First Edition: Sept. 6, 2022

KHN: In The Rush To Curtail Abortion, States Adopt A Jumbled Stew Of Definitions For Human Life
As life-preserving medical technology advanced in the second half of the 20th century, doctors and families were faced with a thorny decision, one with weighty legal and moral implications: How should we define when life ends? Cardiopulmonary bypass machines could keep the blood pumping and ventilators could maintain breathing long after a patient’s natural ability to perform those vital functions had ceased. After decades of deliberations involving physicians, bioethicists, attorneys, and theologians, a U.S. presidential commission in 1981 settled on a scientifically derived dividing line between life and death that has endured, more or less, ever since: A person was considered dead when the entire brain — including the brainstem, its most primitive portion — was no longer functioning, even if other vital functions could be maintained indefinitely through artificial life support. (Varney, 9/6)

KHN: ‘He Stood His Ground’: California State Senator Will Leave Office As Champion Of Tough Vaccine Laws
A California lawmaker who rose to national prominence by muscling through some of the country’s strongest vaccination laws is leaving the state legislature later this year after a momentous tenure that made him a top target of the boisterous and burgeoning movement against vaccination mandates. State Sen. Richard Pan, a bespectacled and unassuming pediatrician who continued treating low-income children during his 12 years in the state Senate and Assembly, has been physically assaulted and verbally attacked for working to tighten childhood vaccine requirements — even as Time magazine hailed him as a “hero.” Threats against him intensified in 2019, becoming so violent that he needed a restraining order and personal security detail. (Hart, 9/6)

KHN: Meet Mary Wakefield, The Nurse Administrator Tasked With Revamping The CDC 
It’s been a rough couple of years for the Centers for Disease Control and Prevention. Facing a barrage of criticism for repeatedly mishandling its response to the covid-19 pandemic and more recently monkeypox, the agency has acknowledged it failed and needs to change. CDC Director Dr. Rochelle Walensky has tapped Mary Wakefield — an Obama administration veteran and nurse — to helm a major revamp of the sprawling agency and its multibillion-dollar budget. Making the changes will require winning over wary career CDC scientists, combative members of Congress, and a general public that in many cases has stopped looking to the agency for guidance. (Whitehead, 9/6)

KHN: Watch: The Mysterious Death Of A Congressman’s Wife 
KHN senior correspondent Samantha Young appeared on CBS News to discuss her exclusive coverage of the death of Lori McClintock, the wife of Northern California congressman Tom McClintock. When Lori McClintock died in December 2021, what caused her death wasn’t clear. The original death certificate, dated Dec. 20, 2021, listed the cause of death as “pending.” (9/6)

The Wall Street Journal: CVS Announces Deal To Acquire Home-Healthcare Company Signify 
CVS Health Corp. is betting $8 billion that the house call is the future of healthcare. The drugstore giant’s deal to acquire home-healthcare company Signify Health Inc., announced Monday, will add 10,000 contracted doctors and clinicians and give CVS a hand in coordinating medical care for millions of Americans. CVS, the nation’s biggest healthcare company by revenue, said that it agreed to acquire Signify for $30.50 per share in an all-cash deal, confirming earlier Wall Street Journal reports. (Terlep, 9/5)

The New York Times: CVS Makes $8 Billion Bet On The Return Of The House Call 
In Signify, CVS is acquiring a company that offers analytics and technology to help a network of 10,000 doctors provide in-home health care to 2.5 million patients across the United States. Signify has a focus on those on Medicare and in underserved communities. “Their interest is to take over the home,” said Dr. Eric Topol, a professor of molecular medicine at Scripps Research in San Diego, who noted that any care provided to patients at home, rather than in the hospital, lightens the financial load on insurance companies, including Aetna, the insurance business that CVS owns. Signify contracts with insurance providers, including Aetna. (Hirsch, 9/5)

Modern Healthcare: CVS Health To Acquire Signify Health For $8 Billion
CVS Health’s Aetna, Humana and UnitedHealth Group’s UnitedHealthcare are the three largest Medicare Advantage carriers and Signify Health’s three largest customers. UnitedHealth Group Optum’s healthcare services arm operates the second-largest home health risk adjustment provider HouseCalls, which will conduct 2 million home visits in 2022, Cowen analyst Gary Taylor wrote in an August research note. Humana last year bought the remaining shares of Kindred at Home, purchasing the nation’s largest home health provider to $8.1 billion.  (Tepper and Perna, 9/5)

The Washington Post: Amazon Care Is Dead, But The Tech Giant’s Health-Care Ambitions Live On 
Late last month, staffers at Amazon Care — the company’s in-person and virtual primary care service — were called into a meeting and given bad news: Amazon was shutting it down. Some employees were let go immediately. Others walked out. Everyone was promised paychecks through the end of December. The news caught Amazon employees by surprise — including those who used the service as patients. The company’s human resources staff had been promoting Amazon Care as a health benefit the same week it shut down, an Amazon employee told The Washington Post. (O'Donovan, 9/4)

Stat: What Happens To Patients When Telehealth Businesses Shutter? 
Buzzy, venture-backed startups and big tech companies that have promised to disrupt health care are indeed doing so — including by shuttering services that early adopter patients may have come to rely on. (Ravindranath, 9/6)

NPR: The VA Says It Will Provide Abortions In Some Cases Even In States Where It's Banned
Now, the VA says it's stepping in to offer abortions in order to protect the health and lives of veterans in places where they can no longer access such reproductive care. Under a new interim final rule, pregnant veterans and VA beneficiaries will be able to get abortions if their life or health would be in danger if the pregnancy went to term. Patients whose pregnancies were the result of rape or incest will also be eligible for abortions. (Hernandez, 9/3)

The Texas Tribune: VA Will Provide Abortions Even In States Like Texas That Ban It
The Department of Veterans Affairs said Friday it will provide abortions for veterans and their beneficiaries as medically necessary or in cases of rape or incest. The VA said it plans to provide abortions across the entire nation — including states, such as Texas, that prohibit the procedure. (Erickson, 9/2)

The Washington Post: Abortion Has Upended The Midterms As Sprint To November Begins
Cat Thomas used to call herself politically independent. But she registered as a Democrat the moment she turned 18 this summer, fearful that Republicans in Pennsylvania would ban abortion. Hope Pierotti, 20, hurried to re-register in her new swing-state home days after Roe v. Wade was overturned, similarly anxious about abortion rights. The procedure is legal in Pennsylvania, but Republicans could pass sweeping new restrictions if they win the governor’s race and keep control of the statehouse. (Knowles and Kitchener, 9/5)

AP: Lawyer's Mission: Translate Tenn.'s Bewildering Abortion Ban
Chloe Akers considers herself a grizzled criminal defense attorney. Until a few months ago, she didn’t spend much time thinking about abortion — for all her 39 years, abortion was not a crime, so she’d never imagined having to defend someone accused of performing one. That changed in June, when the Supreme Court overturned Roe v. Wade. Akers sat down in her law office and pulled up Tennessee’s new criminal abortion statute. She didn’t read it through a political lens; it doesn’t matter whether she likes a law — there are a lot of them she doesn’t like. Instead, she read it like she would any other statute: What does it make illegal? How would it be enforced? She was shocked. She read it maybe 10 times more. Surely, she was missing something. (Galofaro, 9/5)

NPR: Birth Control Access Can Be Limited In Places With Catholic Health Systems
Last week, students returning to campus at Oberlin College in Ohio got a shock: A local news outlet reported that the campus' student health services would severely limit who could get contraception prescriptions. They would only be given to treat health problems — not for the purpose of preventing pregnancy — and emergency contraception would only be available to victims of sexual assault. It turned out the college had outsourced its student health services to a Catholic health agency – and like other Catholic health institutions, it follows religious directives that prohibit contraception to prevent pregnancy. They also prohibit gender-affirming care. (Godoy, 9/4)

The Texas Tribune: Plan B Isn’t Widely Available For The State’s Poorest People
On Friday, Gov. Greg Abbott told The Dallas Morning News that rape victims can take emergency contraception, like Plan B, to prevent a pregnancy. With abortion now banned in Texas, even in instances of incest or rape, the governor recommended the use of emergency contraception to ensure a victim of rape does not become pregnant. (Melhado, 9/3)

The Boston Globe: New Study Examines Program That Could Prevent Half The Cases Of Postpartum Depression In The US
A team of researchers from Providence-based Care New England Health System, Henry Ford Health, and Michigan State University is collaborating on a $6.2 million mental health research study from the National Institutes of Health (NIH), looking into the “ROSE” program. (Gagosz, 9/5)

Fox News: US Reports At Least 30 Kids Test Positive For Monkeypox
Data from the Texas Department of State Health Services shows that there are nine pediatric cases in the state. The Florida Department of Health shows three cases in kids under the age of 4, including one in Brevard County, another in Martin and one in Monroe. (Musto, 9/1)

Bloomberg: Kids With Liver Damage, Polio, Monkeypox, Tomato Flu: Viruses Are Behaving Badly
“Viruses have been doing strange things since the Covid pandemic started,” Sarah Pitt, a principal lecturer in the University of Brighton’s school of applied sciences, wrote in a recent article about a freaky tomato-shaped rash in India. Turns out, it wasn’t an exotic new pathogen, but Coxsackie A16, a common cause of hand, foot and mouth disease. (Gale, 9/5)

NBC News: Monkeypox Cases Are Falling, But Experts Warn That The Outbreak Is Not Over
The number of new monkeypox cases in the United States has fallen by 40% since early August — a signal that the country's outbreak could be abating. According to an NBC News analysis of data from the Centers for Disease Control and Prevention, the seven-day average of new reported cases decreased from a daily average of 465 on Aug. 10, to 281 on Aug. 31. (Edwards, Murphy and Kopf, 9/1)

Becker's Hospital Review: Monkeypox May Cause Heart Muscle Inflammation, Case Report Finds
A patient with a monkeypox infection in Portugal developed myocarditis, or heart muscle inflammation, a week after the onset of monkeypox symptoms, researchers said in a case report published Sept. 2. (Carbajal, 9/2)

NPR: Omicron COVID Boosters: Do I Need One, And If So, When? 
After talking to several infectious disease experts, we found there's a whole range of opinions on who needs to boost and when. So, if you are navigating this decision, here are some things to consider. (9/5)

Forbes: New Bivalent Covid-19 Boosters: When Should You Get These BA.4, BA.5 Updated Vaccines
Going forward, bivalent versions of the Pfizer/BioNTech and Moderna Covid-19 mRNA boosters are what’s going to be available, replacing the original univalent ones. ... In the word univalent, “uni” refers to “one,” as it does in unitard or unibrow, and “valence” refers to the immune system stimulating items in the vaccine. So a univalent vaccine is designed to stimulate your immune system to protect against a single antigen or single microbe. The original univalent Covid-19 mRNA vaccines included one type of mRNA to serve a blueprints for your cells to produce the spike protein that studded the surface of the original version of the SARS-CoV-2. While this univalent vaccine still offers some protection against the currently circulating Covid-19 coronaviruses, its protection is limited since the viruses spike proteins have changed quite significantly. (Lee, 9/5)

The Wall Street Journal: How Pfizer And BioNTech Modified Covid-19 Vaccines For Fall Boosters
Before new versions of the Omicron strain took hold in the U.S., Pfizer Inc. and BioNTech SE had begun tinkering with their widely used Covid-19 vaccine. In May, researchers tracking how coronavirus strains behave saw the potential for Omicron subvariants to predominate. Just in case, the companies started building blueprints of shots reformulated to target BA.4, BA.5 and other substrains, and laid the groundwork for testing them. (Hopkins, 9/5)

Stat: Pfizer Isn’t Sharing Covid Vaccines With Researchers For Next-Gen Studies
Researchers studying next-generation vaccines to fight an evolving Covid-19 threat are running into problems getting existing vaccines to use in their research. (Cohrs, 9/6)

Euronews: China Approves The World's First Inhaled COVID Vaccine For Emergency Use As A Booster 
The world's first inhaled COVID-19 vaccine has been approved in China. The Chinese company CanSino Biologics Inc said on Sunday its inhaled version of a coronavirus vaccine had been approved by the country's drug regulator for emergency use as a booster. (Huet, 9/5)

USA Today: CDC Report: 44% Of People Hospitalized With COVID Got Third Dose, Booster
Nearly half of Americans hospitalized in the spring for COVID-19 were fully vaccinated and got a third dose or booster, according to a report by the CDC. (Rodriguez, 9/2)

CIDRAP: Study: Previous COVID-19 Infection Offers Protection Against BA.5
Infections with previous COVID-19 variants offer more protection against the Omicron BA.5 subvariant in vaccinated people compared with vaccinated people who had no previous  infections, according to a New England Journal of Medicine study yesterday. (9/1)

The Washington Post: Pandemic Trauma Caused Many To Lose Their Sense Of Time 
Did you lose track of time during the early days of the pandemic? If so, you’re not alone. A new study says a majority of Americans experienced time distortions at the beginning of the pandemic, which are common during traumatic times. (Blakemore, 9/5)

Chicago Tribune: University Of Chicago Offers Class On Medical Misinformation
Patients have long been told to turn to their doctors for accurate, trusted health information. But in recent years, especially during the COVID-19 pandemic, doctors’ voices have sometimes been drowned out by social media users who blast misinformation across the globe, leading patients to make questionable, and sometimes dangerous, choices about their health. (Schencker, 9/6)

St. Louis Post-Dispatch: How Therapists Cope With Stress And Deal With Their Own Mental Health
When Dr. Jessi Gold would log off from seeing her patients during the pandemic, she would go straight to bed. “I didn’t know I was burned out until my therapist told me,” she said. “And I’m a burnout expert.” (Sultan, 9/4)

Milwaukee Journal Sentinel: UW Health Nurses Seeking Union Recognition Give 10-Day Strike Notice
UW Health nurses notified hospital officials Friday of their intention to strike, a legally required 10-day notice. Barring a discussion between nurses and hospital officials in which an agreement is reached to recognize the nursing union, SEIU Healthcare Wisconsin, the strike will be held Sept. 13-16. (VanEgeren, 9/1)

Anchorage Daily News: Alaska’s Hospitals Are Relying On Lower 48 Nurses To Fill Empty Positions. It’s A Costly Strategy
Experts say the state’s reliance on travel nurses comes at a cost. The practice is expensive and could both demoralize and lure away permanent full-time workers who traditionally make up the core of hospital care here. (Berman, 9/4)

Stat: Doctors, Seniors Groups Flag Concerns With Medicare Advantage
Doctors, patients, and seniors groups are airing new grievances about Medicare Advantage, arguing the growing government program is failing seniors and making life miserable for doctors and other providers. (Herman, 9/6)

AP: Medicaid Extensions For New Moms Grow, May Run Into Limits 
States around the country are making it easier for new moms to keep Medicaid in the year after childbirth, a time when depression and other health problems can develop. But tight government budgets and the program’s low reimbursement may ultimately limit this push or make it hard for women with extended coverage to find doctors. “A lot of things have changed since the pandemic,” said Venessa Aiken, a new mom in Orlando, Florida. “A lot of places no longer take Medicaid or if they do, you have to wait like two months before you can be seen.” (Murph, 9/5)

NPR: An E. Coli Outbreak Possibly Linked To Wendy's Expands To New York And Kentucky
An E. coli outbreak that was first detected largely in the Midwest is growing, the Centers for Disease Control and Prevention says. There are now reported illnesses in New York and Kentucky in addition to those previously recorded in Indiana, Michigan, Ohio and Pennsylvania. (Hernandez, 9/4)

AP: E. Coli Bacteria Found In Baltimore Drinking Water Samples 
Baltimore officials are encouraging residents to boil water used for drinking or cooking after E. coli bacteria was detected in some samples of the water supply in parts of West Baltimore. The city Department of Public Works issued a series of tweets Monday informing residents that the bacteria, which is often spread during contact with feces, had been found in portions of the city’s ninth council district, which includes the Sandtown-Winchester and Harlem Park neighborhoods. (9/5)

Bloomberg: Arsenic Found In NYC Public Housing Water
Residents of a New York City public housing complex should avoid drinking or cooking with water from their taps after initial samples revealed unsafe levels of arsenic, Mayor Eric Adams’ office said. (Cavaliere, 9/3)

Politico: City Of Jackson ‘Will Be In An Emergency Even After Water Is Restored,’ Mayor Says 
Workers on the front lines of the water crisis in Jackson, Miss., are “optimistic,” but “we are still in an emergency” that won’t end soon, Mayor Chokwe Antar Lumumba said Sunday on ABC’s “This Week.” ... A growing majority of residents had water pressure as of Sunday, but were still under a boil-water notice, the mayor said, saying workers are “optimistic about the progress that has been taking place.” While drinkable water approved by the health department is “days, not weeks, away,” the mayor said, “an equitable water treatment facility is a much longer road ahead.” (Olander, 9/4)

CIDRAP: Online Retailer A Source Of Turtles In Salmonella Outbreak, CDC Says
In an update yesterday on a Salmonella Stanley outbreak tied to small turtles, the Centers for Disease Control and Prevention (CDC) said investigators have identified an online retailer as a source of the illnesses. Five patients reported buying turtles from myturtlestore.com before they got sick. (9/1)

WMFE: AdventHealth Develops A Quick Diagnostic Test For Brain-Eating Amoebas
Researchers at AdventHealth Central Florida have developed a test that can detect brain-eating amoebas in a patient’s body in about five hours. (Prieur, 9/2)

The Guardian: Doomscrolling Linked To Poor Physical And Mental Health, Study Finds 
There’s no shortage of bad news in the media to “doomscroll”, from a global pandemic to the war in Ukraine and an impending climate crisis, but new research suggests the compulsive urge to surf the web can lead to poor mental and physical health outcomes. (Cassidy, 9/5)

North Carolina Health News: Counterfeit Pills More Common In Street Drug Supply 
These days, if you buy a pill off the streets, it’s most likely a counterfeit. Even if a pill says “Xanax” on it — unless acquired directly from a pharmacy — it’s likely something else. (Knopf, 9/6)

Bloomberg: Drug Recalls For Nitrosamines Could Cost Big Pharma Millions
When a drug is recalled because there’s something in it that shouldn’t be, it’s scary but often traceable: Foreign objects such as shards of metal or microorganisms might infiltrate medications through dirty factories or lax manufacturing practices. But recently a more insidious—and difficult to eradicate—form of contamination has surfaced among makers of some of the world’s best-selling pharmaceuticals. They’re called nitrosamines. (Edney, 9/1)

C-HIT.ORG: Yale-Led Study Aims To Transform Heart Disease Diagnosis In Women
Standard medical testing for heart disease is based on research on men, whose chest pains are primarily attributed to blockages in major arteries, according to Dr. Samit Shah, an interventional cardiologist at Yale New Haven Hospital. But women often have heart disease that isn’t caused by such blockages, and their symptoms may not even include chest pains, said Shah, who ultimately diagnosed Lombardi. Shah is trying to transform the diagnosis of women’s heart disease by doing testing that goes beyond the usual practice of looking for blockages. He is about to embark on research with nine other hospitals in the country that will aim to standardize the expanded testing. (McCarthy, 9/5)