First Edition: November 19, 2021

KHN: The ER Charged Him $6,500 For Six Stitches. No Wonder His Critically Ill Wife Avoided The ER
Jason and DeeAnn Dean recently relocated to her hometown of Dellrose, Tennessee, where she grew up on a farm. Both in their late 40s, they’re trying to start a green dream business that combines organic farming with a health and wellness consulting company. They want to inspire people to grow their own food in this fertile rolling farmland, just north of the border with Alabama. Until the business fully launches, Jason is working construction. In May, he was injured on the job site when a piece of sheet metal slipped and caught him on the kneecap. He bled quite a bit. After closing the wound with a butterfly bandage, he thought that might be enough. But on his drive home, he figured it’d be best to have a professional stitch it up. (Farmer, 11/19)

KHN: Vaccine-Or-Test Requirements Increase Work And Costs For Governments
Amanda Kostroski, a 911 dispatcher in Madison, Wisconsin, leaves her busy job once a week to go to a county health clinic to be tested for covid-19. She’s been making the 15-minute drive from work since late September, when Dane County mandated all employees get vaccinated or tested weekly. The testing is free, and she is typically back to work within an hour. Kostroski is among 10% of county employees who are unvaccinated and get weekly tests. She chose not to get immunized because she thinks the vaccines are too new and she fears side effects. (Michelle Gomez and Galewitz, 11/19)

KHN: A Covid Head-Scratcher: Why Lice Lurk Despite Physical Distancing
The Marker family opened their door on a recent evening to a woman dressed in purple, with a military attitude to cleanliness. Linda Holmes, who has worked as a technician with LiceDoctors for five years, came straight from her day job at a hospital after she got the call from a dispatcher that the Marker family needed her ASAP. According to those in the world of professional nitpicking, Pediculus humanus capitis, the much-scorned head louse, has returned. (Ellen Bichell, 11/19)

KHN: What Happens After A Campus Suicide Is A Form Of Prevention, Too
Ethan Phillips was 13 years old when he first heard the term “suicide contagion.” It’s the scientific concept that after one person dies by suicide, others in the community may be at higher risk. Phillips learned the phrase growing up in Fairfax County, Virginia, where more than a dozen teens and preteens died by suicide while he was in middle school. It came up again when a high school classmate killed himself. By the time Phillips entered college at the University of North Carolina-Chapel Hill in 2019, he’d developed “an unfortunate level of experience” in dealing with the topic, he said. (Pattani, 11/19)

KHN: KHN’s ‘What The Health?’: Boosting Confusion
With covid caseloads rising across much of the country, several governors and mayors are unilaterally expanding access to booster shots, getting out ahead of federal health officials. Speaking of federal health officials, President Joe Biden has finally selected a nominee to head the Food and Drug Administration. If confirmed by the Senate, it would be Dr. Robert Califf’s second stint at the agency that oversees an estimated one fifth of all products sold in the United States. Califf previously served — for less than a year — under President Barack Obama. (11/18)

The New York Times: First Known Covid Case Was Vendor At Wuhan Market, Scientist Says
A scientist who has pored over public accounts of early Covid-19 cases in China reported on Thursday that an influential World Health Organization inquiry had most likely gotten the early chronology of the pandemic wrong. The new analysis suggests that the first known patient sickened with the coronavirus was a vendor in a large Wuhan animal market, not an accountant who lived many miles from it. The report, published on Thursday in the prestigious journal Science, will revive, though certainly not settle, the debate over whether the pandemic started with a spillover from wildlife sold at the market, a leak from a Wuhan virology lab or some other way. The search for the origins of the greatest public health catastrophe in a century has fueled geopolitical battles, with few new facts emerging in recent months to resolve the question. (Zimmer, Mueller and Buckley, 11/18)

The Wall Street Journal: New Reconstruction Points To Animal Origins For Covid-19
For his analysis, Dr. Worobey, said, “I just trawled through anything I could find,” including the World Health Organization-led team’s report, genomic data, local media reports, and announcements from Chinese officials that had been taken down but stored on an internet archive. He found that 10 of 19 early patients evaluated by doctors at hospitals in Wuhan worked at the Huanan market or had been there. A 41-year-old accountant believed to have become sick Dec. 8—making him officially the first known case—actually was ill from a dental problem then and developed Covid-19 symptoms on Dec. 16 instead, Dr. Worobey wrote. That would mean he could have caught the virus from someone in the broader community, since he didn’t visit the market, Dr. Worobey said. (McKay, 11/18)

The Washington Post: Leading Scientist Argues First Coronavirus Cases Point To Wuhan Market Origin
Worobey has been open to the theory of a lab leak. He was one of the 18 scientists who wrote a much-publicized letter to Science in May calling for an investigation of all possible sources of the virus, including a laboratory accident. But he now contends that the geographic pattern of early cases strongly supports the hypothesis that the virus came from an infected animal at the Huanan Seafood Market — an argument that will probably revive the broader debate about the virus’s origins.(Achenbach, 11/18)

The Hill: Fauci Says All Adults Should 'Go Get Boosted'
President Biden's chief medical adviser Anthony Fauci on Thursday night urged those 18 and older to get a booster shot for added protection against COVID-19. Fauci said on MSNBC's "All in with Chris Hayes" that he has believed "for some time now" that boosters are effective and should be recommended for all adults in the U.S. who received their vaccine six months ago or longer. "If you're 18 or older, go get boosted," Fauci said. (Breslin, 11/18)

The New York Times: Utah And Massachusetts Expand Access To Boosters For All Adults, Joining Several Other States
Utah and Massachusetts on Thursday joined a growing number of states in broadening access to coronavirus vaccine boosters for all adults, just as federal regulators consider granting requests for Pfizer-BioNTech and Moderna boosters to be authorized for all adults as early as this week, according to people familiar with the planning. The administration of Gov. Charlie Baker announced that all Massachusetts residents ages 18 and older could get a booster, if they met the federal timing rules: six months after receiving the second dose of the Pfizer or Moderna vaccines or two months past getting the single-dose Johnson & Johnson vaccine. (Levin, 11/18)

The Hill: Connecticut Governor Says Boosters Needed For People To Be Fully Vaccinated
“We’re 11 months into the vaccination program. In my view, if you were vaccinated more than six months ago, you’re not fully vaccinated,” Lamont said Wednesday while urging people to get vaccinated, NBC Connecticut reported. “If you were vaccinated more than six months ago, now is the time and go get that booster. I urge you to get it now,” he added. New Mexico Gov. Michelle Lujan Grisham (D) also said Wednesday that she believes full vaccination against the coronavirus now means that people have a booster shot. (Breslin, 11/18)

AP: Alaska Health Officials Say Virus Case Numbers Trending Down
State health officials expressed cautious optimism Thursday about lower COVID-19 case numbers in Alaska following an extended surge in cases that strained hospital capacity. Numbers recently have been trending downward after hitting a bit of a plateau, said Dr. Anne Zink, the state’s chief medical officer. “Hoping to continue to see a downward trend,” she told reporters. “This pandemic continues to have all sorts of twists and turns, and just because it turns downward doesn’t mean it’s going to continue downward or stay there. It takes active work from Alaskans getting vaccinated, distancing, masking.” (11/19)

CBS News: Upper Midwest Faces Spike In COVID-19 Infections: "It's Unprecedented"
The nation is currently facing an alarming COVID-19 spike, with average daily cases jumping 35% in recent weeks, according to the CDC. The upper Midwest has seen the largest surge in infections, with one doctor calling the situation "unprecedented." "I have never seen so many people on a ventilator at one time," said Dr. Joshua Huelster, a critical care physician at Abbott Northwestern Hospital in Minneapolis. (Collin, 11/18)

ABC News: New Mexico Facing 'Serious Problems' Amid Latest COVID-19 Surge, Health Officials Warn
COVID-19 cases in New Mexico are "trending in a worrisome direction," health officials said this week, as they called on residents to get vaccinated amid the surge. New Mexico reported 1,530 new cases and 539 hospitalizations Wednesday, rivaling numbers last seen in December and January, during the state's last COVID-19 wave. (Deliso, 11/18)

Modern Healthcare: 70% Of Hospital Workers Vaccinated, New CDC Data Show
Seven out of 10 U.S. hospital workers were vaccinated against COVID-19 as of Sept. 15, according to a Centers for Disease Control and Prevention study issued Wednesday. Staff working in children's hospitals, in metropolitan counties and in counties with higher vaccination rates were more likely to be vaccinated than their peers, agency officials wrote in an article published in the American Journal of Infection Control. (Gillespie, 11/18)

CIDRAP: CDC Survey Shows COVID-19 Vaccine Uptake Stalled At 70% In HCWs
The US Centers for Disease Control and Prevention (CDC) published a new comprehensive survey of vaccine uptake in healthcare workers (HCWs), showing that after initial enthusiasm, vaccine uptake stalled at 70% by Sep 15, 2021. Results of the survey are published in the American Journal of Infection Control. The study was based on data collected by the Department of Health and Human Services Unified Hospital Data Surveillance System on COVID-19 vaccination coverage among hospital-based healthcare personnel between Jan 20 and Sep 15. (11/18)

The Washington Post: Health Groups Urge Businesses To Voluntarily Adopt Biden’s Vaccine Rule
The American Medical Association and more than 60 other health care associations on Thursday called on employers to voluntarily implement President Biden’s contested vaccine-or-testing mandate, saying businesses had no time to waste ahead of the busy holiday season. “We — physicians, nurses and advanced practice clinicians, health experts, and health care professional societies — fully support the requirement that workers at companies with over 100 workers be vaccinated or tested,” the organizations wrote in a joint statement. “From the first day of this pandemic, businesses have wanted to vanquish this virus. Now is their chance to step up and show they are serious.” (Diamond, 11/18)

The New York Times: The U.S. Army Secretary To National Guard Members Who Resist The Vaccines: Prepare For Discipline
The secretary of the Army has issued a memo warning the hundreds of thousands of soldiers in its National Guard that if they decline to get vaccinated against the coronavirus, they may not be renewed in the guard. “I have determined that all soldiers who refuse the mandatory vaccination order will be flagged,” wrote Christine E. Wormuth, the secretary, in a memo this week, which would prevent them from promotions, awards, bonuses and the like. If troops persist in declining, they will not be permitted “continued service” unless granted an approved exemption from the vaccine, she wrote. (Steinhauer, 11/18)

Crain's Detroit Business: COVID-19 Mandates, Reimbursement Woes Challenge Michigan's Rural Hospitals
Wave after wave of ill patients are landing at the emergency room of Memorial Healthcare in Owosso. The century-old critical-care community hospital 25 miles due west of Flint treated 92 inpatients on Nov. 15, nearly a third of which were COVID-19 positive. The hospital and its 1,500 employees are equipped to handle 85 inpatients — but operating above that threshold is standard now. (Walsh, 11/18)

AP: Nevada Student Suing Over University Vaccination Mandates
A 19-year-old student who says he is immune from COVID-19 because he already had it is suing the University of Nevada, Reno, the governor and others over the state’s requirement that everyone, with few exceptions, show proof of vaccination in order to register for classes in the upcoming spring semester. Jonah Gold claims there is no solid evidence that people who recover from COVID-19 ever lose their immunity. His lawsuit says any benefit of vaccination is outweighed by the threat of harmful side effects and that “COVID-19 vaccination mandates are an unconstitutional intrusion on normal immunity and bodily integrity.” (Sonner, 11/19)

AP: City Of Phoenix Employees Must Be Fully Vaccinated By Jan.18
All city of Phoenix employees will be required to be fully vaccinated against COVID-19 by Jan. 18 under the federal mandate, according to an email sent to city workers Thursday. The email also said employees not in compliance with the vaccine requirement by the deadline will be subject to discipline up to and including being fired. City officials said religious or medical accommodations will be available for those wishing to opt-out of the policy, but won’t be guaranteed. (11/19)

Politico: FDA Said To Be Ready To Endorse Pfizer And Moderna Boosters At Once
The Food and Drug Administration on Friday is expected to authorize Moderna’s Covid-19 booster shot for all adults — a move that would come in tandem with the clearance of Pfizer-BioNtech’s booster for widespread use, two people with knowledge of the matter told POLITICO. The decision comes just days after Moderna officially asked the FDA to green-light its booster for Americans 18 and older, and reflects the administration’s growing unease over the recent rise in Covid-19 cases across the nation. (Cancryn, 11/18)

The Wall Street Journal: Prospects Of Intellectual-Property Waiver On Covid-19 Vaccines Fade
An agreement to waive the intellectual-property rights underpinning Covid-19 vaccines—a prospect poor countries have hoped would ease supplies to the developing world—is becoming increasingly unlikely, say people familiar with the situation, with the U.S. not acting to bridge disagreements between developing world countries and those opposing such a measure. In May, the Biden administration said it would support temporarily suspending patents and other IP linked to the shots to allow developing countries to produce the Covid-19 vaccines created by big drug companies. (Steinhauser, Hinshaw and Hayashi, 11/18)

Stat: Proposal To Waive IP Rights For Covid Vaccines And Drugs Appears Unlikely
A controversial proposal for the World Trade Organization to temporarily waive intellectual property rights and provide greater access to Covid-19 medical products appears unlikely to pass, according to people tracking the latest round of meetings at the global agency. Despite a year-long debate, disagreement remains on the fundamental question of whether a waiver is appropriate and the most effective way to tackle inequitable distribution of Covid-19 vaccines and treatments, according to a trade official who is based in Geneva, Switzerland, where talks are being held. The WTO needs consensus from all of its 164 members for the proposal to be adopted. (Silverman, 11/18)

Reuters: CureVac To Begin Trials For Next-Generation COVID-19 Shots Within Months
German biotechnology company CureVac NV said on Thursday clinical trials for its second-generation COVID-19 vaccine are expected to start within the next few months. Earlier on Thursday, the company published data that showed its next-generation shot, CV2CoV, produced neutralizing antibodies in monkeys that were comparable to those produced by Pfizer Inc's (PFE.N) approved vaccine. The efficacy was also greater than the company's first-generation vaccine, it added. In October, CureVac gave up on its first-generation COVID-19 vaccine candidate, CVnCoV, to focus on collaborating with GSK (GSK.L) to develop improved mRNA vaccine technology. (11/18)

Reuters: AstraZeneca Says To Seek Commercial Price For Preventive Antibody Cocktail 
AstraZeneca (AZN.L) said its antibody cocktail against COVID-19 would - unlike its vaccine - be priced commercially as it negotiates supply contracts with governments around the globe. "We are looking at a commercial pricing strategy. That is part of our negotiations with governments," Iskra Reic, Astra's Executive Vice President for vaccines and immune therapies, said in a media call on Thursday. She added that the group's main objective was to make the shot affordable and broadly available. (11/18)

The Wall Street Journal: House Set To Approve $2 Trillion Social Spending And Climate Bill
The sprawling bill calls for creating a universal prekindergarten program, capping child-care costs for many families, negotiating lower prescription drug prices and expanding tax credits for reducing carbon emissions, among other programs. In addition to expanding tax-enforcement efforts at the Internal Revenue Service, the legislation raises taxes on some corporations and very high-income Americans. Democrats have labored for months to craft an agreement that could pass the House, where the party can bear only three defections and still achieve a majority without GOP support. (Duehren and Rubin, 11/19)

AP: House Moves Toward OK Of Dems' Sweeping Social, Climate Bill
Democrats brushed aside months-long divisions and approached House passage of their expansive social and environment bill Friday, as President Joe Biden and his party neared a defining win in their drive to use their control of government to funnel its resources toward their domestic priorities. Final passage, which had been expected Thursday, was delayed as Minority Leader Kevin McCarthy, R-Calif., held it up with an hours-long broadside criticizing Biden, Democrats and the bill. Most Democrats abandoned the chamber after midnight with McCarthy still talking, and House Majority Leader Steny Hoyer, D-Md., told reporters that leaders planned for passage later Friday. (Fram, 11/19)

The Hill: Biden Administration Reverses Trump-Era Waivers Of Nondiscrimination Protections
The Biden administration is reversing Trump-era rules that allowed federally-funded child welfare agencies to bypass non-discrimination rules if they conflicted with providers' religious beliefs. The Department of Health and Human Services (HHS) on Thursday said it was rescinding waivers granted to three states that allowed faith-based foster care groups that contracted with state agencies to turn away same-sex and non-Christian couples while still receiving federal money. (Weixel, 11/18)

The Washington Post: Democratic Divide Puts Congressional Action On Marijuana In Doubt
A split on Capitol Hill over marijuana policy has lawmakers confronting the possibility that they could again fail to pass any meaningful changes to the federal prohibition of cannabis this Congress, even as polls show vast majorities of Americans support at least partial legalization of the drug. The clash, on one level, follows familiar contours for Washington policymaking: A narrower measure with significant bipartisan support — one that would make it easier for banks to do business with legitimate cannabis firms in states where marijuana is legal — is in limbo while a smaller group of lawmakers pushes for a much broader bill. (DeBonis, 11/18)

Modern Healthcare: How FDA's New Head Could Shape Agency Policy
Dr. Robert Califf was nominated by President Joe Biden last week to lead the Food and Drug Administration. If confirmed, Califf will lead an agency still fighting against the COVID-19 pandemic while working to innovate. Califf previously served as FDA commissioner for nearly a year at the end of the Obama administration. He knows how the agency works and can hit the ground running, stakeholders say. Califf's leadership style revolves around setting key priorities and following through on them, according to Howard Sklamberg, a partner at Arnold & Porter who worked as a deputy commissioner at the FDA during Califf's first tenure. (Goldman, 11/18)

AP: Biden Administration Acts To Restore Clean-Water Safeguards
The Biden administration took action Thursday to restore federal protections for hundreds of thousands of small streams, wetlands and other waterways, undoing a Trump-era rule that was considered one of that administration’s hallmark environmental rollbacks. At issue is a regulation sometimes referred to as “waters of the United States,” or WOTUS, that defines the types of waterways qualifying for federal protection under the Clean Water Act. The regulation has long been a point of contention among environmental groups, farmers, homebuilders, lawmakers and the courts. (Naishadham and Daly, 11/19)

Stat: Can States Convince Courts Opioid Makers Caused A Public Nuisance?
Earlier this week, the state of Washington went to trial relying on a controversial legal theory to win $38 billion from three large pharmaceutical wholesalers for failing to monitor shipments of prescription opioid painkillers and, as a result, jeopardizing public health. As with any trial, legal strategy is something of a gamble. In this instance, Washington Attorney General Bob Ferguson had rejected a settlement offer of $527.5 million over 18 years, which he called “woefully insufficient.” Instead, he believes the state can convincingly argue that the wholesalers caused a “public nuisance,” which generally refers to an action that damages or interferes with a community. (Silverman, 11/18)

The Washington Post: Coalition Of State Attorneys General Opens Investigation Into Instagram’s Impact On Children And Teens
A bipartisan coalition of state attorneys general on Thursday announced an investigation into Meta, focusing on whether the parent company of Instagram and Facebook violated consumer protection laws by promoting the app and other social networking products to children and teens. The probe, announced in a news release by Massachusetts Attorney General Maura Healey (D), follows reports that the company’s internal research suggested that its products negatively impact the mental health of young people, especially teen girls. It highlights ballooning regulatory scrutiny of the tech giant, which is already the target of a federal antitrust lawsuit. (Zakrzewski, 11/18)

AP: State Attorneys General Probing Instagram's Effects On Kids
“For too long, Meta has ignored the havoc that Instagram is wreaking on the mental health and well-being of our children and teens,” said California Attorney General Rob Bonta. “Enough is enough. We’ve undertaken this nationwide investigation to get answers about Meta’s efforts to promote the use of this social media platform to young Californians – and to determine if, in doing so, Meta violated the law.” The investigation targets, among other things, the techniques Meta uses to keep young people on its platforms — and the harms that extended time spent on Instagram can cause. (Ortutay, 11/18)

The Hill: New Suicide Prevention Hotline To Include Texting Option
The Federal Communications Commission (FCC) voted to include a texting option for a new suicide hotline, 988, set to go live next summer. Advocates have pushed for a more accessible version of the existing 1-800-273-8255, and now providers will be required to support messaging to the number beginning July 16, ABC News reported. Currently, the three-digit number is set up only to support calls. “The bottom line is that it shouldn't matter if you make a voice call or send a text message because we should connect people in crisis to the resources they need no matter how they communicate," FCC Chairwoman Jessica Rosenworcel said during an open meeting, per CNN. (Barnes, 11/18)

Bloomberg: Americans Can Soon Text 988 To Reach National Suicide Prevention Lifeline
Americans will be able to text 988 to access the National Suicide Prevention Lifeline, a move seeking to broaden support for at-risk communities, such as youth and people with disabilities. The Federal Communications Commission approved the move Thursday, the agency said in a statement. In 2020, almost 46,000 people in the U.S. died by suicide, provisional data from the Centers for Disease Control and Prevention show, as the pandemic weighed on mental health. (Sirtori-Cortina, 11/18)

NPR: Americans Can Wait Many Weeks to See a Therapist. California Law Aims to Fix That.
When Greta Christina fell into a deep depression five years ago, she called up her therapist in San Francisco — someone she'd had a great connection with when she needed therapy in the past. And she was delighted to find out that he was now "in network" with her insurance company, meaning she wouldn't have to pay out of pocket anymore to see him. But her excitement was short-lived. Over time, Christina's appointments with the therapist went from every two weeks, to every four weeks, to every five or six. (11/18)

CIDRAP: Amid COVID, A 35% Surge In Calls To Mental Health Helplines
An analysis of 8 million mental health helpline calls from 19 countries early in the pandemic reveals a 35% jump in calls related to fear and loneliness rather than to problems with relationships, finances, domestic violence, and suicidal thoughts that dominated before COVID-19 emerged. The study, published yesterday in Nature, suggests that concerns related directly to the pandemic replaced, rather than aggravated, common underlying anxieties, the researchers said. The study team, led by researchers from the University of Lausanne in Switzerland, said they used helpline call data because they provide a real-time picture of the state of public mental health, unaffected by the design and framing of a study. (VanBeusekom, 11/18)

The Hill: CDC: No Trace Of Virus Causing Smallpox Found In Lab Vials, Despite Labels
The Centers for Disease Control and Prevention (CDC) on Thursday determined that vials found at a Pennsylvania facility this week with labels reading "smallpox" did not contain the virus that causes it. "There is no evidence that the vials contain variola virus, the cause of smallpox," the CDC said in a statement, adding that the agency is "in close contact with state and local health officials, law enforcement, and the World Health Organization about these findings." (Jenkins, 11/18)

NBC News: Flu Season: What Outbreaks On College Campuses Tell Us
Flu outbreaks on college campuses most likely indicate a bad flu season ahead, but experts say the unpredictable nature of the flu virus means it’s too soon to know for sure how this season will unfold. The Centers for Disease Control and Prevention is currently investigating an outbreak of influenza at the University of Michigan, where at least 528 students have tested positive for the flu since Oct. 6. The University of Florida, Florida State University, Rowan University in Glassboro, N.J., and the University of Rhode Island are also seeing steep upward trends in campus flu cases this month. (11/19)

The Wall Street Journal: Sleep Apnea Device Recall From Philips Causes New Worry
Over the summer, Royal Philips NV set off a scramble among sleep apnea sufferers when it recalled millions of machines that many use to breathe at night, citing concerns that the foam in the devices could pose a health risk. Last week, users were thrown another curveball when the Food and Drug Administration warned the replacement machines that the Dutch health giant has been cranking out since September may be harmful, too. The FDA didn’t order a recall of some 250,000 replacement devices Philips has sent to users, but said it was concerned that a silicone-based foam used in the substitute devices could emit harmful gases. That has raised new questions among users about what to do. (Roland, 11/18)

Modern Healthcare: Virginia Latest State To Offer Full Year Of Postpartum Medicaid
Virginia became the latest state to offer 12 months of postpartum Medicaid and Children's Health Insurance Program coverage after the Centers for Medicare and Medicaid Services approved the state's Medicaid plan amendment Thursday. More states will likely follow suit next year after an American Rescue Plan provision to simplify the application for expanding postpartum coverage for 12 months goes into effect in April 2022. (Goldman, 11/18)

Gizmodo: Over A Million Americans May Have Permanently Lost Their Sense Of Smell To Covid-19
This new study, published Thursday in JAMA Otolaryngology – Head & Neck Surgery, seems to be one of the first to try gauging the toll of chronic covid-related anosmia in the U.S. The authors were compelled to study the issue after seeing many of these patients in their clinics. “In the last couple of months, my colleagues and I noted a dramatic increase in the number of patients seeking medical attention for olfactory dysfunction.” study author Jay Piccirillo, a otolaryngologist at Washington University in St. Louis and an editor at JAMA Otolaryngology, told Gizmodo in an email. (Cara, 11/18)

CIDRAP: Report Highlights Lack Of Access To Antibiotics In Poor Countries
A new analysis of how the major players in the antibiotic market are responding to the antimicrobial resistance (AMR) threat suggests that interest in antibiotic research and development is growing and that companies are making greater efforts to curb the environmental impact of antibiotic manufacturing. But efforts to make antibiotics more accessible to people in the countries where they are desperately needed are lagging. (Dall, 11/18)

The Hill: Hospital Strain Linked To Thousands Of Excess Deaths Two Weeks Later: Research
A new analysis estimates that hospital strain during the pandemic is linked to thousands of ensuing excess deaths, signaling the significance of ensuring hospitals do not reach full capacity amid COVID-19 surges. The research published by the Centers for Disease Control and Prevention (CDC) on Thursday predicted that when the nationwide intensive care unit (ICU) capacity hits 75 percent capacity, an additional 12,000 excess deaths could be expected within the next two weeks. When hospitals surpass 100 percent ICU bed capacity, the study suggests 80,000 excess deaths would be expected two weeks later. (Coleman, 11/18) 

Crain's Chicago Business: Northwestern Medicine Launches Lung Treatment Center
Northwestern Medicine has launched the Canning Thoracic Institute with a $20 million donation from Madison Dearborn Partners founder John Canning and his wife Rita to meet the growing demand for lung transplants and lung treatments due to COVID-19 and lung cancer, the health system said today. Since July 2020, Northwestern Medicine surgeons have performed more than 30 double-lung transplants on COVID patients, the most of any health system in the world, Northwestern said in a statement. And with more than 47 million Americans having already contracted COVID, demand for inpatient and outpatient pulmonary care is expected to grow, the statement said. In addition, nearly a million people in the Chicago area, or about 10% of the population, suffer from some sort of chronic lung disease, the statement said. (Asplund, 11/18)

Bloomberg: Insurers Balk at Paying for Biogen’s $56,000-a-Year Alzheimer’s Treatment
U.S. health insurers say they want more proof before paying for Biogen Inc.’s Aduhelm, stalling sales of the costly new Alzheimer’s therapy that the company hailed as a breakthrough for patients. None of the 25 large insurers that responded to a Bloomberg News survey judged the $56,000-a-year drug “medically necessary,” a term used to describe treatments that are needed for specific ailments and meet medical standards. Most have deemed Aduhelm experimental, while some say they’re still evaluating it. (Tozzi, LaVito and Dave, 11/18)

The New York Times: CVS Will Close 900 Stores As It Looks Beyond Traditional Pharmacies
CVS will close about 300 stores a year in the next three years, the company said on Thursday, as the pharmacy chain focuses on offering more health care services and expanding its digital services. The closures, which will affect about 9 percent of the company’s stores, are part of an effort to realign its retail strategy, CVS said in statement on its website. The company operates more than 9,900 stores in the United States, according to its website. A CVS spokesman said the company did not expect CVS pharmacies in Target stores to be affected. (Murphy Marcos, 11/18)

Modern Healthcare: CVS To Close 900 Stores In Big Retail Strategy Shift
Big changes are coming for CVS Health, the company announced Thursday. Over the next three years, CVS Health plans to shutter 900 pharmacies and intensify its efforts to reconceive its retail locations as sites for more comprehensive healthcare services. The company, which also operates Aetna health insurance and CVS Caremark pharmacy benefit management subsidiaries, announced a related senior executive leadership shakeup. (Devereaux, 11/18)

The Wall Street Journal: Dominant Eye Surgery Chain LasikPlus Put Profits Over Patient Care, Some Doctors Say
Since the laser surgery that can fix nearsightedness was approved in the 1990s, one firm, called LasikPlus, has grown into the U.S. industry’s dominant force by using low prices as a draw and vacuuming up rival players. Along with its growth, LasikPlus has accumulated critics, including some of its own doctors, current and former, who alleged in lawsuits and interviews that they were pressured by corporate management to follow practices that they felt put the company’s profits over patient care. Some said they were expected to perform so many procedures each day they worried they couldn’t keep up. “It felt like we were in a war zone all the time,” said Therese Alban, who quit LasikPlus two years ago after 15 years there, part of an exodus of about 20% of the chain’s then 40 or so doctors to a rival firm or private practice. (Maremont, 11/18)

Stat: Biotech Companies Scramble To Find Scientists To Manage Troves Of Data
Nikhil Munshi’s lab at the Dana-Farber Cancer Institute has accumulated an overwhelming amount of data — over a thousand terabytes of intel on healthy cells and cancer cells that could help researchers unlock new secrets about health and disease — what he called the “unbelievable complexity of how cells remain normal and become abnormal.” “It’s very, very exciting. We can do things we could not do literally two years ago or five years ago. A petabyte of data sounds like a Star Trek number, but a lot of people have [more],” Munshi, an oncology researcher, said. There’s just one problem: “There’s so much demand for informatics, the supply is not there yet. There really is a shortage of good bioinformaticians.” (Chen, 11/19)

Stat: GSK's Walmsley Predicts A ‘Landmark’ 2022 For The Company
Next year will be a “landmark” one for GlaxoSmithKline, according to CEO Emma Walmsley — though many of the biggest changes she forecasted may not become evident until next year. On next year’s agenda: fresh data from clinical trials of a vaccine for respiratory syncytial virus, a very common childhood illness; a Food and Drug Administration decision for daprodustat, GSK’s experimental treatment for a type of anemia; and the de-merger of GSK’s consumer business from its pharmaceutical arm — twenty-one years after the massive merger that created GlaxoSmithKline in the first place. (Sheridan, 11/18)

Reuters: J&J Sees Potential For 14 New Multibillion-Dollar Drugs By 2025
Johnson & Johnson (JNJ.N) expects to file for approval of 14 new drugs by 2025, and has projected average peak sales of $4 billion a year for each, a top J&J scientist said ahead of a strategy review of the company's pharmaceuticals unit on Thursday. Among the top pipeline assets, Mathai Mammen, global head of research for J&J's Janssen pharmaceutical division, pointed to a drug combination for non-small cell lung cancer, an anticoagulant it is developing with partner Bristol Myers Squibb (BMY.N) and a vaccine for respiratory syncytial virus (RSV). (Erman and Steenhuysen, 11/18)

Bloomberg: J&J Split: What The New Drug Company Will Focus On After Breakup
Johnson & Johnson will focus on developing drugs for conditions such as lung cancer and eye disease as it prepares to make its pharmaceutical and medical-devices business an independent entity. The 135-year-old health giant faces its greatest-ever overhaul as it readies for a spin-out of its consumer unit, following a path trod by rivals such as GlaxoSmithKline Plc and Pfizer Inc. In her first-ever interview, Jennifer Taubert, J&J’s executive vice president and worldwide chairman of pharmaceuticals, told Bloomberg News that the company will invest in new areas of interest. (Griffin, 11/18)

AP: Whitmer Proposes $300M In Water Funding For Communities
Gov. Gretchen Whitmer on Thursday proposed $300 million in water spending to help local utilities address elevated lead levels, plan for pipe replacement and connect users of contaminated wells to municipal supplies. The governor said the funding would expand her $500 million MI Clean Water Plan, some of which has been authorized since it was unveiled more than a year ago. The new funds, which would come from U.S. pandemic relief dollars, would need to be approved by Michigan’s Republican-led Legislature. (Eggert, 11/18)

CBS News: Michigan Marijuana Regulators Recall Cannabis Products From Hundreds Of Stores, Citing "Unreliable" Test Results
The Michigan Marijuana Regulatory Agency issued a recall for marijuana products assessed by testing facilities over the last few months, impacting more than 400 sales locations statewide. The agency said on Wednesday it noticed "inaccurate and/or unreliable results" of products tested by Viridis Laboratories and Viridis North. (Powell, 11/18)

The New York Times: Austria Announces A Lockdown And Vaccination Mandate For All
Austria will go into a nationwide lockdown on Monday and impose a coronavirus vaccination mandate in February, Chancellor Alexander Schallenberg said on Friday. It is the first such lockdown in a European nation since the spring, and the first national vaccine mandate on the continent. “Nobody wants a lockdown — the lockdown is the very last resort, a crude instrument,” Health Minister Wolfgang Mückstein said. “A lockdown is always an imposition, but it is the most reliable instrument we have to break this fourth wave.” (Schuetze and Peltier, 11/19)

Reuters: Britain Was Unprepared For COVID-19, Spending Watchdog Finds
The British government was unprepared for a crisis like the coronavirus pandemic, failed to learn from simulation exercises and was distracted by its departure from the European Union, the government's spending watchdog said on Friday. More than 143,000 people have died from COVID-19 in Britain, sparking criticism of Prime Minister Boris Johnson for his response, which was initially based on plans for dealing with a flu pandemic rather than a novel coronavirus. (Smout, 11/19)

Bloomberg: New Covid Delta Sub-Variant Spreads Fast In U.K., Causes Fewer Symptoms
A more infectious new version of Covid-19’s delta variant is spreading fast in the U.K., accounting for about 12% of the samples gathered in the most recent government survey. That represents a 2.8% daily growth rate for sub-variant AY.4.2 over the course of the REACT survey, from Oct. 19 to Nov. 5, the researchers said. Still, the new sub-variant seemed less likely to cause symptomatic Covid. (Kresge, 11/18)