First Edition: March 14, 2019

Kaiser Health News: Understanding Loneliness In Older Adults — And Tailoring A Solution
For years, Dr. Linda Fried offered older patients who complained of being lonely what seemed to be sensible guidance. “Go out and find something that matters to you,” she would say. But her well-meant advice didn’t work most of the time. What patients really wanted were close relationships with people they care about, satisfying social roles and a sense that their lives have value. And this wasn’t easy to find. We need “new societal institutions that bring meaning and purpose” to older adults’ lives, Fried recently told a committee of the National Academies of Sciences investigating loneliness and social isolation among older adults. (Graham, 3/14)

The New York Times: F.D.A. Moves To Restrict Flavored E-Cigarette Sales To Teenagers
With a few weeks left in his tenure as commissioner of the Food and Drug Administration, Dr. Scott Gottlieb on Wednesday moved to restrict sales of flavored e-cigarettes to try to reduce the soaring rate of teenage vaping. The agency issued a proposal requiring that stores sequester flavored e-cigarettes to areas off limits to anyone under age 18. Retailers, including convenience stores and gas stations, will be expected to verify the age of their customers. (Kaplan, 3/13)

Reuters: U.S. Proposes Stricter Curbs On E-Cigarette Sales
The proposal would allow traditional retailers such as convenience stores to sell tobacco, mint and menthol e-cigarettes, which the FDA says are more popular among adults than minors. But other flavors could only be sold in stores or online when strong age-verification protocols are in place. In an interview on Wednesday, Gottlieb said the new guidelines give the agency flexibility to further restrict sales if youth use trends continue. (3/14)

The Wall Street Journal: FDA Sets Limits On Retail Sales Of Flavored E-Cigarettes
The FDA will require all e-cigarette makers, including Juul, to submit most flavored products currently on the market to the agency for review by August 2021, a year earlier than its previous deadline. The agency will also ban the sale of all flavored cigars introduced to the market since February 2007. Separately, it is pursuing a plan to prohibit flavored cigars entirely, but the broader ban could take years to implement. (Maloney, 3/13)

The Washington Post: FDA Rolls Out Vaping Policy To Make It Harder For Minors To Buy Flavored Products
The new policy would not apply to mint, menthol and tobacco flavors unless those products were being sold in a way that targeted minors, the agency said. E-cigarette advocates say those products are most often used by adult smokers trying to quit, but anti-tobacco groups are skeptical of the claim, saying there isn’t data to support it. (McGinley, 3/13)

The Hill: Outgoing FDA Chief Issues Proposal To Limit Sales Of Flavored E-Cigs
"Evidence shows that youth are especially attracted to flavored e-cigarette products, and that minors are able to access these products from both brick-and-mortar retailers, as well as online, despite federal restrictions on sales to anyone under 18," Gottlieb said in a statement. (Hellmann, 3/13)

Bloomberg: Most Flavored E-Cigarettes To Be Banned From Retail Stores 
The FDA has the “strong support” of President Donald Trump and Health and Human Services Secretary Alex Azar, Gottlieb said in a statement. Health advocates were concerned that Gottlieb’s departure would threaten the likelihood of e-cigarette restrictions being finalized. Azar said Tuesday that Ned Sharpless, head of the National Cancer Institute, would be acting commissioner after Gottlieb leaves later this month. Sharpless has expressed support for Gottlieb’s vaping restrictions. (Edney, 3/13)

Reuters: Democrats Support Expanding Medicare, With Some Caveats That Could Matter To Voters
After launching his 2020 presidential bid last week, John Hickenlooper took a different stance on establishing a "Medicare-for-all" government health insurance program than many of his Democratic competitors. "I probably would oppose Medicare-for-all just because there are over 150 million people, Americans who have some form of private insurance through their business, and the vast majority of them are happy with that," the former Colorado governor said on MSNBC. He added he supported reaching universal health insurance coverage by another route. (3/13)

The New York Times: How ‘Medicare For All’ Would Work (Or Not Work)
“Medicare for all” has become a punching bag for Republicans and a rallying cry for many Democrats. But what exactly is it? (3/13)

Modern Healthcare: Hospitals Could Lose $800 Billion From Medicare Buy-In, AHA Says
Hospital groups on Tuesday pushed back against mounting Democratic support for a public option, saying the policy will lower Medicare reimbursement for providers as people leave commercial plans. In a new analysis of a universal Medicare buy-in policy, the American Hospital Association and Federation of American Hospitals on Tuesday projected hospitals would lose $800 billion over a decade through the lower Medicare reimbursements and raise premiums within the private market—disrupting the employer insurance market where the majority of people get coverage. (Luthi, 3/12)

The New York Times: Pentagon Pushes For Weaker Standards On Chemicals Contaminating Drinking Water
Facing billions of dollars in cleanup costs, the Pentagon is pushing the Trump administration to adopt a weaker standard for groundwater pollution caused by chemicals that have commonly been used at military bases and that contaminate drinking water consumed by millions of Americans. The Pentagon’s position pits it against the Environmental Protection Agency, which is seeking White House signoff for standards that would most likely require expensive cleanup programs at scores of military bases, as well as at NASA launch sites, airports and some manufacturing facilities. (Lipton and Turkewitz, 3/14)

Stat: How Ned Sharpless, Biotech Veteran, Vaulted To The Top Of The FDA
Almost immediately after beginning his Bethesda day job as the nation’s top cancer researcher, Ned Sharpless built a roughly 7-mile detour into his weekly routine: a sojourn to the Food and Drug Administration campus for a pickup basketball game. Whether or not the networking was intentional, Sharpless will soon be spending far more time with the FDA oncologists who once broke his finger. When Scott Gottlieb steps down after a nearly two-year tenure next month, Sharpless will take the helm of that agency, at least in the short term. (Facher and Sheridan, 3/14)

Politico: Pulse Check: Can We Trust Trump On HIV?
The president says he wants to end the HIV epidemic. His track record suggests otherwise. (3/13)

The Hill: Divisions Emerge Over House Drug Price Bills
Divisions are emerging in the House over what lawmakers hoped would be a bipartisan push to lower drug prices. Drug pricing is a rare area where members of both parties think there is a chance for a deal this year. But as House Democrats took the first step on Wednesday to begin moving legislation forward, it was clear that even relatively small-scale drug pricing bills may not have a smooth path ahead. (Sullivan, 3/13)

Stat: Wyden Probes A Patient Advocacy Group Over Its Ties To Opioid Makers 
Amid the ongoing opioid crisis, a U.S. lawmaker is pressing a professional medical society that also functions as a patient advocacy group to disclose detailed information about its ties to drug makers over concerns it tried to sway government moves to curb opioid prescribing. In a March 12 letter, Sen. Ron Wyden (D-Ore.) instructed the American Academy of Pain Medicine to provide a raft of documents, including tax filings; a list of payments from drug and device makers made to the group and its top officer; information about work performed for opioid maker Purdue Pharma; continuing medical education coursework; and its conflict of interest policy, among other things. (Silverman, 3/13)

Stat: Insys May Go Out Of Business As Controversy And Lawsuits Intensify 
Insys Therapeutics (INSY), the once high-flying drug maker that is among the companies blamed for fueling the U.S. opioid crisis, is in danger of going out of business. A combination of financial losses and uncertainty about its cash position prompted its auditor to determine there is “substantial doubt” whether the company can continue “as a going concern,” according to documents filed with the Securities and Exchange Commission. The drug maker added that it is trying to raise funds, but conceded there are “no assurances”. (Silverman, 3/13)

The Associated Press: Hospital Reviews 48 Nurses, Pharmacists Over Dosages, Deaths
The Ohio hospital system where an intensive-care doctor is accused of ordering painkiller overdoses for dozens of patients has put more employees on leave and changed key leaders at the hospital where nearly all those deaths occurred. Mount Carmel Health System said Wednesday that 48 nurses and pharmacists under review have been reported to their respective boards. Thirty of those employees have been put on leave, and 18 no longer work there, including some that left years ago, the system said. (3/13)

The Associated Press: No Dental Insurance? Discount Plans Can Provide Savings
No dental insurance? You're not alone. Roughly 1 in 4 Americans don't have dental coverage, according to industry figures. Employers are by far the biggest provider of dental benefits in the U.S., accounting for nearly half of all enrollees, followed by the government's Medicaid plan for low-income people. Researchers have shown that costs are a bigger obstacle to dental care in the U.S. than all other forms of health care. (3/13)

The New York Times: Parents Wanted Their Unvaccinated Children In School, But A Judge Said No.
With New York State facing one of its most severe measles outbreaks in decades, public health officials in a suburban community took the extraordinary step in December of banning unvaccinated students from attending school, regardless of whether they had received religious or medical exemptions for the vaccine. The parents of 42 children affected by the ban at the school, the Green Meadow Waldorf School, sued the Rockland County health department, asking a federal judge to issue an injunction to allow the children to return. (Gold, 3/13)

The Washington Post: Measles Outbreak: Unvaccinated Children Can't Return To New York School, Federal Judge Rules
Normally, children and their families are able to claim a religion-based exemption from required vaccinations. But Rockland County’s health department has said these are not normal times. Across New York, there have been more than 300 confirmed measles cases, more than 150 in New York City and 146 in nearby Rockland County. In Rockland, most of the cases were found in those who were unvaccinated and under the age of 18. In December, the alarming outbreak compelled county officials to take the drastic — and, they say, unprecedented — step of banning unvaccinated children from attending certain schools that had vaccination rates lower than 95 percent. (Thebault, 3/14)

The Hill: New York Judge Denies Request To Allow Unvaccinated Students To Return To School 
The lawsuit argued that the health department’s decision to bar the students from campus violates the families’ right not to vaccinate their children for religious reasons. "The plaintiffs have not demonstrated that public interest weighs in favor of granting an injunction," Briccetti said in court Tuesday, according to the paper. (Daugherty, 3/13)

The New York Times: Amazon Pulls 2 Books That Promote Unscientific Autism ‘Cures’
Amazon has removed the online listings for two books that claim to contain cures for autism, a move that follows recent efforts by several social media sites to limit the availability of anti-vaccination and other pseudoscientific material. The books, “Healing the Symptoms Known as Autism” and “Fight Autism and Win,” which had previously been listed for sale in Amazon’s marketplace, were not available on Wednesday. The company confirmed that the listings had been removed, but declined to discuss why or whether similar books would be taken down in the future. (Hsu, 3/13)

Reuters: Experts Call For Halt To Gene Editing That Results In 'Designer Babies'
Top scientists and ethicists from seven countries on Wednesday called for a global moratorium on gene editing of human eggs, sperm or embryos that would result in genetically-altered babies after a rogue Chinese researcher last year announced the birth of the world's first gene-edited twins. News of their birth prompted global condemnation of the work, raising the ethical specter of so-called designer babies in which embryos could be genetically modified to produce children with desirable traits. (3/13)

NPR: Moratorium On Gene-Edited Babies Urged By Leading Geneticists
"We call for a global moratorium on all clinical uses of human germline editing — that is, changing heritable DNA (in sperm, eggs or embryos) to make genetically modified children," the 18 scientists and bioethicists from seven countries write in an article published Wednesday by the journal Nature. (Stein, 3/13)

The Associated Press: Scientists Back Temporary Global Ban On Gene-Edited Babies
Some scientists had called for a moratorium before the latest proposal, which carries no legal authority. It came from 18 researchers from seven countries who published a commentary in the journal Nature. They included prominent gene-editing experts Feng Zhang and David Liu of the Broad Institute of MIT and Harvard in Cambridge, Massachusetts. They receive money from the Howard Hughes Medical Institute, which also supports The Associated Press Health & Science Department. The researchers want a temporary ban on research designed to produce a baby from sperm, eggs or embryos that bear altered DNA. Roughly 30 nations already prohibit making babies from such "germline" gene editing, the authors said. It's essentially banned in the U.S. (3/13)

The Wall Street Journal: Scientists Call For Moratorium To Block Gene-Edited Babies
Dr. Doudna, a professor at the University of California, Berkeley, said she opposes implanting edited embryos in humans for now, but supports research into it. When asked to sign onto the Nature comment, she said she decided against it because, “I feel it is a bit late to be calling for a moratorium.” She also said there were probably more effective ways to stop rogue scientists. Gene-editing technology and the Crispr tool, in particular, have been racing ahead even as scientists still try to sort out the ethical issues around its use. Discovered in 2012, Crispr allows scientists to cut, edit and insert new DNA. The Broad and a group that includes Dr. Charpentier and UC Berkeley are involved in a legal dispute over the rights to the technology. (Dockser Marcus, 3/13)

The Washington Post: NIH And Top Scientists Call For Moratorium On Gene-Edited Babies
Separately on Wednesday, Francis Collins, the director of the National Institutes of Health, issued a statement supporting the call for a moratorium and a governing body, and in an interview with The Washington Post, he made clear that this is the U.S. government position, discussed and cleared at the highest levels. “What we’re talking about here is one of the most fundamental moments of decision about the application of science to something of enormous societal consequence. Are we going to cross the line toward redesigning ourselves?” Collins said. (Achenbach, 3/13)

Politico: Scientists From 7 Countries Call For Global Ban On Heritable Gene Edits
Several U.S. companies are focused on using CRISPR technology to edit adult genes to treat rare diseases, cancers and blood conditions like sickle cell disease, but those changes would not be heritable. The therapies are still in development, and none have been approved for market. FDA late last year approved the first in-human CRISPR trial, a joint effort from Editas and Allergan to correct a gene that causes blindness. (Owermohle, 3/13)

Reuters: Special Report: Online Activists Are Silencing Us, Scientists Say
The emails, tweets and blog posts in the "abuse" folder that Michael Sharpe keeps on his computer continue to pile up. Eight years after he published results of a clinical trial that found some patients with chronic fatigue syndrome can get a little better with the right talking and exercise therapies, the Oxford University professor is subjected to almost daily, often anonymous, intimidation. (3/13)

The Wall Street Journal: Unlocking Secrets Of Memory And Time In The Brain
Our bodies know when to fall asleep and when to wake up. Our brains can keep track of short bursts of time like a mental stopwatch. But in our memories, our sense of time is fuzzy. Now, research is beginning to uncover how we put our memories in order. These new insights into the workings of the brain, paired with other findings, could help in the understanding and early detection of diseases such as dementia and Alzheimer’s, scientists say. The idea that we perceive time in our memory subjectively is well known in psychology, says Lila Davachi, a professor of psychology at Columbia University. (Abbott, 3/13)

NPR: Drug Side Effects Can Come Form Inactive Ingredients
If you have a bad reaction to a medicine, it might not be the drug itself, but what are called "inactive ingredients" in the pill or capsule. An article published Wednesday in Science Translational Medicine surveys this field and finds ingredients that are potentially troublesome for some people are ubiquitous. For example, a few years ago study co-author Giovanni Traverso, a gastroenterologist at Harvard-affiliated Brigham and Women's Hospital, came across a patient with a severe gluten intolerance called celiac disease. (Harris, 3/13)

The New York Times: Coping With A Dieting Relative When You’re A Recovering Anorexic
I practice recovery by approaching my fear, modeling intuitive eating for my sister, something I couldn’t do when we were growing up. I tell her when I get peanut butter frozen yogurt at the Bigg Chill or when I have buttered popcorn for lunch (“Not lunch!” she says). When she asks what to do at the gym, I don’t give her the advice my eating disorder would have given me. When she buys chips because she’s “being bad,” I say Pringles are delicious. If she’s tired, I tell her to be kind to her body and take time off. Talking to her, I’m also talking to myself, dismantling my old negative attitudes about food. (Novak, 3/14)

Stat: At A Big Cardiology Meeting, Glitzy Tech Will Collide With Sober Science
Researchers from Stanford will present the results of a study of more than 400,000 patients testing the [Apple Watch's] ability to accurately detect heart rhythm problems, which can lead to strokes and other problems. The Apple-sponsored study will be the first test of whether putting wrist sensors on people to detect heart rhythm changes is a good idea that get them necessary care, or a bad one that is raising false alarms and possibly leading to over-treatment of the worried well. It is also one of the largest heart screening studies ever. (Herper, 3/14)

The Associated Press: Arkansas Lawmakers Send Governor 18-Week Abortion Ban
Arkansas lawmakers on Wednesday sent the governor legislation banning most abortions 18 weeks into a woman's pregnancy, a prohibition that could be the strictest in the country. The House gave final approval by an 86-1 vote to the bill, which Republican Gov. Asa Hutchinson has said he supports. Arkansas already bans abortion 20 weeks into a woman's pregnancy. Hutchinson told reporters he believed the restriction would likely survive a court challenge. (3/13)

The Associated Press: Kansas Conservatives Vote To Condemn New York's Abortion Law
The conservatives who dominate the Kansas Legislature voted Wednesday to tell New York's leaders just how much they hate the Empire State's new law expanding abortion rights, ignoring Democrats who called the endeavor a toothless waste of time and money. The Kansas House voted 85-38 on Wednesday to approve the resolution, which declares that the New York law offends Kansas' and the nation's values and incites "abuse and violence toward women and their unborn children." (3/13)

The Associated Press: Bill Passes To Ban Abortions Based On Gender, Disability
Kentucky’s Republican-led legislature on Wednesday passed its latest measure to put more restrictions on abortion, setting up another legal fight with abortion-rights defenders. The legislation would ban abortion for women seeking to end their pregnancies because of the gender, race or disability of the fetus. The GOP-dominated Senate voted 32-4 to send the bill to the state’s anti-abortion governor, Republican Matt Bevin. Soon after the vote, the American Civil Liberties of Kentucky tweeted: “We will see the state of Kentucky in court (again).” (Schreiner, 3/13)

ProPublica: Oregon Should Overhaul Handling Of Insanity Defendants, Says Head Of Psychiatry Security Review Board
The state of Oregon needs to overhaul the way it handles people found guilty except for insanity and better track what happens to them once they are released from state jurisdiction, the head of the agency that supervises such defendants said. In an interview, Alison Bort, executive director of the Oregon Psychiatric Security Review Board, acknowledged gaps in the system for treating and discharging people found criminally insane and said the state Legislature should consider appointing a state task force to weigh reforms. “I don’t think anyone disagrees we can do better,” Bort said. (Zaitz, 3/13)

The Wall Street Journal: Cuomo Adjusts Budget Proposal, Fearing Federal Health-Care Cuts
Gov. Andrew Cuomo is backing off a proposal to reduce New York’s Medicaid spending in light of additional health-care cuts in President Trump’s budget proposal, state officials said Wednesday. Mr. Cuomo, a Democrat, last month proposed reducing the state Medicaid allocation by $550 million in the coming fiscal year, which starts April 1. The reduction would still have resulted in a year-over-year funding increase, but health-care providers said it would force them to slash services. (Vielkind, 3/13)

The Associated Press: California Jury Awards $29M In Baby Powder Cancer Case
A California jury has awarded $29 million to a woman who claimed her terminal cancer was caused by Johnson & Johnson baby powder. Jurors in Oakland found the company liable Wednesday in a suit that claims asbestos in the powder gave Teresa Leavitt mesothelioma. Some 13,000 similar lawsuits around the country allege New Jersey-based Johnson & Johnson hid the powder's health risks from the public for decades. (3/14)

The Associated Press: Agreement Reached To Increase Alcohol Limits On Beer In Utah
Alcohol limits for beer at Utah grocery stores inched closer to the rest of the country Wednesday under a legislative compromise in the state where the predominant faith teaches abstinence from alcohol. The agreement would raise alcohol limits to 4 percent starting in November, a level that's still lower than almost all other states but would allow beers like Bud Light and Corona to be sold, Republican Sen. Jerry Stevenson said. (3/13)

The Associated Press: Johns Hopkins Wants Armed Police; Baltimore Says Not So Fast
Johns Hopkins University, a thriving private research institution with one of the world's foremost medical schools, wants to create an armed police force similar to those patrolling numerous other U.S. colleges and universities. But in its home city of Baltimore, split by deep divisions and seared by years of discriminatory policing, it's not going to happen easily. A bill that would authorize a force for Johns Hopkins' three city campuses is nearing conclusive votes in Maryland's legislature — just one year after lawmakers chose not to endorse such an idea after being flooded with constituents' objections. (3/13)

Politico: Trump 'Not Thrilled' About California Governor's Death Penalty Moratorium
President Donald Trump on Wednesday criticized California Gov. Gavin Newsom’s plan to issue a moratorium on executions in the state. “Defying voters, the Governor of California will halt all death penalty executions of 737 stone cold killers,” Trump tweeted. “Friends and families of the always forgotten VICTIMS are not thrilled, and neither am I!” (Galioto, 3/13)

The Wall Street Journal: New York City Council Passes Bills Bolstering Lead Testing
New York City’s lead testing and reporting will be expanded under a new package of bills designed to limit exposure in children and improve education around lead poisoning. The 10 measures, which passed Wednesday in the City Council, cover everything from extending requirements for lead-based paint testing at day-care centers to expanding reporting requirements when lead is found. One bill would require the Department of Health and Mental Hygiene and individual landlords to investigate and fix lead issues in places where children spent 10 or more hours a week. (Honan, 3/13)

Reuters: As Wildfires Devour Communities, Toxic Threats Emerge
As an uncontrollable wildfire turned the California town of Paradise to ash, air pollution researcher Keith Bein knew he had to act fast: Little is known about toxic chemicals released when a whole town burns and the wind would soon blow away evidence. He drove the roughly 100 miles to Paradise, located in the Sierra Nevada foothills, from his laboratory at the University of California, Davis, only to be refused entrance under rules that allow first responders and journalists - but not public health researchers - to cross police lines. (3/13)