First Edition: April 22, 2021

KHN: After Accident, Patient Crashes Into $700,000 Bill For Spine Surgery 
Mark Gottlieb’s life changed in an instant when another driver crashed into his car, damaging four vertebrae in his upper spine and smashing six teeth. In the months following that January 2019 crash, Gottlieb got the teeth crowned and, for debilitating neck pain, tried injections, chiropractic care and physical therapy. The treatments were all covered by his car insurance. (Appleby, 4/22)

KHN: California And Texas Took Different Routes To Vaccination. Who’s Ahead?
California and Texas, the country’s two most populous states, have taken radically different approaches to the pandemic and the vaccination campaign to end it. California has trumpeted its reliance on science and policies it says are aimed at improving social equity. Texas state officials have emphasized individual rights and protecting the economy, often ignoring public health warnings but encouraging vaccination — while calling it a personal choice. (Almendrala and West, 4/22)

KHN: Doctors Scramble To Understand Long Covid, But Causes And Prognosis Are Elusive
One night in March 2020, Joy Wu felt like her heart was going to explode. She tried to get up and fell down. She didn’t recognize friends’ names in her list of phone contacts. Remembering how to dial 9-1-1 took “quite a bit of time,” she recalled recently. Wu, 38, didn’t have a fever, cough or sore throat — the symptoms most associated with covid-19 at the time — so doctors at the hospital told her she was having a panic attack. But later she developed those symptoms, along with difficulty breathing, fatigue and neurological issues. (Andrews and Zuraw, 4/22)

The New York Times: Federal Inspectors Fear More Vaccines Were Exposed To Contamination
“There is no assurance that other batches have not been subject to cross-contamination,” the F.D.A.’s 12-page report states. The report amounted to a harsh rebuke of Emergent, which had long played down setbacks at the factory, and added to problems for Johnson & Johnson, whose vaccine had been seen as a game changer because it requires only one shot, can be produced in mass volume and is easily stored. (LaFraniere, Stolberg and Hamby, 4/21)

CBS News: FDA Inspectors Find "Brown Residue" And Other Violations In Plant Making Johnson & Johnson Vaccine 
The Baltimore factory contracted to make Johnson & Johnson's COVID-19 vaccine was dirty, didn't follow proper manufacturing procedures and had poorly trained staff, resulting in contamination of material that was going to be put in the shots, U.S. regulators said Wednesday. The Food and Drug Administration released a statement and a 13-page report detailing findings from its recent inspection of the now-idle Emergent BioSciences factory. Agency inspectors said a batch of bulk drug substance for J&J's single-shot vaccine was contaminated with material used to make COVID-19 vaccines for another Emergent client, AstraZeneca. That batch, reportedly enough to make about 15 million J&J vaccine doses, had to be thrown out. (4/21)

Politico: FDA Inspection Report Casts Doubt On J&J Vaccine Contractor's Ability To Restart Production 
Emergent said that it is working with FDA and J&J to resolve the issues quickly. "While we are never satisfied to see shortcomings in our manufacturing facilities or process, they are correctable and we will take swift action to remedy them," the company said in a statement. It added that "the issuance of findings by the FDA is normal following a facility inspection and provides direction on the necessary steps to improve operations." But it is rare for the agency to move so quickly —releasing a report on an inspection concluded just a day earlier — and to accompany its findings with a statement by top FDA officials. (Owermohle and Banco, 4/21)

Roll Call: Biden To Launch New Tax Credit For COVID-19 Vaccine Time Off 
President Joe Biden is set to announce the availability of new tax credits to subsidize small and medium-sized businesses that provide paid time off for workers to get vaccinated against COVID-19. The eligibility period will run from April 1 through Sept. 30, though it will not be retroactive to Jan. 1, per a White House official, who cited the economic recovery law that created the tax credit. That means employers who already gave folks paid leave will not be able to recoup those funds. (Lesniewski, 4/21)

The Washington Post: U.S. Vaccinations Dropped 11 Percent Over The Past Week — The Biggest Decline Since February 
Daily coronavirus vaccinations have slowed significantly for the first time since February, a sign that demand is slipping even though every American adult is now eligible for the shots. About 3 million Americans are getting vaccinated daily, an 11 percent decrease in the seven-day average of daily shots administered over the past week. The unprecedented drop is rivaled only by a brief falloff that occurred in February, when winter storms forced the closure of vaccination sites and delayed shipments nationwide. (Keating, Nirappil and Stanley-Becker, 4/21)

Stateline: Vaccination Outreach Shifts As Demand Drops In Some States
Four months into the largest vaccination campaign in U.S. history, roughly half of all adult Americans have received at least one shot against COVID-19 and the nation is vaccinating more than 3 million people daily. But those nationwide averages belie looming standstills in pockets of the country where people aren’t showing up for appointments and vaccines are piling up in refrigerators. “We’ve harvested the low-hanging fruit, now we’ve got to do the hard work,” said Dr. William Schaffner, professor of preventive medicine at the Vanderbilt University School of Medicine. “For every incremental increase in the number of people vaccinated, it’s going to get harder and harder.” (Vestal, 4/21)

CNN: US Has The Opportunity To Overcome The Pandemic But A Major Challenge Lies Ahead, Expert Says
On the road toward a return to normalcy, the rapidly climbing number of Covid-19 vaccinations is good news. But a major challenge may lie ahead, a leading health expert says. Tens of millions of Americans haven't started their vaccinations yet, National Institutes of Health Director Dr. Francis Collins told CNN on Wednesday, and "a lot of those folks are still not sure that they want to take part in this amazing opportunity to put this virus behind us." "We have to really figure out how to get the messages out there so that those who are still undecided get the information they need to see why this is really something they would want to do." (Maxouris, 4/22)

AP: Jill Biden Visits US Southwest Amid Vaccine Push
First lady Jill Biden has kicked off a three day visit to the U.S. Southwest on Wednesday with a tour of a vaccination clinic in New Mexico, where early efforts to get people registered for shots helped to propel the state’s standing as a national leader in vaccine distribution. The tour includes stops in Albuquerque and later the Navajo Nation as the United States is set to meet President Joe Biden’s goal of administering 200 million coronavirus doses in his first 100 days in office. The president also outlined his administration’s latest plans to motivate more Americans to get shots as demand diminishes. (Bryan and Lee, 4/21)

Bloomberg: Biden Says He’ll Send Vaccines Overseas Once Supply Sufficient
President Joe Biden said the U.S. wants to share coronavirus vaccines with other countries but won’t begin sending doses abroad until it has sufficient supply at home.“ We’re looking at what is going to be done with some of the vaccines that we are not using. We’ve got to make sure they are safe to be sent,” Biden said at the White House Wednesday. “And we hope to be able to be of some help and value to countries around the world.” (Wingrove and Sink, 4/21)

Modern Healthcare: Navigators To Get Record-Breaking $80 Million To Boost ACA Enrollment
The Biden administration will provide federal marketplace navigators with $80 million in funding to help people enroll in health coverage during the 2022 open enrollment period, HHS said Wednesday. That's an eightfold increase compared to last year and the largest pot of money ever earmarked for navigators. HHS expects the increase in outreach, education and enrollment assistance to ramp up enrollment in health coverage. "Navigators play a key role in helping us educate consumers about health plan options. Today's announcement builds upon the steps the administration has taken to ensure individuals and families can access quality, affordable health coverage during the COVID-19 pandemic," HHS Secretary Xavier Becerra said in a statement. (Brady, 4/21)

Roll Call: House Passes Temporary Extension For Regulating Fentanyl As Schedule 1 Drug 
The House passed legislation by voice vote Wednesday to extend an expiring provision related to the deadly synthetic opioid fentanyl, which was responsible for a large share of drug overdoses in recent years, although senators prefer a different approach. Both chambers have introduced multiple bills that would extend the regulation of fentanyl for varying lengths of time. Currently, fentanyl is listed as a Schedule 1 drug, meaning it has a high potential to be abused and does not have a medical use. (Raman, 4/21)

The Washington Post: House GOP Is Preparing For A Drug Pricing Fight
House Republicans are gearing up for a fight over a drug pricing proposal expected soon from the White House. Their argument is this: It’s hardly the time to crack down on the pharmaceutical industry just as Americans are relying on coronavirus vaccines made by it. (Cunningham and Ellerbeck, 4/21)

Stat: Worried About Drug Pricing, Democrat Pushes Biden To Pledge Support
At least one Democratic lawmaker is openly pushing President Biden to include drug pricing reform in his next big legislative package, after rumors swirled on Capitol Hill this week that the forthcoming legislation might not include provisions on the subject. Rep. Peter Welch of Vermont told STAT he plans to call the White House Wednesday night and is urging his colleagues to pressure the administration in a letter, too. “Anytime there’s even a whisper of a rumor, if it affects something you are passionate about, you get anxious,” Welch told STAT in an interview. (Florko and Cohrs, 4/21)

AP: New Data Reassuring For COVID-19 Vaccination In Pregnancy
One of the largest reports on COVID-19 vaccination in pregnancy bolsters evidence that the shots are safe, although the authors say more comprehensive research is needed. The preliminary results are based on reports from more than 35,000 U.S. women who received either the Moderna or Pfizer-BioNTech shots while pregnant. Their rates of miscarriage, premature births and other complications were comparable to those observed in published reports on pregnant women before the pandemic. (Tanner, 4/21)

CNN: Only 2 "Breakthrough" Infections Among Hundreds Of Fully Vaccinated People, New Study Finds 
For fully vaccinated people, the risk of still getting Covid-19 -- described as "breakthrough infections" -- remains extremely low, a new study out of New York suggests. Among 417 employees at Rockefeller University who were fully vaccinated with either the Pfizer or Moderna shots, two of them or about .5%, had breakthrough infections later, according to the study published on Wednesday in the New England Journal of Medicine. (Howard, 4/21)

Des Moines Register: Iowa Prison Staff Gives Overdoses Of COVID-19 Vaccine To 77 Inmates
Staff from the Iowa Department of Corrections incorrectly gave 77 inmates overdoses of the Pfizer COVID-19 vaccine, the department confirmed to the Des Moines Register. The incident happened Tuesday at the state maximum-security prison at Fort Madison, according to Cord Overton, a spokesperson for the department. Overton did not say how much extra vaccine each inmate was given. (May Sahouri and Leys, 4/21)

The Washington Post: New Yorkers Can Get Vaccinated Under The Natural History Museum’s Iconic — Now Bandaged — Blue Whale
Starting Friday, New York’s American Museum of Natural History will open a mass vaccination site, allowing New Yorkers to register to get a jab under the institution’s iconic 94-foot-long model of a blue whale. (Firozi, 4/20)

Des Moines Register: Gov. Kim Reynolds Implores Unvaccinated Iowans To Take COVID Vaccine
Iowa Gov. Kim Reynolds said Wednesday that "vaccine hesitancy is beginning to become a real factor" in Iowa and across the country. The governor noted during her weekly press conference that 43 of Iowa's 99 counties have declined some or all of next week's COVID-19 vaccine allocation due to decreasing demand for the shots. The Republican governor implored Iowans to take the vaccine, as she did. (Coltrain and Richardson, 4/21)

AP: Vegas Links COVID-19 Plan, Vaccinations; Variants Up In Reno
Lawmakers in Las Vegas are linking plans to fully lift distancing restrictions beginning May 1 with vaccination rates in the state’s key tourism region, while Reno-area businesses could soon have no capacity limits and voluntary distancing rules. County lawmakers in the state’s two most populous areas approved separate reopening plans Tuesday for consideration Thursday by the state’s COVID-19 Response Task Force appointed by Gov. Steve Sisolak. (4/21)

CIDRAP: Study: B117 Variant 45% More Transmissible Than Wild-Type COVID-19
A study yesterday in Cell Reports Medicine shows the B117 variant, first identified in the United Kingdom in December, is 45% more transmissible than the original, wild-type COVID-19 virus, but Pfizer's mRNA vaccine protected elderly populations against infections caused by the variant. The study was based on cases documented in Israel from Dec 6, 2020, through Feb 10, 2021. Within 3.5 weeks of detection, B117 was the dominant strain in Israel. But the nation took a three-pronged approach to controlling a spike in cases, including expanded polymerase chain reaction (PCR) testing, focused surveillance in nursing homes, and prioritized vaccination of those 60 years and older with BNT162b2, the two-dose Pfizer-/BioNTech vaccine. (4/21)

San Francisco Chronicle: California Coronavirus Variants 20% More Infectious, Resistant To Antibodies, New Study Finds
Two California-bred coronavirus variants are about 20% more infectious than the original virus, according to a study published Tuesday by researchers at UCSF, UC Berkeley and the California Department of Public Health. The study results, published in the journal Cell, support previously released research out of UCSF and the Chan Zuckerberg Biohub that had not yet been vetted by peer review. (Arredondo, 4/21)

Fox News: Coronavirus Outbreak In Kentucky Nursing Home Linked To R.1 Variant, Prompts Concern Over Vaccine Impact
A so-called R.1 coronavirus lineage variant was detected in an outbreak at a Kentucky nursing facility where nearly all residents were vaccinated, according to one of the latest reports from the Centers for Disease Control and Prevention (CDC). Health departments noted that coronavirus infections cropped up in a quarter of vaccinated residents, raising concerns about vaccine impact. The unnamed skilled nursing facility offered all residents and staff vaccinations beginning in January, with 90.4% of 83 residents taking up a vaccine and just over half of staffers accepting doses as well. (Rivas, 4/21)

AP: Texas COVID-19 Cases, Deaths Continue An Above-Average Pace
New Texas COVID-19 cases and deaths continued to register Wednesday at an above-average pace. The Texas Department of State Health Services reported 4,518 new cases and 82 COVID-19-related deaths, compared to the rolling seven-day daily average of more than 3,247 new cases and 55 deaths as calculated by Johns Hopkins University researchers. (4/21)

NBC News: Survey By Ohio Regulator Shows Stress, Fatigue Among Pharmacists At Chain Stores
Roughly half of pharmacists in the nation's seventh most populous state say they do not have adequate time to complete their job safely, according to a report released by Ohio's pharmacy regulator Tuesday. The state's 4,000-person survey on pharmacist working conditions found the greatest concerns among pharmacists employed at large chain retail pharmacies. The findings echo NBC News reporting in March that overworked, understaffed pharmacists at chain drug stores say they are reaching a breaking point. (Kaplan, 4/21)

Stat: More Surveillance Is Coming To The OR. Surgeons Warn That's Risky
Though hospitals track patient outcomes for surgeons, most of today’s reporting and analysis falls short of the insights that could be possible with more sophisticated data from the operating room. There’s a growing movement to change that, guided by research linking what happens under the knife to patient outcomes. More rigorous evaluation of surgical technique is on the horizon, aided by technology companies turning laparoscopic cameras and other surgical tools into sources of ground truth. There’s immense promise in using robust data and artificial intelligence to improve the practice of surgery. But surgeons caution that using video and other tech for board certification or performance reviews can be risky. (Aguilar, 4/22)

Modern Healthcare: New Project Eyes Building Climate Resilience At Community Health Clinics
Harvard University is spearheading a new project to create a first-of-its-kind clinical framework focused on protecting the ability of safety-net clinics to provide care for patients during and after a climate-related disaster. The university's Center for Climate Health and Global Environment has partnered with Cambridge, Mass.-based biotechnology firm Biogen and global relief and development organization Americares on a multiyear pilot program to develop a climate resilience toolkit for community health clinics. (Ross Johnson, 4/21)

CIDRAP: Antibiotic Development, Stewardship Advocates See Window Of Opportunity 
The pandemic isn't over yet, but with more and more Americans getting vaccinated against COVID-19 and the light at the end of the pandemic tunnel becoming a little brighter every day—at least in the United States—many clinicians, scientists, and public health advocates are calling for renewed attention to an infectious disease threat that was in the spotlight before the pandemic arrived. Prior to the pandemic, antimicrobial resistance (AMR) was considered one of the major looming health threats facing the world, if not the looming threat. But over the past year, COVID-19, and its multifaceted impact on society, has pushed AMR further back on the agenda, both for the public and policy makers. (Dall, 4/21)

USA Today: Vitafusion Recall: Church & Dwight Recall Select Gummy Vitamins After Reports Of 'Metallic Mesh'
A popular vitamin brand recalled some of its gummy products because they could contain metal. In a recall notice posted on the Food and Drug Administration website Tuesday, New Jersey-based Church & Dwight said it "initiated a voluntary recall of select vitafusion gummy products after the Company’s investigation of two consumer reports identified the possible presence of a metallic mesh material." The products were manufactured from Oct. 29 to Nov. 3, the notice said, and the company is not aware of any reports of consumer illness or injury. However, it said, in "some severe cases, ingesting a metallic material could lead to damage of the digestive tract." (Tyko, 4/21)

Bay Area News Group: California Theme Parks Can Allow Out-Of-State Visitors, According To New State Guidelines
Disney, Universal and other theme parks in the state that had been forced to limit attendance to California residents can now allow out-of-state visitors under revised state guidelines — but not all parks are swinging open their gates to interstate travelers just yet. Revised guidelines in Gov. Gavin Newsom’s Blueprint for a Safer Economy now allow fully vaccinated out-of-state visitors to attend activities or events that are currently limited to California residents only. California theme parks can allow fully vaccinated visitors from out of state, according to California Department of Public Health officials. (MacDonald, 4/21)

AP: AP Source: NFL Exploring Changes To Scouting Combine
The NFL is exploring changes to the annual NFL scouting combine to improve the professional and medical experience for draft prospects, a person familiar with those discussions told The Associated Press on Wednesday. The combine in Indianapolis was canceled this year because of the coronavirus pandemic, so prospects displayed their talents for scouts, coaches and general managers at their college pro days instead. Teams interviewed players virtually and most medical and psychological testing was done by video. About 150 draft prospects did in-person medical evaluations in Indianapolis earlier this month. (Maaddi, 4/22)

USA Today: Justin Fields Has Revealed Epilepsy Diagnosis To NFL Teams, Per Report
Former Ohio State quarterback and NFL hopeful Justin Fields has confirmed to the league's teams that he has been treating epilepsy, according to a report. NFL Network reported that teams became aware of Fields' condition during the pre-draft process and that the condition has not had any effect on Fields' football career. The report also added that doctors are confident that Fields will grow out of the condition, as other members of his family have. (Reyes, 4/21)

AP: Burning Man Mulling Mandatory COVID-19 Vaccines For August
Burning Man festival organizers have said that they are considering requiring attendees to prove they have been vaccinated for COVID-19 if the organizers move forward with plans to hold this year’s counter-culture festival in the Nevada desert. (Sonner, 4/22)

Axios: Pew: Over 80% Of Asian Adults Say Violence Against Them Is Increasing
More than 80% of Asian adults say that violence against them is increasing, according to a new Pew Research Center survey. The big picture: The survey, conducted April 5-11, comes after the recent shootings in Atlanta in which eight people, including six Asian women were killed, as well as a yearlong spike in hate incidents against the Asian American and Pacific Islander (AAPI) community. By the numbers: 32% of Asian adults say they fear someone might threaten or physically attack them, "a greater share than other racial or ethnic groups," Pew writes. (Gonzalez, 4/22)

The New York Times: Arizona Governor Vetoes Bill Restricting L.G.B.T.Q. Education 
Gov. Doug Ducey of Arizona on Tuesday vetoed legislation that would have imposed some of the country’s most restrictive rules regarding L.G.B.T.Q. education, calling the bill “overly broad and vague.” The bill, which was sponsored by eight Republicans and passed the Arizona Senate on a party-line vote, would prohibit schools from teaching about sexual orientation, gender identity and expression and L.G.B.T.Q. history unless a student received “signed, written consent” from a parent or guardian opting them in to the lessons. (Pietsch, 4/21)

Axios: North Dakota Governor Vetoes Transgender Sports Bill
North Dakota Gov. Doug Burgum (R) on Wednesday vetoed a bill passed to prevent transgender students from taking part in K-12 school sports. Why it matters: The bill was one of over 50 in 28 states introduced introduced this year to exclude transgender youth from playing sports on teams that align with their gender identity. Details: The bill stipulated that public schools couldn't "knowingly allow an individual of the opposite sex" to join an all-boys' or all-girls' team. (Falconer, 4/22)

Houston Chronicle: Texas Transgender Sports Bill Will Likely Die In Committee, Chairman Says
A bill that would dictate on which sports teams transgender athletes can compete in public schools was declared all but dead on Wednesday by Rep. Harold Dutton, the Public Education Committee chair who presided over an emotionally charged debate over it a day earlier. The bill drew criticism from more than 1,000 employers across the state and the NCAA, which threatened to cancel future sports championships in the state if it were enacted. (Goldenstein, 4/21)

USA Today: Tennessee Transgender Student 'Bathroom Bill' Clears State Senate
A bill allowing Tennessee students, teachers and school employees to refuse to share bathrooms and locker rooms with their transgender peers cleared the state Senate 21-7 on Wednesday. A similar measure passed the House 65-24 on Monday. The Senate bill, which includes slightly different language, is expected to pass the House and head to Gov. Bill Lee's desk. (Stella Yu, 4/21)

AP: Arkansas Lawmakers Vote Transgender Athlete Ban Expansion
Arkansas lawmakers on Wednesday voted to expand the state’s new ban on transgender girls and women competing on school sports teams consistent with their gender identity. The House voted 74-17 to authorize the attorney general to sue schools that violate the ban. The measure now heads to Republican Gov. Asa Hutchinson, and his office said the governor planned to sign it into law. (4/21)

AP: Idaho 'Fetal Heartbeat' Abortion Ban Bill Heads To Governor
Legislation outlawing nearly all abortions in conservative Idaho by banning them once a fetal heartbeat can be detected headed to Republican Gov. Brad Little on Wednesday. The Republican-dominated Senate voted 25-7 to approve the measure that makes providing an abortion to a woman whose embryo has detectible cardiac activity punishable by up to five years in prison. It would also allow the woman who receives the abortion to sue the provider. (Ridler, 4/21)

AP: Local Officials Get Health Orders Control Under Indiana Bill
Indiana lawmakers voted Wednesday in favor of limiting the authority of county or city health departments by allowing local elected officials to overturn orders or enforcement actions issued during emergencies. Republican supporters say the proposal is meant to provide a “check and balance” protecting the rights of business owners following complaints about COVID-19 orders closing or limiting businesses that have been imposed over the past year. (Davies, 4/21)

Axios: Virginia Governor Signs Bill Legalizing Marijuana Possession Starting July 1
Virginia Gov. Ralph Northam on Wednesday signed a bill that legalizes the possession and growth of small amounts of recreational marijuana starting this summer. Why it matters: Virginia is the first Southern state to legalize recreational marijuana, and the 16th state in the country to do so. Details: Under the law, effective July 1, adults 21 and older can possess up to 1 ounce of marijuana. (4/21)

AP: Medical Marijuana Legal In Utah, But Not Always Affordable
Pain left from oil-field work defeated traditional pain pills and dominated William Adams’ life — until he tried medical marijuana. But even as he began venturing outside his home for the first time in years, Adams discovered he couldn’t afford the cost. Medical cannabis typically isn’t covered by insurance or Medicaid because it remains federally illegal. The group that led the push to legalize it in conservative Utah says that has kept it unreachable for many patients who need it. (Eppolito, 4/21)

USA Today: California Deputy Suspected Of Burning Inmate In Mental Health Unit
A sheriff's deputy in Southern California is accused of burning an inmate with hot water at a jail's mental health center, according to authorities Wednesday. The deputy, who was not identified in a statement by the Orange County Sheriff's Department, was working in the mental health housing module in the Orange County Jail on April 1 when he was serving an inmate with a disciplinary notice for a rule violation. The inmate refused multiple times to sign the notice and stuck his hands in the open hatch in the door, the statement adds. (Aspegren, 4/21)

AP: Tokyo Olympics Torch Relay Has First Positive COVID-19 Case
Tokyo Olympics organizers said Thursday that a policeman tested positive for COVID-19 a day after his assignment last week at the Olympic torch relay. It is the first positive test connected to the relay since it began March 25 from northeastern Fukushima prefecture. (4/22)

Reuters: India Records World’s Biggest Single-Day Rise In Coronavirus Cases 
India recorded the world's highest daily tally of 314,835 COVID-19 infections on Thursday as a second wave of the pandemic raised new fears about the ability of crumbling health services to cope. Health officials across northern and western India including the capital, New Delhi, said they were in crisis, with most hospitals full and running out of oxygen. (Miglani, Arora and Pal, 4/22)

AP: EXPLAINER: Why India Is Shattering Global Infection Records
Authorities were lulled into believing the worst was behind them when cases started to recede in September. Cases dipped for 30 consecutive weeks before starting to rise in mid-February, and experts say the country failed to seize the opportunity to augment healthcare infrastructure and aggressively vaccinate. “We were so close to success,” said Bhramar Mukherjee, a biostatistician at the University of Michigan who has been tracking India’s pandemic. Despite warnings and advice that precautions were needed, authorities were unprepared for the magnitude of the surge, said K Srinath Reddy, president of the Public Health Foundation of India. (Ghosal and Pathi, 4/22)

Reuters: Syria Gets 200,000 Doses Of AstraZeneca Vaccine Under COVAX Scheme - U.N. Officials 
Syria's government has received its first delivery of COVID-19 vaccines through the global COVAX initiative, with almost 200,000 doses of the AstraZeneca (AZN.L) shot, U.N officials said on Thursday. A joint statement by UNICEF, the World Health Organization (WHO) and the GAVI vaccine alliance said the delivery was "critical and timely" and would help health workers "to continue delivering life-saving services in an already exhausted health system as a result of the decade-long war." (Al-khalidi, 4/22)

Politico: EU Preparing Legal Case Against AstraZeneca Over Vaccine Shortfalls 
The European Commission is getting ready to launch legal proceedings against vaccine producer AstraZeneca, according to five EU diplomats. The Commission raised the matter at a meeting of ambassadors Wednesday, during which the majority of EU countries said they would support suing the company over complaints it massively failed to deliver pledged doses to the bloc. (Deutsch and Barigazzi, 4/21)

Politico: UK Coronavirus Contracts Raise Corruption Alarm, Report Warns 
The U.K. government is facing tough questions over its approach to procurement during the pandemic after an investigation found over 20 percent of the £18 billion spent in response to the crisis was linked to at least one red flag indicating corruption. Between February and November last year, 73 COVID-19 contracts, amounting to more than £3.7 billion in public spending, triggered at least one of six standard measures warranting closer scrutiny for corruption, according to a Transparency International report released Thursday. (Collis, 4/22)

AP: Chile Vets Fined For Giving Dog Vaccines Against COVID-19
Health authorities in northern Chile have fined two veterinarians they say were giving or promoting canine vaccines as false protection against COVID-19.Roxana Díaz, deputy health secretary for Antofagasta province, said her agency’s workers had gone to the veterinary practice of Maria Fernanda Muñoz in the city of Calama over a report that people there weren’t using masks and were told it was because they were vaccinated. (4/21)

Bloomberg: Where Covid Kills The Young: Brazil Shows What May Await Others
Like in most countries, the pandemic in Brazil hit the elderly and immuno-compromised first and hardest. But in the past couple of months, the nation that has stood out as nearly a worst-case-scenario for caseloads, deaths and public policy, has shown where the global plague may be headed: for the young. In March, 3,405 Brazilians aged 30 to 39 died from Covid, almost four times the number in January. Among those in their 40s, there were about 7,170 fatalities, up from 1,840, and for those 20-29, deaths jumped to 880 from 245. Those under 59 now account for more than a third of Covid deaths in Brazil, according to research firm Lagom Data. As the elderly get vaccinated, their deaths have fallen by half. (Rosati, Viotti Beck and Preissler Iglesias, 4/22)