First Edition: Oct. 15, 2021

KHN: Schedule Online Visits First? It’s The Next Big Thing In Health Insurance 
At the height of the covid-19 pandemic, people often relied on telemedicine for doctor visits. Now, insurers are betting that some patients liked it enough to embrace new types of health coverage that encourages video visits — or outright insists on them. Priority Health in Michigan, for example, offers coverage requiring online visits first for nonemergency primary care. Harvard Pilgrim Health Care, selling to employers in Connecticut, Maine and New Hampshire, has a similar plan. “I would describe them as virtual first, a true telehealth primary care physician replacement product,” said Carrie Kincaid, vice president of individual markets at Priority Health, which launched its plans in January as an addition to more traditional Affordable Care Act offerings. (Appleby, 10/15)

KHN: How To Crush Medical Debt: 5 Tips For Using Hospital Charity Care 
What if a law passed but no one enforced it? That’s essentially what has happened with one small but helpful rule about hospitals and financial assistance for medical bills. The Affordable Care Act, the health law also known as Obamacare, requires nonprofit hospitals to make financial assistance available to low-income patients and post those policies online. Across the U.S., more than half of hospitals are nonprofit — and in some states all or nearly all hospitals are nonprofit. But many people who qualify for financial assistance — or “charity care,” as it is sometimes known — never apply. (Pisacreta, 10/15)

KHN: KHN’s ‘What The Health?’: The Politics Of Vaccine Mandates
Should covid vaccines be mandated? The answer to that question has become predictably partisan, as with almost everything else associated with the pandemic. Even as the federal government prepares to issue rules requiring large employers to ensure their workers are vaccinated, GOP governors are trying to ban such mandates, leaving employers caught in the middle. (Rovner, 10/14)

Stat: FDA Advisory Panel Endorses Moderna's Covid Booster For Some Groups
A Food and Drug Administration advisory panel voted unanimously Thursday in favor of authorizing booster shots of the Moderna Covid-19 vaccine to people 65 and older, those 18 to 64 with risk factors for severe Covid-19, and those whose jobs put them at high risk for serious complications of Covid-19, such as health care workers. After hours of deliberation, the Vaccines and Related Biological Products Advisory Committee voted 19-to-0 that the Moderna booster should be authorized for these groups at least six months after receiving their second dose. The panel also discussed at what point boosters should be recommended to all adults over 18, saying that at this point it is far too soon to consider the matter. (Herper and Branswell, 10/14)

The Wall Street Journal: Moderna Booster Shot Backed By FDA Advisory Panel 
Moderna said the booster doses can be drawn from the same vials that contain the original two-dose vaccine series, meaning the boosters will be available soon after authorization. Members of the FDA’s vaccine-advisory panel supported Moderna’s booster dose even though the evidence for it was from a small study and had mixed results. (Schwartz and Loftus, 10/14)

Politico: FDA Advisers Endorse Moderna Booster Shot: Three Takeaways
The Moderna plan endorsed by the panel would apply to largely the same groups currently eligible for the Pfizer-BioNTech booster shot. For now, federal regulators only are planning to endorse giving people boosters from the same manufacturer as their initial shots, though the independent advisers will review preliminary data on Friday on so-called “mix-and-match” boosting. The FDA panel’s Friday meeting will also take up of Johnson & Johnson’s proposed booster. (Gardner, Owermohle, Foley and Morello, 10/14)

Austin American-Statesman: Abortion Law Stands After Appeals Court Sides With Texas
A Texas law banning most abortions is still in effect, after a federal appeals court sided with Texas officials a second time and again suspended a lower court ruling that had blocked the law. A three judge panel of the 5th U.S. Circuit Court of Appeals ruled 2-1 late Thursday, refusing a request from the U.S. Department of Justice to allow a lower court ruling blocking enforcement of the Texas law to stand. The law prohibits abortions after six weeks of pregnancy. The federal government is expected to appeal Thursday's ruling to the U.S. Supreme Court, which previously allowed the law to go into effect by declining to intervene at the request of Texas abortion providers. (Mekelburg, 10/14)

AP: Texas Abortion Law Shutting Down Court Avenue For Teens
Veronika Granado anxiously stood before the judge knowing that if she said something wrong, things could end badly for her. But the 17-year-old hadn’t committed a crime. She had not filed a lawsuit. Granado was in a Texas court that day to ask permission to get an abortion. She was among thousands of teens burdened with additional hurdles to legal abortion care, especially if they are of color or live in states where abortion access is already severely limited. (Galvan and Whitehurst, 10/15)

AP: Abortion Supporters Ask Oklahoma Court To Put 3 Laws On Hold
Reproductive rights supporters have filed an appeal asking the Oklahoma Supreme Court to put three anti-abortion laws on hold, including restrictions on medication-induced abortions. The appeal Wednesday comes after District Judge Cindy Truong said she would allow the laws to take effect Nov. 1, pending the outcome of a legal challenge, the Tulsa World reported. (10/14)

USA Today: Biden Touts Vaccination Progress As Cases, Hospitalizations Drop
President Joe Biden on Thursday praised the country's progress and vaccination efforts in fighting the COVID-19 pandemic as case and hospitalization rates continue to decline. "It's working. We're making progress," Biden said in a White House address. Daily cases have declined 47% and hospitalizations are down 38% over the past six weeks, Biden said. Biden's comments came a few hours before a federal advisory committee unanimously supported booster shots of the Moderna COVID-19 vaccine for people 65 and older, as well as younger adults with certain medical conditions or jobs that put them at increased risk for infection. The booster would be half the regular dose, given at least six months after the second shot. (Ortiz and Miller, 10/14)

Bloomberg: Merck’s Covid-19 Pill Set for Review by FDA Advisory Panel
The U.S. Food and Drug Administration is sending Merck & Co.’s Covid-19 pill to an advisory committee for review, using a public forum to discuss any safety concerns ahead of a potential authorization. The FDA announced the hearing for Nov. 30, saying it would weigh data on the use of the drug, molnupiravir, to treat mild-to-moderate cases in high-risk adults, confirming an earlier report by Bloomberg News. It’s the first potential therapeutic treatment for Covid-19 that the agency referred to an advisory panel, the FDA said. (Wingrove, 10/14)

Philadelphia Inquirer: Merck’s COVID-19 Pill And The ‘Unknown Risk’ Of DNA Mutation
The COVID-19 pill developed by Merck and Ridgeback Biotherapeutics appears to reduce the risk of hospitalization by inducing mutations in the coronavirus, preventing it from making copies of itself. Preliminary results from a clinical trial were so promising that the companies stopped it early, and asked the FDA this month for emergency authorization to market the antiviral drug. But in a study led by University of North Carolina researchers earlier this year, the drug also induced low levels of mutations in the DNA of hamster cells — in theory, suggesting it could pose a slight risk of cancer. (Avril, 10/14)

Bloomberg: Hospitals On Lockdown To Be Tracked By CDC, Reversing Trump
The Biden administration is moving the U.S. government’s largest public-health tracking system back to the Centers for Disease Control and Prevention, undoing a much-criticized move by the Trump administration to shift custody of critical data from the nation’s top epidemiological agency. According to a document obtained by Bloomberg News, the Department of Health and Human Services on Oct. 1 signed off on a recommendation to move the system, designed to track pandemic data, out of the management of its own Office of the Chief Information Officer and into CDC’s oversight. The shift comes in the wake of scrutiny over the federal government’s handling of public health data infrastructure, and is intended to ensure long-term stability and ownership of the data system. (Griffin, 10/14)

NBC News: Data Shows More Children Are Getting Sick And Dying From Covid
As the federal government appears ready to approve Covid-19 vaccines for children ages 5 to 11, data shows that September was the country’s worst month for new cases and deaths. Data from the American Academy of Pediatrics shows that cases among children peaked in September, as many schools opened for in-person classes amid the country’s delta variant Covid surge. More than 6 million children have tested positive for Covid since the beginning of the pandemic, with more than 1.1 million new cases recorded from Sept. 3 to Sept. 30. (Chiwaya and Wu, 10/14)

CIDRAP: Kids May Serve As COVID-19 Reservoirs For Variants, Study Says
Using COVID-19 viral load and viral cultures from 110 children, researchers suggest that children may serve as reservoirs for COVID-19, furthering transmission and viral evolution. The researchers created a prospective cohort of patients 21 years or younger who sought care at Massachusetts General Hospital or its urgent care clinics between April 2020 and 2021 (median age, 10 years). About 56% were boys, and 38% were Hispanic. Thirty-six children (33%) required hospitalization, of whom 18 required supplemental oxygen or respiratory support of any kind. (10/14)

Detroit Free Press: New Data: K-12 Schools Without Mask Mandates In Michigan Saw 62% More Coronavirus Spread
Michigan students who attended K-12 schools with mask requirements in August and September had lower rates of coronavirus transmission than those at schools without mandates, new data from the University of Michigan and the state health department shows. "There's a ton of studies out there and we can see it with our own data here in Michigan: Masking helps prevent transmission," said Marisa Eisenberg, an associate professor in U-M's departments of epidemiology and complex systems.Eisenberg led a team at the university comparing case rates among children in school districts with no mask requirements to those with rules in place. (Jordan Shamus, 10/15)

The Boston Globe: Mass. Reports 1,901 New Coronavirus Cases Among Public School Students And 337 Among Staff 
State education leaders on Thursday reported 1,901 new cases among public school students and 337 among staff members for the week that ended Wednesday. The 2,238 total cases were 10 fewer than those reported last week. About 920,000 students across the state are attending school in person, and about 140,000 staff members are inside school buildings. From Oct. 7 to 13, about 0.21 percent of students and 0.24 percent of staff members reported positive cases of the coronavirus to their school leaders. (Gans, 10/14)

Fox News: Texas AG Wins Stay Against San Antonio School District Vaccine Mandate
The Texas Supreme Court halted a coronavirus vaccine mandate for the San Antonio, Texas school district employees on Thursday hours before it was set to take effect. Texas’s highest court sided with Gov. Greg Abbott and Attorney General Ken Paxton by temporarily blocking the mandate but did not rule whether or not the district’s mandate or the governor’s vaccine mandate ban is legal, according to Texas Tribune. The mandate, which said that all employees of San Antonio Independent School District must be vaccinated by Friday, was a direct challenge to Abbott’s recent ban on vaccine mandates and was enacted in August by then-Superintendent Pedro Martinez prompting a lawsuit from Paxton. (Mark Miller, 10/14)

AP: Dozens Of US Nuclear Lab Workers Sue Over Vaccine Mandate
Workers at one of the nation’s premier nuclear weapons laboratories face a deadline Friday — be vaccinated or prepare to be fired. A total of 114 workers at Los Alamos National Laboratory — the birthplace of the atomic bomb — are suing over the mandate, saying exemptions have been unduly denied and their constitutional rights are being violated by Triad National Security LLC, the contractor that runs the lab for the U.S. Department of Energy. (Bryan, 10/14)

AP: Vaccine Proof Or Negative Test Soon Required At Large Events
Starting Nov. 15, people in Washington state will need to either provide proof of COVID-19 vaccination or a negative test in order to attend large events, Gov. Jay Inslee announced Thursday. The new order — which Inslee’s staff said is modeled after similar policies in California and King County — applies to indoor events with 1,000 or more attendees and outdoor events that have more than 10,000 attendees. Events will be required to verify full vaccination status or a negative test within the last 72 hours for all attendees who are age 12 or older. (La Corte, 10/14)

NPR: The Pandemic Has Driven Many Americans To Delay Health Care
Last month, Chelsea Titus, a 40-year-old mother of one in Boise, Idaho, needed surgery to relieve severe pain from endometriosis. But hospitals there are so full of unvaccinated COVID-19 patients that doctors told her she'd have to wait. Nearly 1 in 5 American households has had to delay care for serious illnesses in the past few months, according to a new poll from NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. Titus, who works for a tech company from the home she shares with her husband, her daughter and a labradoodle named Winston, previously had surgery for endometriosis in which doctors removed her uterus and one ovary. When the condition flared again in September, the pain was severe. (Dawson, 10/14)

Politico: Biden Eyeing FDA Veteran Robert Califf To Lead The Agency
Califf previously worked closely with Biden on the Cancer Moonshot initiative launched by the Obama administration. Califf also has a long history with North Carolina, noted Alston & Bird attorney Marc Scheineson, who previously served as FDA associate commissioner for legislative affairs under former FDA Commissioner David Kessler. "Califf should have an inside track for a lot of different reasons," Scheineson said. "Sen. Richard Burr (R-N.C.) can help smooth a confirmation ... to have North Carolina's senator as the ranking member on the committee that confirms him is very important." But consumer advocacy group Public Citizen slammed Califf as a "recycled FDA Commissioner pick" with close ties to the pharmaceutical industry. (Lim, Cancryn and Owermohle, 10/14)

Stat: Is Robert Califf A Savvy Choice To Helm The FDA — Again? 
The Food and Drug Administration has been without a permanent leader for 10 months in large part because of the Senate confirmation process. Key Democrats have voiced public complaints about nearly every potential agency leader, including longtime agency veteran and acting commissioner Janet Woodcock. Robert Califf isn’t going to have any easier of a time if he gets the nod. (Florko, 10/14)

New Orleans Times-Picayune: Larry Hollier, Chancellor Of LSU Health Sciences Center Who Came Under Fire, Resigns Post
Larry Hollier is out as chancellor of the LSU Health Sciences Center in New Orleans, bringing an abrupt end to a 15-year tenure amid a raft of allegations that he pushed for improper pay bumps for his inner circle, underpaid women and violated the university’s policies while hiring and firing people. An LSU announcement Thursday said Hollier would vacate his post immediately. His contract was set to expire at the end of the year. An interim chancellor, who has not yet been named, will take over while LSU searches for Hollier’s replacement. (Cranney, 10/14)

New Orleans Times-Picayune: New Orleans Ambulances To Carry Blood For Pre-Hospital Transfusions
Starting Monday, New Orleans Emergency Medical Services will carry blood in its ambulances for transfusions before arriving at a hospital. The agency has partnered up with The Blood Center to launch the initiative, which it says is the first of its kind in the region. Uncontrolled bleeding is the leading cause of preventable death, and death by bleed-out mostly happens before a patient arrives at a hospital, the agency said. Studies have shown that pre-hospital transfusions can significantly improve a patient's chance of surviving traumatic injuries. (Pierce, 10/14)

The Wall Street Journal: Johnson & Johnson Places Talc Injury Claims In Bankruptcy 
Johnson & Johnson placed into bankruptcy its liabilities for tens of thousands of lawsuits linking talc-based products to cancer, betting the move will help drive a settlement of personal-injury claims that are expected to grow for decades to come. J&J said Thursday that a corporate affiliate holding talc-related liabilities had filed for chapter 11 protection in the U.S. Bankruptcy Court in Charlotte, N.C., shifting the landscape of a yearslong legal fight over whether Johnson’s Baby Powder caused ovarian cancer, asbestos poisoning and other illnesses. The company has maintained that the powder, which it stopped selling last year, is safe and doesn’t contain asbestos. (Scurria, 10/14)

Politico: Confusion Clouds FDA’s Approach To E-Cigarettes
The Food and Drug Administration’s decision this week to authorize the sale of an electronic cigarette was a landmark for the vaping industry — but it may only deepen confusion about the sector’s future. More than a month after a court-ordered deadline to determine which e-cigs could stay on the market, FDA has yet to act on applications from some of the industry’s biggest players, including Juul. (Foley, 10/14)

Stat: New Tools Could Fix Diseases Caused By Large DNA Rearrangements 
Ever since the now Nobel-winning discovery of CRISPR genome editing in 2012, scientists have been racing to improve on its DNA-targeting-and-cutting action. A huge step forward came in 2016, with the invention of base editing, and another with prime editing in 2019, both from the Broad Institute lab of David Liu. The advances made it possible to precisely slice open a double-strand of DNA and change the sequence — swap out a nucleotide for another, or add or subtract a few in one go. But when faced with making bigger deletions, anything over 100 base pairs, even these shiny new tools weren’t up to the task. (Molteni, 10/14)

The Wall Street Journal: Elizabeth Holmes Trial: Dermatologist Describes Theranos Lab Director Stint 
A dermatologist testified Thursday in the criminal trial of Elizabeth Holmes that he agreed to serve as Theranos Inc.’s lab director after being asked to fill the role by one of his patients, but never did much more than sign paperwork and appear in the company’s lab once or twice. Sunil Dhawan told jurors that he accepted the role in November 2014 at the request of Ramesh “Sunny” Balwani, Theranos’s chief operating officer, whom he had treated for almost 15 years. (Randazzo, 10/14)

Mississippi Center for Investigative Reporting: Diabetes Cases Exploding Among Children. Here's Why And What Mississippi Is Doing
The number of diabetes cases among adolescents has nearly doubled since 2001, according to a new study by the American Medical Association. Those numbers are expected to quadruple by 2050. The average age of onset for Type 2 diabetes among children? About 14 — an age that was unthinkable decades ago for a disease associated with adults. Spikes for Type 2 diabetes were highest among Black and Hispanic children. Some attribute the recent spike to COVID-19 — fueled by lockdowns and closed schools, which have reduced access to health care, healthy food and places to exercise. (Hensley, 10/15)

The Hill: Michigan Orders 'All-Hands-On-Deck' Response To Water Crisis
Michigan Gov. Gretchen Whitmer (D) said on Thursday that elevated levels of lead in tap water in the southwestern part of the state would require an "all-hands-on-deck, whole-of-government approach." Whitmer issued an executive order to allocate federal, state and local resources to expeditiously replace all of the lead service lines in Benton Harbor in the next 18 months. (Beals, 10/14)

The Hill: Agencies Warn Of Cyber Threats To Water, Wastewater Systems
A coalition of federal agencies on Thursday warned that hackers are targeting the water and wastewater treatment sectors, strongly recommending that organizations take steps to protect themselves.  In a joint advisory, the FBI, the Cybersecurity and Infrastructure Security Agency (CISA), the Environmental Protection Agency (EPA) and the National Security Agency (NSA) warned of “ongoing malicious cyber activity—by both known and unknown actors—targeting the information technology (IT) and operational technology (OT) networks, systems, and devices of U.S. Water and Wastewater Systems (WWS) Sector facilities.” (Miller, 10/14)

CBS News: Butterball Recalls 14,000 Pounds Of Ground Turkey Sold At BJ's And Kroger Stores 
Butterball is recalling more than 14,000 pounds of ground turkey products sold nationwide because they may contain small pieces of hard blue plastic. The ground turkey items were produced on September 28, 2021, at the Butterball facility in Mt. Olive, North Carolina, according to a notice posted Wednesday by the U.S. Department of Agriculture's Food Safety and Inspection Service, or FSIS. The 675,000-square-foot plant outside Raleigh is the largest turkey processing plant in the world, processing 17 million turkeys a year, according to Butterball. (Gibson, 10/14)

The Wall Street Journal: Why So Many Products On Grocery Store Shelves Claim They Help Your Immune System 
If you’ve seen a barrage of food packages promising to help your immune system lately, you’re not alone. Even cans of cheese balls now are touting immune-system benefits. Good Crisp Co. this summer launched cheddar cheese balls with an ingredient that “helps strengthen the immune system and enhances its key functions,” the label says. (Chaker, 10/14)

The Boston Globe: Mass. Medicaid Fraud Case Settled For Record $25 Million, AG’s Office Says
A private equity firm and two former top executives at a Massachusetts chain of mental health centers have agreed to pay $25 million in a whistleblower lawsuit brought by the attorney general’s office, marking the largest MassHealth fraud settlement in state history, officials said Thursday. South Bay Community Services (formerly known as South Bay Mental Health) has operated facilities in more than a dozen Massachusetts communities, including Boston, Brockton, Fall River, Lowell, Pittsfield, and Worcester, the office of Attorney General Maura Healey said in a statement. (Fox, 10/14)

AP: Kentuckians Can Review Health Coverage Plans On Exchange
Consumers can start logging in to Kentucky’s state-run health insurance exchange to review plans that best suit their needs for 2022, Gov. Andy Beshear said. Starting Friday, Kentuckians can compare state-managed health insurance plans on the web portal, known as kynect, ahead of the enrollment period that begins Nov. 1. (10/15)

NPR: United States Commits Another 17 Million COVID Vaccine Doses To The African Union
The White House says the United States will donate more than 17 million doses of the Johnson & Johnson COVID-19 vaccine from its domestic supplies to the African Union. President Biden made the announcement Thursday as he met with Kenyan Uhuru Kenyatta at the White House, Biden's first one-on-one meeting with an African leader. "We're continuing our shared fight against COVID," Biden said during the meeting. The vaccine donation comes on top of the 50 million vaccines doses already donated by the United States to the African Union, according to the White House.

Bloomberg: England Eases Travel Rules With Cheaper Covid Tests For Arrivals
New rules allowing fully vaccinated travelers returning to England to take lateral-flow coronavirus tests instead of more expensive PCR tests will come into force on October 24. The change will come into effect for families returning from half-term holidays, the Department for Health and Social Care said in an emailed statement. Passengers will able to book the lateral flow test through private providers listed on a government website and will have to upload a photo of their test on or before day two of their arrival to verify the results. Anyone who tests positive will need to self-isolate and take a PCR test free of charge. (Ashton, 10/15)

AP: UK: 1000s May Have Gotten False Negative COVID Test Results
British health officials said Friday that an estimated 43,000 people may have been wrongly told they don’t have the coronavirus because of problems at a private laboratory. The U.K. Health Security Agency said a lab in Wolverhampton, central England, has been suspended from processing test swabs after reports of false negatives. The faulty results were among tests processed at the Immensa Health Clinic Lab between early September and this week. (10/15)

The Washington Post: One Of The World’s Toughest Coronavirus Quarantine Regimes Is Finally Ending
Since early in the pandemic, Australia has imposed some of the world's strictest quarantine requirements, effectively walling itself off and stranding thousands of citizens overseas in a bid to keep the coronavirus out. Now, after a surge in vaccinations, those walls are starting to tumble. Sydney, the country’s largest city, will stop requiring fully vaccinated travelers to quarantine — either in a hotel or at home — next month, a major shift that will speed the return of stranded Australians and open the door to international travelers early next year. (Miller, 10/15)

Bloomberg: Congo Has Vaccinated Less Than 0.1% Of Its 100 Million People
The Democratic Republic of Congo, a nation of 100 million people, is stepping up its coronavirus inoculation campaign amid concern that populations that aren’t immunized could spawn mutations that evade vaccines and spread more rapidly. Congo has vaccinated the lowest proportion of its population out of more than 200 countries and regions tracked by Bloomberg, with just 140,000 shots administered as of Oct. 8. The World Health Organization attributed the slow take-up to hesitancy, which was fueled by the government’s initial rejection of the AstraZeneca Plc inoculation in July, and apathy by its politicians in advocating for vaccines. (Kavanagh and Sguazzin, 10/15)

AP: Russia Struggles To Meet Global Orders For Sputnik V Vaccine
Esperita García de Perez got her first vaccination against COVID-19 in May. That, along with her Catholic faith, made her feel better protected against the virus, and she had hoped to get her second shot of the Russian-developed Sputnik V vaccine a few weeks later. But the 88-year-old is still waiting. She was infected with the virus last month, and now her hopes for survival are pinned on the host of medications and home care she is receiving. (Cano, Litvinova and Arraez, 10/15)

The Wall Street Journal: Pandemic Disruptions Blamed For First Increase In Estimated Tuberculosis Deaths In More Than A Decade 
Estimated deaths from tuberculosis—the deadliest infectious disease until the emergence of Covid-19—increased for the first time in more than a decade last year, the World Health Organization said Thursday, blaming severe disruptions in treatment and diagnosis caused by the coronavirus pandemic. (Bariyo and Steinhauser, 10/14)