First Edition: Dec. 21, 2021

KHN: NICU Bill Installment Plan: That’ll Be $45,843 A Month For 12 Months, Please
Close to midnight on Nov. 12, 2020, Bisi Bennett was sitting on the couch in her pajamas and feeling uncomfortable. She was about seven months pregnant with her first child, Dorian, and the thought that she could be in labor didn’t even cross her mind. Then, she felt a contraction so strong it knocked her off the couch. She shouted to her husband, Chris, and they ran to the car to start the 15-minute drive to AdventHealth hospital in Orlando, Florida. About halfway through the trip, Bennett gave birth to Dorian in her family’s Mitsubishi Outlander. Her husband kept one hand on his newborn son’s back and one hand on the wheel. (Knight, 12/21)

KHN: Crash Course: Injured Patients Who Sign ‘Letters Of Protection’ May Face Huge Medical Bills And Risks
Jean Louis-Charles couldn’t afford spine surgery to ease nagging neck and back pain after a car crash. So he signed a document, promising to pay the bill with money he hoped to get from a lawsuit against the driver who caused the collision. That never happened. Louis-Charles, 68, died hours after the operation at a South Florida outpatient surgery center in March 2019. The surgery center had put him in an Uber with his wife, Marie Julien, according to depositions. After a 60-mile ride home, he collapsed, court records show. Her husband’s death left Julien to deal with more than $100,000 in medical debt, as described in the “letter of protection,” or LOP, that Louis-Charles had signed. (Schulte, 12/21)

KHN: Pandemic Poses Short- And Long-Term Risks To Babies, Especially Boys
The pandemic has created a hostile environment for pregnant people and their babies. Stress levels among expectant mothers have soared. Pregnant women with covid are five times as likely as uninfected pregnant people to require intensive care and 22 times as likely to die. Infected moms are four times as likely to have a stillborn child. Yet some of the pandemic’s greatest threats to infants’ health may not be apparent for years or even decades. (Szabo, 12/21)

KHN: Covered California’s Insurance Deals Range From ‘No-Brainer’ To Sticker Shock 
If you purchase your own health insurance, it’s time to choose your coverage for 2022. If you buy it through Covered California, the chances are better than ever that you will get a big discount on your monthly premium — or pay no premium at all. Many middle-class families who previously paid full fare for their health plans got financial assistance this year through the American Rescue Plan, a law that significantly expanded federal tax credits that reduce the premiums consumers pay. (Wolfson, 12/21)

KHN: Some Groups Are Left Out Of Montana Covid Test Giveaway Program
As Montana’s tally of new covid cases neared 1,000 each day in September, Shelly Stanley-Lehman worried about when the virus would reach her day care in Billings. She wanted to have covid tests on hand to help prevent an outbreak from sweeping through her business, but stores were sold out. She spent days making calls and searching online. When Stanley-Lehman finally got her hands on a box of tests later that month, it was too late — a child’s family member, unknowingly infected, had exposed the day care to covid. The virus quickly spread to four others, including kids and staffers. “We got the tests just in time to close down,” Stanley-Lehman said. (Silvers and Houghton, 12/21)

NBC News: Biden Administration To Make 500 Million At-Home Covid Tests Available For Free
The federal government also plans to set up 20,000 new testing sites nationwide, with the first one opening in New York City before Christmas, the official said. President Joe Biden is scheduled to deliver a speech Tuesday about the administration's plan to combat the pandemic this winter. Testing remains one of the biggest challenges for the administration, with long lines forming at testing centers in recent days and at-home rapid tests selling out quickly, public health officials have said. (Pettypiece, 12/21)

The New York Times: Biden Was In Close Contact With Official Who Tested Positive For Covid
President Biden was in close contact with a White House official who later tested positive for the coronavirus, the administration said on Monday. The president spent about 30 minutes near the official aboard Air Force One on a trip from South Carolina to Pennsylvania on Friday, Jen Psaki, the White House press secretary, said in a statement. The official, who was vaccinated and had received a booster shot, began experiencing symptoms two days later and tested positive on Monday morning. “The president is tested on a regular basis. As part of that regular testing, the president received an antigen test Sunday, and tested negative,” Ms. Psaki said. “This morning, after being notified of the staffer’s positive test, the president received a P.C.R. test and tested negative.” (Rogers, 12/20)

The Washington Post: FDA Approves First Injectable HIV Preventive, Providing Alternative To Daily Pill
The Food and Drug Administration on Monday approved the world’s first injectable medication to reduce the risk of sexually transmitted HIV. Previously, the only PrEP (pre-exposure prophylaxis) medications that have been approved were pills required to be taken daily, such as Truvada and Descovy. For some people, adherence to daily medication can prove challenging or “not a realistic option,” said Debra Birnkrant, director of the FDA’s antivirals division. (Pietsch, 12/21)

CNN: FDA Approves First Injectable PrEP Medication To Lower HIV Risk
Two double-blind clinical trials comparing Apretude with Truvada found significantly lower HIV risk in people getting the injection, the FDA noted. The risk was 69% lower in the first trial, of HIV-negative cisgender men and transgender women who have sex with men, and 90% lower in the second trial, which involved cisgender women. Research also found that Apretude was more likely than Truvada to cause side effects such as injection site reactions, headache, fatigue, back pain, myalgia and rash. (Dillinger, 12/20)

Reuters: Biogen Halves Price Of Alzheimer's Drug To $28,200 
Biogen Inc (BIIB.O) on Monday cut the price of its Alzheimer's drug by about half to $28,200 for an average weight person after facing slower-than-expected U.S. sales on complaints from hospitals that its high cost was not worth its benefits. The U.S. Food and Drug Administration (FDA) approved the drug, Aduhelm, in June to treat the brain-wasting disease despite the view of its outside advisory panel that Biogen had not proven the treatment's clinical benefit. (Khandekar, 12/20)

Stat: Biogen Slashes Price Of Aduhelm In Half, Plans $500M In Cost-Cutting
Biogen said Monday that it has reduced the price of its Alzheimer’s drug Aduhelm by half and is planning a series of cost-cutting measures across the company next year that aim to save $500 million. The moves follow a disappointing commercial launch of Aduhelm, as well as anger over the drug’s high price. (Feuerstein, 12/20)

CBS News: After Criticisms, Biogen Slashes Price Of Its Alzheimer Drug In Half 
Biogen CEO Michel Vounatsos said in a prepared statement that too many patients were not being offered the drug due to "financial considerations," and their disease had progressed beyond the point where Aduhelm could help. (12/20)

NPR: Omicron Is Now The Dominant COVID Strain In The U.S., Making Up 73% Of New Infections
The omicron variant is now considered the most dominant version of the coronavirus — making up 73% of new COVID-19 infections last week in the U.S., according to new data released by the Centers for Disease Control and Prevention on Monday. The new estimates capture cases for the week that ended on Dec. 18. The new estimates underscore just how rapidly it has spread across the U.S. As of a week prior, Dec. 11, it was only detected in 12.6% of positive COVID-19 cases that were sampled. The CDC said it was working on revising some of the earlier numbers after officials finish analyzing more samples of the strain. (Franklin, 12/20)

The Washington Post: WHO says holiday events should be canceled amid omicron spread
The director general of the World Health Organization on Monday urged people to cancel upcoming events as part of a global effort to avoid “increased cases, overwhelmed health systems and more deaths” over the holiday season amid the spread of the omicron variant. Tedros Adhanom Ghebreyesus’s remarks to journalists come as the new variant is quickly infecting more and more people just before the Christmas holiday. At least 48 U.S. states and 89 countries have reported cases. An unvaccinated Houston-area man in his 50s is believed to be the first to die in the United States after being infected by omicron. (Jeong and Francis, 12/21)

CNN: 'An Event Canceled Is Better Than A Life Canceled,' WHO Chief Warns 
It might be time to rethink your festive plans, the World Health Organization has warned amid a rising number of cases of the coronavirus caused by the Omicron variant. World Health Organization Director-General Tedros Adhanom Ghebreyesus said the pandemic might mean canceling in-person events over the holiday period, adding that "an event canceled is better than a life canceled." (Kottasova and Langmaid, 12/21)

Houston Chronicle: First Omicron-Related Death In U.S Reportedly In Harris County
Harris County recorded its first death attributed to the omicron variant of COVID-19, County Judge Lina Hidalgo announced Monday. ABC News said the death was believed to be the first recorded due to the omicron variant. The person who died, a man in his 50s, was a resident of Harris County Precinct Two, Hidalgo said. The man was reportedly unvaccinated. The news was reported hours after Hidalgo raised the county’s coronavirus threat level to ‘significant.” (González Kelly, 12/20)

Houston Chronicle: As Child COVID Hospitalizations Double In Four Days, Highly Transmissible Omicron Poised To Sweep Houston
Harris County reported its first casualty from the COVID-19 omicron variant on Monday, less than one month after the heavily mutated version of the virus was detected in South Africa. Announcing the death, which is believed to be the first recorded due to omicron in the nation, County Judge Lina Hidalgo said the latest variant’s arrival in the Houston area “feels like whiplash” after a period of receding cases. She’s not the only one grappling with the swift rise of omicron amid the busiest travel season of the year: Houston-area doctors watching omicron’s breakneck march across much of the globe said the highly transmissible variant is likely to take hold in the coming months, with potentially severe consequences for the one-third of Texans who remain unvaccinated. The World Health Organization estimates indicate the variant is reproducing itself faster than any previous iteration, with the number of new cases doubling every 1.5 to 3 days. (Mishanec and González Kelly, 12/20)

The Washington Post: Biden Faces Tough Task Of Rallying Exhausted Americans Against Omicron Threat 
Four days before Christmas, as coronavirus cases spike and testing lines snake around city blocks, President Biden on Tuesday will again attempt to persuade Americans to take protections to fend off the fast-spreading omicron variant. But at a moment of great urgency — both for the nation’s health and the president’s standing — he has few new tools at his disposal, at least not politically palatable ones, and public health experts fear that exhausted Americans have tuned out their warnings. (Diamond and Pager, 12/20)

The Boston Globe: Nearly 97 Percent Of Vaccinated Residents In Mass. Who Caught COVID Avoided Hospitalization, Death, Public Health Officials Say
Nearly 97 percent of Massachusetts residents who’ve contracted COVID-19 after getting vaccinated have avoided severe health outcomes such as hospitalization or death, the state Department of Public Health said Monday. The DPH confirmed the tally in a statement. According to the release, DPH culled the 97-percent figure from a review of breakthrough cases in the Commonwealth, and the agency also zeroed in on the unvaccinated population. The review found unvaccinated residents are five times more likely to get infected than fully vaccinated residents, and that unvaccinated residents are 31 times more likely to become infected than fully vaccinated residents who’ve received a booster, the statement said. (Andersen, 12/20)

Politico: ‘It Is Embarrassing’: CDC Struggles To Track Covid Cases As Omicron Looms 
As the world experiences new, more transmissible Covid-19 variants, scientists and health officials in the U.S. are still struggling to gather accurate and timely domestic data to help inform policy decisions to safeguard Americans. Continuing gaps in the CDC’s data collection program, which almost two years into the pandemic still relies on state health departments who use a mix of often incompatible and outdated state systems to identify cases, impedes the nation’s understanding of where and how fast the virus is spreading, according to more than a dozen state and federal officials involved in tracking cases. (Banco, 12/20)

The Washington Post: Vaccine Mandates: Biden's Policies Arrive At Supreme Court 
The Biden administration’s coronavirus protection requirements intended to persuade millions of health-care and other workers to get vaccinated are taking center stage at the Supreme Court. More than half the states and coalitions of business and religious groups are asking the justices for emergency action to block the administration’s nationwide vaccine-or-testing mandate for large businesses, which would cover about 80 million workers. (Barnes, 12/20)

AP: Missouri Court Adds To Ban On Biden Contractor Vaccine Rule 
A federal judge in Missouri added another legal block Monday against President Joe Biden’s requirement that federal contractors receive COVID-19 vaccinations. The new preliminary injunction prohibits enforcement of the contractors’ vaccine mandate in 10 states that collectively sued. It comes on top of a nationwide injunction issued earlier this month by a federal judge in Georgia. (Lieb, 12/21)

The New York Times: Donald Trump Said He Got A Booster Shot And His Supporters Booed 
Former President Donald J. Trump, who for years falsely claimed vaccines were dangerous and pointedly declined to be seen getting vaccinated against Covid-19 while in office, was booed at an event in Houston after saying publicly for the first time that he had received a booster shot. (Paybarah and McCarthy, 12/20)

AP: Maryland Governor Tests Positive For Coronavirus, Feels Fine
Maryland’s governor announced Monday that he has tested positive for the coronavirus and is experiencing cold-like symptoms. Gov. Larry Hogan tweeted that he received a positive rapid test Monday morning as part of his regular testing routine. Hogan, a cancer survivor, said he has been vaccinated and has had a booster shot. (12/21)

AP: Care Rationing Plans Deactivated At Northern Idaho Hospitals
Idaho’s top health official on Monday deactivated crisis guidelines for rationing care at northern Idaho medical facilities as COVID-19 cases have dropped. Idaho Department of Health and Welfare Director Dave Jeppesen said the number of COVID-19 patients remained high but no longer exceeds available health care resources. (Ridler, 12/20)

The Washington Post: NHL is first U.S. sport to halt schedule amid coronavirus surge, with stoppage starting Wednesday
The NHL will halt its season Wednesday amid a spike in coronavirus cases and the rise of the omicron variant, the league announced Monday night, becoming the first major pro sports league in North America with plans to halt play entirely, albeit briefly. Team facilities will be closed from Wednesday through Saturday, and players will return Sunday for coronavirus testing and practice. Games are in line to resume Monday, Dec. 27. The league’s previously scheduled holiday break was Friday through Sunday. (Pell, 12/20)

The Washington Post: NFL’s Covid Testing Rules Divide Public Health Experts 
With the omicron variant baring its teeth, the NFL’s revamped coronavirus testing policy will lead to an increase in infections among its ranks, experts said Monday, and could risk spreading the virus as hospital systems struggle to bear the weight of another wave of covid-19 infections. But some epidemiologists said the league’s plan also could provide a hint of what the general public can expect as the coronavirus becomes further entrenched in everyday life. (Maese, 12/20)

AP: NFL Could Become Trend-Setter For COVID-19 Testing Policies 
The NFL’s decision to reduce COVID-19 testing for asymptomatic, vaccinated players could signal a trend for pro sports leagues and provide an example for society to follow heading into 2022. ... The NFL previously required vaccinated players to get tested weekly before amending the protocols. The NFLPA had advocated for daily testing for vaccinated players but eventually agreed to “target” testing. The NBA didn’t require vaccinated players to get tested during the season but revised its policy to increase testing for a two-week period starting Dec. 26. (Maaddi, 12/21)

AP: AP Source: Several Asymptomatic NFL Players Test Positive
Several asymptomatic, vaccinated NFL players tested positive for COVID-19 on the first day of “targeted” testing, a person familiar with the results told The Associated Press on Monday. Overall, 47 players were placed on the reserve/COVID-19 list, the most in a single day since the pandemic began. The person, speaking on condition of anonymity because of privacy issues, didn’t specify how many of the players are asymptomatic and fully vaccinated. (Maaddi, 12/21)

Los Angeles Times: COVID-19 Outbreak At SpaceX Yields 132 Positive Cases
At least 132 staffers at the SpaceX rocket factory in Hawthorne have tested positive for COVID-19 amid a large, active outbreak that coincides with a busy month of launches for the aerospace manufacturer. The Los Angeles County Department of Public Health released the data as part of a summary of COVID-19 cases throughout the county. There has been at least one other outbreak at SpaceX’s corporate headquarters, where the Elon Musk-led company’s main design, manufacturing and engineering is done, including work on its Falcon 9 rockets and Dragon capsules. (Seidman and Masunaga, 12/20)

Los Angeles Times: Judge Rules Against San Diego Unified COVID Vaccine Mandate
A San Diego County judge has struck down the student COVID-19 vaccine mandate in the San Diego school system, a ruling with potential implications elsewhere, including in the Los Angeles Unified School District. In a four-page decision, Superior Court Judge John S. Meyer concluded that California school systems did not have the authority under state law to establish their own vaccine mandates. His ruling applies only to San Diego Unified. In separate vaccine mandate litigation against L.A. Unified, an L.A. County judge recently appeared to be leaning in the other direction, siding with the right of the Los Angeles district to impose its own requirements. (Blume and Taketa, 12/20)

AP: University Of Oregon Requiring COVID Booster 
As the highly transmissible omicron variant spreads across the country, University of Oregon students, faculty and staff will be required to get a COVID-19 booster shot as soon as they are eligible, school officials announced Monday. Currently the university and the state’s six other public universities require COVID-19 vaccinations for those on campus. As of Monday afternoon, the University of Oregon is the only public university in the state to publicly announce a booster requirement. (12/20)

Modern Healthcare: Oracle To Buy Cerner For $28.3 Billion
Oracle on Monday said it plans to acquire electronic health records giant Cerner in a deal valued at $28.3 billion. The Austin, Texas-based tech giant will acquire Kansas City, Missouri-based Cerner through an all-cash tender offer of $95 per share in a transaction expected to close in 2022. The transaction is subject to certain regulatory approvals and closing conditions, including Cerner stockholders agreeing to sell a majority of Cerner's outstanding shares as part of Oracle's offer. (Kim Cohen, 12/20)

San Francisco Chronicle: CVS Announces First Pharmacies To Close In San Francisco Next Month
CVS Pharmacy will close six of its 21 San Francisco stores in January, a company spokesperson told The Chronicle on Monday. They’re part of a wave of anticipated closures the company first announced mid-November, when it said it would shutter 900 stores nationwide in order to reduce its count by 10%. The closings are to occur at a rate of 300 per year for three years. (Whiting, 12/20)

Modern Healthcare: Report: 10 Private Equity-Backed Healthcare Providers Will Go Public In 2022
More private equity firms took their healthcare provider portfolio companies public in 2021 than ever before, and one research firm thinks the number will almost double in 2022. Data analytics and research firm PitchBook predicts at least 10 private equity-backed healthcare provider platforms will list publicly next year, breaking 2021's record of six such IPOs. The prediction was part of PitchBook's 2022 U.S. private equity outlook. Six PE-backed healthcare provider IPOs in a year might not sound like a lot, but it compares with between zero and two in each of the previous 10 years, PitchBook found. (Bannow, 12/20)

NBC News: Doctors Sue Envision Healthcare, Say Private Equity-Backed Firm Shouldn’t Run ERs In California
An emergency medicine physicians group has sued Envision Healthcare, the giant health care services company, alleging that it violated California laws barring corporations from practicing medicine when it took over staffing of the emergency department at Placentia-Linda Hospital in Placentia, California, in August. The lawsuit was filed by the American Academy of Emergency Medicine Physician Group, or AAEM, a nonprofit professional medical association that provides administrative services to physician groups. For-profit Envision Healthcare says it is the country’s largest emergency medicine group, partnering with 540 health care facilities in 45 states. Envision is owned by KKR, the private equity powerhouse. (Morgenson, 12/21)

Modern Healthcare: Transport Congestion Causing Lengthy Delays For Medical Supplies
Hospitals and other providers are experiencing lags in the delivery of between 8,000-12,000 containers of critical medical supplies and equipment, a setback that could negatively impact patient care and public health. Healthcare resources are being delayed an average of up to 37 days throughout the U.S. transportation system due to supply chain congestion, according to research from the Health Industry Distributors Association. Medical shipments are being held up at U.S. ports for around 17 days. The Long Beach and Los Angeles ports in California have the largest number of delayed medical containers on the West Coast. The Port of Savannah, Georgia is the most congested on the Eastern Seaboard, the association reports. (Devereaux, 12/20)

Stat: University Professor Charged With Insider Trading Over A Cancer Drug Trial
A University of Chicago associate professor who worked as a clinical trial investigator for Five Prime Therapeutics was charged with insider trading in connection with study results for a key cancer drug. In November 2020, Daniel Catenacci was a lead physician and investigator for a Phase 2 trial of a stomach cancer treatment when he learned of positive results from a Five Prime executive. The medicine, known as bemarituzumab, was widely tracked since stomach cancer is the third-leading cause of cancer deaths worldwide and prompted Amgen (AMGN) to buy the company for $1.9 billion a few months later. (Silverman, 12/20)

AP: EU Approves 5th COVID-19 Vaccine For Bloc, One By Novavax 
The European Union’s executive branch on Monday authorized a fifth COVID-19 vaccine for use in the 27-nation bloc, giving the green light to the two-dose vaccine made by U.S. biotech company Novavax. The European Commission confirmed a recommendation from the bloc’s drug regulator to grant conditional marketing authorization for the vaccine for people ages 18 and over. The decision comes as many European nations are battling surges in infections and amid concerns about the spread of the new omicron variant. (Corder, 12/20)

Reuters: As Omicron Threatens A Global Surge, Some Countries Shorten COVID-19 Booster Timelines 
A growing number of countries are reducing the wait time for COVID-19 vaccine boosters from six months to as few as three in a bid to ward off a new surge in infections from the Omicron variant. They are reacting to early evidence suggesting that Omicron is spreading faster than its predecessor, Delta, and is more likely to infect people who were vaccinated or had COVID in the past. Some scientists, however, say that giving boosters too soon could compromise the level of longer-term vaccine protection. (Beasley, 12/20)

The Washington Post: French Police Find 182,000 Fake Covid Health Passes
French police have uncovered 182,000 fake health passes since the documents were introduced this summer in a bid to control the spread of the coronavirus. President Emmanuel Macron introduced the official passes in July, and they have become necessary to gain access to numerous venues, including bars, restaurants and many long-distance trains. They can be obtained through vaccination, recovery from covid-19 or a recent negative test. (Pannett, 12/21)