First Edition: June 22, 2018

Kaiser Health News: Doling Out Pain Pills Post-Surgery: An Ingrown Toenail Not The Same As A Bypass
What’s the right painkiller prescription to send home with a patient after gallbladder surgery or a cesarean section? That question is front and center as conventional approaches to pain control in the United States have led to what some see as a culture of overprescribing, helping spur the nation’s epidemic of opioid overuse and abuse.The answer isn’t clear-cut. (Appleby, 6/22)

California Healthline: California Poised To Expand Access To Hepatitis C Drugs
Patrick Garcia wasn’t completely surprised when he learned recently he had hepatitis C. Until a few years ago, he had experimented with numerous drugs, injecting heroin, methamphetamine, cocaine — you name it. “I haven’t lived exactly a perfect life,” said Garcia, 43, whose mouth, hand and back were injured in a motorcycle wreck last year.Medi-Cal, California’s public health program for the poor, paid for his post-accident care and the bloodwork that led to his hepatitis C diagnosis. But it wouldn’t pay for the pricey new medications that cure the disease. (Bartolone, 6/21)

The New York Times: A Common Virus May Play Role In Alzheimer’s Disease, Study Finds
It has long been a controversial theory about Alzheimer’s disease, often dismissed by experts as a sketchy cul-de-sac off the beaten path from mainstream research. But a new study by a team that includes prominent Alzheimer’s scientists who were previously skeptics of this theory may well change that. The research offers compelling evidence for the idea that viruses might be involved in Alzheimer’s, particularly two types of herpes that infect most people as infants and then lie dormant for years. (Belluck, 6/21)

The Associated Press: New Evidence That Viruses May Play A Role In Alzheimer's
The findings don't prove viruses cause Alzheimer's, nor do they suggest it's contagious. But a team led by researchers at New York's Mount Sinai Health System found that certain viruses — including two extremely common herpes viruses — affect the behavior of genes involved in Alzheimer's. The idea that infections earlier in life might somehow set the stage for Alzheimer's decades later has simmered at the edge of mainstream medicine for years. It's been overshadowed by the prevailing theory that Alzheimer's stems from sticky plaques that clog the brain. (6/21)

Los Angeles Times: Surprising Discovery About Viruses And Alzheimer’s Disease Could Open New Avenues For Treatment
Their surprise discovery emerged as researchers sorted through a vast genomic data bank in search of new ideas for treating Alzheimer’s with drugs designed for other diseases. The study’s authors pored over DNA and RNA sequencing data from 622 brains donated by people affected by Alzheimer’s and 322 brains that were free of the disease. The data they mined is usually discarded, but was archived instead by the National Institutes of Health in a bid to accelerate the discovery of new treatments by fostering “big data” collaborations. This one brought together scientists at Arizona State University’s Banner Neurodegenerative Disease Research Center and Alzheimer’s experts at New York’s Icahn School of Medicine at Mount Sinai. (Healy, 6/21)

NPR: Herpes Viruses And Alzheimer's: A Possible Link
Once the researchers knew the viruses were associated with Alzheimer's they started trying to figure out how a virus could affect the course of a brain disease. That meant identifying interactions between the virus genes and other genes in brain cells. "We mapped out the social network, if you will, of which genes the viruses are friends with and who they're talking to inside the brain," Dudley says. In essence, he says, they wanted to know: "If the viruses are tweeting, who's tweeting back?" And what they found was that the herpes virus genes were interacting with genes known to increase a person's risk for Alzheimer's. They also found that these Alzheimer's risk genes seem to make a person's brain more vulnerable to infection with the two herpes viruses. (Hamilton, 6/21)

Stat: Herpes Viruses Could Play Role In Alzheimer's, New Study Finds
During the 14 months that the two studies have been stuck in publication limbo, experimental Alzheimer’s drugs based on the quarter-century-old “amyloid cascade hypothesis” have been flaming out, each more spectacularly than before. (The hypothesis says that production of an aberrant protein called amyloid-beta creates sticky plaques that destroy brain synapses and neurons.) This year alone has brought the demise of the Eli Lilly/AstraZeneca drug lanabecestat; Lilly’s solanezumab; and Merck’s verubecestat. That brings the number of effective Alzheimer’s treatments based on the amyloid cascade hypothesis to … zero, making the need for new ideas more urgent than ever. (Begley, 6/21)

The Hill: Dems, Health Groups Demand Immigrant Children Be Quickly Reunited With Families
Democrats and medical professionals on Thursday called for children separated from their families at the border to be immediately reunited to minimize any long-term harm to their mental and physical health. “The executive order President Trump signed yesterday does not resolve this crisis that he created,” said Democratic Whip Steny Hoyer (Md.) at a press conference with representatives of health groups. (Hellmann, 6/21)

The New York Times: No Relief In Sight For Parents Of Thousands Of Migrant Children Still In Custody
Micaela Samol Gonzalez, dressed in blue detention scrubs, made her way to the front of a windowless courtroom in Colorado on Thursday and faced the judge. After she gave her name and arranged a future court date for her immigration case, the judge asked whether she had any questions. She had just one. (Healy, 6/21)

The Washington Post: The Chaotic Effort To Reunite Immigrant Parents With Their Separated Kids
Each of the mothers had a different memory of the moment she was separated from her child. For some, it was outside a Border Patrol station just north of the Rio Grande, shortly after being apprehended. For others, it was after an interrogation by federal authorities in a bitterly cold air-conditioned office. Jodi Goodwin, an attorney in Harlingen, Tex., has heard more than two dozen variations of those stories from Central American mothers who have been detained for days or weeks without their children. So far, she has not been able to locate a single one of their offspring. (Sieff, 6/21)

The Associated Press: Confusion And Uncertainty At The Border After Trump Acts
The U.S. government wrestled with the ramifications Thursday of President Donald Trump’s move to stop separating families at the border, with no clear plan to reunite the more than 2,300 children already taken from their parents and Congress again failing to take action on immigration reform. In a day of confusion and conflicting reports, the Trump administration began drawing up plans to house as many as 20,000 migrants on U.S. military bases. But officials gave differing accounts as to whether those beds would be for children or for entire families. (Merchant, Bryan and Long, 6/21)

The New York Times: U.S. Prepares Housing Up To 20,000 Migrants On Military Bases
The United States is preparing to shelter as many as 20,000 migrant children on four American military bases, a Pentagon spokesman said on Thursday, as federal officials struggled to carry out President Trump’s order to keep immigrant families together after they are apprehended at the border. The 20,000 beds at bases in Texas and Arkansas would house “unaccompanied alien children,” said a Pentagon spokesman, Lt. Col. Michael Andrews, although other federal agencies provided conflicting explanations about how the shelters would be used and who would be housed there. There were reports of widespread confusion on the border. (Shear, Cooper and Benner, 6/21)

Reuters: Immigration Detainees Influx Squeezes Healthcare At California Prison: Workers
An influx of hundreds of immigration detainees at a U.S. prison in California is straining its medical staff and raising concerns about the adequacy of healthcare for detainees and inmates, several employees at the prison have told Reuters. The Victorville Federal Correctional Institution, a prison for convicted criminals about 85 miles northeast of Los Angeles, is temporarily housing up to 1,000 men detained by federal immigration officials as a result of the U.S. administration's crackdown on illegal border crossings. (Lynch, 6/21)

Reuters: 'Are You The Mother?' A Woman's Search For Baby Taken By U.S. Immigration
It took 85 days for Olivia Caceres to retrieve her baby boy, pulled from his father's arms at the U.S. border, a traumatic experience many more parents face to reunite with children separated under President Donald Trump's immigration policies. Now nearly 20 months old, Mateo was returned to his family on Feb. 8 after a battle across borders, officialdom and languages. He was filthy and terrified of the dark, his mother said. Months later, the boy still screeches even as Caceres rocks him on her chest, sometimes until dawn. (6/21)

The New York Times: 16 And Alone, Inside A Center For Separated Children In New York
It was just three weeks ago that the 16-year-old was detained by immigration agents in Texas after traveling with his father to the United States. The father was deported back to Guatemala. The child was sent to New York. Today, he sits in a children’s residence, one of an estimated 700 young people who have been placed with child care agencies in New York since President Trump announced his “zero tolerance” policy of separating children from family members when they are apprehended at the southern border. (McKinley, Robbins and Correal, 6/21)

Reuters: Head Of New U.S. Corporate Health Plan Cites Surgery As Biggest Cost
Dr. Atul Gawande, a surgeon who was named this week to head the company being formed by Amazon, Berkshire Hathaway and JPMorgan Chase to trim employee healthcare costs, on Thursday cited surgery as the single biggest U.S. healthcare cost and said there are ways to both cut costs and improve patient care. Speaking in San Diego at the annual meeting of America's Health Insurance Plans, a health insurance trade association, Gawande also said that end-of-life care needs to take into account the wishes of patients, something which he said is now sorely lacking. (Beasley, 6/21)

Stat: How Can Atul Gawande Help Reinvent Health Care With His New Company?
So far, announcements regarding the new enterprise have been light on policy details, leaving many to wonder how exactly it can succeed where so many others have failed. We asked some of the country’s leading health care experts and others for how they would counsel Gawande as he begins his new adventure. (Chen, 6/21)

The Washington Post: Trump Wants To Move Food Stamps To A New Agency. That Could Make The Program Easier To Overhaul.
Conservative groups who have pushed the plan, including the Heritage Foundation, say HHS is better equipped to make major reforms to SNAP than the Agriculture Department. They also argue the consolidation will help administrators better track how much money low-income families receive in benefits — a potential precursor to paring back those programs. (Dewey, 6/21)

The Hill: White House Releases Sweeping Proposal To Reorganize Government 
A new Council on Public Assistance would then oversee programs gathered in one place, including food stamps and Medicaid, and have the power to impose uniform work requirements in those programs, a move strongly opposed by Democrats. The reorganization plan faces tough odds in Congress, where even aside from the dispute over work requirements, any reorganization faces opposition from congressional committees that could lose power if their jurisdictions change. (Sullivan, 6/21)

The Washington Post: Government Reorganization Plan Embraces Conservative Goals For The Safety Net
Whether these changes are a good idea lies at the core of a deep philosophical divide about the proper size of government and its role for people who live in poverty or close to it. “The federal government is bloated, opaque, bureaucratic and inefficient,” Mick Mulvaney, director of the White House’s Office of Management and Budget, said Thursday in unveiling the proposal, much of which would require Congress’s approval. Robert Rector, a senior research fellow for domestic policy studies at the Heritage Society, who has advised Trump administration officials on ideas for safety-net programs that he has advanced for a decade, said, “You have to treat the welfare system holistically.” He said in an interview Thursday that the government could, for instance, align assistance programs to remove financial deterrents to marriage. (Goldstein and Dewey, 6/21)

The Wall Street Journal: Trump Proposes Combining Workforce Training, Welfare Programs In Agency Revamp
Critics say restoring the word “welfare” to the agency’s name would give the assistance programs a negative connotation and make them vulnerable to budget cuts. Proponents argue the consolidation would streamline oversight and make things easier for states and consumers. (Hackman, 6/21)

Stat: White House Proposes A Narrowing Of FDA's Mission — And A New Name
The Trump administration has proposed a fundamental change to the mission of the Food and Drug Administration, one that would transfer most of the responsibility for regulating food safety to the Department of Agriculture and rename the FDA the “Federal Drug Administration. ”The proposal is part of a wide-reaching plan that was released Thursday by the White House and that includes other broader ideas to reform the Department of Health and Human Services. HHS would be renamed the “Department of Health and Public Welfare” and absorb some food assistance programs currently run by the USDA. (Swetlitz, 6/21)

The New York Times: 25th Person At U.S. Embassy In Cuba Is Mysteriously Sickened
Another diplomat working at the United States Embassy in Havana has been sickened by a mysterious attack, bringing to 25 the number of personnel who have fallen ill there, the State Department said on Thursday. The case was the first confirmed in Cuba since August and could suggest that whatever caused the illnesses in late 2016 and the first part of 2017 had started again or was continuing. Complicating the situation for officials was news this spring that at least one diplomat at a consulate in Guangzhou, China, had experienced symptoms almost identical to those reported by diplomats in Havana. (Harris, 6/21)

The Associated Press: Another US Worker Confirmed Hurt By Mystery Cuba Incidents
The new "medically confirmed" worker is one of two who were recently evacuated from Cuba after reporting symptoms. State Department spokeswoman Heather Nauert said the other worker is "still being evaluated" by doctors. Prior to the newest incident, the most recent medically confirmed case from Cuba had been in August 2017, Nauert said. The confirmed Cuba patients have been found to have a range of symptoms and diagnoses including mild traumatic brain injury, also known as concussions. (Lederman and Lee, 6/22)

The Hill: Cigna Announces Goal To Reduce Drug Overdoses By 25 Percent In Key Areas
Cigna, one of the country’s largest health insurers, announced Thursday an initiative to reduce drug overdoses 25 percent by 2021 in certain communities hit by the opioid epidemic. The effort will focus initially on four states — Connecticut, Maryland, New Jersey and Virginia — as well as the metropolitan areas of Chicago, New York, Philadelphia and Washington, D.C. (Roubein, 6/21)

The Associated Press: Pain Medicine Group Cancels Doctor Training About Marijuana
A national medical group Thursday abruptly canceled its plans to train doctors about marijuana for pain relief after a federal agency pulled its funding. The episode highlights an ongoing conflict between federal and state laws on marijuana. The American Academy of Pain Medicine scrubbed its plans for a one-hour online course next month after a request from the U.S. government agency that provided the funding, a spokeswoman for the pain medicine group said. (Johnson, 6/21)

The New York Times: Police Killings Have Harmed Mental Health In Black Communities, Study Finds
The mental health of white Americans was not similarly affected, the researchers found. Nor were negative health effects associated with police killings of unarmed white Americans or armed black Americans. While these findings might seem unsurprising, particularly to African-Americans, the researchers contended that their study was a significant attempt to assess the measurable, if indirect, harms that police violence has inflicted on the broader psychological and emotional well-being of African-Americans.(Eligon, 6/21)

The Washington Post: How Prepared Is The World For The Next Epidemic? This Tool Shows Most Countries Are Not.
Public health officials and business leaders like Bill Gates have long warned that the world is not ready for the next pandemic. Now an initiative led by Tom Frieden, former director of the Centers for Disease Control and Prevention, has developed a tool that spotlights gaps in preparedness, and actions that countries and organizations can take to close them. The new website, PreventEpidemics.org, gives an individual score to each country and uses color codes to rank the world by five levels of preparedness. (Sun, 6/21)

Stat: ‘Living Legos’ Form Blood Vessels To Simulate Heart Disease And Test Drugs
In the field of tissue engineering, many scientists grow cells in sheets, or use an artificial scaffold to give shape and structure to the cells. But Marsha Rolle, associate professor of biomedical engineering at Worcester Polytechnic Institute, and some colleagues are developing a more modular approach, in a process she compares to both building blocks and baking pans. Rolle chose this approach to build both a more accurate model of healthy blood vessels as well as damaged ones, hoping to learn more about cardiovascular diseases and whether drugs will effectively treat them. (Cooney, 6/22)

The Associated Press: Demi Lovato Sings About Addiction Struggles On ‘Sober’
Demi Lovato celebrated six years of sobriety in March, but her new song indicates she may no longer be sober. The pop star released “Sober “ on YouTube on Thursday, singing lyrics like: “Momma, I’m so sorry I’m not sober anymore/And daddy please forgive me for the drinks spilled on the floor.” Lovato tweeted a link to the song with the words “My truth.” The singer-actress struggled with an eating disorder, self-mutilation and other issues, entering rehab in 2010. She has spoken out about her battles with drugs and alcohol over the years, and she’s become a role model for young women and men who have faced their own issues. (6/21)

The New York Times: Obesity Rates Higher In Country Than City
Obesity is more common in rural areas than in cities in the United States, two new studies have found. The two analyses, one of adults and the other of children, used data on weight, height and where people lived that was gathered in a series of nationally representative surveys from 2001 to 2016. They were published online together in JAMA. (Bakalar, 6/21)