First Edition: August 25, 2021

KHN: Microbiome Startups Promise To Improve Your Gut Health, But Is The Science Solid?
After Russell Jordan sent a stool sample through the mail to the microbiome company Viome, his idea of what he should eat shifted. The gym owner in Sacramento, California, had always consumed large quantities of leafy greens. But the results from the test — which sequenced and analyzed the microbes in a pea-sized stool sample — recommended he steer clear of spinach, kale and broccoli. “Things I’ve been eating for the better part of 30 years,” said Jordan, 31. “And it worked.” Soon, his mild indigestion subsided. He recommended the product to his girlfriend. (Norman, 8/25)

KHN: Hot Spots Where Covid Vaccination Lags Push Experimental Antibody Treatment
For months, Joelle Ruppert was among the millions of Americans who are covid vaccine holdouts. Her reluctance, she said, was not so much that she opposed the new vaccines but that she never felt “compelled” by the evidence supporting their experimental use. Nonetheless, after she fell ill with covid last month, Ruppert, a Florida preschool teacher, found herself desperate to try an experimental product that promised to ease her symptoms: infusion with a potent laboratory-produced treatment known as monoclonal antibody therapy. (Aleccia, 8/25)

KHN: From Uber Vouchers To Patient Advocates: What It Takes To Increase ER Addiction Treatment
For years, Kayla West watched the opioid epidemic tear through her eastern Tennessee community. As a psychiatric nurse practitioner, she treated people with mental illness but felt she needed to do more to address addiction. So in 2020, when the state created a position to help hospitals improve addiction care in the emergency room, West jumped at the opportunity. She knew that many people with substance use disorders land in the ER, and that starting medications for opioid use — like buprenorphine (often known by the brand name Suboxone) — could double a person’s chance of staying in treatment a month later. (Pattani, 8/25)

Reuters: COVID Jab Protection Wanes Within Six Months - UK Researchers
Protection against COVID-19 offered by two doses of the Pfizer/BioNTech and the Oxford/AstraZeneca coronavirus vaccines begins to fade within six months, underscoring the need for booster shots, according to researchers in Britain. After five to six months, the effectiveness of the Pfizer jab at preventing COVID-19 infection in the month after the second dose fell from 88% to 74%, an analysis of data collected in Britain's ZOE COVID study showed. For the AstraZeneca vaccine, effectiveness fell from 77% to 67% after four to five months. (8/25)

Stat: As Delta Spread, Covid Vaccine Effectiveness Against Infection Fell To 66%
The effectiveness of Covid-19 vaccines at preventing infection fell in one study of U.S. frontline workers from roughly 90% to 66% as the Delta variant emerged and became dominant in the country, an updated report from the Centers for Disease Control and Prevention released Tuesday indicated. The study, known as HEROES-RECOVER, includes more than 4,000 health care workers, first responders, and other frontline workers in eight locations across six states, all of whom have been tested weekly for infection with SARS-CoV-2. More than 4 in 5 were vaccinated, and the vast majority of them received the mRNA vaccines from either Pfizer-BioNTech or Moderna. (Joseph, 8/24)

Stat: Covid-19 Vaccines Flirted With Perfection. Reality Is More Complicated
When Covid-19 vaccines were reported last fall to be roughly 95% effective at preventing symptomatic Covid-19 infections, the world rejoiced — and even veteran scientists were blown away. Very few vaccines are that protective. Those made to fend off viruses like SARS-CoV-2 — viruses that invade the nose and throat, like flu — typically aren’t at the high end of the efficacy scale. That was the good news. Now, however, our soaring expectations for Covid-19 vaccines are in the process of sinking back to earth. (Branswell, 8/25)

The Wall Street Journal: New U.S. Intelligence Report Doesn’t Provide Definitive Conclusion On Covid-19 Origins
The new assessment, which was ordered by President Biden 90 days ago, highlights the administration’s difficult challenge to wrest more information from Beijing that would shed light on how the global pandemic began. It underscores the importance of inducing China to share lab records, genomic samples, and other data that could provide further illumination on the origins of the virus, which has killed more than four million people world-wide, current and former officials said. “It was a deep dive, but you can only go so deep as the situation allows,” one U.S. official said. “If China’s not going to give access to certain data sets, you’re never really going to know.” (Gordon and Strobel, 8/24)

Stat: WHO Wants Experts To Investigate The Origins Of Covid And Other Pathogens
The Covid-19 pandemic has elevated scrutiny over how pathogens leap into humans like no crisis before it. To better understand how those events happen — and to better respond when they do — the World Health Organization is standing up a new Scientific Advisory Group for the Origins of Novel Pathogens, or SAGO. Now, the agency needs experts to apply. (Joseph, 8/25)

The Hill: American Medical Association Calls For Public, Private Sectors To Mandate Vaccines
The American Medical Association (AMA) on Tuesday urged the public and private sectors to mandate COVID-19 vaccinations, saying the move is key to getting control of the pandemic. The call comes one day after the Food and Drug Administration (FDA) fully approved the Pfizer vaccine, a step that is expected to lead more companies to pull the trigger on mandating vaccination for their employees. The AMA, the country's leading doctors group, is seeking to speed that process along. (Sullivan, 8/24)

The New York Times: Goldman Sachs Mandates Vaccines For Its Workers And Visitors
Goldman Sachs told employees on Tuesday that it will require anyone who enters the bank’s U.S. offices, including clients, to be fully vaccinated starting on Sept. 7, making it the most prominent Wall Street bank to issue such a broad requirement. The announcement, in a memo obtained by The New York Times, came a day after the Food and Drug Administration gave full approval for the Pfizer-BioNTech vaccine, a move that many large corporations had been seeking before making mandates. (Hirsch, 8/24)

AP: Maine Gov: Approval Of COVID-19 Vaccine Means Get Your Shot
The full approval of Pfizer’s coronavirus vaccine means it’s time for Maine’s remaining unvaccinated people to get their shots, the state’s governor said. Maine Gov. Janet Mills said getting vaccinated is especially important because of the rise of the delta variant in the state and elsewhere. Mills, a Democrat, said there is “no time to waste in getting your shot” because of the rise in cases and hospitalizations in Maine. “Getting vaccinated may save your life, the life of a family member or friend, or the life of a child not yet eligible for a vaccine,” Mills said. (8/25)

AP: Philadelphia School Board Votes To Require Vaccine For Staff
The Philadelphia School Board voted unanimously Tuesday night to mandate that its 20,000 teachers and staff members be vaccinated against COVID-19, but details of when the mandate would go into place are still being worked out, school district officials said. The move comes amid other state and local mandates for teacher vaccinations in the last week including New Jersey Gov. Phil Murphy’s mandate Monday that teachers and school staff statewide be vaccinated by Oct. 18 or submit to regular testing. New York City Public Schools also issued a no-option vaccination mandate for the city’s 148,000 public school teachers and staff Monday. (8/24)

CNN: US Coronavirus: Covid Cases Among Children Have Surged To One Of Its Highest Rates Of The Pandemic. Experts Warn It May Get Worse 
Last week, the number of Covid-19 cases in children in the US reached levels not seen since the winter surge. And with the return to school, the Delta variant on the rise and winter approaching, health officials are concerned it could get worse. After a decline in early summer, child cases have increased exponentially -- with more than a four-fold increase in the past month, according to the latest report from the American Academy of Pediatrics and the Children's Hospital Association. From about 38,000 cases a week near the end of July, the week ending August 19 saw more than 180,000 cases in children, the report said. (Holcombe, 8/25)

Politico: NIH Director: Vaccine Approval For Kids Unlikely Before Late 2021
One of the federal government’s top public health experts on Tuesday predicted it is unlikely children under the age of 12 will be eligible to receive the coronavirus vaccine before late 2021, contradicting the speedier timelines offered by other Biden administration officials. Vaccine makers Pfizer and Moderna are currently studying the shot’s safety and efficacy in younger children and infants, with Pfizer expected to deliver the results of its trials for 5-11-year-olds to the Food and Drug Administration sometime in September. (Forgey, 8/24)

CNN: Next Up For Covid Vaccines: Kids Under 12 
The US Food and Drug Administration has given full approval to Pfizer's coronavirus vaccine for people age 16 and older. Approval for youths ages 12-15 is expected to follow soon. "I don't think it'll be long before they extend it to 12 to 15 -- maybe within a few weeks to a month or so," said Dr. Bob Frenck, director of the Vaccine Research Center at Cincinnati Children's Hospital. Parents are already clamoring to hear more about approval or authorization for children under 12, however. Studies looking at that are underway. (Fox, 8/24)

The Wall Street Journal: Some Parents Push To Give Covid-19 Vaccine To Children Under 12, Against Government Guidance
Monday’s decision prompted many parents to call their pediatricians and ask them whether they will administer vaccines for children under 12. The FDA’s approval generally means vaccines are eligible for off-label use, meaning beyond approved populations, but the CDC said Monday they aren’t authorizing that. Pfizer’s vaccine is authorized for emergency use for children aged 12 and up and fully approved for those 16 and up. Moderna Inc.’s and Johnson & Johnson’s vaccines are authorized only for those 18 and over and aren’t fully approved. Parents are reporting mixed success. Some say they have been able to schedule appointments, while others say they have been refused. (Schwartz and Marie Chaker, 8/24)

Politico: CDC Pandemic Response Limited By Patchy Data On Breakthrough Infections
The Centers for Disease Control and Prevention is using outdated and unreliable data on coronavirus breakthrough infections to help make major decisions, such as who gets booster shots, according to three officials with direct knowledge of the situation. The agency originally tried to track all infections in vaccinated people, from mild to severe. But in May it decided to focus on the most severe cases, saying that would allow it to better monitor overall conditions and make more informed, targeted policy decisions. (Banco, 8/25)

Politico: House Advances $3.5T Budget, Ending Stalemate Between Pelosi And Centrists
The agreement between Pelosi and the group of centrists led by Rep. Josh Gottheimer (D-N.J.) followed several hours of frenetic negotiating Monday night that carried over into Tuesday. Pelosi outlined the details of the compromise in a statement released during the vote, even going so far as to thank Gottheimer and his group "for their enthusiastic support for the infrastructure bill." “I am committing to pass the bipartisan infrastructure bill by September 27. I do so with a commitment to rally House Democratic support for its passage," Pelosi said. “We must keep the 51-vote privilege by passing the budget and work with House and Senate Democrats to reach agreement in order for the House to vote on a Build Back Better Act that will pass the Senate." (Caygle, Ferris, Wu and Adragna, 8/24)

CNN: Joe Biden And Ron DeSantis Square Off Over Coronavirus Response, With Cases In Florida Surging 
President Joe Biden and Florida Gov. Ron DeSantis have found their chosen rhetorical rivals in the fight against the coronavirus: each other. And neither seems eager to back down anytime soon. The recent uptick in direct rhetoric between the Biden White House and the Republican governor with unbridled political aspirations reached its crescendo earlier this month, when Biden suggested DeSantis' actions were "not good" for Floridians and the governor responded that he didn't want to "hear a blip" from Biden on coronavirus. (Merica, 8/24)

The Wall Street Journal: Kamala Harris Pushes Ahead With Vietnam Trip Despite Possible Havana Syndrome Incident
Vice President Kamala Harris temporarily delayed a flight from Singapore to Vietnam on Tuesday after her office was made aware of what the State Department called a “possible anomalous health incident” in Hanoi. Government officials have used that language to describe what is more commonly called Havana Syndrome, a series of unexplained medical symptoms first experienced by State Department personnel stationed in Cuba beginning in late 2016. After an assessment, the decision was made to continue the trip, the State Department said. (Parti and Solomon, 8/24)

The Hill: Two US Diplomats To Be Evacuated From Vietnam After 'Acoustic Incidents': Report
Two U.S. diplomats have reportedly been evacuated out of Vietnam due to reported "Havana syndrome" incidents this week. The incidents were apparently the cause of Vice President Harris's flight delay to Singapore on Tuesday. Senior U.S. officials told NBC News that the "anomalous health incident" that Harris's office cited for the delays was, in fact, suspected cases of Havana syndrome, the mysterious illness that has primarily affected diplomats in overseas offices. It was first detected in 2016 when it affected CIA officials in Havana. (Choi, 8/24)

AP: Harris: US To Provide Vietnam 1 Million More Vaccine Doses
The United States will provide an additional 1 million coronavirus vaccine doses to Vietnam, Vice President Kamala Harris announced Wednesday, offering additional aid to a country currently grappling with a fresh coronavirus surge and stubbornly low vaccination rates. Harris, speaking at the top of a bilateral meeting with Vietnamese Prime Minister Pham Minh Chinh, said that the doses would begin to arrive within the next 24 hours. That brings the total vaccine donation to Vietnam to 6 million doses from the U.S. (Jaffe, 8/25)

NBC News: Unfriendly Skies: FAA Releases PSA After Thousands Of Unruly Passengers Are Reported
Unruly passengers aboard commercial flights are making the skies anything but friendly, according to the Federal Aviation Administration. In its effort to curb what it has described as a dramatic increase in unruly or dangerous behavior aboard passenger airplanes, the FAA released a public service announcement Tuesday with a simple message: "Unruly behavior doesn't fly." The 33-second video depicts pilots speaking over airwaves to relay messages like "We've got a disruptive customer in the back," "We'd like to divert" and "We need to get off the airplane." Shouts and sounds of commotion are heard while ominous music plays. (Planas, 8/24)

The Wall Street Journal: Supreme Court Reinstates ‘Remain In Mexico’ Policy For Asylum Applicants
The Supreme Court on Tuesday reinstated a Trump-era policy that requires asylum applicants to wait in Mexico while their claims are evaluated by U.S. authorities. The three liberal justices dissented. President Biden canceled the Trump administration Migrant Protection Protocols, commonly called the Remain in Mexico policy, responding to criticism that it forced vulnerable migrants to wait out their cases in violent border cities. Lower courts found the administration failed to follow proper procedures in ending the policy and that the alternative of paroling into the U.S. asylum applicants en masse may violate federal law. (Bravin, 8/24)

AP: WA Commissioner Walks Out Of Meeting During Mask Protest
The regular meeting of the Franklin, Washington, County commissioners disintegrated into a rally against the state’s mask mandate, with one commissioner walking out in protest. The mandate reinstated Monday to curb the surging number of COVID-19 cases and deaths requires people to wear masks inside public buildings. The Tri-City Herald reports Franklin County Commissioner Clint Didier, along with dozens of audience members, came to the Tuesday meeting without a mask and refused to put one on. (8/25)

AP: Masks To Be Required In Oregon's Outdoor Public Settings
People in Oregon, regardless of vaccination status, will once again be required to wear masks in most public outdoor settings — including large outdoor events where physical distancing is not possible — beginning Friday. The mandate, announced Tuesday by Gov. Kate Brown, is part of a growing list of statewide requirements implemented in Oregon in an attempt to slow the rapid spread of COVID-19. Oregon is one of a handful of states with an indoor mask mandate in effect. But it’s the first to reinstitute a statewide mask requirement for outdoor public areas where people are close together, according to the governor’s office. (Cline, 8/25)

The Boston Globe: Mass. Reports 131 Total Breakthrough COVID-19 Deaths As Of Aug. 21, Or 0.003 Percent Of All Fully Vaccinated People 
As of last Saturday, 131 people in Massachusetts who had been fully vaccinated against COVID-19 had died from the disease, the Department of Public Health reported Tuesday, representing a tiny fraction of all vaccinated people and underscoring the protection the vaccines provide against severe illness and death. The deaths accounted for 0.003 percent of the 4,449,267 people in Massachusetts who were fully vaccinated as of Saturday, the department said in its weekly update on breakthrough COVID-19 metrics. (Kaufman, 8/24)

CBS News: Louisiana Reports Record Number Of COVID-19 Deaths
Louisiana reported 139 coronavirus-related deaths on Tuesday – the state's highest reported number of deaths in a single day since the pandemic began, the Louisiana Department of Health tweeted. The previous record, 129 deaths, was reported on April 14, 2020. "Each death is a terrible loss, even more so because we know most COVID deaths can now be prevented through safe and effective vaccines," Louisiana Governor John Bel Edwards tweeted. The state's health department reported 3,814 new cases of the virus Tuesday, noting an increase across all age groups within the state. The largest percentage increase of cases were among those aged 5 to 17. (Powell, 8/24)

Los Angeles Times: Coronavirus Cases Force 6,500 LAUSD Students To Miss School 
Coronavirus cases resulted in 6,500 students missing one or more days during the first week of school in the Los Angeles Unified School District as officials responded to early results from the largest school-based coronavirus testing effort in the nation. About 3,000 students were in isolation because they tested positive for an infection either during the first week or in the days before the Aug. 16 start of classes. An additional 3,500 were in quarantine after they were identified as close contacts of those who tested positive. (Blume, 8/24)

AP: Earlier Diabetes Tests Recommended For Overweight US Adults
The guidance from the U.S. Preventive Services Task Force, an advisory group to the U.S. government, was published online in the Journal of the American Medical Association. It updates the task force’s 2015 recommendations, and says even earlier screening should be considered for overweight or obese American Indians, Black people, Hispanics and other groups with disproportionately high diabetes rates. The American Diabetes Association says overweight or obese adults of any age should be screened. Screening means blood tests to measure sugar levels and sometimes involves drinking a sugary liquid first. The new guidance suggests that people whose tests are normal could be screened every three years. (Tanner, 8/24)

Stat: Diabetes Rises In Kids, As Screening Age Drops To 35 For Overweight Adults
The age at which adults who are overweight or obese should be screened for type 2 diabetes is going down while the prevalence of both forms of the disease is going up among children and adolescents — two developments reported Tuesday that signal a growing burden of these chronic health conditions among Americans. The U.S. Preventive Services Task Force lowered its recommended age to 35 — down from 40 in its 2015 guidance — to test people with above-normal BMIs for elevated glucose levels that could mean prediabetes or diabetes itself. The new evidence review and recommendations, published in the Journal of the American Medical Association, would make more than 40% of adults eligible for screening, and an estimated one-third will likely meet USPSTF criteria to undertake preventive steps. (Cooney, 8/24)

AP: US Open Offering Tennis Players Access To Mental Health Pros
Players at the U.S. Open will have access to licensed mental health providers and quiet rooms as part of an initiative announced Tuesday by the U.S. Tennis Association. The USTA said it seeks to “ensure that a comprehensive and holistic approach will be taken with all aspects of player health, including mental health.” “Our goal is to make mental health services as readily available to athletes as services for a sprained ankle — and with no stigma attached,” said Dr. Brian Hainline, a USTA first vice president. “We will provide an environment that fosters wellness while providing the necessary resources to readily allow mental health care seeking.” (8/25)

NPR: More Americans Would Like Mental Health Support But Can't Afford It 
For many Americans who, like Parrish, live with a mood disorder, cost remains a major hurdle to accessing mental health care, according to a survey on mood disorders published this week by the National Alliance on Mental Illness, or NAMI. Over half of the survey's respondents (which included people living with mood disorders and their caregivers) said that cost prevents them from trying a treatment they're interested in, says psychiatrist Ken Duckworth, NAMI's chief medical officer. (Chatterjee, 8/24)

Houston Chronicle: Syphilis In Newborns Is Up 250% During Pandemic. Experts Blame Lack Of Education, Stigma Around STIs.
In April, the department reported a marked increase in fetal deaths linked to congenital syphilis during the pandemic, up from four in 2019 to 14 in 2020 — an increase of 250 percent. Since 2019, all fetal deaths linked to syphilis in Harris County were among either Black or Latino fetuses, according to the department. That year, the Centers for Disease Control and Prevention reported 1,870 cases of congenital syphilis across the U.S. (Garcia, 8/24)

Reuters: High Blood Pressure Driven By Obesity, Poverty - WHO Study
Nearly 1.3 billion people globally suffer from hypertension, a silent killer often driven by obesity that increases the risk of heart disease, stroke and kidney disease, the World Health Organization (WHO) said on Wednesday. Hypertension can be easily diagnosed by monitoring blood pressure, and treated with low-cost drugs, but half of affected people are unaware of their condition which is left untreated, the WHO and Imperial College London said in a joint study published in The Lancet. (Nebehay, 8/25)

The New York Times: How Exercise May Help Keep Our Memory Sharp
An intriguing new study shows how exercise may bolster brain health. The study was in mice, but it found that a hormone produced by muscles during exercise can cross into the brain and enhance the health and function of neurons, improving thinking and memory in both healthy animals and those with a rodent version of Alzheimer’s disease. Earlier research shows that people produce the same hormone during exercise, and together the findings suggest that moving could alter the trajectory of memory loss in aging and dementia. (Reynolds, 8/25)

The Hill: Wildfire Smoke Leads To Worst Air Quality On Record In Nevada Counties
Wildfires continuing to spread across California have pushed smoke across to neighboring states, with several Nevada counties reporting their worst air quality index (AQI) levels on record this week. The Air Quality Management Division of Nevada’s Washoe County, home to Reno, on Tuesday reported an AQI number of 289, falling within the range of government agencies consider to be “very unhealthy.” The county shared images on Twitter of the same area in Reno, with one taken last month showing a clear mountain view, and the other taken Tuesday showing it darkened and clouded with smoke. (Castronuovo, 8/24)

The Washington Post: The Viral Milk Crate Challenge Has Left People Injured. Doctors Are Begging Them To Stop
“It’s the biggest thing that’s going on in every neighborhood right now,” said Derek, a 38-year-old social media personality based on Long Island and better known as Itsbizkit who preferred not to give his last name, for privacy reasons. “You go to any park or public place right now and you’ll see crates there.” But many see the Milk Crate Challenge as taking up where the Tide Pod Challenge left off — as a viral meme that has become a public health hazard. Some doctors are also warning that the injuries from the challenge are putting more stress on hospitals at a time when emergency rooms nationwide are overwhelmed because of the surge in coronavirus infections. (Bella, 8/24)

CIDRAP: Two US Salmonella Outbreaks Linked To Italian-Style Meats
Two US outbreaks of Salmonella, one S Typhimurium and the other S Infantis, have been linked to Italian-style meats, although none are connected to a specific product or brand yet, according to a Centers for Disease Control and Prevention (CDC) investigation notice today. A total of 36 people across 17 states are affected. The S Typhimurium outbreak began May 30 and has thus far affected 23, hospitalizing 9 patients, and the S. Infantis outbreak began May 9 and has thus far affected 13 people, hospitalizing 3 patients. (8/24)

CIDRAP: HPV Vaccine Tied To Lower Rates Of Vaccine Virus Strains But Not Others
A study in JAMA Network Open yesterday showed lower rates of vaccine strains of human papillomavirus (HPV) infections in vaccinated girls and young women in New York City but higher rates of some high-risk non-vaccine strains. The large cohort study followed girls ages 13 to 21 who received the quadrivalent (four-strain) Gardasil vaccine over a 12-year period, from 2007 to 2019. A total of 1,453 participants were included, with a mean age of 18.2 years, and roughly half (694 participants) were vaccinated prior to their first sexual intercourse. (8/24)

CIDRAP: Post-Vaccination SARS-CoV-2 Antibodies Found In Breast Milk
After COVID-19 vaccination, 21 lactating healthcare workers showed significant increases in SARS-CoV-2 antibodies in their breast milk, according to a study published in Breastfeeding Medicine late last week. The researchers recruited from the University of Florida health system from December 2020 to March 2021 and sampled blood and breast milk pre-vaccination, 16 to 30 days after the first dose, and 7 to 10 days after the second dose. All healthcare workers received either the Pfizer/BioNTech or Moderna vaccine. (8/24)

CIDRAP: Study: Patients, Not Staff, Source Of Most Hospital COVID Spread
Most hospital patients diagnosed as having COVID-19 contracted the virus from other patients rather than healthcare workers (HCWs), with 21% of patients causing 80% of cases, finds a UK study today in eLife. A team led by researchers at the University of Cambridge analyzed data from five wards at the university's Addenbrooke's Hospital during a COVID-19 outbreak among patients and HCWs from March to June 2020. The team applied a new network reconstruction algorithm to infer patterns of virus spread among patients and HCWs. (Van Beusekom, 8/24)

Roll Call: Rising Hospitalizations Aren't Only About COVID-19 Cases 
Hospitals across the country are reaching capacity, the result not only of increasing COVID-19 cases, but also side effects of the pandemic, from delayed surgeries that are now urgent to mental health problems among children.  Exacerbating the problem, hospitals are facing new staffing challenges as doctors, nurses and other support staff buckle under the pressures. (Raman, 8/24)

Modern Healthcare: Insurers Have Stopped Waiving Costs For Preventable COVID-19 Care 
Most private insurers are no longer waiving cost sharing for COVID-19 treatment due to the widespread availability of vaccines rendering the illness largely preventable. While federal law requires private insurance plans to cover COVID-19 testing and vaccinations, there are no national regulations regarding out-of-pocket costs for treatments. (Devereaux, 8/24)

Modern Healthcare: Hospital Operating Margins Lower In High Delta Areas 
A new report finds hospital operating margins hovered around 4% in July, with those in regions with high rates of the delta variant coming in lower. Kaufman Hall's National Hospital Flash Report shows the median hospital margin index was 4.1% in July including CARES Act stimulus funding distributed by the federal government, which the report noted is close to June levels. Without CARES Act funding, that was 3.2%. (Bannow, 8/24)

Modern Healthcare: Insurers To Get A Break On Price Transparency, Surprise Billing
Health plans will have more time to get ready for several requirements under the insurer price transparency rule and the ban on surprise billing, according to federal guidance published last week. The Biden administration won't crack down on insurers for failing to publish machine-readable files of provider rates until July 1, even though the requirement takes effect at the start of next year. But that doesn't mean they're going away. (Brady, 8/24)

Houston Chronicle: NRA Cancels Annual Meeting In Houston Because Of COVID
The National Rifle Association announced it has canceled its annual meeting planned for Houston next weekend because of rising COVID-19 cases in Houston. “We make this difficult decision after analyzing relevant data regarding COVID-19 in Harris County, Texas,” the NRA said in a statement on its website. “We also consulted with medical professionals, local officials, major sponsors and exhibitors, and many NRA members before arriving at this decision.” (Wallace, 8/24)

AP: With Hospitals Overwhelmed By Virus, Idaho Seeks Volunteers
Idaho’s hospitals are bursting at the seams as coronavirus numbers continue to skyrocket across the state, prompting state leaders to call on residents to serve as volunteers to help keep medical facilities operating. “There’s a wide variety of positions available, a wide variety of skillsets — we need positions in every part of the state,” Elke Shaw-Tulloch, administrator for the Idaho Department of Health and Welfare’s Division of Public Health, said during a press briefing Tuesday afternoon. (Boone, 8/25)

AP: Arkansas Runs Out Of Intensive Care Beds For COVID Patients
Arkansas on Tuesday ran out of intensive care unit beds for COVID-19 patients for the first time since the coronavirus pandemic began, Gov. Asa Hutchinson announced, as a surge in cases continued overwhelming hospitals in the state. The state’s ICU capacity for COVID patients barely eased hours after Hutchinson’s announcement, with only one hospital in southeast Arkansas showing availability, according to the state’s system for coordinating coronavirus patients. Virus patients make up about half of the state’s ICU beds. The number of virus patients in ICUs and on ventilators reached a new high in the state on Monday. (DeMillo, 8/24)

Houston Chronicle: Harris County Approves $30 Million For More Nurses To Ease Latest COVID-19 Surge
Harris County Commissioners Court on Tuesday unanimously approved $30 million to send more nurses to Houston-area hospitals strained by this latest surge in COVID-19 patients. The money will come from Harris County’s allotment of the American Rescue Plan Act. County Judge Lina Hidalgo said while the entire sum will probably not be needed, court members need to act quickly to help short-staffed medical facilities. (Despart, 8/24)

AP: West Virginia Mayor Seeks $500 For Vaccinated Workers
The mayor of West Virginia’s largest city wants to give $500 to all city workers in Charleston who are fully vaccinated against the coronavirus. Mayor Amy Shuler Goodwin announced Tuesday that she sent a letter to the City Council requesting approval for either a cash payment or a $500 health savings account contribution to eligible employees. Workers must have at least two doses of either Pfizer or Moderna vaccines or the one-dose Johnson & Johnson vaccine, the city said in a statement. The payment would come from the city’s allocation of American Rescue Plan funding, the statement said. Goodwin anticipates the cost would be $450,000 if all city employees participate. (8/25)

AP: Audit: California Agency Bungled COVID-19 Funds For Homeless
A California agency didn’t properly distribute federal relief funds meant to help homeless residents during the coronavirus pandemic, and the mismanagement was so prolonged that local organizations may lose the money because of missed deadlines, auditors said Tuesday. After receiving $316 million under the federal CARES Act to reduce the impact of COVID-19 on unhoused people, the California Department of Housing and Community Development “did not take critical steps to ensure those funds promptly benefited that population,” the state auditor’s office said in a report. (8/25)

Reuters: New Zealand Pushes Ahead With Vaccinations As Delta Outbreak Widens
New Zealand recorded 62 new cases of COVID-19 on Wednesday, taking the total number of infections in the latest outbreak to 210 as the government scrambled to scale up vaccinations amid growing criticism. Most of the cases are in the largest city Auckland, while 12 are in the capital Wellington, the Director General of Health Ashley Bloomfield said at a news conference. (Menon, 8/25)

Reuters: Vietnam Urges WHO To Send More COVID-19 Shots As Cases Surge Despite Lockdown
While the rapid spread of the Delta variant and low vaccinations have caught much of Asia off-guard, no country shows more vividly than Vietnam how easily the highly infectious version of the coronavirus can foil strict containment policy. Vietnam had successfully contained the coronavirus for most of last year but since April has been dealing with a large COVID-19 outbreak in Ho Chi Minh City, driven by the Delta. (Lin, 8/25)

The Washington Post: Paralympics Village Faces Largest Covid Outbreak As Games Begin
Five people residing at a housing complex reserved for Paralympics athletes, coaches and committee officials tested positive for the new coronavirus in Japan, event officials announced on Wednesday, just a day after the formal commencement of the games. This is the largest single-day tally for people living in the Paralympics Village. The area is designed to be a protective bubble shielding residents from the coronavirus.So far, the Paralympics Games — which had its opening ceremony on Tuesday — has recorded 169 infections of the deadly virus so far, according to the event’s organizing committee. This figure includes the 11 cases recorded inside the village. (Jeong, 8/25)

AP: Japan To Further Expand Virus Emergency Areas As Cases Surge
Japan was set to expand its coronavirus state of emergency for a second week in a row Wednesday, adding several more prefectures as a surge in infections fueled by the delta variant strains the country’s health care system. The government last week extended the state of emergency until Sept. 12 and expanded the areas covered to 13 prefectures from six including Tokyo. Sixteen other prefectures are currently under quasi-emergency status. (Yamaguchi, 8/25)

The New York Times: China Will Hold The Unvaccinated ‘Accountable’ If There Are Outbreaks
The authorities in at least 12 cities in China have warned residents that those who refuse Covid-19 vaccinations could be punished if they are found to be responsible for spreading outbreaks. The latest government notices, issued this and last week, reflect China’s anxiety about stamping out the more transmissible Delta variant, which has spread recently in several cities. China has fully vaccinated roughly 55 percent of its population, but officials have said that rate needs to hit 80 percent for the country to reach herd immunity. (Wee and Chen, 8/25)