First Edition: Dec. 20, 2022

KHN: The Official Who Investigates Suspicious Deaths In Your Town May Be A Doctor — Or Not 
When a group of physicians gathered in Washington state for an annual meeting, one made a startling revelation: If you ever want to know when, how — and where — to kill someone, I can tell you, and you’ll get away with it. No problem. That’s because the expertise and availability of coroners, who determine cause of death in criminal and unexplained cases, vary widely across Washington, as they do in many other parts of the country. “A coroner doesn’t have to ever have taken a science class in their life,” said Nancy Belcher, chief executive officer of the King County Medical Society, the group that met that day. (Young, 12/20)

KHN: Inside A Children’s Hospital: Struggling To Cope With A Surge Of Respiratory Illness
Waiting for their turn in the emergency room, dazed-looking parents in winter coats bounced crying children in their arms, trying to catch the eye of Dr. Erica Michiels. Us! Pick us next! they seemed to plead with tired eyes. Michiels directs pediatric emergency medicine at Corewell Health Helen DeVos Children’s Hospital in Grand Rapids, Michigan. Lips pressed together in a thin line, she surveyed what she calls the “disaster” area. “People have been out here waiting for a couple hours, which is heartbreaking,” she said. (Wells, 12/20)

KHN: Medicare Pay Cuts Will Hurt Seniors’ Care, Doctors Argue
Doctors are urging Congress to call off cuts scheduled to take effect on Jan. 1 in the reimbursements they receive from Medicare. In what has become an almost yearly ritual, physician groups are arguing that patients will have greater difficulty finding doctors who accept Medicare if lawmakers allow the pay cuts to happen. Whether doctors’ efforts to stave off the cuts will succeed as in past years remains to be seen. (McAuliff, 12/20)

Stat: Congress Reaches Major Health Policy Deal On Medicare, Medicaid
Leaders in Congress have reached a sweeping deal to ease Medicare pay cuts to doctors, make major changes to post-pandemic Medicaid policy, and to help prepare for future pandemics. Lawmakers are aiming to pass a health care policy package along with legislation to fund the federal government by Friday. (Cohrs and Owermohle, 12/19)

Politico: Why Democrats Warmed To Severing Medicaid Eligibility From The Covid Public Health Emergency
Republicans have long demanded an end to the Covid-era Medicaid policy that gives states more funding and bars them from kicking people off the rolls. Now, Democrats are prepared to join them — four people close to the negotiations tell POLITICO. Congressional negotiators are set to unveil the text of the 2023 omnibus spending bill on Monday. Lawmakers and staff have been scrambling for weeks to find ways to pay for a slew of health care programs, such as permanent telehealth flexibility, providing longer Medicaid coverage for new mothers and avoiding scheduled cuts to doctors’ payments, prompting formerly resistant Democratic members to take a fresh look at moving up the end-date of the Covid-19 Medicaid policy by at least three months — to April 1. (Ollstein, 12/19)

The Hill: Medicaid Expansion Linked With Improved Cancer Survival In Young Adults 
Expanded Medicaid coverage under the Affordable Care Act (ACA) is linked with better survival outcomes for young Americans newly diagnosed with cancer, research shows. The two-year survival benefit was most pronounced among individuals who identify as Hispanic or Black and those with breast cancer or stage IV cancers. (Melillo, 12/19)

The Washington Post: Chief Justice Roberts Temporarily Halts End Of Title 42 At Border 
Chief Justice John G. Roberts Jr. on Monday temporarily left in place a pandemic-era policy that allows the government to quickly expel millions of migrants from U.S. borders and had been set to expire Wednesday. Roberts’s brief order was an “administrative stay” that allows the court to consider an emergency application from Republican state officials who want the Title 42 policy to remain while litigation continues. (Marimow and Sacchetti, 12/19)

AP: Panel Warns FDA’s Beleaguered Tobacco Unit Lacks Direction 
The lack of clear direction and priorities at the U.S. Food and Drug Administration’s tobacco division has hampered its ability to regulate electronic cigarettes and other products, according to an expert panel assembled to examine problems at the agency. A blistering report released Monday describes the FDA’s tobacco program as “reactive and overwhelmed,” in its effort to oversee both traditional tobacco products and a sprawling market of largely unauthorized electronic cigarettes. The experts say FDA’s inconsistent approach to regulation is at least partially to blame for the spread of thousands of e-cigarette varieties that remain popular among teenagers. (Perrone, 12/19)

The Washington Post: Major Effort Needed To Remove Illegal Vaping Products, Review Finds
An independent review of the Food and Drug Administration’s tobacco regulators described them as overwhelmed, reactive and fatigued by an oppressive workload involving e-cigarettes and called for a major effort, by several parts of the Biden administration, to remove millions of illegal vaping products from the market. The report, by the Reagan-Udall Foundation for the FDA, also said the agency’s Center for Tobacco Products, created by federal law in 2009, has fallen short in laying out clear priorities and has been besieged by lawsuits brought by tobacco and vaping companies, on the one hand, and public health groups on the other. (McGinley, 12/19)

Stat: Audit Of FDA’s Tobacco Oversight Underscores Agency’s Struggle To Regulate The Booming Vaping Market
The stinging review, which was ordered by FDA Commissioner Robert Califf in July, was conducted by the independent Reagan-Udall Foundation and a panel of five former regulators. In a statement Monday, Califf said that the center’s leadership will review the findings and “will provide an update by early February.” (Florko, 12/19)

AP: Children's Medicine Shortage Hits As Flu Season Starts Fast 
“At this point, it’s more like toilet paper at the beginning of the (COVID-19) pandemic,” said Dr. Shannon Dillon, a pediatrician at Riley Children’s Health in Indianapolis. “You just have to look in the right place at the right time.” Drugmaker Johnson & Johnson says it is not experiencing widespread shortages of Children’s Tylenol, but the product may be “less readily available” at some stores. The company said it is running its production lines around the clock. (Murphy, 12/19)

AP: Kentucky On Track For Worst Flu Season In At Least A Decade
Gov. Andy Beshear reported six flu-related pediatric deaths Monday as health officials warn that Kentucky is on pace for its worst influenza season in at least a decade. Beshear encouraged Kentuckians to get vaccinated against the flu. None of the children who died in the current influenza season received a flu shot, according to the Department for Public Health. (12/19)

Fortune: Why Do You Have A Sore Throat When You Wake Up In The Morning. Experts Say It's Not Always COVID Or Flu 
It’s tripledemic season, with rising cases of COVID, flu, and RSV, so waking up with a sore throat can be pretty alarming. Do you have one of these potentially serious viruses? Strep throat? Just a cold? “When you first wake up with a sore throat, it’s difficult to know if you have a bacterial infection or virus without being tested for them directly,” says Dr. Barbara B. Bawer, a family medicine physician at the Ohio State University Wexner Medical Center. It’s also possible that something such as allergies, acid reflux, or the lack of humidity in your bedroom is to blame. (Brody, 12/19)

The New York Times: The ‘Tripledemic’ Holiday: How To Fly More Safely (Hint: Wear A Mask) 
You should “absolutely” be wearing masks while traveling, epidemiologists, infectious disease doctors and air-filtration experts said. Even though planes have great filtration systems, you’ll likely be on crowded planes with other travelers for extended periods of time, increasing the chances of exposure, said Saskia Popescu, an infectious disease epidemiologist and assistant professor at the Schar School of Policy and Government at George Mason University. (Mzezewa, 12/19)

Bloomberg: China’s Covid-19 Outbreak Has US Worried About New Variants
The US is concerned China’s runaway Covid-19 outbreak might spawn new mutations of the virus, as the world’s most populous country continues to grapple with the impact of loosening “Covid Zero” protocols that had kept the pandemic at bay. (Marlow, 12/19)

Reuters: U.S. State Dept Says Toll Of COVID In China A Concern For The World
The United States hopes that China can address the current COVID-19 outbreak as the toll of the virus is a global concern due to the size of the Chinese economy, State Department spokesperson Ned Price said on Monday. "The toll of the virus is of concern to the rest of the world given the size of China's GDP, given the size of China's economy," Price told a daily briefing at the State Department. (Pamuk, 12/19)

Reuters: Appeals Court Says U.S. Cannot Mandate Federal Contractor COVID Vaccines 
A U.S. appeals court on Monday said the White House could not require federal contractors to ensure that their workers are vaccinated against COVID-19 as a condition of government contracts. The U.S. government has contracts with thousands of companies, and courts have said the issue could affect up to 20% of U.S. workers. (Shepardson, 12/19)

AP: Probation For Ex-Teacher In NY Who Gave Teen Vaccine Dose
A former Long Island high school teacher accused of injecting a teen with a COVID-19 vaccine at her home without his parents’ knowledge pleaded guilty to a misdemeanor and was sentenced to community service and probation, avoiding a felony charge that could have sent her to prison. Laura Parker Russo, 55, pleaded guilty to a misdemeanor count of attempting the unauthorized practice of medicine when she appeared in a courtroom in Mineola, New York, on Friday. She also pleaded guilty to disorderly conduct. (12/17)

San Francisco Chronicle: FDA Eyes Updating Vaccines To Better Attack Virus
Federal regulators are considering whether today's COVID-19 vaccines are sufficiently protective or may need updating to fight emerging generations of the coronavirus. (Beamish, 12/19)

San Francisco Chronicle: Two Subvariants Now Account For Nearly 70% Of COVID Cases In U.S.
The two latest fast-spreading strains of the coronavirus. named BQ.1 and BQ.1.1, now account for nearly 7 in 10 of the COVID-19 cases in the United Stated, tracking by the Centers for Disease Control and Prevention shows. The two subvariants of the omicron variant totaled 69.1% of cases as of Saturday. (Beamish, 12/19)

San Francisco Chronicle: Dr. Wachter Cites “Confusion & Misinformation” On Myriad COVID Topics
UCSF’s Dr. Bob Wachter, one of the Bay Area’s most prominent voices on COVID-19, says COVID confusion and misinformation abound, and he is seeing a lot of it around the basic topics of masks, vaccines, and home tests. In a lengthy thread, he told his many Twitter followersover the past couple of days that these “correct” statements are the starting point: “Wearing the wrong mask, or wearing a mask incorrectly, doesn’t work. (Beamish, 12/19)

The Atlantic: Consider Armadillo COVID
This past spring, Amanda Goldberg crouched in the leafy undergrowth of a southwestern Virginia forest and attempted to swab a mouse for COVID. No luck; its nose was too tiny for her tools. (Tayag, 12/19)

CIDRAP: Report Describes Misdiagnoses Of Mpox 
A new study from Israel describes 26 cases of misdiagnosed mpox. Of the 26, 6 patients (23%) who were given a diagnosis of bacterial tonsillitis, 6 (23%) primary syphilis, 5 (19.2%) oral or genital herpes, and 4 (15.3%) bacterial proctitis or anal abscess. The study was published in the International Journal of Infectious Diseases. (Soucheray, 12/19)

The New York Times: Homicides Of Children Soared In The Pandemic’s First Year, CDC Reports 
As the pandemic spread across the United States in 2020, the number of children who were killed rose precipitously, as did the number injured by firearms, scientists reported in two studies on Monday. A majority of the homicides were among Black children, and almost half were among children in the southern United States. Each of those groups also accounted for most of the children brought to pediatric hospitals with gun injuries. (Rabin, 12/19)

The Wall Street Journal: Gun Injuries Among Children Surged During Pandemic, Study Says 
The incidence of firearm injuries among children in the U.S. rose sharply in the early years of the Covid-19 pandemic, according to a new analysis of data from 49 children’s hospitals. The analysis, published Monday in the journal JAMA Pediatrics, showed that at least 2,759 children age 17 and younger were treated at hospitals for gun-related injuries between April 2020 and December 2021. That figure is more than 50% above the figure for the corresponding 21-month period in 2018 and 2019. (Mosbergen, 12/19)

The Texas Tribune: Uvalde Shooting Victims’ Care Was Delayed By Medical Response
Bullets had pierced Eva Mireles’ chest as she tried to shield students from a gunman’s semiautomatic rifle. But the fourth grade teacher at Robb Elementary was still conscious when police carried her out of classroom 112 and through a hallway crowded with dead and dying victims. “You’re fine. You’re fine,” said her husband, Uvalde school district police officer Ruben Ruiz, who had been frantically trying to rescue her since the attack began. (Despart, Kriel, Serrano, Lee, Hernandez, Cahlan, Piper and Garcia, 12/20)

Politico: Judge Strikes Down California Gun Law Modeled On Texas Abortion Measure 
A federal judge has blocked a California gun law that emulated a controversial Texas abortion measure — and which was intended to provoke a court fight. The injunction from Judge Roger Benitez sets California’s law, which enables private citizens to sue manufacturers of illegal guns, on a potential path to the U.S. Supreme Court. That could set up a test of both laws — an outcome that California Gov. Gavin Newsom has sought. (White, 12/19)

AP: Massachusetts Court Rules Against Medically Assisted Death
The highest court in Massachusetts said in a decision Monday that allowing doctors to prescribe a lethal dose of medication to mentally competent patients with terminal illnesses is not protected by the state constitution. “Although we recognize the paramount importance and profound significance of all end-of-life decisions, after careful consideration, we conclude that the Massachusetts Declaration of Rights does not reach so far as to protect physician-assisted suicide,” the Supreme Judicial Court wrote in its decision. “We conclude as well that the law of manslaughter may prohibit physician-assisted suicide, and does so, without offending constitutional protections.” (Pratt, 12/19)

The Boston Globe: Supreme Judicial Court Rejects Bid To Legalize ‘Physician-Assisted Suicide’
A doctor who provides life-ending medication to a patient can be prosecuted for manslaughter, the state’s highest court ruled Monday, declaring that the state constitution does not protect a right to what justices termed “physician-assisted suicide.” (Ellement and Weisman, 12/19)

CBS News: Navy Concludes Suicides Of Three Sailors Assigned To USS George Washington Were Not Connected
The Navy's investigation into the suicides of three sailors assigned to the USS George Washington concluded the deaths were not connected, but stress related to life in a shipyard environment was a "contributing factor" in at least one of the suicides. (Watson, 12/20)

Stateline: As Fentanyl Use Spikes, Feds Urge States To Ease Methadone Rules
Advocates for people with addiction and the methadone industry have long sought the permanent rule changes proposed last week, which would allow more of the nation’s 476,000 methadone patients to take their daily dose in the privacy of their own homes. (Vestal, 12/19)

San Francisco Chronicle: Narcan Would Be Required In Libraries, Bars In New California Bill
Assembly Member Matt Haney knows firsthand how fast and easy access to opioid reversal medication can mean the difference between life and death for overdose victims. (Gardiner, 12/19)

Los Angeles Times: California Could Decriminalize Psychedelics Under New Bill
The possession and personal use of certain psychedelic drugs such as “magic mushrooms” and ayahuasca would be decriminalized in California under a bill introduced Monday backed by mental health professionals and veterans groups. (Wiley, 12/19)

AP: Anxiety Added As Condition For Medical Weed In New Mexico
Officials in New Mexico have approved anxiety disorders as a qualifying condition under the state’s medical marijuana program. When approving the move last month, the New Mexico Medical Cannabis Advisory Board cited that up to 25 percent of New Mexico’s adult population — roughly 465,000 people — could be experiencing the effects of such disorders. The ruling takes effect Jan. 1. (12/17)

The Washington Post: How Hobbies May Help Gird Against Dementia 
To many, the word “hobby” signifies something lightweight or trivial. Yet taking on a new hobby as one ages might provide an important defense against dementia, some experts say. About 5.8 million adults over 65 in the United States live with Alzheimer’s disease or other dementia disorders, according to the Centers for Disease Control and Prevention. One in 9 Americans over 65 has Alzheimer’s, according to the Alzheimer’s Association. And although the rate of dementia may be falling thanks to lifestyle changes, more of us are living longer, which means the societal burden of dementia is rising. (Rowan, 12/19)

The Wall Street Journal: The $3,000 Fat-Removal Surgery Trending on TikTok
For anyone in the market, there are numerous ways to get a new face—not just Botox, facelifts and nose jobs, but injectable fillers, thread lifts and adhesive tape, among others. Now, yet another face-altering procedure is stirring attention online: buccal fat removal. Pronounced like “buckle,” buccal fat removal is a cosmetic surgery that extracts fat from the cheeks, giving patients the appearance of dramatic cheekbones and a thinner face. Photos of celebrities with exaggerated hollow cheeks have caused speculation to swirl on social media about who has undergone the surgery. Meanwhile, people on TikTok are posting warnings, jokes and updates about their own buccal surgeries. (Wong, 12/19)

The Washington Post: New Drugs To Battle Obesity: What You Need To Know 
Getting the drugs has been a challenge for some patients. Huge demand and production problems have led to supply shortages in some cases. In addition, the costs are high and the insurance coverage for treating weight-loss — as opposed to diabetes, the original use — is patchy. But the market is changing rapidly, so stay tuned. (McGinley and Bernstein, 12/19)

Modern Healthcare: Health Systems Recruit Retired Clinicians To Rejoin Workforce
Bayhealth has been feeling the vice grip of the “Great Resignation” for years. The Dover, Delaware-based health system has offered bonuses and partnered with local nursing schools to alleviate its clinician shortage, but the strategies have only done so much. “A lot of people had to start thinking out of the box,” said Director of Education Angel Dewey. (Devereaux, 12/20)

The Mercury News: Santa Cruz County Mental Health 911 Calls Analyzed In New Report
The front-line response to emergency calls involving individuals experiencing a mental health crisis has been the subject of much debate on the local and national levels in recent years. But for the first time in Santa Cruz County, officials say they have a cross-jurisdictional survey that can serve as a “baseline of understanding” for ongoing discussions about how the response effort can be refined and improved. (Hattis, 12/19)

Bloomberg: Instacart Founder Apoorva Mehta Sued For Creating ‘Copycat’ Startup
Instacart Inc. cofounder Apoorva Mehta was accused in a lawsuit of using stolen trade secrets to create a healthcare startup that was a copy of an existing company. (Schneider, 12/20)

Stat: Pharma Wins Changes In Bill Regarding FDA’s Accelerated Approval
A bill that makes it easier for the Food and Drug Administration to withdraw drugs that were approved under an accelerated timeline also dropped provisions the industry had opposed, according to three drug lobbyists. (Wilkerson, 12/19)

CNBC: Key Things To Know About Health Savings Accounts As You Near Retirement
If you have a health savings account and are nearing retirement age, be aware that some of the rules are different for the older crowd. HSAs, which can only used in conjunction with so-called high-deductible health plans, offer a “triple tax” benefit: Contributions are made pre-tax, any earnings are tax-free and qualified withdrawals also are untaxed. (O'Brien, 12/19)

Bloomberg: NHS Faces Crisis Week As UK Nurses, Ambulance, Health Workers Strike
People in Britain can call 999 if they have chest pains but shouldn’t contact the emergency services for problems that aren’t life threatening, a health minister said as nurses and ambulance workers go on strike. (Akil Farhat and Chandler-Wilde, 12/20)

AP: UK Sending 1,200 Troops To Fill In As Ambulance Crews Strike
The British government said Sunday it will dispatch 1,200 troops to fill in for striking ambulance drivers and border staff as multiple public sector unions walk off the job in the week before Christmas. (Lawless, 12/18)

The New York Times: One Day With An Ambulance In Britain: Long Waits, Rising Frustration
Rachel Parry and Wayne Jones, two paramedics with the Wrexham Ambulance Service, pulled up to a hospital in northern Wales with a patient just after 10 a.m. one early December morning. That’s when their wait began. It would be 4:30 p.m. before their patient, a 47-year-old woman with agonizing back pain and numbness in both of her legs, would be handed over to the emergency department of Wrexham Maelor Hospital. It was more than 12 hours since she had first called 999, the British equivalent of 911. (Specia, 12/20)