First Edition: April 4, 2023

KHN: Raincoats, Undies, School Uniforms: Are Your Clothes Dripping In ‘Forever Chemicals’? 
There could be more than just fashion risks involved when buying a pair of leggings or a raincoat. Just how much risk is still not clear, but toxic chemicals have been found in hundreds of consumer products and clothing bought off the racks nationwide. Thousands of perfluoroalkyl and polyfluoroalkyl substances, or PFAS, exist since the first ones were invented in the 1940s to prevent stains and sticking. PFAS chemicals are used in nonstick cookware, water-repellent clothing, and firefighting foam. (Norman, 4/4)

KHN: Fatigue Is Common Among Older Adults, And It Has Many Possible Causes
Nothing prepared Linda C. Johnson of Indianapolis for the fatigue that descended on her after a diagnosis of stage 4 lung cancer in early 2020. Initially, Johnson, now 77, thought she was depressed. She could barely summon the energy to get dressed in the morning. Some days, she couldn’t get out of bed. But as she began to get her affairs in order, Johnson realized something else was going on. However long she slept the night before, she woke up exhausted. She felt depleted, even if she didn’t do much during the day. (Graham, 4/4)

The Hill: White House Rolls Out New Cancer Initiative To Help Implement ‘Moonshot’ 
Federal health officials on Monday outlined a new framework aimed at helping to implement the White House “Cancer Moonshot” initiative. One of the main goals of the Moonshot initiative is to reduce cancer mortality by at least 50 percent over the next 25 years. To accomplish that, the new National Cancer Plan includes eight distinct goals to prevent cancer, reduce mortality and maximize quality of life for people living with it.  (Weixel, 4/3)

Healio: National Cancer Plan Outlines Eight Goals, Strategies To Achieve Biden’s Moonshot Vision
The eight goals listed in the plan include: prevent cancer; detect cancers early; develop effective treatments; eliminate inequities; deliver optimal care; engage every person; maximize data utility; and optimize the workforce. (4/3)

The New York Times: Millions On Medicaid May Soon Lose Coverage As Pandemic Protections Expire
In a closet-sized windowless office, Kialah Marshall maintains an Excel spreadsheet with a prosaic title, “Medicaid Unwinding,” the source material for a mind-numbing routine. Five days a week, she and a group of co-workers in a poor section of Kansas City, Missouri’s largest city, call 75 to 100 Medicaid recipients from a list of about 19,000 who receive care at Swope Health, a federally funded network of health clinics. Their assignment is straightforward: warning those patients that they could lose their health insurance for the first time in at least three years. (Weiland, 4/3)

Axios: Inflation Drove ACA Premiums Up
Inflation and higher health spending helped drive monthly premiums for Affordable Care Act coverage up an average of 3.4% between 2022 and 2023, reversing a trend of recent declines, according to a new report from the Urban Institute and the Robert Wood Johnson Foundation. Why it matters: Some of the increase was also attributed to uncertainty over whether Congress would extend or make permanent premium subsidies, which complicated insurers' decision making. Extending subsidies would incentivize healthy people who choose to buy coverage previously deemed unaffordable. (Dreher, 4/4)

Axios: Hospitals Likelier To Offer Discounts To Patients Who Pay Cash
Hospitals routinely charge less to patients who pay in cash and seek to recoup the difference from commercially insured patients in markets where they can exert leverage, according to a new Johns Hopkins study published in Health Affairs. Why it matters: The analysis for 70 services — drawn from data reported by 2,379 hospitals as of September 2022 — provides another window into the opaque world of hospital pricing and could be a data point for employers in their negotiations with insurers or directly with providers. (Bettelheim, 4/4)

The Hill: Lithium-Contaminated Water In Pregnancy Could Be Linked To Increased Risk Of Autism 
By cross-checking lithium levels in Danish public waterworks with the country’s extensive civil data on pregnancy and psychiatric disorders, the researchers found that as lithium concentrations increased, so too did autism diagnosis. ... The country was also an ideal test case because its consumption of bottled water ranks among the lowest in Europe — meaning Danes predominantly rely on tap water, according to the authors. (Udasin, 4/3)

Reuters: Florida Senate Passes Six-Week Abortion Ban
Florida's Republican-led Senate passed a bill on Monday to outlaw most abortions after six weeks of pregnancy, bringing the state a step closer to joining others across the U.S. South in banning almost all abortions. Florida currently has a law banning abortions after 15 weeks of pregnancy, which is being challenged in court. Republicans in the state House of Representatives and Senate filed concurrent bills last month to restrict the procedure further, starting at six weeks of pregnancy. (Borter, 4/3)

The Washington Post: Florida Democratic Chair, Lawmaker Among 11 Detained At Abortion Rally
Florida Democrats chair Nikki Fried and state Senate Minority Leader Lauren Book (D) were among 11 people arrested Monday night while protesting abortion legislation outside Tallahassee’s City Hall, police said. Fried tweeted late Monday that she had been released. It was not immediately clear whether the others had also been released. (Knowles and Ables, 4/4)

Reuters: Planned Parenthood Seeks To Block Utah Ban On Abortion Clinics 
Planned Parenthood on Monday asked a state court judge in Utah to block a law set to take effect next month that would effectively ban abortion clinics from operating in the state. Planned Parenthood said the law, which would eliminate the licensing process for abortion clinics and thus effectively make it impossible to get an abortion anywhere but in a hospital, violated the state constitution's rights to privacy and bodily integrity, in a lawsuit filed in the Third Judicial District Court in Salt Lake City. (Pierson, 4/3)

AP: Abortion Bills Gain No Ground In Kentucky With Ban In Place
After years of setbacks, abortion-rights supporters in Republican-leaning Kentucky thought they achieved a breakthrough in November, when voters defeated a measure aimed at denying any constitutional protections for abortion. But their hopes that the state’s sweeping abortion ban might be relaxed vanished well before the GOP-dominated Legislature ended its annual session. ... A handful of abortion bills, including proposals to restore abortion rights or add rape and incest exemptions to the sweeping ban, either failed to get a committee hearing or never were assigned to a committee. (Schreiner, 4/3)

Houston Chronicle: Texas Abortion Funds Restart Out-Of-State Help After Court Ruling
Some Texas abortion funds are back to helping people access the procedure in states where it's still legal, following months of legal uncertainty and a court ruling that at least partly shields them from prosecution under the state's bans. In a statement Monday, the Lilith Fund announced that it was restarting its logistical support. (Goldenstein, 4/3)

Fox News: Congressional Lawmakers Slam Biden Administration For Proposing Slush Fund For Pro-Abortion Orgs
Congressional lawmakers accused the Biden Administration of using regulations for the Tri-Agencies – Department of Health and Human Services, or HHS; Labor Department and Treasury Department – to create a slush fund for abortion providers like Planned Parenthood. The Committee on Education and the Workforce submitted a letter to HHS secretary Xavier Becerra, Treasury secretary Janet Yellen and Department of Labor acting secretary Julie A. Su, opposing rules seeking to eliminate an exemption to contraceptive coverage services for groups and organizations that have moral objection to such services. (Wehner and Pandolfo, 4/3)

The Hill: North Dakota Legislature Fails To Override Veto Of Transgender Pronoun Bill 
North Dakota House Republicans on Monday failed to secure enough votes to override Gov. Doug Burgum’s (R) veto of legislation that would have allowed state employees and educators to misgender transgender staff and students. The North Dakota House in a 56-36 vote on Monday failed to secure the two-thirds majority needed to override Burgum’s veto of Senate Bill 2231, which had sought to prevent public schools and state government entities from adopting policies that require students and employees to address a transgender person using pronouns consistent with their gender identity. (Migdon, 4/3)

The Washington Post: FDA To Okay Second Omicron-Targeting Booster For Some, Officials Say 
Federal regulators have decided to authorize a second omicron-specific coronavirus vaccine booster shot for people who are at least 65 or have weak immune systems — an effort to provide additional protection to high-risk individuals, according to several officials familiar with the plan. The Food and Drug Administration is expected to announce the step in the next few weeks, and the Centers for Disease Control and Prevention is expected to move quickly to endorse it, said the officials, who spoke on the condition of anonymity because they were not authorized to publicly discuss internal discussions. *McGinley and Sun, 4/3)

CNN: A New Approach To A Covid-19 Nasal Vaccine Shows Early Promise
Scientists in Germany say they’ve been able to make a nasal vaccine that can shut down a Covid-19 infection in the nose and throat, where the virus gets its first foothold in the body. In experiments in hamsters, two doses of the vaccine – which is made with a live but weakened form of the coronavirus that causes Covid-19 – blocked the virus from copying itself in the animals’ upper airways, achieving “sterilizing immunity” and preventing illness, a long-sought goal of the pandemic. (Goodman, 4/3)

AP: University Facing Class-Action Over COVID Campus Lockdown 
A lawsuit against the University of Delaware over its campus shutdown and halting of in-person classes because of coronavirus can proceed as a class action on behalf of thousands of students who were enrolled and paid tuition in spring 2020, a federal judge has ruled. (Chase, 4/3)

AP: Medical Examiners Group Steps Away From 'Excited Delirium'
A leading group of medical experts says the term “excited delirium” should not be listed as a cause of death. Critics have said the term has been used to justify excessive force by police. The National Association of Medical Examiners had been one of the last to take a stand against the commonly used but controversial term. In a statement posted on its site March 23, the association said “excited delirium” or “excited delirium syndrome” should not be used as a cause of death. The statement has no legal weight, but will be influential among medical examiners. (Johnson and Foley, 4/3)

Modern Healthcare: Rural Hospitals Seek Mergers Amid Financial Distress
Unprofitable rural hospitals often merge with health systems, helping them stay open but also increasing the likelihood of price hikes for services. Between 2010 and 2018, 17% of unprofitable rural hospitals merged with another organization while 7% closed, according to an analysis of data from 325 unprofitable hospitals. Of the financially unstable hospitals that didn’t close or consolidate, about half became profitable over that span, according to a study published Monday in Health Affairs. (Kacik, 4/3)

Modern Healthcare: Sanford Health, Fairview Health Services Delay Merger Again
Sanford Health and Fairview Health Services will delay the closing of their proposed merger for a second time, the nonprofit health systems said Monday. The proposed $14 billion deal, first announced in November 2022, was initially slated to close March 31, pending regulatory approval. Sioux Falls, South Dakota-based Sanford and Minneapolis-based Fairview agreed in February to postpone the closing date until May 31 to give Minnesota Attorney General Keith Ellison (D) more time to evaluate the merger. (Kacik, 4/3)

Modern Healthcare: Staffing Agencies For Travel Nurses Under Fire In Texas, Other States
A growing number of state legislators want to prevent staffing agencies from gouging health systems that use temporary workers. Contract labor, particularly in nursing, has been key to overcoming staffing shortages in the last few years, and many health systems have paid premium rates to fill workforce gaps created by employees who left during the COVID-19 pandemic. As a result, labor costs skyrocketed and pressured balance sheets—and are only just now beginning to normalize. (Hudson, 4/3)

The Wall Street Journal: Mounjaro Could Eclipse Ozempic As The Most Powerful Weight-Loss Drug 
People who are overweight are flocking to the drug Ozempic to slim down. Looming is an even more powerful weight-loss treatment. The drug Mounjaro helped a typical person with obesity who weighed 230 pounds lose up to 50 pounds during a test period of nearly 17 months. No anti-obesity drug has ever safely made such a difference. In the coming months, it is widely expected to get the go-ahead from U.S. health regulators to be prescribed for losing weight and keeping it off, and some patients are already using it unapproved for that purpose. (Loftus, 4/3)

CNN: Alzheimer's And HRT: Study Suggests Sweet Spot To Avoid Dementia
Alzheimer’s disease strikes women harder than men — over two-thirds of those who descend into dementia’s devastating twilight are female at birth. That’s likely due to biological reasons that remain poorly understood, according to the Alzheimer’s Association. One key piece of the enigma: Women lose sexual hormones such as estrogen when they undergo menopause, either naturally through the body’s decreased production or by removal of the ovaries via surgery. However, just how the loss of those hormones and the impact of hormone replacement therapy, or HRT, affects dementia risk is also unclear. (LaMotte, 4/3)

AP: Nevada Is The State With The Most Superbug Fungus Infections
Federal public health officials have identified southern Nevada as the place in the U.S. with the highest number of cases of a potentially lethal fungus that is resistant to common antibiotics, and can be a major risk for hospital and nursing home patients. The Centers for Disease Control and Prevention tracked and found that in 2022, Nevada had 16%, or 384 of the country’s 2,377 clinical cases of the superbug called Candida auris — followed by California with 359 cases, Florida with 349 cases and New York with 326. (4/3)

CNN: Eye Drop Recall: FDA Inspection Finds Sterilization Issues At Recalled Manufacturer's Facility In India
The manufacturer of eye drops that have been linked to an outbreak of serious bacterial infections in the US, including at least three deaths, did not follow proper protocol to prevent contamination of its products, according to an inspection report published Friday by the US Food and Drug Administration. The FDA visited a Global Pharma Healthcare facility in India for an inspection that started in mid-February, 2½ weeks after the company recalled EzriCare Artificial Tears due to possible contamination. (McPhillips, 4/3)

CBS News: Eye Drops Recall: FDA Finds Dirty Equipment At Manufacturer Linked To Bacterial Outbreak In EzriCare, Delsam Pharma Products
Federal inspectors found dozens of issues at an eye drops manufacturer now linked to a fatal outbreak of drug-resistant bacteria, inspection records released by the Food and Drug Administration show, ranging from dirty equipment and clothing to missing safeguards and procedures. The FDA's findings were detailed in citations issued to Indian manufacturer Global Pharma Healthcare Pvt Ltd after an inspection from February 20 through March 2. This appears to have been the company's first visit from the FDA to their plant in India: no other inspections are on record for the site. (Tin, 4/3)

CIDRAP: CDC Says Listeria Outbreak Linked To Deli Meat And Cheese Is Over
The Centers for Disease Control and Prevention (CDC) said last week that a multistate Listeria outbreak that began in 2021 is now over after 16 cases and 1 death. The CDC said in an investigation notice that the outbreak was tied to meat and cheese from deli counters, including a deli in Brooklyn, New York, where five case patients bought sliced deli meat and cheese. Whole genome sequencing showed that bacteria from patient samples were closely related genetically, indicating that people got sick from the same food source, and identified the outbreak strain in sliced meat and environmental samples from the Brooklyn deli. But no single food source was identified. (Dall, 4/3)

The Atlantic: Hiccups Have A Curious Connection To Cancer
Colleen Kennedy, a retired medical assistant, was prepared for the annihilation of chemotherapy and radiation treatment for stage-three lung cancer. She hadn’t expected the hiccup fits that started about halfway through her first treatment round. They left her gasping for air and sent pain ricocheting through her already tender body.  At times, they triggered her gag reflex and made her throw up. After they subsided, she felt tired, sore, breathless—as if she’d just finished a tough workout. They were, Kennedy, now 54, told me, “nothing compared to what we would consider normal hiccups at all.” They lasted for nearly a year. (Renault, 4/3)

AP: Ricochet, San Diego’s Surfing Therapy Dog, Dies At 15 
Ricochet, the beloved Golden Retriever who found her calling as a therapy dog when she learned to surf, has died in Southern California. The 15-year-old canine helped countless veterans and kids during more than a decade providing therapy in the waves off San Diego, according to her owner Judy Fridono. The dog, who died Friday, was diagnosed with liver cancer last August, she said. ... Ricochet worked as a therapy dog for Pawsitive Teams and the Naval Medical Center San Diego where she supported people with trauma, anxiety and other emotional challenges, the Union-Tribune said. (4/3)

The New York Times: New Marburg Outbreaks In Africa Raise Alarm About The Deadly Virus’s Spread
Two concurrent outbreaks of the Marburg virus, a close cousin of Ebola that can kill as many as 90 percent of the people it infects, are raising critical questions about the behavior of this mysterious bat-borne pathogen and global efforts to prepare for potential pandemics. Marburg, a hemorrhagic fever, is rare: Just a handful of outbreaks have been reported since the virus was identified in 1967. But a steady uptick in occurrences in Africa in recent years is raising alarm. (Nolen, 4/3)