First Edition: April 22, 2019

Kaiser Health News: Destination Limbo: Health Suffers Among Asylum Seekers In Crowded Border Shelter
Immigrants from Mexico and Central America seeking asylum in the United States frequently end up at border shelters in Tijuana, Mexico. They stay in them for weeks as they wait for the U.S. government to approve or deny their applications. Most of the refugees get sick during their journeys due to insufficient food, a lack of clean water and poor sanitation at camps and shelters along the way. But perhaps their biggest health problem is depression and anxiety: They have suffered violence and been threatened by gangs and left behind everything they know in the world. (De Marco, 4/22)

Kaiser Health News: Listen: Syphilis Spreads Into Rural America
Lauren Weber, one of Kaiser Health News’ new Midwest correspondents, joined St. Louis Public Radio reporter Jeremy Goodwin on “St. Louis on the Air” Friday to discuss how syphilis is making inroads into rural counties across the Midwest and West. In Missouri, the total number of syphilis patients has more than quadrupled since 2012, testing the weakened public health safety net in areas unfamiliar with the potentially deadly infection. Listen to the interview on the St. Louis Public Radio website. (4/19)

The New York Times: Hospitals Stand To Lose Billions Under ‘Medicare For All’
For a patient’s knee replacement, Medicare will pay a hospital $17,000. The same hospital can get more than twice as much, or about $37,000, for the same surgery on a patient with private insurance. Or take another example: One hospital would get about $4,200 from Medicare for removing someone’s gallbladder. The same hospital would get $7,400 from commercial insurers. The yawning gap between payments to hospitals by Medicare and by private health insurers for the same medical services may prove the biggest obstacle for advocates of “Medicare for all,” a government-run system. (Ableson, 4/21)

The New York Times: ‘Medicare For All’ Is Hammering Health Care Stocks. For Now.
UnitedHealth Group has been a stock market darling for much of the past decade, dependably churning out earnings increases and rewarding shareholders with staggering returns. Its latest quarterly report, issued on Tuesday, was superb, as expected. Earnings per share jumped 24 percent. Based on the news about the diversified health service company’s fundamental businesses, you might have expected its stock price to rise. Nope. UnitedHealth’s share price dropped 4 percent that day and almost 2 percent the next. And, along with much of the health care sector, it has been on a downward trend for the past few months. (Sommer, 4/19)

The New York Times: Republicans Offer Health Care Bills To Protect Patients (And Themselves)
President Trump and Republicans in Congress say they are committed to protecting people with pre-existing medical conditions. But patients with cancer, diabetes and H.I.V., for example, would have significantly less protection under Republican proposals than under the Affordable Care Act. The proposals may provide some political cover for Republicans on an issue likely to figure prominently in the 2020 elections. But a close inspection of the Republican bills shows that their protections are undercut by a combination of imprecise language, explicit exceptions and “rules of construction” that explain how the legislation is to be interpreted. (Pear, 4/20)

The Associated Press: Kansas To Let Farm Bureau Health Coverage Avoid ACA Rules
Kansas will allow its state Farm Bureau to offer health care coverage that doesn't satisfy the Affordable Care Act after Democratic Gov. Laura Kelly on Friday declined to block a Republican-backed effort to circumvent former President Barack Obama's signature health care law. Kelly allowed an insurance bill to become law without her signature, and it includes provisions that will exempt the bureau from state insurance regulations in the health care coverage it offers to its members. (Hanna, 4/19)

The New York Times: Wary Of Chinese Espionage, Houston Cancer Center Chose To Fire 3 Scientists
Two tenured scientists at a renowned cancer hospital in Houston have resigned, and the hospital is seeking to fire a third, in connection with an investigation into possible foreign attempts to take advantage of its federally funded research, the authorities said. The departures are one of the first publicly revealed outcomes of dozens of similar investigations nationwide, as federal officials have increasingly warned of foreign exploitation of American-backed research — particularly from the Chinese. (Zaveri, 4/22)

The Associated Press: Texas Cancer Center Ousts 3 Over Chinese Data Theft Concerns
"As stewards of taxpayer dollars invested in biomedical research, we have an obligation to follow up," Pisters said. MD Anderson received $148 million in NIH grants last year. The center provided internal documents to the Chronicle regarding the cases but the names of the scientists were redacted. The newspaper said all three are ethnically Chinese. Two of them resigned ahead of termination proceedings and the third is challenging the dismissal. (4/20)

Politico: State Republicans Challenge Democrats With ‘Born-Alive’ Bills
Republican legislators across the country are rallying behind President Donald Trump's efforts to link Democrats with "infanticide," daring Democratic governors to veto "born alive" bills animating the party's base before the 2020 elections. Bills approved by GOP-run legislatures in Montana and North Carolina this week would penalize health care providers for failing to care for an infant who survives an abortion attempt. The measures, which are also winding through legislatures in Texas and elsewhere, are being pushed by anti-abortion groups that quickly seized on bills in New York and Virginia aimed at loosening restrictions on third-trimester abortions. (Rayasam and Goldberg, 4/20)

The Associated Press: US Judge Blocks Part Of Ohio Ban On Abortion Procedure
A federal judge blocked part of an Ohio law late Thursday that bans the abortion method of dilation and evacuation in most cases, adding to a list of restrictions on the procedure that are or soon could be in legal limbo. Senior U.S. District Judge Michael Barrett in Cincinnati ordered the state not to bring criminal charges against doctors who perform the D&E procedure under most circumstances until the case can be fully litigated. Other parts of the law were allowed to proceed. (4/19)

The New York Times: The Giants At The Heart Of The Opioid Crisis
There are the Sacklers, the family that controls Purdue Pharma, the maker of OxyContin. There are the doctors who ran pill mills, and the rogue pharmacists who churned out opioid orders by the thousands. But the daunting financial muscle that has driven the spread of prescription opioids in the United States comes from the distributors — companies that act as middlemen, trucking medications of all kinds from vast warehouses to hospitals, clinics and drugstores. The industry’s giants, Cardinal Health, McKesson and AmerisourceBergen, are all among the 15 largest American companies by revenue. (Hakim, Rashbaum and Rabin, 4/22)

The Associated Press: FDA OKs 1st Generic Nasal Spray Of Overdose Reversal Drug
U.S. regulators have approved the first generic nasal spray version of Narcan, a drug that reverses opioid overdoses. The Food and Drug Administration on Friday OK'd naloxone spray from Israel's Teva Pharmaceuticals. Naloxone has been sold as a nasal spray in the U.S. since 2016 under the brand name Narcan. Pharmacists can dispense it without a prescription. It is also sold as a generic or brand-name drug in automatic injectors, prefilled syringes and vials. (4/19)

NPR: Prison For Forced Addiction Treatment? A Parent's 'Last Resort' Has Consequences
Robin Wallace thought her years of working as a counselor in addiction treatment gave her a decent understanding of the system. She has worked in private and state programs in Massachusetts and with people who were involuntarily committed to treatment. So in 2017, as her 33-year-old son, Sean Wallace, continued to struggle with heroin use — after years of coping with mental health issues and substance use — she thought she was making the right choice in forcing him into treatment. (Becker, 4/20)

NPR: When Opioid Prescribers Are Arrested, What Happens To Their Patients?
A pharmacist in Celina, Tenn., was one of 60 people indicted on charges of opioid-related crimes this week, in a multistate sting. John Polston was charged with 21 counts of filling medically unnecessary narcotic prescriptions. He was also Gail Gray's pharmacist and the person she relied on to regularly fill her opioid prescriptions. "I take pain medicine first thing in the morning. I'm usually up most of the night with pain," she says. "I hurt all the time." (Farmer, 4/19)

Stat: Disappointing Trial Results Dim Hopes For A New Class Of Pain Drugs 
They were supposed to be novel pain treatment and future blockbusters. Instead it appears that hopes for a class of medicines called NGF inhibitors are increasingly dim. Pfizer (PFE) and Eli Lilly (LLY) announced late Thursday that their experimental NGF inhibitor didn’t meet its goals in a trial meant to support approval by the Food and Drug Administration. And, more damning, patients who got the drug had significantly more issues of joint damage — the big risk tied to NGF treatments — than those who got over-the-counter pain pills like ibuprofen. (Garde, 4/19)

Politico: The Next E-Cig Battle: Should There Be Ads For Vaping Products?
E-cigarette companies that the FDA has already threatened for appealing to teens may land in more hot water with new campaigns that target older adults, say public health advocates and House Democrats. After the FDA told them to stop pitching in a way that attracted teens, Juul and other companies have begun flooding television, radio and print media with ads that tout their potential to help adults quit traditional cigarettes. But they don’t have the data to back up such claims, say researchers, and the new ads might confuse teens even more. (Owermohle, 4/19)

The Hill: Anti-Smoking Advocates Question Industry Motives For Backing Higher Purchasing Age 
Public health and anti-tobacco advocates are no longer facing fierce opposition from the tobacco industry in their push to raise the legal purchasing age from 18 to 21. The reversal, prompted in large part by rising youth vaping rates, means tobacco companies such as Altria are now on the front line pushing “Tobacco 21” legislation in state legislatures and on Capitol Hill in an effort to stave off stronger regulations that could have disastrous effects on the industry, including bans on the sale of flavored tobacco products that are appealing to kids. (Hellmann, 4/20)

The New York Times: 20 Years After Columbine, Schools Have Gotten Safer. But Fears Have Only Grown.
Present your driver’s license to be scanned and verified. Have your photograph taken. Pass your belongings through a metal detector. Welcome to your child’s school. Twenty years after the Columbine High School shooting, a school visit can feel like going to the airport. See-through backpacks and armed officers are common sights on campus. So are “run, hide, fight” trainings, full of tips on how to survive an active shooter. Some days might bring lockdown drills that students are not told in advance are rehearsals, not real threats. And in rare cases, the adult teaching algebra or social studies might be armed. (Goldstein, 4/20)

The New York Times: Columbine Survivors Reflect, And Reckon With Specter Of Future Shootings
The survivors walked their children through hallways that had once been filled with violence. This is where we hid from the gunmen, they told their children. That is where the gunmen entered the school, they added. This is how we escaped. Twenty years after two students attacked Columbine High School in Littleton, Colo., killing 12 of their peers and one teacher and marking the beginning of an era of school threats and mass shootings, Columbine’s survivors are now parents. (Turkewitz, 4/20)

The Associated Press: Two-Wave US Flu Season Is Now The Longest In A Decade
Three months ago, this flu season was shaping up to be short and mild in the U.S. But a surprising second viral wave has made it the longest in 10 years. This flu season has been officially going for 21 weeks, according to reports collected through last week and released Friday by the Centers for Disease Control and Prevention. That makes it among the longest seen since the government started tracking flu season duration more than 20 years ago. Some experts likened the unusual double waves to having two different flu seasons compressed, back-to-back, into one. (4/19)

The Wall Street Journal: Emergency Rooms Get A Makeover For The Elderly
Marcus Overton isn’t a stranger to emergency rooms—and he doesn’t like them. “They’re chaotic and loud,” says the 75-year-old San Diego resident, who battles diabetes and heart-valve problems. “They usually put you in a bed, pull a curtain around you, and you wait.” But last month, the former actor and arts administrator sought treatment for shortness of breath at an ER designed for elderly patients and their families. It was a wholly different experience. (Howard, 4/21)

The New York Times: Why Does Exercise Guard Against Cancer? Inflammation May Play A Role
One of the most important benefits of exercise is in how it reduces our risk of developing a number of types of cancer — especially colorectal cancer, which according to some estimates is the malignancy most influenced by physical activity. But how workouts guard against colon cancer remains largely unknown. Physical activity speeds the movement of waste through the intestines, as anyone who has had to hunt for a bathroom during a workout knows. But this does not seem to fully account for the protective effects of exercise. Instead, a small study published in February in The Journal of Physiology suggests we should also look to changes in our bloodstream after exercise. (Reynolds, 4/22)

Stat: Can Virtual Reality Boost Positive Feelings In Patients With Depression?
The University of California, Los Angeles, psychiatry researcher and her colleagues are testing whether virtual reality can curb anhedonia, a symptom of depression and other serious mental health conditions that’s marked by a lack of interest or ability to feel pleasure. They’re putting patients into pleasant scenarios — like a stroll through a sun-soaked forest while piano music plays — and coaching them to pay close attention to the positive parts.The idea is to help patients learn to plan positive activities, take part in them, and soak up the good feelings in the process. (Thielking, 4/22)

The Associated Press: Blankets, Bed-Sharing Common In Accidental Baby Suffocations
Accidental suffocation is a leading cause of injury deaths in U.S. infants and common scenarios involve blankets, bed-sharing with parents and other unsafe sleep practices, an analysis of government data found. These deaths "are entirely preventable. That's the most important point," said Dr. Fern Hauck, a co-author and University of Virginia expert in infant deaths. (Tanner, 4/22)

The Washington Post: Postpartum Depression Risk Factors
After Ann’s daughter was born, the infant cried a lot because of acid reflux. “When she wouldn’t stop, I got angry. I felt like a monster,” said Ann, who requested that she be identified only by her middle name because of privacy concerns. At first, the new mother chalked up her irritability and guilty feelings to stress and sleep deprivation, but when the worrisome feelings lingered, Ann knew something was wrong. (Fraga, 4/20)

The New York Times: Commuting While Pregnant: A Long Ride Could Be A Risky One
It’s no secret that the United States lags the rest of the developed world when it comes to policies that support mothers and families. As former President Barack Obama put it in 2014: “Family leave. Child care. Flexibility. These aren’t frills. They’re basic needs. They shouldn’t be bonuses. They should be the bottom line. ”Five years and little progress later, we’re learning more and more about the toll inflexible work cultures have on new and expectant mothers. Last fall, a New York Times investigation exposed the devastating cost of pregnancy discrimination on women in physically demanding jobs. (Salam, 4/19)

The New York Times: The Search For A Biomarker For Early Autism Diagnosis
Every pediatrician knows that it’s important to diagnose autism when a child is as young as possible, because when younger children get help and intensive therapy, their developmental outcomes improve, as measured in everything from improved language, cognition and social skills to normalized brain activity. “The signs and symptoms for most children are there between 12 and 24 months,” said Dr. Paul S. Carbone, an associate professor of pediatrics at the University of Utah and a co-author of “Autism Spectrum Disorder: What Every Parent Needs to Know,” published by the American Academy of Pediatrics. “If we can get them in for evaluation by then, the therapies are available as young as those ages, you can easily start by 2,” he said. “We’d like to give kids the benefit of getting started early.” (Klass, 4/22)

The New York Times: Should You Be Eating Eggs?
Once more, Humpty Dumpty took a great fall last month when a new study linked egg consumption to cardiovascular disease. What follows may — or may not — put Humpty back together again, especially for egg lovers who cheered the latest dietary guidelines that seemed to exonerate this popular cholesterol-rich food. While suggesting that Americans “eat as little dietary cholesterol as possible,” the guidelines’ scientific report in 2015 stated “cholesterol is not a nutrient of concern for overconsumption.” (Brody, 4/22)

The Washington Post: Medical Mystery With Disabling Symptoms Took Three Years To Solve
Kimberly Ho, a newly minted nurse at Children’s National Medical Center just off a 12-hour overnight shift, struggled to focus on a presentation about working with sexually traumatized children and adolescents. As the picture of a skin infection flashed on the screen, the 22-year-old snapped to attention. The instructor was recounting the story of a teenage patient who had been given an incorrect diagnosis by a doctor in training — a breach of hospital protocol that had caused an uproar. The lecture, aimed at new staff members, emphasized the importance of working within the chain of command. The girl’s actual diagnosis was largely beside the point — except to Ho. (Boodman, 4/20)

The Washington Post: Epidermolysis Bullosa: Texas Baby Ja’bari Gray Was Born Without Skin, Mother Says
It should have been one of the happiest moments of Priscilla Maldonado’s life, but, instead, the 25-year-old mother was terrified. It was New Year’s Day, and she had just delivered her newborn son, Ja’bari. She said she heard her son’s soft cries — and then the hospital room fell silent. No one told her she had a healthy baby boy. No one told her how much he weighed or how long he was. No one brought him to meet his mother and place him on her chest. (Bever, 4/19)

NPR: Scientists Dig Into Hard Questions About The Fluorinated Pollutants Known As PFAS
Scientists are ramping up research on the possible health effects of a large group of common but little-understood chemicals used in water-resistant clothing, stain-resistant furniture, nonstick cookware and many other consumer products. Per- and polyfluoroalkyl substances are generally referred to by their plural acronym, PFAS. PFAS are resistant to water, oil and heat, and their use has expanded rapidly since they were developed by companies in the mid-20th century. Today, PFAS' nonstick qualities make them useful in products as diverse as food wrappers, umbrellas, tents, carpets and firefighting foam. The chemicals are also used in the manufacture of plastic and rubber and in insulation for wiring. (Hersher, 4/22)

The New York Times: How To Protect Yourself From Air Pollution While Traveling
When Yondje Choi was told she would need a face mask for an upcoming trip to South Korea, Ms. Choi, a 31-year-old New Yorker, was shocked. “I knew air pollution is a major problem in Beijing, but I didn’t know it was this bad here,” she said last month in Seoul. While China takes a bulk of the heat when it comes to unhealthy levels of air quality, air pollution is a major issue throughout Asia and beyond, even to Europe and North America. Without research and self-care, even short-term visitors may feel the effects. Here are some precautions you can take to help you breathe easier. (Yoon, 4/21)

NPR: Can The Culture Of Overtreatment Be Curbed In Medical Training?
When family physician Jenna Fox signed on for a yearlong advanced obstetrics fellowship after her residency to learn to deliver babies, she knew she'd need to practice as many cesarean sections as possible. The problem was, she also knew C-sections aren't always good for patients. Many women's health experts argue they're often unnecessary and increase health risks for mom and baby. Doctors are working to decrease high C-section rates in hospitals around the country. Fox and her colleagues on the labor and delivery floor at the University of Rochester try hard to prevent them, particularly primary C-sections, when a woman needs one for her first baby. (Gordon, 4/19)

NPR: You Can Help: When A Loved One Shows Signs Of Suicide Risk, Reach Out
If you know someone struggling with despair, depression or thoughts of suicide, you may be wondering how to help. Most Americans say that they understand that suicide is preventable and that they would act to help someone they know who is at risk, according to a national survey conducted by the American Foundation for Suicide Prevention and the National Action Alliance for Suicide Prevention in 2018. (Chatterjee, 4/20)

NPR: When Is Snoring A Sign Of A Serious Health Issue?
An estimated 40 percent of adults in the U.S. snore. And, men: You tend to out-snore women. (Yes, this may explain why you get kicked or shoved at night!) And despite the myth that snoring is a sign of deep sleep, there's really no upside to it. "Snoring really does not demonstrate anything good," says Erich Voigt, an ear, nose, and throat doctor and sleep specialist at New York University Langone Health. "You can have beautifully deep sleep in a silent sleep." (Aubrey, 4/22)

The Associated Press: Washington State Lawmaker's Comments Raise Ire Of Nurses
A Washington state lawmaker has angered nurses and spawned a flurry of viral hashtags and memes on social media by saying that some nurses may spend a lot of time playing cards in small, rural hospitals. State Sen. Maureen Walsh, a Republican representing College Place, Washington, made the comments this week while debating a Senate bill that would require uninterrupted meal and rest breaks for nurses. The bill would also provide mandatory overtime protections for nurses. (4/20)

The Associated Press: Idaho, Utah Passengers Had Possible Hepatitis A Exposure
Health officials in Idaho say anyone who used an on-board restroom during a Greyhound bus trip from Salt Lake City to Boise on April 10 might have been exposed to hepatitis A. The Central District Health Department in Idaho is asking anyone who used the restroom to contact them to get information about potential exposure. The district says riders on the bus from Utah to Idaho who were exposed could receive a vaccine to protect them from the virus through April 23. (4/19)

Los Angeles Times: Build 10,000 Houses For Homeless In 10 Years? L.A. Is Closer, But It’ll Have To Stretch Funds
In 2016, Los Angeles voters approved a $1.2-billion bond measure to help fund housing for homeless people, with a goal of 10,000 new units in a decade. Now, after hustling to get as many housing projects started as soon as possible, city officials are coming to the end of the money available through Proposition HHH, and it’s not certain that promise will be kept. The city has committed two-thirds of the bond to secure a little more than half the units the measure was intended to subsidize. (Smith, 4/21)

The Star Tribune: UnitedHealth Grows Digital Health Business In Minneapolis
UnitedHealth Group is trying to grow in the crowded digital health market by rolling out new features for employers while expanding its downtown Minneapolis workforce to about 140 workers. For several years, employer health plans have hired its Rally Health division to provide a digital platform where workers can track their progress toward incentives in company-sponsored wellness programs. Now, UnitedHealth says employers can more easily access tools for finding doctors, comparing procedure costs, learning about insurance benefits and, in a few cases, scheduling appointments. (Snowbeck, 4/20)

Modern Healthcare: Colo. Governor Commends County's Plan To Address Suicides
Eagle County, Colorado, is best known for the world-famous Vail Ski Resort, but the area also has a dark side that it's trying to combat. The county of roughly 55,000 averages one suicide attempt per day, according to public health director Chris Lindley. One in four of its seventh and eighth graders seriously considered suicide last year, according to the most recent Healthy Kids Colorado Survey. Of that group, 16% have made a plan, some in pacts with others. (Bannow, 4/19)