First Edition: Aug. 23, 2022

KHN: The $18,000 Breast Biopsy: When Having Insurance Costs You A Bundle
When Dani Yuengling felt a lump in her right breast last summer, she tried to ignore it. She was 35, the same age her mother had been when she received a breast cancer diagnosis in 1997. The disease eventually killed Yuengling’s mom in 2017. (Sausser, 8/23)

KHN: From Book Stacks To Psychosis And Food Stamps, Librarians Confront A New Workplace
For nearly two decades, Lisa Dunseth loved her job at San Francisco’s main public library, particularly her final seven years in the rare books department. But like many librarians, she saw plenty of chaos. Patrons racked by untreated mental illness or high on drugs sometimes spit on library staffers or overdosed in the bathrooms. She remembers a co-worker being punched in the face on his way back from a lunch break. One afternoon in 2017, a man jumped to his death from the library’s fifth-floor balcony. Dunseth retired the following year at age 61, making an early exit from a nearly 40-year career. (Scheier, 8/23)

KHN: ‘American Diagnosis’: As Climate Crises Batter The Bayou, Houma People Are Being Displaced 
Lanor Curole is a member of the United Houma Nation. She grew up in Golden Meadow, a small bayou town in Southern Louisiana. The impacts of repetitive flooding in the area forced her to move farther north. Louisiana’s coastal wetlands lose about 16 square miles of land each year. This land loss, pollution from the 2010 BP oil spill, and lingering devastation from Hurricanes Katrina and Ida are pushing many Houma people out of their homes. (8/23)

Politico: 'Bittersweet': Fauci Will Leave Government, Excited For What Comes Next
Anthony Fauci, the nation’s top infectious disease expert who in his effort to lead the response to Covid-19 became one of the most divisive public health figures in recent memory, announced he will step down later this year. Fauci, who has led the National Institutes of Health’s National Institute of Allergy and Infectious Diseases for 38 years, told POLITICO on Monday that leaving his government post was “bittersweet” but he was also excited for what comes next. (Lim, Cancryn, Gardner and Ward, 8/22)

The New York Times: Fauci Says He Will Step Down In December To Pursue His ‘Next Chapter’ 
The announcement by Dr. Fauci, 81, was not entirely unexpected. He has hinted for some time that he was thinking of retiring, saying last month that he would “almost certainly” do so by 2025. In an interview Sunday evening, he said he was “not retiring in the classic sense” but would devote himself to traveling, writing and encouraging young people to enter government service. “So long as I’m healthy, which I am, and I’m energetic, which I am, and I’m passionate, which I am, I want to do some things outside of the realm of the federal government,” Dr. Fauci said in the interview, adding that he wanted to use his experience and insight into public health and public service to “hopefully inspire the younger generation.” (Stolberg, 8/22)

Fox News: Pandemic Politics: Fauci Praised, Pummeled As He Announces His Exit 
Soon after Anthony Fauci announced he will be stepping down in December, White House chief of staff Ron Klain hailed the doctor: "I cannot think of a public servant who has done as much to save as many lives for as long a period as Dr. Tony Fauci. And he is a gem of a person." Just as quickly, Donald Trump Jr. tweeted that Fauci was giving up his post as President Biden’s chief medical adviser "likely to avoid being questioned by a GOP controlled house on how he got everything so wrong for so long!" The dueling narratives were under way. (Kurtz, 8/23)

National Institutes Of Health: Statement By Anthony S. Fauci, M.D. 
It has been the honor of a lifetime to have led the NIAID, an extraordinary institution, for so many years and through so many scientific and public health challenges. I am very proud of our many accomplishments. I have worked with — and learned from — countless talented and dedicated people in my own laboratory, at NIAID, at NIH and beyond. To them I express my abiding respect and gratitude. (Anthony S. Fauci, 8/22)

Stat: Pfizer Seeks Authorization For New Covid Booster, Without Fresh Clinical Data
Pfizer and BioNTech said Monday that they have asked the Food and Drug Administration to authorize a new booster shot targeted at the Omicron BA.4/BA.5 strain of the coronavirus that causes Covid-19, the first step in a process that could lead to more effective booster shots. (Herper, 8/22)

CIDRAP: Pfizer Files For Emergency Use Of Its BA.4/BA.5 Omicron Booster 
In a statement, Pfizer said its EUA would clear the booster for use in people ages 12 and older. The company said the clinical trial is expected to begin later this month, but it has already scaled up production and will be ready to ship the vaccine in September, as soon as the FDA approves the emergency use authorization (EUA) application. To speed the consideration of the EUA, the FDA told Pfizer it could submit clinical data for its bivalent BA.1 vaccine alongside preclinical and manufacturing data on its BA.4/BA.5 vaccine. Preclinical data in animals suggest that the BA.4/BA.5 bivalent booster prompts a strong neutralization antibody response against Omicron BA.1, BA.2, and BA.4/BA.5 variants, as well as to the original SARS-CoV-2 virus. (Schnirring, 8/22)

AP: Pfizer Seeks OK Of Updated COVID Vaccine Booster For Fall 
Moderna is expected to file a similar application soon for updated boosters for adults. The U.S. has a contract to buy 105 million of the Pfizer doses and 66 million Moderna ones, assuming FDA gives the green light. (Neergaard, 8/22)

CIDRAP: Study: Incubation Times Of SARS-CoV-2 Variants Fell Over Time
As the dominant circulating strain of SARS-CoV-2 evolved from Alpha to Omicron, the incubation period from infection to symptoms or first positive COVID-19 test result gradually decreased, from 5 to 3.4 days, according to a systematic review and meta-analysis published today in JAMA Network Open. (Van Beusekom, 8/22)

San Francisco Chronicle: Regular Exercise May Cut COVID Risks, Study Finds
Regular physical activity could lower the likelihood of adverse COVID-19 outcomes, according to a study published Monday in the British Journal of Sports Medicine. In the peer-reviewed analysis of data from 16 global studies that included more than 1.8 million adults, the researchers found that those who engaged in regular physical activity had a lower risk of infection, hospitalization, severe COVID-19 illness and COVID-19-related death as compared with their inactive peers. (Fracassa and Vaziri, 8/22)

ABC News: Monkeypox Now Reported In All 50 States
Monkeypox has now been detected in all 50 states, health officials revealed. Wyoming became the final state to report a case of the disease on Monday. The Wyoming Department of Health announced the case in an adult male in Laramie County, which includes the capital of Cheyenne. (Kekatos, 8/22)

The Hill: About Half Of Men Who Have Sex With Men Reduced Sexual Activity Due To Monkeypox: Survey 
Roughly half of men who have sex with men have reported reducing their number of sexual partners and encounters in response to the monkeypox outbreak, according to a survey released on Monday by the Centers for Disease Control and Prevention (CDC). Forty-eight percent of the poll’s participants said they reduced their number of sexual partners, 50 percent reduced their number of one-time sexual encounters, and 49 percent reduced how much sex they had with partners they met through dating apps or sexual venues. (Choi, 8/22)

KCRA: California To Refer To Virus As Mpox And MPX, Drops Monkeypox Term
California health officials Friday confirmed they are avoiding using the term "monkeypox" and will now refer to it as "mpox" or “MPX.” ... The change comes as the World Health Organization has called for a new term for the virus to make it less stigmatizing and discriminatory. (Zavala, 8/20)

Stat: U.S. Plan To Stretch Monkeypox Vaccine Supply Runs Into Problems
The Biden administration’s plan to stretch supplies of monkeypox vaccine by giving people fractional doses of the product is running into problems, with some local health officials saying they are unable to extract the targeted number of doses from vials. (Branswell and Gaffney, 8/23)

BioProcess International: Bavarian Nordic Deal With GRAM For Monkeypox Vax
“Rapidly increasing the supply and safe delivery of monkeypox vaccine to Americans at the highest risk of contracting the virus is a top priority for President Biden,” said Bob Fenton, coordinator of the White House National Monkeypox Response. “This partnership between Bavarian Nordic and GRAM will significantly increase the capacity to fill and finish government-owned doses – for the first time in the US – and allow us to deliver our current and future supply more quickly to locations nationwide.” (Nelson, 8/22)

Reuters: Analysis: Experts Question Reliance On Monkeypox Vaccine With Little Data, Short Supply
Several countries, including the United States, Britain and Spain, are stretching out the available doses, with unknown outcomes. Indeed, the Bavarian Nordic shot has not undergone clinical trials to evaluate the vaccine's ability to prevent monkeypox in humans, though initial studies suggest it will provide some protection. "The whole vaccination strategy for monkeypox is associated with a lot of uncertainties," said Dr Dimie Ogoina, a professor of medicine at Niger Delta University in Nigeria and member of the WHO's monkeypox emergency committee. (Rigby and Grover, 8/23)

The Washington Post: Judge To Rule By Wednesday On Federal Challenge To Idaho Abortion Ban
A federal judge in Idaho will rule by Wednesday on whether a near-total ban on abortion can take effect in the state, following a Justice Department lawsuit that says the statute violates a federal requirement to provide medical care when a pregnant person’s life or health is at stake. The case marks the Justice Department’s first attempt to fight a strict abortion ban in court following the Supreme Court decision in June that overturned Roe v. Wade, upending the right to terminate a pregnancy that had been enshrined in federal law for nearly 50 years. (Stein, 8/22)

Bloomberg: Idaho’s Abortion Limits May Conflict With US Law, Judge Says
Idaho lawmakers offered to revise a plan to prosecute doctors for performing abortions to allow emergency health exceptions after a judge said the state’s strict enforcement may run afoul of federal law. (Rosenblatt, 8/22)

Topeka Capital-Journal: Kansas Abortion Amendment Recount Wraps Up. After $119,000 Spent, 63 Votes Changed.
After five days, multiple credit cards, $119,000 and no shortage of confusion, a hand recount of the Kansas abortion amendment vote in nine counties changed the ultimate margin of the outcome by only 63 votes, after its sound defeat on Aug. 2. The recount, requested by Melissa Leavitt, a Colby resident who has trafficked in election conspiracy theories, and Mark Gietzen, a Wichita anti-abortion activist, wasn't expected to meaningfully change the results. The "no" vote side lost 57 votes overall, while the "yes" votes gained only six votes. That's a small fraction of the over 922,000 Kansans who voted on the amendment. (Bahl, 8/22)

NPR: 3 More States Are Poised To Enact Abortion Trigger Bans This Week
A number of states have codified abortion bans without the use of a trigger law. So far, a total of 14 states have near-total abortion bans or bans after six weeks of pregnancy. Barring any last-minute court intervention, three of those states are expected to implement even more draconian laws starting Aug. 25. (Kim, 8/22)

The Washington Post: More Trigger Bans Loom As 1 In 3 Women Lose Most Abortion Access Post-Roe
Two months after the Supreme Court overturned Roe v. Wade, about 20.9 million women have lost access to nearly all elective abortions in their home states, and a slate of strict new trigger laws expected to take effect in the coming days will shut out even more. Texas, Tennessee and Idaho all have existing restrictions on abortion, but the laws slated to begin Thursday will either outlaw the procedure entirely or heighten penalties for doctors who perform an abortion, contributing to a seismic shift in who can access abortion in their home states. (Shepherd, Rachel Roubein and Kitchener, 8/22)

AP: College Students Return To Campus Without Access To Abortion 
Students returning to college are confronting a new reality in states such as Texas, Ohio and Indiana: Abortion, an option for an unplanned pregnancy when they were last on campus, has since been banned, often with few exceptions. Students said they’ve made changes both public and intimate since the U.S. Supreme Court decision this summer that overturned the landmark Roe v. Wade ruling. Students said they’re using more birth control, and some have made a plan to leave the state for an abortion if they become pregnant. They’re also taking public stances, with increased activism by both opponents and supporters of abortion rights. (Rodgers and Franko, 8/22)

Politico: White Coats In The State Capital: OB-GYNs Become Political Force In Abortion Wars 
Red state lawmakers rushing to pass new abortion restrictions are being stymied by an unexpected political force — OB-GYNs. These physicians — many of whom have never before mobilized politically — are banding together in the wake of the Supreme Court overturning Roe v. Wade, lobbying state lawmakers, testifying before committees, forming PACs, and launching online campaigns against proposed abortion restrictions. Legislators who are themselves physicians are using their medical backgrounds to persuade colleagues to scale back some of the more restrictive and punitive portions of anti-abortion laws being considered. (Ollstein and Messerly, 8/22)

Los Angeles Times: Newsom Vetoes Bill Proposing California Overdose Prevention Sites 
California Gov. Gavin Newsom on Monday vetoed a controversial bill that would have allowed supervised injection site pilot programs in Los Angeles, San Francisco and Oakland, in efforts to prevent drug overdose deaths and connect people to treatment for addiction. The number of safe injection sites that would have been authorized by the bill could have induced a “world of unintended consequences,” Newsom wrote in his veto message. (Wiley, 8/22)

The New York Times: Red Flag For Shootings? Life Crisis, Not Mental Illness, Experts Say
America’s mass killers fit no single profile and certainly no pattern of insanity — many, if not most, had never been diagnosed with a serious psychiatric disorder. Background checks can prevent someone with a diagnosis of mental illness from acquiring a gun, but psychologists say there is a wide divide between a clinical diagnosis and the type of emotional disturbance that precedes many mass killings. (Dewan, 8/22)

The New York Times: Defense Argues Gunman In Parkland School Shooting Was Born ‘Damaged’
The troubled life of Nikolas Cruz, who killed 17 people at his former Florida high school four years ago, began long before he was born, his lead defense lawyer told jurors on Monday, arguing that his biological mother’s heavy consumption of alcohol and drugs while pregnant irreparably harmed his developing brain. At birth, he was deprived of oxygen by an umbilical cord wrapped three times around his neck, and doctors spent the first minute after his delivery resuscitating him. (Mazzei, 8/22)

Miami Herald: Mom Did Crack, Drank While Pregnant, Parkland Shooter’s Jailed Sister Testifies
Danielle Woodard hadn’t seen her baby biological brother in person since Sept. 24, 1998, when he was born at the hospital. They reunited, in a way, almost 24 years later. Woodard, who herself is in jail in Miami awaiting trial in a carjacking case, took the witness stand on Monday, testifying on behalf of younger brother Nikolas Cruz, who is facing the death penalty as he’s being sentenced for the February 2018 massacre at Marjory Stoneman Douglas High in Parkland. (Ovalle, 8/22)

AP: California To Protect Health Benefits For Young Immigrants
About 40,000 low-income adults living in the country illegally won’t lose their government-funded health insurance over the next year under a new policy announced Monday by California Gov. Gavin Newsom’s administration. California already pays for the health care expenses of low-income adults 25 and younger, regardless of their immigration status. A new law scheduled to take effect in January 2024 would extend those benefits to cover all adults who, but for their immigration status, would qualify for the state’s Medicaid program. (Beam, 8/23)

AP: Nebraska Medical Marijuana Effort Falls Short On Signatures 
Proposals to legalize medical marijuana in Nebraska will not appear on the November general election ballot after the efforts failed to collect enough signatures, the state’s top elections official said Monday. (8/22)

NBC News: One State Declined A Simple Tweak To Its Summer Meals Program. Thousands Of Kids Paid The Price
Missouri was the only state that did not allow a grab-and-go option for its Summer Food Service Program operators, according to an exclusive NBC News analysis based on responses from all 50 states. The result was a dramatic drop in the number of meals that Missouri kids received: up to 97% fewer than last summer at some sites, community operators across the state told NBC News. (Chuck, 8/23)

The Wall Street Journal: Where Are People Living The Longest? See Where Your State Ranks In Life Expectancy
Where should you live to have the longest life expectancy? New data suggests heading out West is a good bet. Hawaii has the highest life expectancy of any U.S. state, according to new federal figures released on Tuesday by the Centers for Disease Control and Prevention. The combined average life expectancy for men and women in the state was 80.7 years old, the only U.S. state with an average expectancy rate above 80 years.  Washington state has the second-highest life expectancy, at 79.2 years. California was also high on the list, at 79.0 years. (Ansari, 8/23)

NBC News: Map: How Much Life Expectancy Declined In Each State In 2020
The average life expectancy in the U.S. dropped by nearly two years in 2020, down to 77 years from 78.8 in 2019. It was the country’s lowest average in nearly two decades. A new report from the National Center for Health Statistics looks at how that decline varied from state to state. ... (Bendix and Chiwaya, 8/23)

The Washington Post: One Side Effect Of Cruise Covid Rules: Norovirus Has Plummeted
One apparent result of the measures cruise lines have taken against covid-19: Outbreaks of gastrointestinal illness have been far lower than in pre-pandemic years. So far this year, cruise lines have reported two outbreaks of vomiting and diarrhea to the Centers for Disease Control and Prevention that affected 3 percent or more of passengers or crew. ... The two outbreaks, affecting a total of 113 people, took place on a Carnival Cruise Line ship in late May and a luxury Seabourn voyage from late April through May. (Sampson, 8/22)

Stat: In Early Research, An AI Model Detects Signs Of Parkinson’s Using Breathing Patterns
James Parkinson first flagged a link between changes in breathing patterns and the debilitating disease that now bears his name. But since his work in the early 19th century, only minimal progress has been made in treating a condition that has become alarmingly prevalent. (Ross, 8/22)

Stat: Unlikely Protein Implicated In Mouse Study Using ALS Patients' Spinal Fluid
It was a shot in the dark — or at best, a dimly lit room: injecting a mouse with a little bit of spinal cord fluid from someone with the most common form of amyotrophic lateral sclerosis, or ALS. (Cueto, 8/22)

Stat: ‘A Golden Age’: Long Neglected In Medicine, Rare Kidney Diseases See A Surge In Research
After having her son, Judy Akin got sick much more often than before, and her blood pressure was on the rise, but she led a busy, active life. The ailments were a consequence of stress, she imagined. Doctors told her she just had to shed some pounds to feel better. (Cueto, 8/23)

Bloomberg: Are Synthetic Hallucinogens Illegal? DEA Delay On Psychedelics Creates Limbo
The US Drug Enforcement Agency had planned a public hearing for Monday on its bid to categorize five hallucinogenic compounds as Schedule 1 drugs — an imprimatur reserved for substances with a high potential for abuse and no recognized medical use, such as LSD and heroin. Instead, it withdrew its bid to do so late last month, sending the substances back to the Department of Health and Human Services for review. (Kary, 8/22)

Stat: Major Indian Generic Drugmaker Closes A U.S. Facility After Years Of Manufacturing Problems 
After a decade of manufacturing problems, a U.S. federal court ordered a unit of Wockhardt, one of the largest makers of generic drugs, to refrain from making allegedly adulterated medicines at a facility in Illinois. However, the U.S. subsidiary, Morton Grove Pharmaceuticals, recently decided to discontinue operations at the site, according to court documents. (Silverman, 8/22)

Modern Healthcare: CommonSpirit To Launch Nation's Largest Nursing Residency Program
In his first weeks as CEO of CommonSpirit Health, Wright Lassiter is focusing on a few key priorities he says will help the largest not-for-profit system in the country navigate a post-COVID world. ...  CommonSpirit, which has 150,000 employees across 21 states, is forming an internal staffing agency and nursing residency program to bolster its workforce. (Kacik, 8/22)