First Edition: Sept. 20, 2021

KHN: I Got A ‘Mild’ Breakthrough Case. Here’s What I Wish I’d Known. 
The test results that hot day in early August shouldn’t have surprised me — all the symptoms were there. A few days earlier, fatigue had enveloped me like a weighted blanket. I chalked it up to my weekend of travel. Next, a headache clamped down on the back of my skull. Then my eyeballs started to ache. And soon enough, everything tasted like nothing. As a reporter who’s covered the coronavirus since the first confirmed U.S. case landed in Seattle, where I live, I should have known what was coming, but there was some part of me that couldn’t quite believe it. I had a breakthrough case of covid-19 — despite my two shots of the Pfizer-BioNTech vaccine, the second one in April. (Stone, 9/20)

KHN: Ask KHN-PolitiFact: Is My Cloth Mask Good Enough To Face The Delta Variant?
In recent months, some European airlines have banned the use of cloth face coverings to control the spread of the coronavirus during air travel, instead favoring surgical masks — sometimes referred to as medical or disposable — and N95 respirators. It’s another salvo in the debate over the effectiveness of the ubiquitous cloth mask, which sprang into fashion when surgical masks and N95s were harder to find in the pandemic’s early days. The Centers for Disease Control and Prevention still promotes cloth face coverings in its guidance about masks. (Gomez, 9/20)

Stat: FDA Advisory Panel Recommends Booster Doses Of Covid-19 Vaccine Only For Older And High-Risk Americans
An advisory panel to the Food and Drug Administration on Friday recommended against a booster dose of a Covid-19 vaccine for most Americans at this time — a major rebuke to the Biden administration — but voted unanimously to recommend one to Americans who are 65 or older. The FDA is not required to follow the recommendation of its advisory committees but generally does. If the recommendation is adopted by the FDA and Centers for Disease Control and Prevention, it would put the U.S. policy on a par with countries like the United Kingdom. (Branswell and Herper, 9/17)

NPR: FDA Panel Says Pfizer COVID Booster OK For Older People And Those At High Risk
In a surprising vote, a panel of advisers to the Food and Drug Administration on Friday recommended against approval of a booster dose of the Pfizer-BioNTech COVID-19 vaccine for people 16 years and older. The 16-2 vote against broad use of the booster, which would be given about six months after completion of the two-dose immunization regimen, dealt a setback to Pfizer and complicates the FDA's approach to boosters. After a brief intermission following the rejection, FDA officials returned to the meeting with a revised booster question. The panel then voted 18-0 in support of the agency authorizing a booster shot of the vaccine for people 65 and older or at high risk of severe COVID-19. (Hensley, 9/17)

Politico: Collins, Fauci Endorse And Explain FDA’s Recommendation For Limited Use Of Boosters 
U.S. health officials supported the recommendation from the FDA advisory panel that booster vaccines be limited to those 65 years and older and individuals at high risk for severe disease despite the expectation that the additional shots would be suggested for everyone who received the initial vaccination. National Institutes of Health Director Francis Collins said Sunday that the guidance issued Friday by the Food and Drug Administration is in line with what the Biden administration planned for a booster rollout, though not identical. (Crummy, 9/19)

The New York Times: Fauci Urges Americans Not To Get Boosters Before They Are Eligible 
Dr. Anthony S. Fauci, the nation’s top infectious disease doctor, defended President Biden’s decision last month to announce the availability of Covid booster shots before regulators had weighed in, and he urged vaccinated Americans to wait until they were eligible for an extra shot before getting one. Dr. Fauci’s remarks on three Sunday morning news shows followed a vote Friday by an advisory panel to the Food and Drug Administration, which recommended that those who received the Pfizer-BioNTech vaccine get a booster dose if they are over 65 or are at high risk of developing severe Covid-19. The panel’s recommendation, represented a more limited plan than one that Mr. Biden had announced over the summer, in which he said that, beginning Sept. 20, all Americans who had been fully vaccinated would be eligible for booster shots eight months after their last dose. (Thomas, 9/19)

The Washington Post: Fauci Says Data On Moderna, Johnson & Johnson Boosters ‘A Few Weeks Away’ From FDA Review
Anthony S. Fauci, the White House’s chief coronavirus medical adviser, said data about booster shots for those who had received the Moderna or Johnson & Johnson coronavirus vaccines could be a few weeks away from being reviewed by the Food and Drug Administration, days after an FDA panel approved booster shots for a limited population of those who had received the Pfizer-BioNTech vaccine. “The actual data that we’ll get [on] that third shot for the Moderna and second shot for the J & J is literally a couple to a few weeks away,” Fauci said on NBC News’s “Meet the Press” on Sunday. “We’re working on that right now to get the data to the FDA, so they can examine it and make a determination about the boosters for those people.” (Wang, 9/19)

AP: Top Doctors Say Not So Fast To Biden's Boosters-For-All Plan
Just one month ago, President Joe Biden and his health advisers announced big plans to soon deliver a booster shot of the coronavirus vaccine to all Americans. But after campaigning for the White House on a pledge to “follow the science,” Biden found himself uncharacteristically ahead of it with that lofty pronouncement. Some of the nation’s top medical advisers on Friday delivered a stinging rebuke of the idea, in essence telling the White House: not so fast. (Miller, 9/18)

CIDRAP: CDC: Moderna COVID Vaccine Most Protective Against Hospital Cases 
All three COVID-19 vaccines currently in use in the United States offer significant protection against hospitalization for COVID-19, but Moderna is the most effective among US adults who are not immunocompromised, according to new data published today in Morbidity and Mortality Weekly Report. ... In a study involving a case-control analysis of 3,689 adults who were hospitalized at 21 US hospitals at some point from Mar 11 through Aug 15, the vaccine effectiveness (VE) against COVID-19 hospitalizations was 93% for Moderna, 88% for Pfizer/BioNTech, and 71% for the single-dose Johnson & Johnson (J&J) vaccine. (Soucheray, 9/17)

Houston Chronicle: 'Abort Abbott': Protesters Rally At City Hall To Decry Texas' Strict Abortion Law
About 50 people gathered Sunday outside Houston City Hall to protest Texas Senate Bill 8, which outlaws abortions after six weeks and puts the power of enforcement in the hands of individual citizens. Bearing signs and shirts with slogans such as “Abort Abbott” and “Don’t Mess With Uterus,” the protesters decried what they feel is a tyrannical exertion of control over women’s bodies. “This is not about ‘saving lives,’ this is about controlling the lives of women, and we will fight back against it just as we have done before,” said Khloe Liscano, 27, one of the organizers of Sunday’s event, to the crowd. (González Kelly, 9/19)

AP: Cecile Richards: Court's Texas Move Could Mean End Of Roe
A year after the death of Supreme Court Justice Ruth Bader Ginsburg, one of the country’s top abortion-rights activists warned that the Supreme Court’s recent inaction on Texas’ extremely restrictive new abortion law could signal the end of judicial checks and balances on the issue. “For a lot of people, they’ve always assumed that, even if they lived in a state that passed restrictions on reproductive care, that there was always a judicial system that would be there to protect them and declare these laws unconstitutional,” Cecile Richards, former president of Planned Parenthood, told The Associated Press in an interview this week. “That isn’t happening any more.” (Kinnard, 9/18)

The New York Times: With Abortion Rights Under Threat, Democrats Hope To Go On Offense 
Democrats in Virginia and beyond are focusing in particular on suburban women, who played a large role in electing President Biden, but whose broader loyalty to his party is not assured. With Republicans smelling blood in next year’s midterm elections as Mr. Biden’s approval ratings slip and the economy faces a potential stall over the lingering pandemic, Democrats are looking for issues like abortion to overcome their voters’ complacency now that Donald J. Trump is gone from office. (Gabriel, 9/19)

Axios: Manchin Wants To Pause Voting On $3.5T Spending Bill Until 2022
Sen. Joe Manchin (D-W.Va.) is privately saying he thinks Congress should take a “strategic pause” until 2022 before voting on President Biden’s $3.5 trillion social-spending package, people familiar with the matter tell Axios. Why it matters: Manchin’s new timeline — if he insists on it — would disrupt the plans by House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Chuck Schumer (D-N.Y.) to vote on the budget reconciliation package this month. (9/19)

Politico: Clyburn, Yarmuth Say Congress Might Miss Sept. 27 Infrastructure Deadline
Reps. Jim Clyburn and John Yarmuth both said Sunday that there is a chance Congress will not vote in time to meet the Sept. 27 deadline for the bipartisan infrastructure bill. House Speaker Nancy Pelosi set a date of Sept. 27 for the infrastructure bill the Senate passed in August, which some progressives in the party only agreed to support if the $3.5 trillion budget reconciliation bill was voted on as well. Appearing on CNN’s “State of the Union,” Clyburn (D-S.C.) , the House majority whip, said that the passage of the infrastructure bill may not be doable in the time frame since the reconciliation package won’t be done by that time. (Crummy, 9/19)

Politico: Sinema Tells White House She’s Opposed To Current Prescription Drug Plan 
The White House has a new headache as it struggles to get its multitrillion-dollar party-line spending bill passed: Sen. Kyrsten Sinema's objections to drug pricing reforms that are already struggling to make it through the House. The Arizona Democrat is opposed to the current prescription drug pricing proposals in both the House and Senate bills, two sources familiar with her thinking said. They added that, at this point, she also doesn’t support a pared-back alternative being pitched by House Democratic centrists that would limit the drugs subject to Medicare negotiation. (Barron-Lopez, 9/19)

CBS News: Sanders Says Democrats Are "Going To Come Together" On Reconciliation Bill
Senator Bernie Sanders of Vermont, the chairman of the Senate Budget Committee, predicted Sunday that Democrats will "come together" to pass the $3.5 trillion social spending package under consideration in Congress, even as two key Senate Democrats remain steadfast in their opposition to the plan's cost. "I expect, because of the pressure of the American people, we're going to come together again and do what has to be done," Sanders, an independent who votes with the Democrats, said in an interview on "Face the Nation." Democratic-led House committees completed work last week in crafting their respective portions of the massive $3.5 trillion package, which includes President Biden's plans for universal pre-K, expanding Medicare, child and elder care, and the environment. (Quinn, 9/19)

AP: Democrats Push To Retool Health Care Programs For Millions
Dental work for seniors on Medicare. An end to sky’s-the-limit pricing on prescription drugs. New options for long-term care at home. Coverage for low-income people locked out of Medicaid by ideological battles. Those are just some of the changes to health care that Democrats want to achieve with President Joe Biden’s massive “Build Back Better” plan. The $3.5 trillion domestic agenda bill touches almost all aspects of American life, from taxes to climate change, but the health care components are a cornerstone for Democrats, amplified during the COVID-19 crisis. (Alonso-Zaldivar and Mascaro, 9/19)

Stat: Senate Broadens Its Plans To Penalize Pharma For Hiking Drug Prices
A key Senate panel is expanding its plans to punish drug makers that hike prices faster than inflation, according to an internal Senate document described to STAT. The policy, which is being considered as part of Democrats’ efforts to include drug pricing reforms in a sweeping government spending package, has the potential to change the way drug makers set launch prices for drugs, and how they choose to adjust prices over time. (Cohrs, 9/20)

Modern Healthcare: Large Insurers Prepare To Profit From Democratic Proposal To Expand Medicaid
Private insurers are set to win big if House Democrats' plan to close the Medicaid expansion coverage gap passes Congress. The proposal, which passed a key committee this week, would create a new federal Medicaid look-alike program in non-expansion states, with its administration to be outsourced to managed care organizations and other third parties by the Health and Human Services Department through a bidding process. Managed-care organizations, which deliver Medicaid benefits on the behalf of states, already cover 54 million people, nearly 70% of Medicaid beneficiaries, according to the Kaiser Family Foundation. (Hellmann and Tepper, 9/17)

The Wall Street Journal: Immigration Measure Can’t Be Included In $3.5 Trillion Package, Senate Parliamentarian Says 
The arbiter of Senate procedural rules said Sunday that Democrats’ plan to provide a pathway to citizenship for millions of immigrants living in the country illegally couldn’t be included in a wide-ranging $3.5 trillion proposal expanding the safety net and responding to climate change. The decision from the office of Senate parliamentarian Elizabeth MacDonough said that the plan to legalize a group including young immigrants, farmworkers, essential workers and those living in the U.S. on humanitarian grounds didn’t comply with the chamber’s rules. (Hackman and Hughes, 9/19)

AP: Haitians On Texas Border Undeterred By US Plan To Expel Them
Haitian migrants seeking to escape poverty, hunger and a feeling of hopelessness in their home country said they will not be deterred by U.S. plans to speedily send them back, as thousands of people remained encamped on the Texas border Saturday after crossing from Mexico. Scores of people waded back and forth across the Rio Grande on Saturday afternoon, re-entering Mexico to purchase water, food and diapers in Ciudad Acuña before returning to the Texas encampment under and near a bridge in the border city of Del Rio. (Lozano, Gay and Spagat, 9/19)

Politico: Battle Over Biden’s Massive Child-Care Bill Takes New Turn With Virus 
Working women, whose child care duties vastly expanded during the pandemic, are bracing for a new hit to their incomes and careers as the resurgent coronavirus jeopardizes plans to keep kids in school full time. After 18 months of shutdowns, online learning and canceled summer camps, the return to classrooms was supposed to be a turning point for women, whose participation in the labor force plunged to its lowest level in more than three decades during the pandemic. But as Covid-19 cases rose in the summer, more than 40,000 women dropped out of the labor force between July and August, even as Americans flocked back to work, government data shows. Men returned to the job over that period at more than three times that rate. (Cassella, 9/18)

The New York Times: Average Daily Deaths In The United States Surpass 2,000. 
The average U.S. daily death toll from Covid-19 over the last seven days surpassed 2,000 this weekend, the first time since March 1 that deaths have been so high, according to a New York Times database. Texas and Florida, two of the hardest-hit states in the country, account for more than 30 percent of those deaths: Florida, where 56 percent of the population is vaccinated, averages about 353 deaths a day, and Texas, where 50 percent of the population is vaccinated, averages about 286 deaths a day. In the United States as a whole, 54 percent of all people are vaccinated. (9/20)

The Boston Globe: Coronavirus Was The Top Cause Of Law Enforcement Deaths In The First Six Months Of 2021, Report Says
COVID-19 was the leading cause of law enforcement deaths in the first six months of 2021, higher than the next two top causes combined, according to a report by the National Law Enforcement Officers Memorial Fund. The report states that 71 officers died nationwide in the first six months of the year as a result of contracting the coronavirus while executing official duties. That marks a 7 percent decrease compared to 2020, when 76 officers died of COVID-related causes during the first half of the year and no vaccines were available. “However, this would still make COVID-19 related fatalities the single highest cause of law enforcement deaths occurring in the first six months of 2021,” the report released this summer states. (Sweeney, 9/20)

The New York Times: Memorial Along National Mall Honors Pandemic Victims 
Peering at a sea of white flags blanketing the National Mall, Dr. Laura A. Valleni recalled the scores of pregnant women who had contracted the coronavirus at her hospital in South Carolina. Babies have been born prematurely, mothers have died and a surge of children has overwhelmed the pediatric unit for the past two months, she said. “I’ve been grappling with when it became OK for even one person to die of preventable illness,” said Dr. Valleni, a neonatal physician at Prisma Health Children’s Hospital–Midlands in Columbia, S.C. “There’s such tremendous grief.” (Cameron, 9/17)

Stat: Winter Is Coming, Again: What To Expect From Covid-19 In The New Season
Winter is coming, again. A year ago, experts warned that the United States faced a grim winter if Americans didn’t mask up and social distance to slow transmission of the SARS-CoV-2 virus before “indoor weather” — aka winter — settled in for its long stay. We all know how well that warning was heeded. In January, cases topped 300,000 a day; Covid ended the lives of about 95,000 Americans before the month was out. Now indoor weather again looms in many parts of this country, and daily case counts are rising well into the six figures. (Branswell, 9/20)

CIDRAP: Key Nursing Home Staff Lag In COVID-19 Vaccination, Study Shows 
A study yesterday in JAMA Internal Medicine finds that substantially higher proportions of US nursing home residents are vaccinated against COVID-19 than health workers, with certified nursing assistants (CNAs), who perform the vast majority of direct resident care, lagging considerably. ... Sixty percent of staff and 81.4% of residents, on average, from more than 14,900 nursing homes were fully vaccinated. Mean vaccination rates were lowest among CNAs (49.2%) and registered and licensed practical nurses (61.0%), while therapists, physicians, and independent practitioners had 70.9% and 77.3% coverage, respectively. (Van Beusekom, 9/17)

Politico: Mississippi’s Governor Criticizes Biden’s Vaccine Mandate While Suggesting People Get Vaccinated 
Mississippi Gov. Tate Reeves argued against the White House’s vaccine mandate, calling the "unilateral action" an attack on the people of his state and threatening to sign onto a Republican-led lawsuit against it, despite the state having the country’s highest death rate per capita. In a contentious interview on CNN’s “State of the Union,” Reeves on Sunday criticized President Joe Biden’s push for more vaccinations by requiring employers with over 100 employees to require their workers to be vaccinated. (Crummy, 9/19)

AP: Many Faith Leaders Say No To Endorsing Vaccine Exemptions
As significant numbers of Americans seek religious exemptions from COVID-19 vaccine mandates, many faith leaders are saying: Not with our endorsement. Leaders of the Greek Orthodox Archdiocese of America said Thursday that while some people may have medical reasons for not receiving the vaccine, “there is no exemption in the Orthodox Church for Her faithful from any vaccination for religious reasons.” The Holy Eparchial Synod of the nationwide archdiocese, representing the largest share of Eastern Orthodox people in the United States, urged members to “pay heed to competent medical authorities, and to avoid the false narratives utterly unfounded in science.” (Smith, 9/17)

The Washington Post: Covid Hospital Bills Arrive For Patients As Insurers Restore Deductibles And Copays 
Jamie Azar left a rehab hospital in Tennessee this week with the help of a walker after spending the entire month of August in the ICU and on a ventilator. She had received a shot of the Johnson & Johnson vaccine in mid-July but tested positive for the coronavirus within 11 days and nearly died. Now Azar, who earns about $36,000 a year as the director of a preschool at a Baptist church in Georgia, is facing thousands of dollars in medical expenses that she can’t afford. (Rowland, 9/18)

Modern Healthcare: FEMA Agrees To Cover COVID-19 Expenses For NYC Public Hospitals
New York City's public hospital system will receive additional government support for the expenses it accrued during the early months of the COVID-19 pandemic. Following pressure from New York lawmakers and health system officials, the Federal Emergency Management Agency agreed to cover almost all of the hospitals' excess costs from that period of the pandemic, Senate Majority Leader Chuck Schumer (D-N.Y.) and Rep. Ritchie Torres (D-N.Y.) said during a news conference Wednesday. In October 2020, NYC Health + Hospitals submitted a reimbursement request to FEMA, asking for about $900 million to offset expenses related to hiring extra staff and expanding bed capacity to treat hospitalized COVID-19 patients. (Devereaux, 9/17)

Fox News: Horse Tranquilizer Crops Up In Overdose Deaths Around US
A horse tranquilizer drug often found mixed with opioids is increasingly involved in overdose deaths in some U.S. states. The drug, called xylazine, is a sedative used in veterinary medicine, and it is not approved for use in humans. Recently, the tranquilizer began popping up in the U.S. illegal drug supply, frequently in combination with heroin or fentanyl (both types of opioids), a mixture sometimes referred to as "tranq dope," Live Science previously reported. (Rettner, 9/18)

The New York Times: They Shunned Covid Vaccines But Embraced Antibody Treatment 
Vaccine-resistant Americans are turning to the treatment with a zeal that has, at times, mystified their doctors, chasing down lengthy infusions after rejecting vaccines that cost one-hundredth as much. Orders have exploded so quickly this summer — to 168,000 doses per week in late August, up from 27,000 in July — that the Biden administration warned states this week of a dwindling national supply. (Mueller, 9/18)

CNN: Covid-19 Cases Forcing Hospitals To Ration Care Is Unfair And Unacceptable, Expert Says 
With the spread of the Delta variant and lagging vaccination rates, Covid-19 cases have strained many hospitals across the US -- which one expert called unfair and unacceptable. Montana's health care system is under that strain, including St. Peter's Health in Helena, which is operating under crisis standards of care. "We are at the point where not every patient in need will get the care we might wish we could give. It is not business as usual at your local health care system," Dr. Shelly Harkins, chief medical officer of St. Peter's Health, said. (Holcombe, 9/20)

CNN: After 169 Hospitals, A Dad Finally Got The Covid-19 Care He Needed -- And Changed Dozens Of Skeptics' Minds 
Every breath Robby Walker takes is one that almost didn't happen. Just a few weeks ago, the Florida father of six was on a ventilator with Covid-19 pneumonia in both lungs. Like most Americans hospitalized with Covid-19, Walker was not vaccinated. "He is in dire need of an ECMO treatment, which is not available at the hospital that he is in," his wife Susan Walker told CNN in August. ECMO treatment uses an external machine that can function as the body's heart and lungs. It can be used for organ transplant patients, victims of severe heart attacks and seriously ill Covid-19 patients -- including young adults. (Yan, 9/19)

Philadelphia Inquirer: Philly's School Nurses Are Exhausted As Shortages And COVID-19 Double Their Workload
As the only medical professional in a building with nearly 900 students, Girls’ High school nurse Anne Smith is busy every day in a regular year. With a pandemic raging, Smith is now drowning, she said. Smith left work at 8 p.m. on Tuesday. She had been at school more than 12 hours, seen 21 students, tested 10 for COVID-19. There were jobs left to do when she walked out the door, but she was too exhausted to continue. And the veteran nurse — who has 21 years as a school nurse, and nearly 40 in the profession — sees a crisis in the Philadelphia School District. “They don’t have the manpower to handle the pandemic,” Smith said. “One nurse in each school can’t do it.” (Graham, 9/20)

CIDRAP: Long COVID Linked To Age, Comorbidities, Women
Long COVID-19 was more likely to occur in those 40 and older, women, and those with at least one underlying health condition, according to an MMWR study today. The researchers looked at a random selection of 366 adults in Long Beach, California, who had COVID-19 from Apr 1 to Dec 10, 2020. Two months later, 35.0% said they still experienced an average of 1.30 symptoms. Then at a median of 202 days after the initial diagnosis, 31.4% still had symptoms, with the most common being fatigue (13.7% of total cohort), shortness of breath (10.4%), and a distorted sense of smell (9.6%). (9/17)

The Hill: White House Debates Vaccines For Air Travel
The Biden administration is facing an internal debate over whether to impose vaccine mandates for air travel, with President Biden’s chief medical adviser, Anthony Fauci, saying he would support a mandate but the White House claiming a new policy isn’t forthcoming. The potential of a mandate for domestic air travel would be fiercely opposed by Republicans and the travel industry and could add to the pushback Biden has received over his mandate on COVID-19 vaccines and testing for companies with at least 100 employees. (Gangitano, 9/19)

The Washington Post: Pre-Flight Testing Can Reduce The Number Of Covid-Infected Passengers, Study Shows
A study of Italy-bound Delta Air Lines passengers found that a mandatory PCR coronavirus test taken within three days of flying weeded out the vast majority of covid-infected travelers. The study examined data from the airline’s program that allowed travelers to avoid quarantine in Italy if they provided proof of a negative molecular test within 72 hours and got a rapid test at the airport in Atlanta or New York before departing. Passengers had to undergo another rapid test after landing in Italy. (Sampson, 9/17)

USA Today: 'Hog Wild': Insurers, Consumers Decry Coronavirus Test Costs As Labs Charge Up To $14,750
When Congress passed emergency legislation last year to get people quick and free access to COVID tests amid a nationwide shortage, lawmakers mandated key stipulations. Health insurance companies had to cover the test with no financial obligation to consumers and pay the list price for labs outside the insurers' networks. But some insurers and cost-conscious consumers are fighting what they consider high-priced tests from labs that charge 10 times or more than Medicare’s rate of $51 per test. The insurers allege in lawsuits that some labs are profiteering in the midst of a pandemic, but labs contend insurers are withholding payments for legitimate services desperately needed to protect patients and help public health track the virus. (Alltucker, 9/20)

CBS News: Chris Rock Says He Contracted Breakthrough Case Of COVID-19 
Chris Rock has contracted a breakthrough case of COVID-19. The 56-year-old comedian took to Twitter on Sunday to share the news. "Hey guys I just found out I have COVID, trust me you don't want this. Get vaccinated," he wrote. Back in May, Rock revealed on "The Tonight Show Starring Jimmy Fallon" that he had been vaccinated. (McRady, 9/20)

Modern Healthcare: Kaiser Permanente's Labor Woes Worsen As Union Authorizes Strike Vote
The labor union representing 24,000 Kaiser Permanente employees is pausing participation in its labor-management partnership with the integrated health system and is prepared to ask its members to vote on a strike, union leaders said Friday. The United Nurses Associations of California/Union of Health Care Professionals, which includes registered nurses, pharmacists, rehab therapists, midwives and optometrists, also said the landmark labor-management partnership created in 1997 is "on life support." (Christ, 9/17)

AP: Use Of OxyContin Profits To Fight Opioids Formally Approved
A judge formally approved a plan Friday to turn OxyContin maker Purdue Pharma into a new company no longer owned by members of the Sackler family and with its profits going to fight the opioid epidemic. U.S. Bankruptcy Judge Robert Drain officially confirmed the reorganization Friday, more than two weeks after he announced he would do so pending two largely technical changes to the plan presented by the company and hashed out with lawyers representing those with claims against the company. (Mulvihill, 9/17)

Bloomberg: CDC To Spend $2.1 Billion On Push To Curb Hospital Infections
U.S. health authorities plan to spend $2.1 billion to improve infection prevention and control across American health care, by far the largest single such outlay in the country’s history. The Centers for Disease Control and Prevention plans to distribute the funds over the next several years to health departments and medical providers, including hospitals and nursing homes. The money was authorized as part of the $1.9 trillion American Rescue Plan President Joe Biden signed in March. Money will begin flowing as soon as October to help bolster staff at nursing homes stretched by Covid-19 cases and labor shortages, the CDC said. (Tozzi, 9/17)

Stat: Former Mylan IT Exec Pleads Guilty To Insider Trading
A former Mylan information technology executive pleaded guilty to an insider trading scheme in which he acted on tips from another executive ahead of public announcements about earnings, drug approvals, and a pending merger with a Pfizer (PFE) division. In court documents, the U.S. Securities and Exchange Commission alleged that Dayakar Mallu, 51, was tipped by an unnamed senior manager at Mylan and acted on the information four separate times between September 2017 and July 2019. In exchange for the inside information, the former Mylan executive shared a portion of the profits with the manager through cash transactions in India. (Silverman, 9/19)

USA Today: Chantix Recall: Pfizer Recalls Smoking Cessation Drug For Cancer Risk
Pfizer is voluntarily recalling all lots of its popular anti-smoking drug Chantix for high levels of nitrosamine, which can increase the risk of cancer. According to the notice posted on the Food and Drug Administration website, the recall is for all lots of 0.5 mg and 1 mg varenicline tablets. The recall notice says that long-term ingestion can lead to a "potential increased cancer risk in humans, but there is no immediate risk to patients taking this medication." (Tyko, 9/17)

Stat: New Colon Cancer Study Suggests Mirati Has The Best KRAS-Blocking Drug
A drug from Mirati Therapeutics designed to block the cancer protein called KRAS shrank tumors in 22% of patients with advanced colon cancer, according to results from a clinical trial presented Sunday. When the Mirati drug, a pill called adagrasib, was combined with another targeted medicine, the colon cancer response increased to 43%. The adagrasib study results are the strongest reported to date for a new class of cancer drugs that work by blocking the effects of a specific type of KRAS alteration called G12C. The Mirati drug is potentially superior to a competing drug from Amgen that won U.S. approval in May to treat patients with KRAS-targeted lung cancer. (Feuerstein, 9/19)

CIDRAP: Highly Resistant Bacteria From Pet Store Puppies Continue To Cause Illness
A new study led by researchers with the Centers for Disease Control and Prevention (CDC) indicates that strains of extensively drug-resistant (XDR) bacteria linked to pet store puppies have been circulating for a decade and continue to cause illness. The study, published this week in JAMA Network Open, identified 168 patients who had XDR Campylobacter jejuni infections with epidemiologic or molecular links to pet store puppies from 2011 to 2020. Analysis of bacterial isolates from the patients found resistance to seven classes of antibiotics, including antibiotics that are recommended for treatment of Campylobacter infections. (Dall, 9/17)

Fox News: Study Suggests Microbiome Could Be Key To Losing Weight
Results from a new study indicate that a person's ability to shed pounds could have to do with what's in their guts – specifically, their microbiome.Microbiome are microorganisms that help us break down food, and each has an army of these tiny assistants. Researchers from the Institute for Systems Biology in Seattle decided to take a look at what role microbiome might play when it comes to weight loss. The scientists tracked the baseline microbiome of 105 people who were trying to lose weight and found that despite the entire group implementing healthier diet changes, roughly half of them did not lose weight. In looking at the participants' baseline gut microbiome, the researchers discovered that the people whose bodies were resistant to weight loss had microbiome with lower bacterial growth rates than their now-thinner counterparts. (Dumas, 9/18)

CNN: Uncontrollable Vomiting Due To Marijuana Use On Rise, Study Finds 
An unusual illness is on the rise in the United States, especially in states that have legalized marijuana. Habitual users of cannabis, including teenagers, are showing up in emergency rooms complaining of severe intestinal distress. "They are writhing, holding their stomach, complaining of really bad abdominal pain and nausea," said Dr. Sam Wang, a pediatric emergency medicine specialist and toxicologist at Children's Hospital Colorado, who treats adolescents with the condition. (LaMotte, 9/17)

CIDRAP: Pneumonic Plague Case Identified In Wyoming
One pneumonic plague case in Fremont County, Wyoming, was reported to the Wyoming Department of Health (WDH) Sep 15, according to a WDH notice. This marks the seventh human case in Wyoming since 1978, with the most recent being an imported case in 2008.The patient was in contact with sick pet cats and is reported to have serious illness. (9/17)

CNN: Vaccine Gap Stokes Super Spreader Fears Ahead Of UN's First Post-Covid Meeting 
US fears that this week's annual world leader jamboree at the United Nations could spark a super spreader event will highlight the stark inequality of global access to Covid-19 vaccines — even as developed nations begin offering booster shots. Scores of presidents, prime ministers and foreign ministers are set to ignore an American suggestion to stay home and address the UN General Assembly virtually and will converge on New York City in person this week. (Collinson, 9/20)

The Washington Post: American Samoa, One Of The Last Places Without Coronavirus, Has First Infection 
American Samoa reported its first coronavirus case, 18 months into the pandemic, after a traveler tested positive after flying to the U.S. territory from Hawaii. The positive case was discovered during a quarantine period required upon arrival in American Samoa. The traveler was fully vaccinated, according to a news release published Friday by American Samoa’s Department of Homeland Security, and the positive result was confirmed by the Health Department Thursday. Officials say the individual tested negative before traveling. The traveler was asymptomatic when tested, according to the news release, and will continue to be monitored. (Firozi and Shammas, 9/19)

NPR: Afghan Health Care Is 'On The Verge Of Collapse' Says Health Minister : Goats And Soda
Dr. Wahid Majrooh is acting minister of public health in Afghanistan, and he faces two looming challenges: leading the country's COVID response and maintaining health-care services in the wake of the Taliban takeover in mid-August. The COVID situation is daunting: over 150,000 cases and 7,000 deaths so far. The overall health-care picture is critical as well. To prevent the Taliban from gaining access to aid money, the World Bank and other international aid organizations suspended $600 million in funding, including support for the Sehatmandi project, which paid salaries for 20,000 health-care workers at 2,800 facilities across the country. Because of the suspension in funds, more than 2,000 of these facilities are shutting down, leaving the Afghan people bereft of care, both because of the inability to pay staff and the general lack of funding for health-care resources. (Thiagarajan, 9/18)

AP: UK Court Rules Under-16s Can Get Puberty Blocking Drugs
Britain’s Court of Appeal ruled Friday that doctors can prescribe puberty-blocking drugs to children under 16, overturning a lower court’s decision that a judge’s approval should be needed. Appeals judges said the High Court was wrong to rule last year that children considering gender reassignment are unlikely to be able to give informed consent to medical treatment involving drugs that delay puberty. The December 2020 ruling said because of the experimental nature of the drugs, clinics should seek court authorization before starting such treatment. (9/19)

Reuters: Cambodia Bat Researchers On Mission To Track Origin Of COVID-19 
Researchers are collecting samples from bats in northern Cambodia in a bid to understand the coronavirus pandemic, returning to a region where a very similar virus was found in the animals a decade ago. Two samples from horseshoe bats were collected in 2010 in Stung Treng province near Laos and kept in freezers at the Institut Pasteur du Cambodge (IPC) in Phnom Penh. (Liu and Thul, 9/20)

Bloomberg: Bats In Laos Caves Harbor Closest Relatives To Covid-19 Virus
Bats dwelling in limestone caves in northern Laos were found to carry coronaviruses that share a key feature with SARS-CoV-2, moving scientists closer to pinpointing the cause of Covid-19. Researchers at France’s Pasteur Institute and the University of Laos looked for viruses similar to the one that causes Covid among hundreds of horseshoe bats. They found three with closely matched receptor binding domains -- the part of the coronavirus’s spike protein used to bind to human ACE-2, the enzyme it targets to cause an infection. (Gale, 9/18)

Fox News: Lancet Article Calls For ‘Objective, Open And Transparent’ Debate Over COVID-19 Origins 
The Lancet medical journal has published an article calling for an "objective" and "transparent" debate about the true origins of the SARS-CoV-2 virus, more than a year and a half after its controversial article condemning "conspiracy theories" that suggest the virus leaked from a laboratory in China. The article published Friday, titled, "An appeal for an objective, open and transparent scientific debate about the origin of SARS-CoV-2," is signed by 16 scientists arguing that a laboratory-related accident is "plausible," as is the virus having a natural origin, and that neither theory should be ruled out yet. (Chasmar, 9/19)