers are lobbying Congress, investing in new technologies and renegotiating contracts with insurers in response to rising prior authorization demands—despite of some of the largest carriers promising to cut back on preapproval rules. Their tactics highlight provider skepticism of moves by UnitedHealth Group, Cigna, Blue Cross Blue Shield of Michigan and other insurers to lift some precertification requirements. Providers question whether these new policies will actually reduce administrative burden or if insurers are mostly engaged in a public relations campaign to forestall government intervention. (Tepper, 10/16)

The CT Mirror: Yale Wants $80M From CT For Prospect Hospitals Deal, Sources Say
Yale New Haven Health executives want the state to provide $16 million per year for five years, or $80 million total, to help support their acquisition of three Connecticut hospitals that recently were hit with a cyberattack, sources with knowledge of the request told The Connecticut Mirror Monday. (Carlesso and Altimari, 10/16)

Modern Healthcare: Aspirus Health, St. Luke's Duluth Acquisition Plans Move Forward
Aspirus Health and St. Luke’s Duluth signed a definitive agreement, with plans for Aspirus to complete its acquisition of St. Luke's next spring. In July, Wausau, Wisconsin-based Aspirus and St. Luke’s, a two-hospital system based in Minnesota, signed a letter of intent. Aspirus would invest at least $300 million over eight years in St. Luke’s as part of the definitive agreement announced Monday. Also, Aspirus said it would expand its health plan to St. Luke’s service area within two years of closing. (Kacik, 10/16)

Crain's Chicago Business: Silver Cross Hospital CEO Ruth Colby Dead At 69
Ruth Colby, president and CEO of Silver Cross Hospital in New Lenox, died at age 69 from complications following a surgery, the hospital said in a statement. Colby passed away Sunday at an undisclosed Chicago academic medical center. She had been CEO of Silver Cross for six years. (10/16)

Also —

The Boston Globe: Boston Medical Center Uses Solar Panels For Patient Energy Assistance
Boston Medical Center has spent a lot of energy helping low-income communities. Now with actual electrical energy, it will do more. The health system announced Monday that it will use energy credits generated from a new solar array on its administrative building to help reduce patients’ electric bills. The program, called Clean Power Prescription, is in a similar vein to its long-operating food pantry, which gives patients access to healthy and locally-grown foods via a prescription. (Bartlett, 10/16)

Modern Healthcare: Rite Aid Bankruptcy Could Mean Pivot Into Healthcare Services
As Rite Aid seeks Chapter 11 bankruptcy protection, some industry watchers say the company's restructuring plans could be an opportunity for big strategy changes. Rite Aid filed for bankruptcy Sunday after being unable to resolve financial woes and opioid-related lawsuits. It has shuttered hundreds of stores in recent years and is expected to close more. Rite Aid also is selling pharmacy benefit manager Elixir Solutions to MedImpact, another PBM, for $575 million. (Hudson, 10/16)

Axios: Rite Aid Bankruptcy: Drugstore Chain Failed To Keep Up With Rivals CVS And Walgreens
The slow-motion collapse of Rite Aid threatens to eliminate the nation's third-largest drugstore chain. With about 2,100 stores and more than 45,000 employees — including 6,100+ pharmacists — Rite Aid filed for Chapter 11 bankruptcy protection on Sunday, hoping to emerge as a sustainable enterprise. (Bomey, 10/16)

NBC News: What Rite Aid's Bankruptcy Means For Local Retail Pharmacies
Drugstores have done the wrong thing over and over again, said Neil Saunders, the managing director at the consulting company GlobalData. The result is that people don't want to shop at them, and that has made lots of openings for competitors. ... "They've shot themselves in the foot, and now they're reaping the consequences of all those years of poor decisions and underinvestment.” ... "We're still going to have a physical pharmacy retail space, but it's going to be somewhat smaller than it has been traditionally," he said. (Jay, 10/17)

CNN: Why CVS, Walgreens And Rite Aid Are Closing Thousands Of Stores 
Drugstore chains for decades saturated US cities, suburbs and small towns with new stores. Now, they are closing thousands of stores, leaving gaps in communities for medicines and essentials. Researchers find pharmacy closures lead to health risks such as older adults failing to take medication. (Meyersohn, 10/17)

Modern Healthcare: Independent Pharmacies Target PBMs, DIR Fees Through LLC
Independent drugstores are opening up a new front in their battle against pharmacy benefit managers. The National Community Pharmacists Association, which represents more than 19,400 pharmacies, has formed a limited liability company that aims to recover direct and indirect remuneration fees from PBMs. (Berryman, 10/16)

In other pharmaceutical news —

The New York Times: F.D.A. Plans To Ban Hair Straighteners With Formaldehyde 
The Food and Drug Administration has proposed banning hair-straightening products that contain or emit formaldehyde, more than a decade after the cosmetic industry’s own experts declared the products unsafe. Frequent use of chemical hair straighteners has been linked to a possible increase in the risk of developing cancer of the uterus, which is also called endometrial cancer. Women who use the products often face more than twice the risk of those who do not. (Rabin and Jewett, 10/16)

Reuters: Merck's Keytruda Gets FDA Nod For Expanded Use In Lung Cancer 
The U.S. Food and Drug Administration on Monday approved the expanded use of Merck & Co's blockbuster immunotherapy Keytruda in early-stage patients with non-small cell lung cancer who can get their tumors removed surgically. The U.S. health regulator's approval extends Keytruda's use in combination with chemotherapy as a treatment given before surgery to shrink the size of the tumor in patients. (10/16)

Stat: FDA’S Warning To J&J’s Abiomed Signals A Crackdown On Digital Health Tools
The Food and Drug Administration is following through on its promise to regulate more health software tools, starting with a public reprimand of Johnson & Johnson’s heart pump company, Abiomed. (Lawrence, 10/16)

Stat: Will Ozempic-Type Obesity Drugs Pay Off For Society? Makers Say Yes
Here at ObesityWeek, one of the largest conferences on obesity, Novo Nordisk and Eli Lilly are displaying more than a dozen studies that together carry the message: Our blockbuster weight loss treatments will be worth it for society. (Chen, 10/17)

Stat: Studies Point To Risks Of Excluding People With Obesity From Drug Trials
People with obesity often go underrepresented in drug development trials, a critical gap that researchers say leaves drugmakers and doctors unsure of efficacy or risks in that patient population. (Nayak, 10/16)

Stat: How Lotte Bjerre Knudsen Helped Kick Off The Age Of Wegovy 
Lotte Bjerre Knudsen was still getting used to all the empty benches in her lab when she ran into a tall man with black wide-framed glasses in the hallway: Mads Krogsgaard Thomsen, the new head of research at the Danish drugmaker Novo Nordisk, and her new boss. He was just one of many changes she had found upon returning from maternity leave earlier that week — along with the departures of nearly every colleague with whom she had spent the last three years struggling to create a potential blockbuster medicine. (Molteni, 10/17)

MedPage Today: Abortion Info Buried On Many Hospitals' Websites, Study Shows 
Hospitals and their health systems are not advertising abortion in a way that is consistent with other common outpatient procedures, a cross-sectional observational study of U.S. hospital websites showed. Of the 222 patient-facing websites sampled, 79.4% did not mention abortion, while only 11.1% did not mention colonoscopy, reported Ari Friedman, MD, PhD, of the University of Pennsylvania Perelman School of Medicine in Philadelphia, and co-authors. Websites described offering abortion care 6.3% of the time compared with 85.6% for colonoscopy, they noted in the Annals of Internal Medicine. (Robertson, 10/16)

Stat: Measuring The Long-Term Cost Of Restricting Abortion Access
When Diana Greene Foster and her team at the University of California, San Francisco, started their study on the lives of women who were denied abortions in 2008, they sought to investigate a rather commonly held view: That having an abortion hurt women’s mental and physical health, including by leading to PTSD and drug and alcohol use disorder. (Merelli, 10/17)

The 19th: Ohio Issue 1: What To Know About The Abortion Amendment Before November
Ohioians are voting on whether to approve a constitutional amendment that would create a right to abortion in the state. Ohio is the only state directly voting on abortion this year, and it is attracting high levels of outside investment and national attention. Both abortion rights advocates, who are on a winning streak with ballot measures nationwide, and anti-abortion advocates see the vote as a critical test for the 2024 election. (Panetta, 10/16)

KFF Health News: Michigan Voters Backed Abortion Rights. Now Democrats Want To Go Further. 
Nearly every day, Halley Crissman and her physician colleagues in Michigan must tell patients seeking abortions they’re very sorry that they can’t proceed with their scheduled appointments. “Patients tell me, ‘Doctor, why are you stopping me from getting the care that I need?’” said Crissman, an OB-GYN who provides abortions as part of her practice and is also an assistant professor at the University of Michigan. “The answer is that Prop 3 made access to abortion care a right in Michigan. But these [other] laws remain on the books.” (Wells, 10/17)

TheGrio: Abortion Rights Group Says Name Change Is About Centering Black Women
Reproductive Freedom for All wanted to center Black women and other women of color with its latest name change. (Keith Gaynor, 10/16)

Mother Jones: The Rise Of The Abortion Cowboy
Dr. Aaron Campbell is part of a growing cadre of abortion providers traveling great distances to provide care. (Andrews, 10/17)

In other news about reproductive health care —

CNN: You Can Advocate For Yourself In Labor, And A Nurse Shares How 
Most people anticipate the day of their child’s birth to be one of the happiest of their lives, but the experience isn’t always so uncomplicated. Things can change quickly when delivering a baby, and the experience could start to look different from what you expected, said North Carolina-based labor and delivery nurse Jen Hamilton. The goal of labor is to have a happy and healthy mom and baby at the end, but it should be the minimum of what we strive for, she said. (Holcombe, 10/16)

Stat: Teva Sues Colorado Over Plan To Lower Cost Of Epinephrine Injectors
In the latest tussle over the cost of medicines, Teva Pharmaceuticals has filed a lawsuit alleging that a new Colorado program aimed at making epinephrine auto-injectors more affordable violates its constitutional rights. (Silverman, 10/16)

In other health news from across the U.S. —

Marin Independent Journal: Marin County To Expand Involuntary Medication Of Jail Inmates
Marin County plans to expand a program that allows medications to be administered to jail inmates against their will. Last fall, the Board of Supervisors allowed court-ordered medications to be given to inmates who have been deemed incompetent to stand trial — without their consent, if necessary. Prior to the authorization, inmates had to remain in jail for months until a bed became available at a state hospital. (Halstead, 10/16)

Axios Philadelphia: Philly Mayor Jim Kenney To Sign Order Protecting Gender-Affirming Care 
Mayor Jim Kenney will sign an executive order Tuesday protecting access to gender-affirming health care in Philadelphia. Major medical associations consider such care necessary and potentially lifesaving. (D'Onofrio, 10/16)

CIDRAP: Wisconsin, Illinois Confirm Measles Cases
Health departments in two Midwestern states—Wisconsin and Illinois—have reported measles cases, according to official statements. In Wisconsin, Milwaukee’s health department last week reported an infection in a Milwaukee resident who works in Waukesha County. City, county, and state health officials are working to identify people who may have been exposed. Meanwhile, the Illinois Department of Public Health (IDPH) on October 13 announced that a measles infection has been confirmed in Cook County, which includes Chicago. The case is the state’s first since 2019. The patient is unvaccinated and had been exposed during international travel. The patient’s rash began on October 9, and the IDPH said the infectious period likely ranges from October 5 through October 13. (Schnirring, 10/16)

Houston Chronicle: Weeks After Texas Eliminated Tampon Tax, Advocates Fight For More Accessibility To Period Products
Dana Marlowe, founder of the nonprofit I Support the Girls, said the next step is providing free menstrual products in all city and state buildings, especially public schools. ... "Period poverty is a public health crisis that people don't like to talk about because periods are considered a taboo topic, and if we aren't willing to fully acknowledge and talk about periods, then we can't help women, girls and menstruators in need live their lives with dignity," Marlowe said. (Garcia, 10/16)

Kansas City Star: Mom Died In Hospital Lobby After Hours Of Waiting: WA Lawsuit
When Cheyenna Costello arrived at a Washington hospital with stomach pains, she was assessed as “critically ill” and in need of immediate medical attention, according to a new lawsuit. Despite this, the “vibrant, much-loved” 41-year-old mother of three was left to wait in the emergency room’s lobby at Providence Regional Medical Center on Nov. 2, 2022, the lawsuit says. (Marnin, 10/16)

KFF Health News: For People With Sickle Cell Disease, ERs Can Mean Life-Threatening Waits 
Heather Avant always dresses up when she goes to the emergency room. “I’ve been conditioned to act and behave in a very specific way,” said Avant. “I try to do my hair. I make sure I shower, have nice clothes. Sometimes I put on my University of Michigan shirt.” It’s a strategy to combat discrimination the 42-year-old photographer in Mesquite, Texas, has developed over a lifetime of managing her sickle cell disease, a rare blood disorder that affects an estimated 100,000 Americans. The hereditary condition can affect a person of any race or ethnicity, but Black patients, like Avant, make up the majority of those afflicted in the U.S. (Hutchinson, 10/17)

On drug use and addiction —

CBS News: "Melanie's Law" Enacted To Prevent Fentanyl Overdoses In California Schools
Middle and high school students across California will be protected by a new law requiring life-saving prevention and response resources for fentanyl overdoses under legislation signed by Gov. Gavin Newsom on Friday. Newsom announced on Friday that he had signed Senate Bill 10 or Melanie's Law, introduced by Sen. Dave Cortese, D-San Jose, which aims to prevent and respond to youth fentanyl overdoses through mandated school safety plans requiring prevention, response, training, education and awareness. (10/16)

Columbus Dispatch: Animal 'Tranq' Embedded In Ohio And Kentucky Fentanyl Supply
A Northern Kentucky doctor saw a patient who was hospitalized for weeks as caregivers removed all the skin from her forearms to save them from amputation. Dr. Mike Kalfas said the woman had been using the opioid drug fentanyl tainted with an animal sedative that caused tissue death, a situation that's becoming more and more common in the Cincinnati area. (DeMio, 10/16)

The Colorado Sun: A Homeless Recovery Campus On The Plains Is So Successful Colorado Is Making More
D.J. Poole’s rock bottom was a sleeping bag on a cold Denver sidewalk. Years of chasing heroin and meth had landed him outside, alone. He had been kicked out of a Denver Rescue Mission rehab program, which meant he couldn’t sleep there anymore. Poole, 33, had spent time in jail, and had burned so many bridges he figured there was no one left to help him. Then, during another round of detox, an addiction counselor suggested that Poole sign up for Fort Lyon. (Brown, 10/16)

Axios: Making Sense Of How Social Factors Shape Children's Health
Children who grow up in different environments tend to have distinct physical health, mental health and cognitive outcomes, according to a new study in JAMA Pediatrics. The study offers a comprehensive view of how dozens of social determinants of health interact with one another and affect a child's development — and also could serve as a guide for policymakers to better target policies to address glaring health disparities. (Owens, 10/17)

MedPage Today: Behavioral Health Concerns Common For Low-Income Kids 
A substantial proportion of young kids from low-income families had elevated levels of emotional and behavioral health problems seen in pediatric primary care, researchers found. In a retrospective cohort study of 15,218 children ages 2 to 6 years, fully one-third of children had screening tool scores reflecting clinically elevated levels of emotional and behavioral problems over time, Robert Ammerman, PhD, of Cincinnati Children's Hospital Medical Center, and colleagues reported in JAMA Pediatrics. (Henderson, 10/16)

In other news about children's health —

NPR: Soaring Myopia Among Kids—Too Little Time Outdoors, Too Much Time On Screens
The World Health Organization warns that by 2030, 40% of the world's population will be nearsighted. In the U.S. alone, myopia rates have soared over the past 50 years, from 25% in 1971 to nearly 42% in 2017. Many of these myopia cases are in children—who are going nearsighted at increasingly younger ages. In China, where they specifically track early onset myopia, over 80% of teens and young adults are now nearsighted. (Zomorodi, Monteleone, Meshkinpour, and Faulkner White, 10/17)

HealthDay: Non-White Kids With Recurrent Ear Infections Less Likely To Get Specialist Care 
Which U.S. kids see specialists for ear infections and have tubes placed to drain fluid and improve air flow differs significantly by race. Asian, Hispanic and Black children are much less likely than white kids to see ear, nose and throat (ENT) doctors, new research shows. "For the first time, our study found there are significant differences in the rate of ENT office visits for children with ear infections, based on race and ethnicity," said lead author Dr. Yu Shi, an assistant professor of anesthesiology at the Mayo Clinic in Rochester, Minn. (Murez, 10/17)

NPR: Red Dye 3 Appears In Many Foods Kids Eat. Consumer Advocates Want FDA To Ban It
There's new pressure on the Food and Drug Administration to take action on the synthetic food coloring, red No. 3, after California passed a law to ban it last week. California became the first state to ban four food additives, including red No. 3, and public health advocates are pushing to remove the dye from the food supply nationwide. "I think the passage of the bill in California creates undeniable pressure on the FDA," says Dr. Peter Lurie, president and executive director of the Center for Science in the Public Interest. (Aubrey, 10/16)

Military.com: Whiteman Air Force Base Is Scrambling To Find Out Why High Radon Levels At A Day Care Center Were Ignored 
Whiteman Air Force Base in Missouri said it is conducting a new round of radon testing at a base day care more than a year after high levels of the radioactive gas -- which can cause lung cancer -- were found in rooms of the facility and nothing was done. In an Oct. 10 memo sent to all personnel at the base, officials said that testing was done at the child development center in early 2022 and two rooms were found to have the gas in levels that required "mitigation to reduce the radon levels below the acceptable federal level." (Novelly, 10/16)

On gun violence and children —

The New York Times: Murders in U.S. Fell 6 Percent in 2022 as Violent Crime Declined
But young people make up a growing share of those dying by gun violence, which is now the leading cause of death for children in the United States. (Dewan, 10/16)

Axios: Life Expectancy Gap In America Widens Depending On College Education
The U.S. is failing less-educated people given the dismal life expectancy prospects they face compared to their more educated peers, researchers said. While the U.S. economy outperforms other countries by metrics such as economic growth and inflation rates, two prominent economists argue the life expectancy gap says otherwise. (Rubin, 10/16)

CBS News: Researchers Discover Genetic Reason Why Some People Live To 100
Centenarians are the fastest-growing age group in America, but why do some people reach this milestone and others fall short? Researchers in Sweden followed 12 blood biomarkers for 35 years in more than 1,200 adults who lived to see their 100th birthday. (Marshall, 10/16)

More health and wellness news —

The Washington Post: Census Should Reflect That Race Isn’t Real, Advocates Say 
The Human Genome Project convinced the vast majority of scientists that race doesn’t exist. Now a cohort of professionals and academics wants to change society. (Trent, 10/16)

The Baltimore Sun: Bipolar Disorder Is Little Researched, But Doctors At Johns Hopkins Aim To Change That
Bipolar disorder ... remains under-researched, even compared to other mood disorders. While an estimated 2.6% of Americans who are 18 or older have bipolar disorder, people with the condition, especially those who are Black or African American, are often misdiagnosed. Researchers and clinicians at the Johns Hopkins School of Medicine, however, hope that will soon change. They’re recruiting people with the diagnosis for a longitudinal study, in which researchers will follow participants for at least five years with the aim of better understanding the disease and how to treat it. (Roberts, 10/16)

The Washington Post: Sleep Problems Can Increase As You Age. These Tips Can Help.
Older people need about the same amount of sleep as younger ones — generally, seven to eight hours, says Rosanne M. Leipzig, a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York. But about 30 percent of older people get less than seven hours of sleep daily, and almost 20 percent report either frequent insomnia or poor sleep quality, according to a 2022 study published in the journal BMC Public Health. If you have been struggling with sleep, consider the following. (Levine, 10/16)

The Washington Post: Why Fall Stirs Up So Many Allergies, And What To Do About It
Elevated weed pollens and mold often occur at the same time common respiratory viruses emerge, making fall “particularly difficult” for many, one expert says. (Cimons, 10/16)

AP: Israel-Hamas War: Gaza Hospitals Warn That Thousands Could Die If Supplies Run Out
Medics in Gaza warned Sunday that thousands could die as hospitals packed with wounded people ran desperately low on fuel and basic supplies. Palestinians in the besieged coastal enclave struggled to find food, water and safety ahead of an expected Israeli ground offensive in the war sparked by Hamas’ deadly attack. Israeli forces, supported by a growing deployment of U.S. warships in the region, positioned themselves along Gaza’s border and drilled for what Israel said would be a broad campaign to dismantle the militant group. A week of blistering airstrikes have demolished entire neighborhoods but failed to stem militant rocket fire into Israel. (Jobain, Kullab and Nessman, 10/15)

The Guardian: ‘People Are Terrified’: Gaza’s Main Hospital Overflows With The Living And The Dead
At Gaza City’s Dar Al Shifa hospital, the living sleep between beds filled with patients, in corridors, and even in the grounds, while the dead overflow the morgue. ... Shifa is not just Gaza’s largest medical facility, but the nerve centre of its entire healthcare system, and the Israeli assault on the territory has brought it to breaking point. Local authorities and aid groups in Gaza estimate that between 35,000 and 40,000 people are sheltering there. ... “The crowding is going to lead to an infectious disease outbreak. There is an impending public health catastrophe at Shifa hospital,” said Dr Ghassan Abu-Sittah.

The New York Times: Gaza’s Hospitals Face ‘Impossible’ Choices With Israel Evacuation Order 
“It’s absolutely impossible to evacuate the hospital,” said Dr. Muhammad Abu Salima, the director of Gaza City’s Al Shifa Hospital, the territory’s largest medical complex. “There is nowhere in Gaza that can accept the number of patients in our intensive care unit or neonatal intensive care unit or even the operating rooms.” (Abdulrahim, 10/15)

On the water crisis in Gaza —

AP: Gaza's Limited Water Supply Raises Concerns For Human Health
A lack of clean water in the Gaza Strip is raising major concerns for human health. “Gaza is running out of water, and Gaza is running out of life,” said Philippe Lazzarini, chief of the U.N. agency for Palestinians. Gaza normally gets its water supplies from a combination of sources, including a pipeline from Israel, desalination plants on the Mediterranean Sea and wells. Those supplies were slashed when Israel cut off water, along with the fuel and electricity that power water and sewage plants, in the wake of the Hamas attacks. (Burakoff, 10/16)

Reuters: In Gaza, People Resort To Drinking Salty Water, Garbage Piles Up
As Israeli air strikes pounded the Gaza Strip ahead of an expected ground offensive, the enclave's residents were getting more desperate by the hour as water runs out, garbage piles up, explosions flatten homes and hospitals struggle to cope. Desperate to get some drinking water, some people began digging wells in areas adjacent to the sea or were relying on salty tap water from Gaza's only aquifer, which is contaminated with sewage and seawater. (Al-Mughrabi, 10/16)

In other global health news —

Reuters: Deadly Indonesian Cough Syrup Was Almost Pure Toxin, Court Papers Show
An Indonesian drugmaker whose cough syrup is among products linked to the deaths of more than 200 children last year used ingredients with toxin concentrations of up to 99% in 70 batches of medicine, prosecutors said in a court filing. The accusations against drugmaker Afi Farma were made in a court in Kediri, in the province of East Java, where the company is based, and Reuters is the first to report the charge that it used highly toxic ingredients. (Widianto, 10/15)

Reuters: Italy To Charge Foreigners 2,000 Euros A Year For Health Service 
Foreigners who live in Italy will be able to use the national health service after paying a 2,000-euro ($2,109) annual fee, the government said on Monday. The charge, part of the 2024 budget adopted by the cabinet, will apply only to citizens from outside the European Union, the economy ministry said in a statement. ... Foreign workers, job seekers, asylum seekers and unaccompanied minors currently have access to free healthcare, like Italian nationals. (10/16)

USA Today: Overwhelmed By The War In Israel? Here's How To Protect Your Mental Health
After Sept. 11, 2001, the public psyche in the United States was punctured, our nation had been attacked on the mainland unlike ever before, and many Americans overpersonalized the new risk and felt unsafe. (Dr. Marc Siegel, 10/16)

Bloomberg: Sickle Cell Disease Gene Therapy Treatment Costs: Is The Netflix Model Viable? 
An estimated two-thirds of sickle cell treatment-seeking patients will be publicly insured, either through Medicare or state Medicaid programs. The wave of new gene therapy could cost $12.2 billion per year, which means state governments are in for a world of hurt, financially speaking. (Jessica Karl, 10/16)

The Atlantic: Is Novo Nordisk’s Success Really Trouble For Denmark? 
Over the past couple of years, no new pharmaceutical drug—perhaps no product, period—has had such widespread impact as the diabetes medication Ozempic and the weight-loss drug Wegovy, both made by Danish company Novo Nordisk. Most obviously, the drugs have changed the lives of the millions of people who now count on them to help control their appetite. These two products have taken Novo Nordisk from a successful but second-tier drugmaker to the most valuable company in Europe. (James Surowiecki, 10/16)

The Washington Post: What Is The Line Between Life And Death? Here’s My Answer
Where, exactly, is the line between life and death? Does the answer change if the person asking is not a philosopher but a transplant surgeon eager to save a life? Or a patient desperate for a new organ? (Pete Singer, 10/17)

Stat: Long-Term Steroid Use Should Be A Last Resort 
Steroids were once the only treatment option for some chronic conditions. Today, many other treatments exist, but doctors often stick with the tried-and-true steroids. There are good reasons for this: They are low-cost and readily approved by insurance companies. But while generally safe for short-term use, long-term steroids pose significant dangers. When weeks on steroids turn into months, or years, the risks grow, and patients should ask questions. (Judy Hoffstein, 10/16)

Kansas City Star: Missouri, Kansas Lawmakers, Support Stillborn Prevention Act
On March 5, 2020, I walked into the hospital 39 weeks pregnant. I hadn’t felt my baby move since the day before. Being a first-time mom, I had no idea what to expect. Was my baby OK? Was he sleeping? Had he run out of room? No. The answer to all the above questions was no. (Erica Bailey, 10/17)