First Edition: April 25, 2022

KHN: Physicians Are Uneasy As Colorado Collects Providers’ Diversity Data 
Shaunti Meyer, a certified nurse-midwife and medical director at STRIDE Community Health Center in Colorado, doesn’t usually disclose her sexual orientation to patients. But at times it feels appropriate. After telling a transgender patient that she is a lesbian, Meyer learned the woman had recently taken four other trans women, all estranged from their birth families, under her wing. They were living together as a family, and, one by one, each came to see Meyer at the Aurora clinic where she practices. Some were at the beginning of their journeys as transgender women, she said, and they felt comfortable with her as a provider, believing she understood their needs and could communicate well with them. (Hawryluk, 4/25)

KHN: Despite Losing Federal Money, California Is Still Testing Uninsured Residents For Covid — For Now
California is still offering free covid testing to uninsured residents even though the federal government ran out of money to pay for it. While Congress debates whether to put more money into free testing, California is leaning on programs it already had in place: special state-based coverage for uninsured Californians, school testing, and free tests offered by clinics, counties, and other groups. Absent free options, people without health insurance could pay as much as several hundred dollars out-of-pocket depending on where they get tested. (Bluth, 4/25)

KHN: Journalists Cover The Gamut, From Rising Insulin Costs To Delays In Autism Care For Children
KHN Midwest correspondent Bram Sable-Smith shared a firsthand perspective on ballooning insulin costs on “Tradeoffs” on April 21. ... KHN’s Colleen DeGuzman profiled the last abortion clinic in the Rio Grande Valley on KUT and “Texas Standard” on April 21. (4/23)

NBC News: Covid Was Third Leading Cause Of Death In U.S. Again In 2021
For the second year in a row, Covid was the third-leading cause of death in the U.S., according to a Centers for Disease Control and Prevention report released Friday. Covid was the underlying cause of more than 415,000 deaths in 2021, or 13 percent of the national total, the report found. That's an increase from 10 percent in 2020. Per capita, Covid death rates increased among every age group in 2021 except those 85 and older. (Bendix, 4/22)

CIDRAP: COVID-19 Third Leading Cause Of Death In US In 2021
Approximately 60,000 more people died from COVID-19 in 2021 than the first year of the pandemic. In both years, the death rates from COVID-19 were highest in Americans ages 85 and older. Overall death rates were highest among non-Hispanic American Indian/Alaskan Native and non-Hispanic Black or African American people, the CDC said in a statement. (Soucheray, 4/22)

The Wall Street Journal: Pandemic Border Policy Could Complicate Covid Relief, Ukraine Bills
When Congress returns this week, a pandemic-era immigration policy could complicate efforts to pass further coronavirus relief legislation and possibly another Ukraine aid measure if centrist Democrats side with Republicans in opposing the Biden administration’s repeal of the border rules. Earlier this month, the Biden administration said that in May it will end its use of Title 42, a controversial policy dating to the Trump administration that allows Border Patrol agents to quickly turn away migrants at the southern border. (Collins and Hackman, 4/25)

Stat: White House Offered Covid Spending Details, But Peeking Was A Process
It was a striking visual for the television cameras. White House Press Secretary Jen Psaki took to the lectern, waving a thick, 385-page binder as evidence that contrary to Republicans’ accusations, President Biden had been transparent with Republicans about how his administration had spent billions of dollars to fight Covid-19.“You can have access to this for a prop if you would like it as well,” Psaki offered to reporters. “We’ll make copies for you.” But when STAT took the White House up on the offer, officials refused to make copies of the binder. In fact, it wouldn’t even let STAT take photographs of the contents. Instead, the administration gave this reporter one hour to look through the nearly 400 pages of budget tables and congressional correspondence. White House officials offered the review in a small conference room in the Eisenhower Executive Office Building across the street from the White House, under the supervision of a budget office employee. (Cohrs, 4/25)

The Hill: White House Official: US Must Respond To Rising COVID-19 Cases ‘With Care And Caution, But Not Overreacting’ 
White House COVID-19 response coordinator Ashish Jha on Sunday said the U.S. should respond to the rising number of coronavirus cases “with care and caution, but not overreacting. ”The number of daily COVID-19 cases in the U.S. has been on the rise, hitting roughly 66,000 infections on Friday, according to the Centers for Disease Control and Prevention. Asked by co-anchor Dana Bash on CNN’s “State of the Union” about the rise, Jha said the nation should react to the increasing infections differently now compared to one year ago because the U.S. now has vaccines, booster shots and therapeutics. (Schnell, 4/24)

Fox News: Biden Official Says Court Plays 'Important Role' Days After Fauci Questions Their Involvement
The White House has contradicted Dr. Anthony Fauci on mask mandate decisions, saying that the judiciary plays an "important role" and simply made an "incorrect decision." "Obviously, the judiciary has an important role to play," White House COVID Coordinator Ashish Jha said on Sunday’s "State of the Union." "What you heard out of the administration, out of the Department of Justice, is the assessment that this is an incorrect decision and the DOJ is now appealing this decision." A U.S. district court judge in Florida this week struck down the travel mask mandate for mass transit, leading to the Transportation Security Administration to announce it would no longer enforce mask requirements. (Aitken, 4/24)

San Francisco Chronicle: Oakland To Consider Mask Mandate For Indoor Events Of 1,000 People
An Oakland City Council member will introduce an ordinance next month that requires people to wear masks at large indoor gatherings of 1,000 people or more. The ordinance will drop the city’s current requirement that people must show proof of vaccine to enter into bars, restaurants, gyms and other businesses. People will still have to show proof of vaccine when entering into senior centers and assisted care facilities. (Ravani, 4/22)

San Francisco Chronicle: COVID Positive Test Rate In S.F. Tops ‘Too High’ Level Of 5% Amid Statewide Rise
The coronavirus test positivity rate in San Francisco hit 5% on Friday, according to new city data. The percentage of tests that are coming back positive — a key indicator of pandemic trends — is rising sharply and has passed a level that public health officials consider worrisome. A rule of thumb among infectious disease experts is that 5% is considered “too high,” according to researchers at Johns Hopkins University. (Vaziri, 4/22)

Bay Area News Group: COVID-19 Outbreak Hits Another Bay Area Cruise Ship Voyage
Scores of passengers aboard the Ruby Princess cruise ship became sick with COVID-19 on a San Francisco to Hawaii voyage that ended last week and followed a trip to Panama in which dozens of passengers also were stricken with the virus on the same ship. The San Francisco Department of Public Health said 143 passengers aboard the Ruby Princess’ San Francisco to Hawaii round trip that ended April 11 tested positive for the virus, nearly twice as many as the 73 reported sick with COVID-19 after the ship’s March 27 return to San Francisco from Panama. (Woolfolk, 4/23)

Bloomberg: NYC Covid Latest Trends Show Decline In Cases In Glimmer Of Hope For U.S.
The recent resurgence of Covid-19 in New York City may be relatively muted compared with the huge spike earlier this year, if recent patterns hold. The largest U.S. city is seeing a downturn in Covid-19 cases for the first time since early March, local government data show, in what could be a positive sign for the rest of the country. In Manhattan, where case counts have been the highest recently, the seven-day average of cases dropped for four days in a row through April 19. In Philadelphia, local health officials ended a mask mandate this week, citing data showing cases leveling off. (Muller, 4/23)

Bloomberg: Pfizer Paxlovid Covid Pill Will Soon Be Available Across The U.S.
The U.S. government is finishing plans to make Pfizer Inc.’s Covid-19 pill available at any pharmacy across the country, with supply increasing as the BA.2 sub-variant drives an uptick in cases and hospitalizations. The administration will outline a plan next week aimed at getting the pill, Paxlovid, to additional people who’d otherwise face a more serious case of Covid-19, an administration official said Friday. The official asked not to be identified ahead of an announcement. Use of oral antiviral pills in the U.S. jumped 103% between March 27 and April 10, the official said. The White House wants to drive that number higher, and signal to health providers to err on the side of prescribing the pills, rather than worrying about scarcity. (Wingrove and Rutherford, 4/22)

Bloomberg: Why Nasal Sprays Are Poised to Be the Next Weapon for Fighting Covid
“Covid isn’t just a sprint, it’s a marathon,” says [Marty] Moore, the relentlessly upbeat founder of Meissa Vaccines Inc. Today’s vaccines have largely won the sprint of preventing serious disease, “and thank goodness for that,” he says. “But now we need something else to gain control of the virus.” Moore is among a growing cohort of virologists proposing we spray vaccines up people’s noses rather than inject them into arms. The advantage of that approach, they argue, is it can trigger the body to develop infection-blocking defenses in the sinuses and throat and allow it to start fighting illness much faster than an injected vaccine can. (Loh, 4/25)

USA Today: Research Into COVID Loss Of Taste And Smell Sheds New Light On Problem
For Elizabeth Byland, 35, the story isn't over. An improv professor at Virginia Commonwealth University in Richmond, Byland lost her sense of smell when she was infected in July 2020, and it's still not fully back to normal. Her dogs now have the scent of orange slices. Carrots taste like soap, her favorite body wash smells "putrid" and her beloved pizza is inedible. Her husband and nearly everything else has a background scent like a subway system. "The sad part is, it's become my normal," Byland said. "I don't think about it as much as I used to." (Weintraub, 4/24)

AP: COVID Shots Still Work But Researchers Hunt New Improvements
Moderna and Pfizer are testing 2-in-1 COVID-19 protection that they hope to offer this fall. Each “bivalent” shot would mix the original, proven vaccine with an omicron-targeted version. Moderna has a hint the approach could work. It tested a combo shot that targeted the original version of the virus and an earlier variant named beta — and found vaccine recipients developed modest levels of antibodies capable of fighting not just beta but also newer mutants like omicron. Moderna now is testing its omicron-targeted bivalent candidate. (Neergaard, 4/24)

Los Angeles Times: How Many California Lives Were Saved By COVID-19 Vaccines?
The arrival of the first COVID-19 vaccines in December 2020 marked the start of a new, safer phase of the pandemic. For all that we know of life in the vaccine era — the inequities, the breakthrough infections, the partisan battles over mandates — it’s been hard to know what life would have been like without the shots. A new project from researchers at UC San Francisco in collaboration with the California Department of Public Health draws the clearest picture to date on what the state might have looked like had the vaccines never materialized. (Purtill, 4/22)

USA Today: More Children Were Hospitalized For COVID During Omicron, CDC Study Finds. Most Were Unvaccinated
Children may be less likely than adults to be hospitalized with COVID-19, but a recent study found those who are still unvaccinated are suffering the worst consequences of the disease compared with their vaccinated peers.  Researchers at the Centers for Disease Control and Prevention looked at hospitalizations in 14 states among children aged 5 to 11 throughout the pandemic. They found COVID-19-related hospitalization rates were about twice as high among unvaccinated children as those who were vaccinated during the omicron wave from December to February, according to the report published last week in the agency’s Mortality and Morbidity Weekly Report. (Rodriguez, 4/23)

PolitiFact: Fact Check: COVID-19 Is Snake Venom, Claims Anti-Vax Documentary
A new anti-vaccine documentary ridiculously claims that the coronavirus is not a virus, but a synthetic version of snake venom that evil forces are spreading through remdesivir, the mRNA COVID-19 vaccines and drinking water to "make you a hybrid of Satan." The 48-minute film, released April 11, is the latest in an expanding genre of mega-viral, conspiracy-laden videos made in the mold of the "Plandemic" video from May 2020. Its title, "Watch the Water," is a nod to a favorite refrain of the QAnon conspiracy theory, which is centered around the belief that a secret cabal of Satan-worshipping pedophiles is running a global sex-trafficking ring. (McCarthy, 4/22)

NPR: How COVID's Deadly Conspiracy Theories Cost One Woman Her Life
One thing everyone agrees on is that Stephanie didn't have to die. Even months after it happened, her family is struggling to figure out why. "There is no perfect puzzle piece," says Stephanie's daughter Laurie. "I literally go through this all the time." Stephanie was 75 when she succumbed to COVID-19 this past December. But Laurie says it wasn't just COVID that killed her mother. In the years leading up to her death, Stephanie had become embroiled in conspiracy theories. Her belief in those far-out ideas caused her to avoid vaccination and led her to delay and even refuse some of the most effective treatments after she got sick. "I don't believe she was supposed to die," Laurie says. "I blame the misinformation." (Brumfiel, 4/24)

Bloomberg: NYC Suspends School Staff For Allegedly Using Fake Vaccine IDs
The New York City Department of Education suspended about 70 employees for allegedly using fake vaccination cards, the teachers’ union said. The department placed the employees on unpaid leave with benefits, effective April 25, and the Special Commissioner of Investigation for the New York City School District and law enforcement agencies are investigating the incident. (Querolo, 4/22)

San Francisco Chronicle: Truck Convoy Protests Outside The Home Of East Bay Legislator Proposing Vaccine Mandate, Abortion Bills
A group of people who oppose vaccine mandates drove their trucks and vans in Oakland’s Rockridge neighborhood and protested outside the home of an East Bay state legislator while she was reportedly inside. The protest, captured in online videos, involved a convoy of about 20 vehicles, according to the California Highway Patrol. Protesters gathered, apparently, in opposition to a pair of bills written by Assembly Member Buffy Wicks, D-Oakland, that would, separately, require California businesses to mandate COVID vaccinations among their employees and end a state requirement that coroners investigate stillbirths. Wicks already announced in late March that the vaccination bill was being put on hold. (Cano, 4/23)

AP: New Mississippi Law Bans COVID-19 Vaccine Mandates 
Mississippi is enacting a new law that says state and local government agencies cannot withhold services or refuse jobs to people who choose not to get vaccinated against COVID-19. The ban applies to state agencies, city and county governments and schools, community colleges and universities. COVID-19 vaccination mandates have not been widespread in Mississippi, but some lawmakers said they were acting against the possibility of government overreach. Republican Gov. Tate Reeves said Friday that he had signed House Bill 1509, and it became law immediately. (Pettus, 4/23)

Modern Healthcare: CMS Proposes 5 Medicare Special Enrollment Periods
Medicare beneficiaries experiencing specific illnesses or circumstances could soon get Part B coverage outside the normal open enrollment periods under a proposed rule released Friday. Individuals who are impacted by an emergency or disaster, formerly incarcerated people and those subject to a health plan or employer error that prevented them from enrolling in Medicare on time could get coverage during special enrollment periods under the Centers for Medicare and Medicaid Services proposal. (Goldman, 4/22)

Stat: Travel Nurses Remain Pricey, And It’s Weighing On Hospital Profits
An underwhelming first quarter at the country’s biggest hospital chain shows the pandemic’s stranglehold on labor costs is proving to be more stubborn than many had expected. Investor-owned HCA Healthcare knocked down its full-year revenue and profit expectations on Friday, a move that sent shares tumbling and triggered a flurry of questions from analysts about its travel nurse spending. The Nashville-based hospital chain is a stock market darling that tends to dwarf its peers profit-wise, so its results don’t bode well for the rest of the sector. (Bannow, 4/22)

Bay Area News Group: Stanford Nurses Announce Strike
A union representing nurses at Stanford Hospital and Lucile Packard Children’s Hospital announced that it will begin a strike Monday, in advance of a formal bargaining session on Tuesday with hospital representatives. According to a statement Sunday evening, about 93 percent of eligible nurses authorized the strike, which the Committee for Recognition of Nursing Achievement (CRONA) will use to set up a picket line and hold a 9 a.m. Monday press conference outside Stanford Hospital along Welch Road at Pasteur Drive. (Kelly, 4/24)

The Boston Globe: Hospitals Seek To Solve Their Own Staffing Shortages
At Newton-Wellesley Hospital, there has long been a shortage of surgical technologists, the people responsible for setting up operating rooms and equipment. The pandemic only made it more difficult to recruit for those positions. Now, the hospital has begun a program with Newton’s Lasell University to offer free training and a job for people interested in becoming surgical technologists. “If you create a culture of investing in your staff, [people] feel valued and invested in and choose to stay,” said Errol Norwitz, the hospital’s president. “That’s the kind of culture I’m trying to create here.” (Bartlett, 4/22)

The Boston Globe: A ‘Scary Man,’ Or Someone Like Your Uncle? Mass. Requires Doctors To Undergo Implicit Bias Training In An Effort To Address Health Care Inequities
Not long ago Dr. Khama Ennis was chatting with an emergency-medicine colleague about incidents in the ER. The colleague recounted his struggle managing an aggressive patient. He described the person as “a big huge Black guy.” “The hairs on the back of my neck stood up,” Ennis, who is Black, recalled in an interview. She wondered how the patient’s skin color could be relevant to his violent behavior, although it had clearly contributed to her colleague’s fear. Ennis, an emergency doctor and president of the medical staff at Cooley Dickinson Hospital in Northampton, described this incident in a presentation to the Massachusetts Medical Society on combating racism in medicine. To her surprise and delight, a videotape of her hourlong presentation is now among the courses that doctors can take to fulfill a new requirement to receive or renew their medical licenses. (Freyer, 4/22)

Stat: There's A New Crop Of Treatments For ADHD In Kids. Are They Any Better?
Parents and doctors now have more tools than ever before to help kids manage symptoms of attention deficit hyperactivity disorder (ADHD). But experts say there’s a looming question about the next generation of treatments: Are these new drugs and devices any better than what’s come before? At least four new treatments — two drugs, a nerve stimulation device, and a prescription video game — have come to market in recent years to manage or treat symptoms of ADHD. The condition, which is marked by an inability to focus, impulsivity, and hyperactivity, has historically been treated with stimulants. But with new drug formulations and entirely novel approaches, experts say it’s proven difficult to grasp how different options stack up to one another, because there are rarely any studies that compare ADHD treatments head to head. (Farah, 4/25)

Los Angeles Times: Overdoses Drive 56% Increase In L.A. County Homeless Deaths
Deaths of homeless people in Los Angeles County soared by 56% in the year after the start of the pandemic, driven primarily by an increase in overdoses, according to a study published this month. Between April 1, 2020, and March 31, 2021, 1,988 deaths of people experiencing homelessness were reported, up from 1,271 in the 12 months prior, pre-pandemic, according to the Department of Public Health study. (Martinez and Lin II, 4/22)

The New York Times: Mayor Proposes 1,400 Shelter Beds To Move Homeless People Off Streets 
Putting additional funding behind his efforts to move homeless people off New York City streets, Mayor Eric Adams announced on Sunday that he would propose a $171 million investment in homeless services that would include funding for 1,400 specialized shelter beds. The spending comes as the city carries out an aggressive plan to remove homeless people from encampments and the subway system. (Ashford, 4/24)

AP: SC Bill Allowing Birth Control Without Prescription Advances 
Supporters of a bill to allow women to get birth control pills at South Carolina pharmacies without a doctor’s prescription are trying to get it passed before this year’s session ends. A House subcommittee on Wednesday approved the bill, sending it to the chamber’s full medical committee. The bill has already passed the Senate, but there are just nine regular legislative days left in the General Assembly’s 2022 session. (4/23)

Houston Chronicle: Eliminating The Tampon Tax: Texas Groups Team Up
A coalition of menstrual health organizations is appealing a decision by the Texas Comptroller’s Office to deny its protest against the state sales tax, which they say unfairly and unconstitutionally does not exempt tampons, pads and other hygienic products. If the dispute isn’t resolved on the administrative level, Meghan McElvy, partner at the Houston-based international law firm Baker Botts, said she plans to take the case all the way to the Texas Supreme Court if necessary. The law firm is taking up the case pro bono on behalf of the Texas Menstrual Equity Coalition. “It’s just kind of a no-brainer issue to me,” McElvy said. “(Male) libido enhancers are tax-exempt, but medically necessary products for women are not.” (Goldenstein, 4/23)

CIDRAP: Flu Rise Continues, With Bigger Impact In Certain Regions
Flu activity in the United States, as measured by outpatient visits for flulike illness, continues a steady rise that began in the middle of February, with activity highest in the northeast, south central, and mountain regions of the country, the US Centers for Disease Control and Prevention (CDC) said in its latest update today. (4/22)

The Washington Post: Exercise May Help Prevent Depression 
Already known to help ease depression, regular exercise may also help prevent it, with people who exercised just half the recommended weekly amount lowering their risk for depression by 18 percent, according to research published in the journal JAMA Psychiatry. However, those who were more active, meeting at least the minimum recommended physical activity level, reduced their risk for depression by 25 percent, compared with inactive people. (Searing, 4/24)

AP: WHO: 1 Child Has Died In Mystery Liver Disease Outbreak 
The World Health Organization says at least one death has been reported in connection with a mysterious liver disease outbreak affecting children in Europe and the United States. ... WHO didn’t say in which country the death occurred. (4/24)

Stat: WHO Says 12 Countries Have Reported Unusual Cases Of Hepatitis In Kids
The World Health Organization said Saturday that 12 countries have reported at least 169 unusual cases of hepatitis in children, with 17 of the children having undergone liver transplants as a consequence. At least one child has died. The WHO’s European division, which is taking the lead on the investigation into the mysterious outbreak, urged countries to look for, investigate, and report similar cases. (Branswell, 4/23)

AP: Ebola Case Confirmed In Congo's West Equateur Province 
A new Ebola case has been confirmed in Congo’s northwest Equateur Province in the city of Mbandaka, Congo health authorities said Saturday, declaring an outbreak nearly four months after the last one ended in the central African nation. The one case was confirmed in a 31-year-old man who began experiencing symptoms on April 5 and sought treatment at a health facility after more than a week of being taken care of at home, the World Health Organization said. He was admitted to an Ebola treatment center Thursday for intensive care but died the same day. (Maliro and Petesch, 4/23)

The Washington Post: As World Reopens, North Korea Is One Of Two Countries Without Vaccines
As mask mandates and social distancing requirements lift around the world, North Korea remains one of two countries that have not administered any coronavirus vaccines, with no sign of how it can ever begin to reopen despite a brewing humanitarian crisis for its people. The vaccines that were allocated for North Korea through a United Nations-backed global vaccination effort are no longer available, officials said this month, after Pyongyang repeatedly rejected the initiative’s offers of millions of doses. ... North Korea and Eritrea are now the only two countries in the world that have not administered vaccines. (Lee and Kim, 4/24)

The New York Times: The Drive To Vaccinate The World Against Covid Is Losing Steam
In the middle of last year, the World Health Organization began promoting an ambitious goal, one it said was essential for ending the pandemic: fully vaccinate 70 percent of the population in every country against Covid-19 by June 2022. Now, it is clear that the world will fall far short of that target by the deadline. And there is a growing sense of resignation among public health experts that high Covid vaccination coverage may never be achieved in most lower-income countries, as badly needed funding from the United States dries up and both governments and donors turn to other priorities. (Robbins and Nolen, 4/23)

CIDRAP: Effect Of Nations' COVID Restrictions On Mental Health Varied By Type, Group 
Two studies published yesterday in The Lancet Public Health detail how COVID-19 restrictions moderately affected adults' mental health in 15 nations, with one finding that the type of lockdowns were linked to the level of distress and opinion of the government, and the other suggesting that mental health declined slightly but significantly under lockdown—especially among women. (Van Beusekom, 4/22)