First Edition: November 12, 2021

KHN: How Low Can They Go? Rural Hospitals Weigh Keeping Obstetric Units When Births Decline
As rural hospitals struggle to stay financially stable, their leaders watch other small facilities close obstetrics units to cut costs. They face a no-win dilemma: Can we continue operating delivery units safely if there are few births? But if we close, do we risk the health and lives of babies and mothers? The other question this debate hangs on: How few is too few births? Consider the 11-bed Providence Valdez Medical Center, which brings 40 to 60 newborns into the world each year, according to Dr. John Cullen, one of several family physicians who deliver babies at the Valdez, Alaska, hospital. The next nearest obstetrics unit is a six- to seven-hour drive away, if ice and snow don’t make the roads treacherous, he said. (Huff, 11/12)

KHN: Readers And Tweeters Find Disadvantages In Medicare Advantage
With Medicare Advantage open enrollment open until Dec. 7, millions of seniors will consider costs, benefits and networks when selecting a new plan (“Medicare Plans’ ‘Free’ Dental, Vision, Hearing Benefits Come at a Cost,” Oct. 27). Many consumers may not be aware that some health plans have frustrating restrictions buried deep within that limit access to critical procedures. For example, Aetna recently began requiring prior authorization for cataract surgeries across all its health plans — including Medicare Advantage. Tens of thousands of Americans covered by Aetna have had their sight-restoring surgeries delayed or canceled, while insurance company representatives decide who gets to see better — and who must wait for their cataract to get worse before insurance will cover cataract surgery. (11/12)

KHN: KHN’s ‘What The Health?’: Why Health Care Is So Expensive, Chapter $22K
Congress appears to be making progress on its huge social spending bill, but even if it passes the House as planned the week of Nov. 15, it’s unlikely it can get through the Senate before the Thanksgiving deadline that Democrats set for themselves. Meanwhile, the cost of employer-provided health insurance continues to rise, even with so many people forgoing care during the pandemic. The annual KFF survey of employers reported that the average cost of a job-based family plan has risen to more than $22,000. To provide what their workers most need, however, this year many employers added additional coverage of mental health care and telehealth. (11/11)

NPR: All California Adults Can Receive A COVID-19 Vaccine Booster Shot
All fully vaccinated adults in California seeking a COVID-19 booster shot should be eligible to get one, California Department of Public Health officials say. In a letter Thursday, officials directed health care providers not to deny booster shots to adult patients. The announcement opened up booster shot eligibility to millions of residents across the state. (Franklin, 11/11)

Los Angeles Times: No Eligible Californian Should Be Denied Booster, Officials Say
No fully vaccinated adult should be denied a COVID-19 booster shot, the California Department of Public Health says. The move comes as health authorities are trying to increase the number of Californians getting the booster shots, fearing that slow early demand could increase the chances of another winter coronavirus wave. “Do not turn a patient away who is requesting a booster,” Dr. Tómas Aragón, the state health officer and public health director, wrote in a letter. Booster patients must be adults, and at least two months must have passed since receiving a Johnson & Johnson vaccine or six months since getting the second dose of the two-shot Pfizer-BioNTech or Moderna vaccination series. (Lin II and Money, 11/11)

The Washington Post: Top Biden Health Officials Push To Make Coronavirus Booster Shots Available To All Adults 
Anxious about a surge of coronavirus infections enveloping Europe as cases tick up in the United States, senior health officials in the Biden administration are pressing urgently to offer vaccine booster shots to all adults. But support for the renewed push is not unanimous. Centers for Disease Control and Prevention Director Rochelle Walensky has expressed caution about making extra shots so broadly available now, according to several officials familiar with the situation who spoke on the condition of anonymity to discuss internal deliberations. As a result, tension is rising among officials over how quickly to proceed and who should get the shots. (McGinley, Sun and Pager, 11/11)

The New York Times: Colorado’s Governor Says High Risk To The Virus Makes All Vaccinated Adults Eligible For Boosters
Citing the pervasive spread of the coronavirus across Colorado, Gov. Jared Polis said on Thursday that all adults would be eligible for a booster shot because of their high risk of exposure, assuming enough time had passed since their initial doses. Mr. Polis, a Democrat, signed an executive order declaring the entire state at high risk from exposure and urged boosters for any adult at least six months past their second dose of the Pfizer-BioNTech or Moderna vaccines, or two months past the single-dose Johnson & Johnson vaccine. (Hassan and Slotnik, 11/11)

The Washington Post: Booster Shots Are Most Popular In Poorly Vaccinated States Where Coronavirus Rages
Several northern, mostly rural states that are battling coronavirus surges with few mask mandates and low vaccine rates are now leading the nation on another preventive front: booster shots. The rate at which fully vaccinated residents are getting the shots is highest in the states that also have high rates of new coronavirus cases, including Alaska, North Dakota and Montana, according to a review of state data by The Washington Post. In swaths of the country where health officials will not impose mask and vaccine mandates to curb the virus’s spread, or have had their powers stripped away by Republican state lawmakers or governors, boosters are one of the few shields left for those worried about contracting and spreading the virus. (Keating, Nirappil and Shepherd, 11/11)

AP: COVID-19 Hot Spots Offer Sign Of What Could Be Ahead For US
The contagious delta variant is driving up COVID-19 hospitalizations in the Mountain West and fueling disruptive outbreaks in the North, a worrisome sign of what could be ahead this winter in the U.S. While trends are improving in Florida, Texas and other Southern states that bore the worst of the summer surge, it’s clear that delta isn’t done with the United States. COVID-19 is moving north and west for the winter as people head indoors, close their windows and breathe stagnant air. “We’re going to see a lot of outbreaks in unvaccinated people that will result in serious illness, and it will be tragic,” said Dr. Donald Milton of the University of Maryland School of Public Health. (Johnson, 11/11)

Bloomberg: Covid Surge In Arizona, New Mexico, Western US States Packs ICUs, Hospitals
Hospitals in some parts of the U.S. are already starting to see the impact of an autumn wave of Covid-19 infections, the latest sign that the health-care system still faces serious pressure from the virus, even in places that have achieved relatively high vaccination rates. Intensive-care unit beds occupied by Covid-19 patients are climbing in 12 states from two weeks earlier, with most of them in a contiguous strip running from Arizona and New Mexico, through the Great Plains and into Minnesota. In several Western states, many doctors and nurses haven’t caught their breath from the last round of infections. (Levin and Del Giudice, 11/11)

ABC News: Albuquerque Hospitals Enact Crisis Standards Of Care During 'Unprecedented' Time
The two largest hospital systems in Albuquerque, New Mexico, have activated crisis standards of care due to an "unprecedented level" of activity during the pandemic, hospital officials announced Thursday. University of New Mexico Health System and Presbyterian Healthcare Services leaders said in a joint press briefing that they have transitioned to crisis standards of care at their Albuquerque metro hospitals. The move comes as the hospitals are being stretched to the limit in terms of space and staffing due to increasing COVID-19 hospitalizations and a high volume of patients with acute conditions, officials said. (Deliso, 11/11)

AP: New Mexico Hospitals Seek Relief Amid Wave Of Patients
Two of New Mexico's largest hospitals on Thursday announced that they would be focusing on patients who need care the most, meaning non-medically necessary procedures will likely have to be delayed. While most patients are not dealing with coronavirus infections, officials at Presbyterian Healthcare Services and University of New Mexico Health say the ability to grow the capacity that was built over the last year due to the pandemic is now limited by space and the availability of healthcare workers. (11/11)

Dallas Morning News: Texas Republican State Sen. Bob Hall Says People Should Avoid The COVID-19 Vaccine
Republican state Sen. Bob Hall on Wednesday continued his broadsides against COVID-19 vaccines in a Facebook video viewed by more than 2,000 in which he told viewers to avoid the vaccine and echoed inaccurate claims that the vaccine is doing more harm than good. Hall has been careful to state that he is not against people getting the vaccine, but began his video with the unfounded and inaccurate “punchline” that COVID-19 vaccines are “killing more people than they are saving.” (Janowski, 11/11)

Bloomberg: India’s Covaxin Found 77.8% Effective In Lancet Covid Study
Covaxin, a vaccine developed by India’s medical research agency and Bharat Biotech International Ltd., was 77.8% effective at preventing symptomatic Covid-19 in an interim analysis of a long-awaited study. Covaxin, which uses traditional, inactivated-virus technology, induced a robust antibody response two weeks after the second dose was given, the investigators concluded. No severe adverse events or vaccine-related deaths occurred during the randomized trial involving 24,419 adults. The research, conducted between November 2020 and May 2021 in India, was published in The Lancet. (Kay, 11/11)

The Wall Street Journal: AstraZeneca Plans To Start Selling Covid-19 Vaccines At Profit
AstraZeneca AZN -0.35% PLC said it would start pricing its Covid-19 vaccine to make it profitable, ending a period in which it had pledged to roll out the shots at cost during the pandemic. The Anglo-Swedish pharmaceuticals giant said it would shift away from a nonprofit approach to the vaccine starting in 2022, signing new contracts that will allow it to make money off the shot. The company expects some earnings contribution from new orders in the fourth quarter of this year. The company said the shot generated $1.05 billion in revenue in the third quarter. (Butini, 11/12)

Bloomberg: Moderna Defends Covid Shot As Questions On Heart Risks Mount
Moderna Inc. held a brief conference call to defend the safety of its Covid-19 shot from a barrage of questions about associated heart risks in young people. Chief Medical Officer Paul Burton acknowledged on the call that the company’s vaccine does appear linked to increased chances of an inflammatory heart condition known as myocarditis in young men. Moderna maintains that the shot’s benefits continue to outweigh the extremely rare risk of myocarditis, he said Thursday. (Griffin, 11/11)

Stat: BioNTech's CEO Wants To Widen Covid-19 Vaccine Access On His Terms
Two years ago, Ugur Sahin was an under-the-radar but extremely determined scientist running a company called BioNTech, which was trying to generate interest in using mRNA technology to combat different illnesses. Since then, he partnered with Pfizer to develop a Covid-19 vaccine that this year is forecast to generate about $19 billion in revenue for the company, assuming 2.5 billion doses are shipped. The vaccine is an historic success story — scientifically, medically, and financially — for both companies. But there are also questions about the extent to which booster doses will — or should be — needed as well as criticism about ensuring global access to vaccines in order to eradicate the pandemic. We spoke this week with Sahin over coffee about these issues. (Silverman, 11/11)

AP: EU Authorizes 2 Medicines For People At Risk Of Severe COVID
The European Medicines Agency has recommended the authorization of two new medicines against the coronavirus for people at risk of severe disease. In a statement on Thursday, the EU drug regulator said it had concluded that the monoclonal antibody treatments — a combination of casirivimab and imdevimab, and the drug regdanvimab — have both been proven to significantly reduce the risk of hospitalization and death in patients vulnerable to serious COVID-19. The EMA described the safety profile of both medicines as “favorable,” and said that despite a small number of side effects, “the medicines’ benefits are greater than their risks.” (11/11)

NBC News: How Covid Antiviral Pills Work and What That Could Mean for the Pandemic
Covid-19 may soon be treatable with a pill. In the past six weeks, two drugmakers have announced promising clinical trial results for their experimental oral antiviral pills and will soon have their data evaluated by the Food and Drug Administration. (Hickok, 11/12)

CBS News: FDA Recalls 2.2 Million Ellume COVID-19 Home Tests Due To False Positives
The U.S. Food and Drug Administration announced the recall of 2.2 million home COVID-19 tests made by Ellume, the first company to get FDA approval for over-the-counter COVID tests, due to "higher-than-acceptable false positive test results." The recall is an expansion of last month's recall of 200,000 kits for the same issue. About 35 false positives through the Ellume COVID-19 Home Test were reported to the FDA, with no deaths reported, the agency said. But false positives could lead to negative outcomes such as getting unneeded COVID-19 treatment from a health care provider or a delayed diagnosis for the person's actual illness, the FDA added. (Picchi, 11/11)

The Wall Street Journal: Ellume Recalls More Than 2 Million At-Home Covid-19 Tests Over False Positives
The Food and Drug Administration said more than 2 million at-home Covid-19 tests from Australia-based Ellume USA LLC have been recalled because of a number of false-positive results. The federal agency categorized the recall as a Class I, its most serious classification. It said false-positive test results could lead to serious health issues including unnecessary treatments and isolation, delayed treatments of the actual illness and spread of Covid-19 if those who received false-positive results are clustered with those who accurately tested positive. (Calfas, 11/11)

The Hill: White House Expanding Health Care For Veterans Exposed To Burn Pits
The White House on Thursday marked Veterans Day by announcing expanded health care resources for individuals exposed to burn pits and other environmental hazards during their time in the military. Assistance for those exposed to burn pits has been a personal issue for President Biden, who has on multiple occasions spoken about how he believes his son Beau Biden's exposure to them may have been linked to the brain cancer that killed him in 2015. (Samuels, 11/11)

Politico: Report Shines Light On Veterans Affairs’ Digital Health Overhaul
The Department of Veterans Affairs deployed a digital scheduling system despite knowing about significant problems, like giving veterans misleading information about their appointments, according to a new watchdog report, POLITICO’s Darius Tahir writes. The finding is more fodder for observers of the troubled digital health overhaul at the VA. A scandal over falsified wait times at a VA facility in Phoenix helped prompt the development of the scheduling system — which was later folded into a broader electronic health record modernization that’s been delayed as part of a “strategic review” initiated by VA Secretary Denis McDonough. (Owermohle and Cancryn, 11/11)

The New York Times: Veterans Have Become Unlikely Lobbyists In Push To Legalize Psychedelic Drugs
Jose Martinez, a former Army gunner whose right arm and both legs were blown off by a roadside bomb in Afghanistan, has a new calling: He’s become one of the most effective lobbyists in a campaign to legalize the therapeutic use of psychedelic drugs across the country. On a Zoom call this spring with Connie Leyva, a Democratic legislator in California who has long opposed relaxing drug laws, Mr. Martinez told her how psilocybin, the psychoactive ingredient in “magic” mushrooms, had helped to finally quell the physical pain and suicidal thoughts that had tormented him.Ms. Leyva says she changed her mind even before the call ended, and she later voted yes on the bill, which is expected to become law early next year. (Jacobs, 11/11)

CBS News: CVS Withdraws Supreme Court Case On Disability Rights, Announces New Partnership
The CVS pharmacy chain has reached an agreement with a coalition of disability rights organizations and dropped a legal case that had made it all the way to the U.S. Supreme Court. The court was scheduled to hear arguments in the dispute next month, and the ruling could have had far-reaching effects on disability rights. (Roppolo, 11/11)

The Hill: Bloomberg Vows To Spend $120M To Fight Fatal Drug Overdoses
0 seconds of 15 secondsVolume 90% Michael Bloomberg announced on Wednesday that his eponymous philanthropy is making a $120 million investment to help fight fatal drug overdoses. Bloomberg Philanthropies will invest $120 million over five-years in Kentucky, New Jersey, New Mexico, North Carolina and Wisconsin to help address the opioid overdose crisis, according to a statement from the group. The organization said those five states represent areas that have been “hard hit” by the opioid epidemic. They will each receive $10 million over the next five years. (Schnell, 11/11)

The Hill: Republican Oklahoma Governor Orders Halt To Nonbinary Birth Certificates
Oklahoma Gov. Kevin Stitt (R) signed an executive order on Monday halting the state from issuing nonbinary birth certificates. The order mandates the Oklahoma State Department of Health (OSDH) to “cease amending birth certificates” in any way that is inconsistent with state law, and to “remove from its website any reference to amending birth certificates” that doesn’t align with state law. Stitt further urged the Oklahoma state legislature to “immediately pass legislation that will clarify, to the extent necessary, that changes in sex or gender on a birth certificate, or a designation of non-binary is contrary to Oklahoma law.” (Williams, 11/11)

AP: With US Aid Money, Schools Put Bigger Focus On Mental Health
In Kansas City, Kansas, educators are opening an after-school mental health clinic staffed with school counselors and social workers. Schools in Paterson, New Jersey, have set up social emotional learning teams to identify students dealing with crises. Chicago is staffing up “care teams” with the mission of helping struggling students on its 500-plus campuses. With a windfall of federal coronavirus relief money at hand, schools across the U.S. are using portions to quickly expand their capacity to address students’ struggles with mental health. (Thompson, Hollingsworth and Belsha, 11/11)

NPR: New Clues To The Biology Of Long COVID Are Starting To Emerge
Kelly LaDue thought she was done with COVID-19 in the fall of 2020 after being tormented by the virus for a miserable couple of weeks. "And then I started with really bad heart-racing with any exertion. It was weird," says LaDue, 54, of Ontario, N.Y. "Walking up the stairs, I'd have to sit down and rest. And I was short of breath. I had to rest after everything I did." (Stein, 11/12)

CBS News: Once-Healthy Kids Struggling With Symptoms Months After COVID-19 Infection
Madison Foor, a 14-year-old competitive dancer, was healthy before she contracted COVID-19 in January. Ten months later, she uses an inhaler every day. "It feels a little scary, like I can't breathe," she said. (Oliver, 11/11)

CIDRAP: Study Shows Cancer Patients Can Safely Receive COVID-19 Vaccines
A study yesterday in the Journal of Clinical Oncology shows COVID-19 vaccines are safe in people undergoing treatment for cancer and produce modestly impaired immune responses. Booster vaccine doses, however, enhance immunity. The study was based on 762 active oncology patients at Massachusetts General Hospital, who were compared to 1,638 healthy controls. The patients were currently receiving cancer treatments, including chemotherapy, bone marrow transplants, corticosteroids, and radiation. All three vaccines currently used in the United States were included in the study. (11/11)

CIDRAP: Tests Reveal Much Higher COVID Rate In Unvaccinated Nursing Home Staff
Positive COVID-19 test results were more than 10 times more common among unvaccinated, asymptomatic healthcare professionals (HCP) in Veterans Health Administration (VHA) long-term care facilities than among their fully vaccinated counterparts, according to a research letter yesterday in JAMA Network Open. Researchers at the VA Boston Healthcare System tracked mandatory weekly COVID-19 test results among 1,269 HCP and twice-weekly antigen testing among 704 more from Jan 15 to Jun 8, 2021. (11/11)

Reuters: Biogen Says Aduhelm Lowers Levels Of Second Protein Associated With Alzheimer's
Biogen Inc's (BIIB.O) Alzheimer's drug Aduhelm, approved by U.S. regulators last year for its ability to reduce amyloid brain plaques, also lowers levels of a second protein that accumulates in the brains of people with the disease, according to new data released by the company on Thursday. Biogen said its Phase III studies found that Aduhelm significantly lowered blood levels of an abnormal form of the protein tau - another target of experimental Alzheimer's drugs - that forms toxic tangles of nerve fibers associated with the mind-wasting disease. (Beasley, 11/11)

Stat: Cortexyme Bets On A Lower Dose Of Its Once-Failed Alzheimer’s Drug 
Cortexyme, pressing forward after its novel approach to Alzheimer’s disease failed in a mid-stage trial, believes a lower dose of the medicine might safely treat a subset of patients. But detailed data, presented at a medical conference Thursday, suggest the path ahead could be difficult. In the roughly 650-patient study, Cortexyme’s drug proved no better than placebo at slowing patients’ decline, as measured by tests of cognition and ability to complete basic activities. However, the failed trial taught the company how to succeed next time, said Michael Detke, Cortexyme’s chief medical officer, at the Clinical Trials on Alzheimer’s Disease meeting in Boston. (Garde, 11/11)

The New York Times: Bariatric Surgery May Lower Risk For Severe Liver Disease, New Study Finds
One in four American adults has fatty liver disease caused by obesity, not drinking, and there is no medical treatment for it. Doctors say the only way to keep it in check is to lose weight and eat a healthier diet. Now a new study reports that bariatric surgery, in addition to helping with weight loss, can protect the liver. The findings were striking: Of a group of more than 1,100 patients who had an aggressive form of fatty liver disease, those who had weight-loss surgery cut their risk of advanced liver disease, liver cancer or related death by almost 90 percent over the next decade. (Caryn Rabin, 11/11)

Stat: Rectify Is Hoping It Can Mend Broken ABC Transporters, Starting In The Liver
A former Vertex scientist is setting his sights on an entire family of transporter proteins that can cause scores of rare inherited conditions. His startup, Rectify Pharmaceuticals, recently completed a Series A to solve the problems created when so-called ABC transporters break — but the path ahead isn’t as easy as 1, 2, 3. There are 48 distinct ABC transporter proteins found in humans, and they each perform essential functions for organs. Some help cells pump out natural and artificial antibiotics; others move lipids; and still more pass peptides through the cell membrane. But when ABC transporters aren’t formed correctly, they give rise to huge problems. (Bender, 11/12)

CIDRAP: Multivalent Ebola Vaccine Enters Clinical Trial
Oxford University today announced the launch of a multivalent (multi-strain) Ebola virus vaccine, which targets the two species likely to infect humans. The small phase 1 trial is enrolling 26 healthy UK adults ages 18 to 55 with the goal of assessing immune response and safety, the university said in a statement. The vaccine targets the Zaire and Sudan strains and uses the same adenovirus vector as the AstraZeneca-Oxford COVID-19 vaccine. (11/11)

Stat: Optogenetics Tools Pinpoint Location, Timing Of Memory Formation 
A mouse finds itself in a box it’s seen before; inside, its white walls are bright and clean. Then, a door opens. On the other side, a dark chamber awaits. The mouse should be afraid. Stepping into the shadows means certain shock — 50 hertz to the paws, a zap the animal was unfortunate enough to have experienced just the day before. But when the door slides open this time, there is no freezing, no added caution. The mouse walks right in. ZAP. The memory of this place, of this shock, of these bad feelings had been erased overnight by a team of neuroscientists at four leading research institutions in Japan using lasers, a virus, and a fluorescent protein normally produced in the body of sea anemones. (Molteni, 11/11)

Bloomberg: Zipline Drone Startup To Start Medicine Deliveries In Utah
California drone startup Zipline plans to begin delivering medicine and other supplies to homes in Salt Lake City, Utah. The company, whose fixed-wing drones have been transporting medical supplies to rural clinics in Rwanda and Ghana since 2016, has signed a service agreement with Utah-based Intermountain Healthcare to make deliveries to its patients in the city. Zipline said it expects to make its first deliveries in the spring of 2022 and to reach hundreds per day within four years of launching the service. (Boudway, 11/11)

CIDRAP: Beta-Lactam Plus Doxycycline Tied To Better Pneumonia Outcomes In Elderly
A retrospective study of elderly pneumonia patients treated at Department of Veterans Affairs (VA) hospitals found that use of doxycycline as part of guideline-concordant therapy was associated with lower mortality than regimens without doxycycline, researchers reported this week in Clinical Infectious Diseases. Of the 70,533 patients 65 and older who were hospitalized with community-acquired pneumonia (CAP) at VA hospitals from 2002 through 2012, 5,282 (7.5%) received empiric therapy with a beta-lactam antibiotic plus doxycycline. That combination is an alternative regimen recommended for CAP under 2019 American Thoracic Society/Infectious Diseases Society of America guidelines, but prior to this study, there was limited evidence supporting its use. (11/11)

Stat: 5 Health Tech Startups Targeting The Medicaid Population To Watch
When it comes to new opportunities, health tech companies tend to follow the money. That means that for years, Medicaid — the public insurance program serving nearly one in five U.S. residents — has been largely left behind in the race to use tech to provide more convenient, better care. That’s changing though, amid increased calls for equity and inclusion in health care and as a growing cadre of private and public payers begin to align themselves with value-based care models that reward clinicians for the quality of care they provide, rather than the quantity of services given. There’s a crop of pioneering startups beginning to court the roughly 73 million people covered by Medicaid. (Brodwin, 11/12)

Modern Healthcare: Domestic Policy Bill Gains Could Offset Losses for Hospitals in Medicaid Gap States
States without Medicaid expansion under the Affordable Care Act may benefit from proposed funding to close coverage gaps, in spite of other planned cuts to the public insurance program, according to researchers. The current draft of President Joe Biden's Build Back Better Act includes provisions to increase healthcare subsidies and extend coverage, particularly for the 12 states in the Medicaid expansion gap and residents with incomes below the federal poverty level. (Devereaux, 11/11)

Roll Call: McGovern Nudges Medical Schools To Invest In Nutrition Education 
Medical schools should beef up curriculums to include robust nutrition education to give physicians the tools to combat diet-related conditions that cost the federal government billions of dollars each year to treat, according to House Rules Chairman Jim McGovern. The Massachusetts Democrat predicted during an online news conference Wednesday that the House will overwhelmingly adopt a sense of the Congress resolution that calls on medical schools, graduate medical programs and health professional training programs to expand nutrition education. (Ferguson, 11/11)

AP: Health Care Coverage Axed For Striking WVa Hospital Workers
Health care coverage has been stopped for striking maintenance and service workers at a West Virginia hospital, a union said. About 1,000 members of the the Service Employees International Union District 1999 went on strike last week at Cabell Huntington Hospital after their contract expired. Union organizing director Sherri McKinney said in a statement that the coverage was cut off without notification to striking employees and union retirees, The Herald-Dispatch reported. (11/11)

Modern Healthcare: Tenet's Outpatient Push Comes As CMS Moves The Other Way
The Centers for Medicare and Medicaid Services may be slowing payment reforms designed to transition some procedures from inpatient to outpatient settings, but that isn't dimming confidence about Tenet Healthcare's investments in ambulatory surgical centers. Tenet's latest move, announced Monday, is its $1.2 billion acquisition of SurgCenter Development and that company's ownership stakes in 92 ambulatory surgical centers. (Bannow, 11/11)

The Wall Street Journal: Plaintiffs Want Teligent Price-Fixing Lawsuit To Continue Despite Bankruptcy
Drug buyers are seeking court permission to continue a price-fixing lawsuit against Teligent Inc. despite the halt on litigation that kicked in when the drugmaker filed for bankruptcy. A group of drug-buying cooperatives, employee welfare benefit funds, retail pharmacies and national health insurers asked the U.S. Bankruptcy Court in Wilmington, Del., on Wednesday to allow a federal lawsuit to continue against Teligent, a generic drugmaker that sought chapter 11 protection last month. (Yerak, 11/11)

Reuters: Aegon, Other Insurers Hit By U.S. COVID-19 Deaths In Third Quarter
Dutch insurer Aegon NV (AEGN.AS)reported a 16% fall in third- quarter operating profit on Thursday due to higher COVID-19 related mortality claims in the Americas, the latest European insurer to suffer from new waves of the pandemic. Aegon, which does two-thirds of its business in the United States, said "unfavourable mortality claims" in the Americas in the third quarter were $111 million, up from $31 million a year earlier. (Sterling, 11/11)

Reuters: Merck Says Making Progress On Meeting Surge In Lab Gear Demand
Germany's Merck KGaA (MRCG.DE), which is investing to catch up with ballooning demand for its biotech manufacturing supplies, said the order book in COVID-19 related lab gear was still growing faster than sales but it was getting a better handle on the situation. "We are really very well trained at this time to deal with the supply chain pressures... We have made tremendous progresses, however, our order book is still growing faster than our sales," Chief Executive Belen Garijo told journalists after releasing full quarterly results. (11/11)

Modern Healthcare: Cerner's Scheduling System For The VA Runs Into New Issues
A government watchdog has flagged issues with the Veterans Affairs Department's new scheduling platform, which is part of a multibillion dollar effort to modernize the agency's electronic health records system. The new system, built by Cerner as part of a $10 billion contract, was launched at two facilities in Washington state and Ohio last year despite knowledge at the VA of "significant" system and process limitations, the VA Office of Inspector General stated in a report released Thursday. (Hellman, 11/11)

Los Angeles Times: L.A. Getting Influx Of Federal Money To Keep Using Hotels To House Homeless People
Throughout the pandemic, the city and county of Los Angeles have rented thousands of hotel rooms for homeless people at risk of contracting coronavirus. This massive effort was partially made possible by the federal government’s willingness to reimburse local governments for each dollar they spent renting the rooms and repurposing hotels into temporary housing. The Federal Emergency Management Agency’s reimbursement of costs associated with sheltering people in individual rooms was slated to run through the end of the year. (Oreskes, 11/11)

AP: Leaders Stress Need For More Veterans Centers In Minnesota
Four Minnesota political leaders toured a veterans center in St. Paul on Thursday to pay tribute to those who served in the military and call for better access to mental health care and readjustment services for veterans. Gov. Tim Walz, U.S. Sen. Amy Klobuchar and U.S. Reps. Angie Craig and Dean Phillips made the visit on Veterans Day to highlight the value of centers like the three in Minnesota for helping veterans get the support they need. Among other things, the centers provide counseling, employment assistance and referrals for other services. (Karnowski, 11/11)

AP: Maine To Expand Mental Health Help For Farmers
Maine is using a federal grant to try to help the state’s farmers deal with stress. The U.S. Department of Agriculture has given the state $500,000 toward the effort. Maine Department of Agriculture, Conservation and Forestry Commissioner Amanda Beal said Wednesday the grant would support the Maine Farmer and Rancher Stress Assistance Network. Farmers in Maine and beyond have had to contend with the coronavirus pandemic, droughts and supply chain difficulties in recent months and years, Beal said. She said the stress assistance network will provide direct service for farmers as well as referrals for farmers anticipating stress and conflict. (11/12)

AP: West Virginia Opening First Medical Cannabis Dispensary
West Virginia’s first medical cannabis dispensary is opening more than four years after state lawmakers allowed a regulatory system for those products to be established. Trulieve Cannabis Corp. is set to debut a retail location in Morgantown on Friday with a second shop opening in Weston next Monday. “We’re thrilled to be first to market in West Virginia and to continue building the foundation for the West Virginia’s emerging medical cannabis market,” Trulieve CEO Kim Rivers said in a statement. (11/12)

Georgia Health news: Georgia’s Uninsured Could Get Coverage Under Biden Proposal
At least 2.2 million low-income adults — nearly all in Texas and the Southeast — would be eligible for government-funded health insurance under the Democrats’ $1.75 trillion social spending and climate change plan. That’s the number of people who are eligible for Medicaid under the Affordable Care Act but have been left uninsured because they live in one of the dozen states that have not expanded coverage under the 2010 law. They are in the coverage gap — with incomes too high to qualify for Medicaid, but below the $12,880 annual federal income minimum for an individual to qualify for subsidized coverage in the insurance marketplaces created by the ACA. (Galewitz and Miller, 11/11)

AP: Last 3 Florida School Districts Drop Student Mask Mandates
The last three school districts in Florida that required at least some students to wear masks are dropping their mandates for student facial coverings. Starting Friday, grade school students in Miami-Dade schools can opt out of wearing a mask if they have their parents’ permission. Masks already had been optional for high school and some middle school students. In neighboring Broward County, all students can go without masks starting the week after next. No opt-out form from parents is required, though the school district is strongly encouraging students to wear facial coverings, according to the Miami Herald. Masks already were optional for high school and technical college students. (11/11)

The Washington Post: Ted Pharmacy In Loudoun County Gave Wrong Coronavirus Vaccine Dose To More Than 100 Children Ages 5 To 11, Officials Say
A Loudoun County pharmacy has been ordered to stop administering coronavirus vaccine shots after it incorrectly gave 5-to-11-year-olds formulations designed for older kids and adults, the Virginia Department of Health said this week. Ted Pharmacy in Aldie administered the shots to 112 children on Nov. 3 and 4, officials said, giving them vaccine formulas designed for older children or adults but in smaller amounts. The Pfizer-BioNTech vaccine, the only one so far authorized in the U.S. for children under 12, is supposed be given to them at one-third of the dosage given to adolescents, teenagers and adults. (Thompson, 11/11)

The Washington Post: Employers Forbidden To Contact Remote Workers After Hours In Portugal
A set of laws passed in Portugal on Friday prohibits employers from contacting remote workers after hours — except under extenuating circumstances — in an effort to promote work-life balance in an era of burgeoning remote work set off by the coronavirus pandemic, and to attract “digital nomads” from around the world. The new rules, which impose fines on violators, apply to companies with more than 10 employees. They also mandate that employers pay staff for work-related expenses incurred while working at home, such as electricity or Internet costs, and that employees and superiors meet in person every two months to avoid isolation, the Associated Press reported. The laws also establish that in jobs where remote work is possible, parents can choose to work remotely, without making prior arrangements, up until their child is 8. (Fernández Simon, 11/11)

The New York Times: Europe Had Over Half Of The World’s Covid Deaths Early This Month, The W.H.O. Says
Coronavirus deaths in Europe rose 10 percent in the first week of this month and made up over half of the 48,000 coronavirus deaths reported globally in that time, even as new cases and deaths dropped or remained stable in the rest of the world, according to World Health Organization figures released this week. The highest number of deaths were recorded in Russia, which has reported record Covid tolls in recent weeks, followed by Ukraine and Romania. The numbers of new infections were highest in Russia, Britain and Turkey, according to the W.H.O. figures. (Kwai, 11/11)

AP: Dutch Government Expected To Announce Partial Lockdown
The Dutch government is widely expected to announce a partial lockdown Friday amid soaring COVID-19 cases that are putting the country's health care sector under renewed strain. The move comes amid a surge in coronavirus infections across Europe in recent weeks. (11/12)

AP: 2 Athletes COVID-19 Positive In Beijing Games Warmup Events
Organizers of February’s Winter Olympics in Beijing said Friday that two foreign athletes had tested positive for COVID-19 in ongoing test events for the Games. They also expressed sympathy for a Polish luge competitor who fractured his leg at the Olympics sliding center this week in a crash that has been blamed on human error. The two who tested positive are among 1,500 competitors and staff who have come into the country since the test events began in early October, said Huang Chun, the deputy director general of the pandemic prevention office for the Games. (11/12)