First Edition: Nov. 22, 2022

KHN: Schools, Sheriffs, And Syringes: State Plans Vary For Spending $26B In Opioid Settlement Funds 
With more than 200 Americans still dying of drug overdoses each day, states are beginning the high-stakes task of deciding how to spend billions of dollars in settlement funds from opioid manufacturers and distributors. Their decisions will have real-world implications for families and communities across the country that have borne the brunt of the opioid crisis. Will that massive tranche of money be used to help the people who suffered the most and for programs shown to be effective in curbing the epidemic? Or will elected officials use the money for politically infused projects that will do little to offer restitution or help those harmed? (Pattani, 11/22)

KHN: Treating Long Covid Is Rife With Guesswork 
Medical equipment is still strewn around the house of Rick Lucas, 62, nearly two years after he came home from the hospital. He picks up a spirometer, a device that measures lung capacity, and takes a deep breath — though not as deep as he’d like. Still, Lucas has come a long way for someone who spent more than three months on a ventilator because of covid-19. “I’m almost normal now,” he said. “I was thrilled when I could walk to the mailbox. Now we’re walking all over town.” (Farmer, 11/22)

KHN: California Aims To Maximize Health Insurance Subsidies For Workers During Labor Disputes 
This spring, Chevron workers testified that the company revoked health coverage for hundreds of members of the United Steelworkers Local 5 at the Richmond, California, refinery during a strike that ultimately lasted two months. Thousands of nurses at Stanford Health Care were told in April they would lose their health insurance if they did not return to work during their weeklong strike. More than 300 workers at Sequoia Hospital in Redwood City received a similar message after going on strike in mid-July as contract negotiations stalled. (Sciacca, 11/22)

ABC News: Fauci To Brief Reporters For Last Time Before Leaving Government After 50 Years
Dr. Anthony Fauci, the nation's top infectious disease expert, is scheduled to brief reporters from the White House on Tuesday in what is likely to be his final briefing before leaving the government at the end of the year. Fauci was expected to press the idea that Americans should get up-to-date on their COVID and flu shots ahead of winter. (Flaherty, 11/22)

Reuters: U.S. Supreme Court Rebuffs Dispute Over Nursing Home COVID Suits 
The U.S. Supreme Court on Monday declined to hear California nursing home operator Glenhaven Healthcare's bid to avoid a lawsuit filed in state court over the COVID-19 death of a resident, turning away the company's effort to move the case into federal court to gain immunity from such litigation. The justices rebuffed Glenhaven Healthcare's appeal of a lower court's ruling allowing the family of deceased resident Ricardo Saldana to proceed with the lawsuit in a California state court. (Pierson, 11/21)

AP: Dismissal Motion Could Delay Wis. Abortion Challenge For Months
Wisconsin Attorney General Josh Kaul said Monday that he wants his lawsuit challenging the state’s 173-year-old abortion ban to move quickly through the courts, but it could be months before anything happens after defense attorneys signaled they would try to dismiss it next year. The case is almost certain to end up in the state Supreme Court. Conservative justices hold a one-vote majority on the court but Democrats are banking on a progressive candidate winning retiring Justice Patience Roggensack’s seat in April’s election, giving liberals the edge. Impending delays in the abortion lawsuit make it likely the case could land at the court after the new justice takes the bench in August. (Richmond, 11/21)

AP: N. Dakota Faults Judge's Reasoning In Blocking Abortion Ban 
The North Dakota attorney general’s office said Monday that a judge did not use a “rational mental process” when he determined there was a “substantial probability” that a constitutional challenge to the state’s abortion ban would succeed. The state argued in a filing that South Central District Judge Bruce Romanick erred in blocking the ban from taking effect before a lawsuit by North Dakota’s lone abortion clinic is resolved. (Kolpack, 11/21)

Politico: Anti-Abortion Groups Blame GOP Silence For Election Defeat 
Abortion opponents are pushing the GOP to campaign more openly and forcefully against the procedure after the party suffered a string of losses in House, Senate, state legislative and ballot initiative fights. Less than six months after celebrating their decades-long goal of toppling Roe v. Wade and watching access to abortion nearly disappear in a quarter of the country, conservatives saw their hard-fought court victory galvanize abortion-rights supporters to outspend and outvote them in the midterms. (Ollstein and Messerly, 11/21)

AP: Indiana Doctor Defends Actions In 10-Year-Old's Abortion 
An Indianapolis doctor who provided abortion drugs to a 10-year-old rape victim from Ohio defended her actions before a judge Monday in an episode that drew national attention in the weeks after the U.S. Supreme Court overturned Roe v. Wade. Dr. Caitlin Bernard testified during the second day of a court hearing on an attempt to block Indiana’s Republican attorney general from seeking patient medical records. (Davies, 11/22)

The Wall Street Journal: Kids Sick With RSV And Flu Are Straining Schools And Parents 
Tensions are rising between parents and school nurses over children showing up to school with coughs, colds and symptoms of viral infections. ... Some parents are sending children to school sick or returning them too quickly after illness, school nurses say, with parents citing an inability to take more time off work and a broader weariness from dealing with so much illness during the Covid-19 pandemic. (Janin, 11/21)

Stat: Why Don't Americans Have At-Home Flu Tests?
Flu season is underway. RSV is putting record numbers of children in hospitals. And health professionals are gearing up for another Covid winter. With so many potential viruses in play, it would be helpful if Americans had a way to distinguish between different ailments at home. (Trang, 11/22)

Los Angeles Times: How To Stay Safe At Thanksgiving As COVID-19, Flu And RSV Rise
While it’s impossible to eliminate the risk of catching COVID-19, the flu or RSV, health experts say there are several now-familiar steps that can be taken to boost protection. There’s currently no vaccine for RSV — or respiratory syncytial virus, which can cause serious symptoms and even death in young children and older people — that’s not the case for the flu or COVID-19. (Money and Lin II, 11/21)

The Boston Globe: A New Coronavirus Variant Has Taken Over, Sparking Concerns Of A Winter Surge
A new subvariant has taken over as the predominant version of coronavirus circulating in Massachusetts, causing experts to worry about a potential rise of infections this winter, especially as people gather indoors for the holidays. But for most people who have been fully vaccinated, they say, it will likely pose more of a nuisance than serious health threat. (Cross, 11/21)

Becker's Hospital Review: Fewer Coinfections Than Expected: 3 COVID-19 Surveillance Trends To Note
Although COVID-19 positivity rates are up, there have been fewer coinfections with other respiratory viruses than expected, according to recent findings from Helix, a lab that assists the CDC with variant tracking. Helix shared some of the latest observations from its COVID-19 and viral surveillance efforts in a Nov. 21 email, noting COVID-19 positivity rates are rising for the first time since July, with the highest growth in adults between 18 and 24. (Carbajal, 11/21)

CIDRAP: US Pandemic Death Toll Higher Than In 20 Peer Countries
COVID-19 exacted a higher infection-related and excess all-cause death toll from the United States than from 20 peer countries throughout the pandemic but had less of an impact in the most-vaccinated states in the Delta and Omicron surges, suggests a study published late last week in JAMA. (Van Beusekom, 11/21)

Bay Area News Group: Paxlovid Antiviral Pills Tested To Treat Long COVID
Could Paxlovid solve one of the pandemic’s biggest puzzles? A new study at Stanford University aims to find out. In the nation’s first medical trial of an antiviral strategy to treat long COVID, scientists are testing the drug to see if it helps ease the misery of fatigue, brain fog, shortness of breath, body aches, digestive symptoms and heart problems. (Krieger, 11/21)

CIDRAP: Imaging Spotlights Brain Changes 6 Months After COVID-19 
A study using a special type of magnetic resonance imaging (MRI) has revealed brain changes in COVID-19 patients up to 6 months after recovery from their infections, according to findings to be presented at next week's Radiological Society of North America (RSNA) annual meeting in Chicago. ... The MRI results showed significant changes in the brain linked with fatigue, insomnia, anxiety, depression, headaches, and cognitive problems in the COVID-19 patients compared with controls. (11/21)

CIDRAP: Scientists Start Work On WHO Priority Pathogen List Revisions 
The World Health Organization (WHO) today announced the launch of a global scientific effort to update the list of priority pathogens, a list used to guide investments and research, especially for vaccines and treatments. It said the process began on Nov 18 with a meeting of more than 300 scientists, who are examining evidence on 25 virus families and bacteria, as well as "Disease X," an unknown pathogen that could cause a serious international epidemic. The group will consider scientific criteria, as well as the potential socioeconomic, access, and equity impact. (11/21)

NBC News: 'Good' Cholesterol May Not Protect Against Heart Disease, Study Finds
The new findings surprised the researchers, who originally designed their study to understand how cholesterol levels in Black and white middle-aged adults without heart disease affected their future risks. Previous research on "good" cholesterol and heart disease consisted of mostly white adults. “I did not expect high levels of HDL would not be protective,” said the study’s senior author, Nathalie Pamir, an associate professor of cardiovascular medicine in the Oregon Health and Science University School of Medicine. “And I certainly did not expect low levels to have no predictive value for Black adults.” (Carroll, 11/21)

Reuters: Predictive Value Of 'Good' Cholesterol Level Varies By Race, U.S. Study Finds
The widely-held concept that levels of "good" cholesterol in the blood can indicate heart disease risk is not equally true for Blacks and whites, and the measure itself may be of less value than previously thought, according to a U.S. study published on Monday. (Lapid, 11/21)

USA Today: HIV Treatment, Prevention Efforts Must Target Black Women, Experts Say
Though men remain the largest group of people diagnosed with HIV, Black women make up the majority of new HIV cases among women. Seven thousand women diagnosed with the virus in 2018, and Black women made up more than 4,000 cases, according to the Centers for Disease Control and Prevention, which reports transgender women in a separate category. (Hassanein, 11/21)

The New York Times: In Women And Nonbinary People, Monkeypox Cases May Have Been Missed
In the monkeypox outbreak that unspooled this summer in the United States and dozens of other countries, men who have sex with men were the most at risk. But thousands of women were also infected, and many more cases were probably missed, according to the first ever study of women and nonbinary people who had contracted the disease. (Mandavilli, 11/21)

Axios: How Medical Inflation Is Ensnaring Big Employers
A convergence of factors driving up health costs is threatening to make next year a very pricey one for big employers, forcing some to make difficult tradeoffs and eat some of the added expense. (Reed and Gonzalez, 11/21)

Modern Healthcare:  Insurance Claim Denial Rates Rising As Health Systems Struggle
Health systems across the country have experienced a significant rise in denied claims over the past year, leading to more administrative work for providers, less cash flow for hospitals and, in some cases, postponed patient care. (Devereaux, 11/21)

Stat: The Case For Universal Oral Health Coverage, According To The WHO
On Friday, oral health advocates across the globe got an early holiday gift from their longtime wish lists. They had been waiting their whole careers — for some STAT spoke with, up to nearly half a century — for oral health to be folded into conversations calling for health care access for all. The World Health Organization’s new Global Oral Health Status report took that first step. (Castillo, 11/21)

Stat: Can Telehealth Help Hospitals Mitigate The Climate Crisis? 
As the world stares down the barrel of climate change, the health care system — which is responsible for about 9% of all U.S. greenhouse gas emissions — is finally starting to take action. Hospitals, in particular, are working to stem their impact, and have held up telehealth as a prime strategy to cut down on carbon, by eliminating millions of miles of travel to and from health care centers. (Palmer, 11/22)

Modern Healthcare: Providence Closes 27 Southern California Retail Clinics
Renton, Washington-based Providence closed all 27 of its Providence ExpressCare facilities on Nov. 17 after the Southern California retail clinics posted “unprecedented operating losses” amid labor shortages, inflation, supply chain disruption, lower-than-expected volumes and a more competitive retail clinic sector, the spokesperson said. (Kacik, 11/21)

Modern Healthcare: Intermountain Healthcare Posts $2.16B Profit Through 3rd Quarter
Intermountain Healthcare continues to make money during a difficult stretch for the hospital sector, recording $2.16 billion in net income for the first nine months of the year, according an unaudited financial report issued Thursday. (Hudson, 11/21)

The Boston Globe: Community College Working To Ease Nursing Shortage
Northern Essex Community College is participating in a national program to address the nursing shortage and make the profession more accessible to people from diverse backgrounds. (Laidler, 11/21)

Reuters: Hair Straightener Lawsuits Mount Following Government Cancer Study 
Lawyers have filed at least nine lawsuits against L’Oreal USA Inc and other makers of hair straightener products since last month's release of a U.S. government study linking frequent use of the products to uterine cancer, according to court records. (Jones, 11/21)

Des Moines Register: Jury Awards Iowa Man $27 Million After His Meningitis Was Misdiagnosed
A Polk County jury has awarded a Des Moines man $27 million in damages after a local urgent care clinic failed to diagnose him with a serious meningitis infection that ultimately resulted in permanent brain damage. (Ramm, 11/21)

The New York Times: A Botched Cancer Test, a National Scandal, and an Irish Hero
A subsequent official inquiry revealed that at least 220 other Irish women had also developed cervical cancer after receiving negative results for state-run Pap smears that, a later review showed, should have been flagged as likely positive. According to 221+, an advocacy group founded by Vicky Phelan and other affected women and their survivors, around 30 of these women have since died. (O'Loughlin, 11/17)

NBC News: Brett Favre Helped An Experimental Drug Maker Get $2M In Welfare Money. Experts Doubt The Drug Can Work
Four years ago, Hall of Fame quarterback Brett Favre joined forces with a Florida neuroscientist to promote an experimental drug — a nasal spray designed to quickly treat brain injuries from a concussion. (Dilanian and Strickler 11/21)

The Hill: House Democrats Call On DOJ To Respond To Anti-Trans Threats Of Violence Against Children’s Hospitals
Dozens of House Democrats are calling on the Department of Justice (DOJ) to counter online threats of violence directed against several children’s hospitals across the country. In a letter to Attorney General Merrick Garland, the Democrats asked the DOJ to outline the steps the agency is taking to counter anti-transgender threats of violence and to provide further guidance to health care providers on how to protect their staff and patients from such threats. (Weixel, 11/21)

The Washington Post: Police Identify Colorado Shooting Victims Using Proper Pronouns, Names
When the names of those shot to death in a Colorado Springs LGBTQ bar were read at a police news conference Monday, one thing stood out from the procedure that has become routine in a nation plagued by mass shootings: The police chief stated the pronouns of the deceased. “Kelly Loving. Kelly’s pronouns are she/her. Daniel Aston. Daniel’s pronouns are he/him. Derrick Rump. Derrick’s pronouns are he/him,” and so on, went Chief Adrian Vasquez. It was a small gesture, but an important one, LGBTQ advocates said. (Pietsch, 11/22)

The 19th: Club Q Shooting Reshapes Trans Day Of Remembrance For Colorado Springs Community
LGBTQ+ advocates and lawmakers in Colorado feel numbness, anger, and sorrow in the aftermath of the Colorado Springs shooting on Saturday that killed five people and injured at least 18 others at Club Q — an LGBTQ+ bar that has stood as a community space for two decades. The timing of the killings just before the annual Transgender Day of Remembrance (TDOR) brought an even greater sense of devastation and urgency to LGBTQ+ people in the community and national advocates. (Rummler, 11/21)

The Wall Street Journal: Colorado Springs Suspect Anderson Lee Aldrich Had Firearms Despite Violent Threats
Several Colorado lawmakers are asking why the state’s red-flag law wasn’t used to seize weapons from the alleged gunman in the deadly shooting at an LGBT nightclub in Colorado Springs after a prior arrest for violent threats last year. (Frosch, Elinson and Caldwell, 11/21)

Las Vegas Review-Journal: Southern Nevada Health District Unveils Needle-Exchange Vending Machine
A vending machine dispensing free kits aimed at reducing the risk of HIV and hepatitis C and at treating opioid overdose was unveiled Monday at the headquarters of the Southern Nevada Health District. (Hynes, 11/21)

The Wall Street Journal: Vending Machines Dispense Narcan To Reverse Opioid Overdoses 
Vending machines stocked with overdose-reversing nasal spray are part of the latest attempt to diminish a record tide of drug deaths. ... “If we hadn’t had that vending machine, I might not have had my brother alive today,” said LuDene LoyaltyGroves, who works at a homeless shelter in Moses Lake, Wash. People staying with her brother in a nearby encampment retrieved Narcan from a vending machine at the shelter and used it to revive him repeatedly, she said. (Wernau and Maher, 11/21)

AP: New York Issues First Licenses For Legal Pot Dispensaries
New York issued its first 36 cannabis dispensary licenses on Monday, taking a monumental step in establishing a legal — and lucrative — marketplace for recreational marijuana. (Calvan, 11/21)

The New York Times: With Anxiety On The Rise, Some Children Try ‘Exposure Therapy’
Audrey Pirri, 16, had been terrified of vomiting since she was a toddler. She worried every time she shared a meal with family or friends, restricting herself to “safe” foods like pretzels and salad that wouldn’t upset her stomach, if she ate at all. She was afraid to ride in the car with her brother, who often got carsick. She fretted for hours about an upcoming visit to a carnival or stadium — anywhere with lots of people and their germs. But on a Tuesday evening in August, in her first intensive session of a treatment called exposure therapy, Audrey was determined to confront one of the most potent triggers of her fear: a set of rainbow polka dot sheets. (Hughes, 11/21)

The FERN: Why America’s Food-Security Crisis Is A Water-Security Crisis, Too 
Deepak Palakshappa became a pediatrician to give poor kids access to good medical care. Still, back in his residency days, the now-associate professor at Wake Forest University School of Medicine in Winston-Salem was shocked to discover that a patient caring for two young grandchildren was food insecure. “Our clinic had set up one of those food drive boxes, and near the end of a visit, she asked if she could have any of the cans because she didn’t have food for the holidays,” he recalls. Thirteen years later, Palakshappa’s clinic team now asks two simple questions of every patient to ascertain whether they’ll run out of food in a given month. (Nargi, 11/20)

The New York Times: How To Handle IBS And Other Digestive Issues During The Holidays 
Whether someone has been managing symptoms for years or is newly diagnosed, gastrointestinal conditions can require constant attention. And while holiday plans are disruptive for most — with late nights, indulgent food, extensive travel and intensive social time — the consequences are often higher for people with I.B.D. and I.B.S. Experts shared strategies to help navigate the season. (Latifi, 11/19)

Stat: A Simple Screening Could Help Millions Of Women Prevent Heart Disease 
Early one afternoon in 2000, Monique Shields, just a few weeks shy of her 30th birthday, left her busy day as an executive assistant at Starbucks’ corporate headquarters to go to her routine prenatal checkup. Following standard care practice, the nurse checked Shields’ blood pressure. It was sky-high. Her health care team sent her to the emergency department for monitoring. (Courage, 11/22)

NBC News: Fungal Infections To Become More Common As Their Ranges Expand
“We’re definitely seeing disease in locations that we previously have not,” said Dr. George Thompson, an infectious disease specialist at the University of California, Davis. “And that’s concerning, because if we’re recognizing those locations, where are the places it’s occurring that just have not been recognized quite yet?” (Yang and Bendix, 11/21)

Los Angeles Times: Kidney Specialists Revisit Bruce Lee's Cause Of Death 
Did too much water kill Bruce Lee, the martial-arts legend known for saying, “Be water, my friend”? That’s the notion put forth in a new research paper by a group of kidney specialists from Spain. (D'Zurilla, 11/21)