The Wall Street Journal: Officials Adopt New Message On Covid-19 Behaviors: It’s Your Call 
In the latest phase of the Covid-19 pandemic, federal and local officials are telling people to decide for themselves how best to protect against the virus. Health officials are leaving it up to people to assess if they need booster shots, whether to wear a mask and how long to isolate after a positive test. Businesses, schools and other entities are scaling back specific guidelines as they prepare for a return to normal. (Hopkins, 4/17)

NBC News: Fear, Uncertainty And Apathy: Covid Infections Rise, But Hospitalizations Remain Low
People may want reassurances about the virus and what's coming next, but they are hard to find in the data. Instead, the numbers point to a murky picture of Covid, particularly looking at case counts and hospital occupancy. At this point, hospitalizations are probably the most solid measure of where the country is on Covid, and they are still low nationally. Hospitalizations are up very slightly from the previous week but still nearly at the lowest they have been in 21 months and nowhere near previous spikes. (Chinni, 4/17)

Fortune: The COVID Wave America Doesn’t Care About: ‘Everybody Is Sick Of COVID’
The U.S. is in a stealth wave of stealth Omicron—probably. It can’t be known for certain because the country doesn't have the data it should have. That’s not for lack of technology or supply, but for lack of willpower. Americans largely don’t want to get tested for COVID right now. But it sure seems like another COVID wave, and Americans want to ignore it. On Thursday the U.S. had a seven-day average of nearly 42,000 cases, according to the Johns Hopkins University and Medicine Coronavirus Resource Center dashboard, based on U.S. Department of Health and Human Services data—up 6,000 cases from a week ago and 14,000 cases from two weeks ago. (Prater, 4/16)

The Washington Post: A Tale Of Many Pandemics: In Year Three, A Matter Of Status And Access 
At this precarious moment in the pandemic — with cases comparatively low but poised to rise again — the reality is that people are experiencing many different pandemics depending on their job, health, socioeconomic status, housing and access to medical care. ... For millions of Americans, the pandemic remains a ubiquitous threat to their lives and livelihoods. They are immunocompromised or otherwise at higher risk of severe illness, unable to take paid time off or to work from home, and they struggle to make ends meet. (Abutaleb, 4/16)

The New York Times: Is Covid More Dangerous Than Driving? How Scientists Are Parsing Covid Risks
Scientists are thinking anew about how to discuss Covid risks. Some have studied when people could unmask indoors if the goal was not only to keep hospitals from being overrun but also to protect immunocompromised people. Others are working on tools to compare infection risks to the dangers of a wide range of activities, finding, for instance, that an average unvaccinated person 65 and older is roughly as likely to die from an Omicron infection as someone is to die from using heroin for a year-and-a-half. (Mueller, 4/17)

Also —

CNN: Is Herd Immunity For Covid-19 Still Possible? 
This time last year, the brand new, stunningly effective Covid-19 vaccines were rolling out across the country, injecting a strong note of optimism into the United States' once fumbling pandemic response. Millions of people were lining up daily to get their shots. Instead of the steady drumbeat of cases, hospitalizations and deaths, we were tracking a new number: the percentage of Americans who had been vaccinated. This number, we believed, was our best chance to beat the virus. The US was caught up in a fever dream of reaching herd immunity, a threshold we might cross where vulnerable individuals -- including those too young to be vaccinated or those who didn't respond well to the vaccines -- might be protected anyway because, as a community, we would weave an invisible safety net around them. (Goodman, 4/15)

Houston Chronicle: Harris Health Has No COVID Patients, A Pandemic Milestone
For local Harris County healthcare workers, Good Friday marked a milestone. The Harris Health System discharged its only COVID-19 patient from the Lyndon B. Johnson Hospital Friday afternoon, according to a tweet from the system's president and CEO Dr. Esmaeil Porsa. That gave the hospital zero COVID-19 patients for the first time since the start of the pandemic in March 2020, the health service stated. (Umanzor, 4/16)

In other news about the spread of covid —

AP: Hawaii Laboratory Detects Case Of Omicron Subvariant XE 
A COVID-19 omicron variant hybrid called XE has been detected in Hawaii, the Hawaii state Department of Health said. The department’s laboratories division confirmed one case of XE in its latest variant report, the Honolulu Star-Advertiser reported Friday. The hybrid contains genetic material from both BA.1 and BA.2 variants. The department found it in a sample collected last month. (4/15)

Fox News: East Coast COVID-19 Cases On The Rise
As sub-variants of omicron continue to spread in the U.S. and abroad, infections are rising in East Coast states and cities. There were 54,543 new cases in the US. in the past day, according to the Johns Hopkins Coronavirus Resource Center. There were also 778 new deaths. 12,736 of those infections were in New York, Virginia reported nearly 1,100, 775 were in Maryland and the COVID-19 level in the District of Columbia was raised to "Medium" at the beginning of the month. (Musto, 4/15)

Las Vegas Review-Journal: COVID Reinfections A Growing Number Of Cases In Nevada
Reinfections account for about 9 percent of new COVID-19 cases reported in Nevada, according to state data, a growing number blamed in part on easily transmissible variants. This is triple the overall rate of 3 percent of cases since the beginning of the pandemic, according to data from the Nevada Department of Health and Human Services. “Since January, reinfections are a greater proportion of total infections,” said Dr. Marc Kahn, dean of the Kirk Kerkorian School of Medicine at UNLV. “And most of that is because of the infectivity of both omicron and the BA.2 variant.” (Hynes, 4/15)

Bangor Daily News: Community Transmission Of COVID Is High Throughout Most Of Maine
The community transmission levels of COVID-19 have significantly increased throughout the state since last month, data released on Thursday by the U.S. Centers for Disease Control and Prevention show. This comes as wastewater data collected from several Maine cities show an increased presence of the virus, rivaling other major U.S. cities, according to Maine Center for Disease Control and Prevention data. Community transmission levels are high in Somerset, Aroostook, Penobscot, Washington, Waldo, Knox, Kennebec, Oxford, Cumberland, York and Sagadahoc counties, according to U.S. CDC data. (Stockley, 4/15)

AP: Republican Ohio Gov Mike DeWine Tests Positive For COVID-19 
Ohio Gov. Mike DeWine has tested positive for COVID-19. The 75-year-old Republican said in an announcement late Friday he was diagnosed by his personal physician after experiencing mild symptoms such as a runny nose, head ache, body aches and a sore throat. DeWine was administered a monoclonal antibody treatment, which is designed to fight the infection. He said he is following the U.S. Centers for Disease Control and Prevention protocol and quarantining. (Smyth, 4/15)

NBC News: She Was Hospitalized For Covid Months Ago. Her Only Ticket Out Is A New Pair Of Lungs
While most Americans are shedding their masks and returning to their pre-pandemic lives, Marie Jackson remains in a Chicago hospital room. She has been there for more than 250 days. There is no indication yet when Jackson, 53, will be able to go home. She's waiting on a new pair of lungs; hers were irreversibly scarred when she was sickened by Covid-19 last July. (Edwards, 4/16)

On covid research —

Bloomberg: Long Covid May Be Result Of Coronavirus Persisting In Feces
Covid-19 patients can harbor the coronavirus in their feces for months after infection, researchers found, stoking concern that its persistence can aggravate the immune system and cause long Covid symptoms. In the largest study tracking SARS-CoV-2 RNA in feces and Covid symptoms, scientists at California’s Stanford University found that about half of infected patients shed traces of the virus in their waste in the week after infection and almost 4% patients still emit them seven months later. The researchers also linked coronavirus RNA in feces to gastric upsets, and concluded that SARS-CoV-2 likely directly infects the gastrointestinal tract, where it may hide out. (Gale, 4/15)

Fortune: Are Pets Spreading COVID? It's Less Likely With Omicron, Study Finds
Only 10% of household pets whose owners had Omicron came down with the virus and none were symptomatic, making them unlikely candidates to mutate and spread a more dangerous version of COVID, according to a new study released this week by Spanish researchers. ... Other studies have found that other COVID variants like Alpha and Delta were more easily transmitted to household pets, that infected pets were more likely to show symptoms, and that higher viral loads were detected in the pets, according to the study. (Prater, 4/16)

CIDRAP: Psychiatric Disorders May Up Risk For COVID-19 Reinfection 
A history of certain psychiatric disorders may predispose fully vaccinated COVID-19 survivors to reinfection, according to a study of 263,697 US veterans published yesterday in JAMA Network Open. Researchers from the San Francisco Veterans Affairs (VA) Health Care System and the University of California retrospectively analyzed the administrative and electronic health records of US veterans who completed their COVID-19 vaccine primary series at least 14 days earlier from Feb 20, 2020, to Nov 16, 2021. Patients had received the Pfizer/BioNTech, Moderna, or Johnson & Johnson vaccine. (Van Beusekom, 4/15)

CIDRAP: Upper Airway Infections In Kids With COVID-19 Rose With Omicron Surge
Rates of upper airway infections (UAIs) such as croup and bacterial tracheitis among pediatric COVID-19 patients, though low, rose after the Omicron variant became dominant in December 2021, with more than one fifth of hospitalized children with both conditions developing severe illness, estimates a study today in JAMA Pediatrics. (4/15)

The New York Times: Americans Over 60 Should Get Second Booster, Official Says 
Americans over 60 should get a second booster shot of a coronavirus vaccine, Dr. Ashish K. Jha, the new White House Covid-19 response coordinator, said on Sunday, citing “pretty compelling” new data from Israel indicating that a fourth shot significantly reduced infections and deaths among older people there. Dr. Jha’s comments, on “Fox News Sunday,” came after the Food and Drug Administration on March 29 authorized second booster shots of the Pfizer-BioNTech and Moderna coronavirus vaccines for everyone 50 and older. (Lamb, 4/17)

San Francisco Chronicle: When Are COVID Experts Getting Their Second Booster Shots? Here’s What 6 From The Bay Area Said
The experts we interviewed almost unanimously encourage those 65 and older, as well as those of any age who are immunocompromised, to get an additional booster as soon as they’re eligible. Some also say that people between 50 and 65 who are generally healthy should consider doing so if they live or work around a lot of people, like in nursing homes or hospitals. For those who don’t fall into one of those categories, but are eligible now — for instance, over 50 and in good health or with a mild underlying condition — the optimal timing is less clear. It depends on each person’s age, health, environment and behavior, and appetite for risk. (Ho, 4/16)

Pioneer Press: COVID-19 Booster Shots Urged As Breakthrough Cases Dominate Minnesota Outbreak 
Minnesota health officials are reminding everyone who’s eligible to get a booster dose of the COVID-19 vaccine as the number of breakthrough cases continues to climb. State data shows in late February and early March, the last four weeks of statistics available, the majority of new infections, hospitalizations and deaths from COVID-19 were Minnesotans who had completed their initial series of vaccines. The state does not track whether residents with breakthrough infections had a booster shot. (Magan, 4/15)

More on the vaccine rollout —

The Hill: Coons Says Millions Of Vaccine Doses Will Expire Without COVID-19 Funding
Sen. Chris Coons (D-Del.) on Sunday said millions of vaccine doses will expire if Congress does not pass additional COVID-19 funding. “We are going to lose millions of doses of vaccine that will expire,” Coons told moderator Margaret Brennan on CBS’s “Face the Nation” when asked if vaccines will go bad should Congress not approve more funds. ... Congress, however, is currently on recess. (Schnell, 4/17)

KHN: Attendance Plummets At LA Covid Vaccination Events 
Nurse Angel Ho-king sways her head to the sound of salsa music as she waits for people willing to roll up their sleeves to get a shot. Ho-king is part of a four-person crew staffing a covid-19 vaccine table at a health fair in Rampart Village, a predominantly immigrant neighborhood about 10 minutes from Dodger Stadium. In three hours on a recent Saturday, Ho-king and Brenda Rodriguez, a medical assistant, vaccinated 16 people — far fewer than they had anticipated. Nearly everyone who showed up at the fair, organized by Saban Community Clinic, was an adult seeking a booster shot or a young child getting a first dose (children ages 5 to 11 became eligible for a vaccine late last year). (de Marco, 4/18)

USA Today: COVID Vaccines: Americans Must Reset Their Expectations, Experts Say
Denny Mitchell couldn’t believe he tested positive for the coronavirus in January. The 45-year-old from Houston never left the house without his mask, he avoided indoor dining at all costs, and most important, he was fully vaccinated. But he still got sick. “I was surprised because I was taking so many precautions,” he said. It’s no longer unusual to hear of someone getting COVID-19 even though they’re fully vaccinated and boosted. Yet, many Americans are still shocked when it happens to them. (Rodriguez, 4/17)

Stat: Kizzmekia Corbett On The Pandemic And Her Path To Becoming A Scientist
The world knows Kizzmekia Corbett as one of the designers of the Moderna Covid-19 vaccines. And in her new job as an assistant professor at Harvard’s T.H. Chan School of Public Health, Corbett plans to work on vaccine design to help the world better handle future pandemics. But the 36-year-old from Hillsborough, N.C., is also a passionate promoter of social justice and diversity in science, someone who hopes one day to advise presidents and who feels a deep commitment to public service. She’s frank, openly admitting on Twitter to being “completely in my feels” earlier this month when she was the answer of a Jeopardy question — a show she grew up watching with her grandmother. (Branswell, 4/18)

AP: Suit Seeks To Overturn Renewed Philadelphia Mask Mandate
Several businesses and residents have filed suit in state court in Pennsylvania seeking to overturn Philadelphia’s renewed indoor mask mandate scheduled to be enforced beginning Monday in an effort to halt a surge in COVID-19 infections. The lawsuit, filed in Commonwealth Court on Saturday, said Philadelphia lacks the authority to impose such a mandate. (4/16)

NJ.com: When Mask Mandates End, Advocate Asks NJ Transit To Have A Face-Covering-Only Car
A commuter advocate and passenger asked NJ Transit officials to consider designating one car on each train where face coverings or masks would be required to be worn, to accommodate passengers with immunodeficiency diseases or other health issues that might make them susceptible to COVID-19. (4/17)

The New York Times: Most Broadway Theaters Will Drop Vaccine Checks, But Not Mask Mandate 
Most Broadway theaters have decided to stop checking the vaccination status of ticket holders after April 30, but all will continue to require that audience members wear masks inside theaters through at least May 31. The Broadway League, a trade association, announced the change on Friday. The decision was made by the owners and operators of Broadway’s 41 theaters, who had initially decided to require vaccines and masks last summer, before the city imposed its own mandates. The theater owners — six commercial and four nonprofit entities — have been periodically reconsidering the protocols ever since. (Paulson, 4/15)

Vox: It’s Time To Rethink Mask Mandates 
The pandemic is different than it used to be — but we’re still fighting about masks. Vaccines that keep most Covid-19 cases from leading to hospitalization are now widely available, and many of those at highest risk have access to treatments to prevent severe illness. Nevertheless, public attention and policy are still focused on mask mandates, like the one Philadelphia reinstated on April 11. (Landman, 4/15)

In related news about nursing homes —

AP: Vaccine Mandate Prompts Officials To Eye Nursing Home Sale 
Local officials are citing the COVID-19 vaccine mandate for healthcare workers among reasons for selling a county-owned nursing home in southwestern Virginia. The Bedford County Board of Supervisors is scheduled to hold a special meeting to consider selling the nursing home. The nursing home was established as the County Poor Farm in 1831. (4/16)

USA Today: COVID-19 Staffing Crunch Forces Nursing Homes Across US To Shut Down
A 99-bed nursing home in one of Cleveland's poorest neighborhoods will close its doors in less than two months. Like many nursing homes in urban and rural pockets of America, Eliza Bryant Village has struggled to maintain operations during the COVID-19 pandemic. Costs are too high and reimbursement isn't enough. The home loses more than $100 each day for every resident covered by Medicaid, which represents about 95% of the home's population. (Alltucker, 4/18)

The Boston Globe: Survey Finds Widespread Grief Among Children From COVID-19 Losses
Nearly 60 percent of Massachusetts parents and caregivers who responded to a recent online survey said their family had lost at least one person to COVID-19, another sign that the pandemic’s effects promise to be far-reaching and long-lasting. “We have an epidemic of grief among children and their families,” said Lisa Lambert, executive director of the Parent/Professional Advocacy League, a Massachusetts organization focused on the mental health of children and families, which conducted the survey in February. Lambert said she was surprised by the high number who reported losses. (Freyer, 4/17)

Stateline: As Teen Mental Health Worsens, Schools Learn How To Help
Teen mental health already was deteriorating before the coronavirus pandemic. In the two years since, the isolation, grief and anxiety created by school closures, deaths and loss of family income have led to even steeper declines in children’s mental health, experts say. Awash in federal pandemic relief money—roughly $190 billion in education and health grants over the next four years—states are responding. Last year, 38 states enacted nearly 100 laws providing additional resources to support mental wellbeing in K-12 schools, according to the National Academy for State Health Policy, a Portland, Maine-based policy research group. Dozens of additional school mental health bills became law this year in at least 22 states, according to the group. (Vestal, 4/18)

In other mental health news —

AP: 'Magic Mushrooms' For Therapy? Vets Help Sway Conservatives
Matthew Butler spent 27 years in the Army, but it took a day in jail to convince him his post-traumatic stress disorder was out of control. The recently retired Green Beret had already tried antidepressants, therapy and a support dog. But his arrest for punching a hole in his father’s wall after his family tried to stage an intervention in Utah made it clear none of it was working. (Whitehurst, 4/16)

And more public health news —

AP: FDA Investigating Lucky Charms After Reports Of Illness
The U.S. Food and Drug Administration is investigating Lucky Charms cereal after dozens of customers complained of illness after eating it. The FDA said Saturday it has received more than 100 complaints related to Lucky Charms so far this year. “The FDA takes seriously any reports of possible adulteration of a food that may also cause illnesses or injury,” the agency said in a statement. Several hundred people have also posted on a food safety website, iwaspoisoned.com, complaining of nausea, diarrhea and vomiting after eating Lucky Charms. (Durbin, 4/16)

Fox News: Staying Hydrated May Lower Risk Of Heart Failure, Study Says
Drinking water to maintain a healthy sodium level in the bloodstream may reduce the risk of heart failure, a chronic condition where the heart has difficulty pumping blood to match the body’s needs, according to a recent paper published in the European Heart Journal. Over 6.2 million Americans suffer from heart failure, which is more than 2% of the United States population and is more common in those ages 65 and older, according to a recent press release on the study. A team from the National Heart, Lung, and Blood Institute analyzed data from the Atherosclerosis Risk in Communities study, which has been following approximately 16,000 adults over thirty years to better understand atherosclerosis and heart disease. (Sudhakar, 4/16)

USA Today: Are Long Nails Health Hazards? Experts Weigh In On Bacteria, Fungi
Long nails are a major trend these days, seen on the hands of superstars like Cardi B and Billie Eilish. But a biologist warns this new trend may come with health hazards when considering what may be growing underneath. Jeffrey Kaplan, a biology professor at American University, told USA TODAY that the area under the fingernail in the crevice is where most of the bacteria live. "The longer the nail, the more surface area there is for microorganisms to adhere," he said. "Studies have found 32 different bacteria and 28 different fungi underneath fingernails." (Gilbert, 4/16)

The Wall Street Journal: Peloton To Cut Price Of Bikes, Raise Subscription Fees
Peloton Interactive will cut prices of its stationary bikes and treadmills and raise monthly subscriptions for online workout classes. The changes are part of an effort by Peloton’s new chief executive to create a company more focused on its digital business and less reliant on sales of connected exercise equipment. (Terlep, 4/14)

KHN: Journalist Puts In A Plug For Better Sleep Cycles During The Pandemic
KHN assistant social media manager Krishna Sharma discussed how work flexibility can help overcome some sleep problems on Newsy on April 14. ... KHN correspondent Aneri Pattani discussed a surge in the street supply of fentanyl, a powerful synthetic opioid painkiller, during the pandemic on SiriusXM’s “Doctor Radio Reports” on April 8. (4/16)

AP: E-Cigs Using Synthetic Nicotine Come Under FDA Oversight
U.S. regulators will soon begin cracking down on vaping companies using a now-closed loophole, including a line of fruit-flavored e-cigarettes that have become teenagers’ top choice. Under a law taking effect [April 14], the Food and Drug Administration can regulate e-cigarettes and similar products that use synthetic nicotine. The action targets Puff Bar and several other vaping companies that recently switched their formulas to laboratory-made nicotine to skirt FDA oversight. (Perrone, 4/14)

Axios: FDA Increasing Oversight Of Synthetic Nicotine Products
While the measure doesn’t outlaw synthetic nicotine products automatically, companies are now required to register with the FDA and submit their products for review within 30 days. The new law also subjects synthetic nicotine products to the same age limit and sales restrictions as natural tobacco products. (Robinson, 4/16)

Fox News: Promising Cancer Vaccine In The Works Utilizing Similar MRNA Technology That Combats COVID: Duke Researchers
COVID-19 vaccine technology doesn’t just fight viruses – it can combat cancer. Duke researchers find potential in a cancer vaccine based on the same messenger RNA, or mRNA, technology used by COVID-19 vaccines to combat a type of breast cancer that over expresses a protein called HER2, according to a recent Fox 8 report. "It is a product which is RNA nucleic acid which encodes a specific protein and then that can be encapsulated in something we like to call a lipid nanoparticle, which is really a little fat bubble, and that can be injected into your body and sort of teaches your body what to go after immunologically," said Dr. Zachary Hartman, assistant professor in the departments of surgery, pathology, and immunology at Duke University School of Medicine. (Sudhakar, 4/16)

The Baltimore Sun: Drug Treatment: There’s An App For That Too, And University Of Maryland Medical Center Midtown Has Been Testing It With Positive Results 
Addiction treatment providers scrambled at the start of the coronavirus pandemic to find ways to keep people engaged after they shut their physical doors. For most, that meant telehealth, or audio or video calls. But with fatal overdoses spiking in Maryland and nationally, leaders of the Center for Addiction Medicine at the University of Maryland Medical Center Midtown Campus turned to an extra measure that is turning into a bright spot in their efforts. It’s a mobile app they began testing about a year ago specifically for those with opioid use disorders. Called reSET-O, it’s for those being treated for opioid use. Another called reSET is for those being treated for use of alcohol and other substances. They were the first prescription apps approved by the U.S. Food and Drug Administration for substance use disorders, in 2018 and 2017, respectively. (Cohn, 4/18)

And STAT examines the FDA's Breakthrough Devices Program —

Stat: Patients, Providers Left With Questions As FDA Names Breakthrough Devices
Since launching in 2017, an ambitious and secretive Food and Drug Administration program to speed up medical device development has helped at least 44 authorized devices hit the market. There are now more than 650 devices that have earned “breakthrough designation,” a signal that the agency believes — based on early data and the options currently available to patients — that a product could one day be “more effective” at treating or catching serious or even fatal conditions. STAT has identified details on more than two-thirds of those products in an authoritative new database, the Breakthrough Device Tracker. (Palmer and Aguilar, 4/18)

Stat: FDA Breakthrough Device Program Delivers Biggest Gains To Companies
Five years ago, the Food and Drug Administration launched a new program with the best of intentions: to speed the development and review of cutting-edge and potentially lifesaving medical devices, all in the name of getting them to patients faster. The initiative, known as the Breakthrough Devices Program, was set up to identify devices that the agency believed could provide “more effective” treatment or diagnosis for deadly and debilitating conditions than the current standard of care. And it came with perks: Among them, manufacturers of devices that receive the designation — more than 650 products so far — are given the opportunity to talk more often with regulators and design flexible clinical trials, potentially easing the path to market. But a STAT investigation has found that while the program has delivered big benefits to companies making devices, its value to patients is still far from clear. (Palmer and Aguilar, 4/18)

Modern Healthcare: Bright Health To Exit Six States Following Year Of Losses
Bright Health Group will no longer offer individual and family plans in Illinois, New Mexico, Oklahoma, South Carolina, Utah or Virginia after 2022, a move to stabilize its finances following a rough year. The insurtech earlier this year outlined plans to curtail its growth and exit expensive markets as a result of the pandemic driving up medical costs for members gained through the special enrollment period. "Delivering on our commitment to provide a truly aligned model of care requires that we continually evaluate market changes and evolve to make the greatest impact both today and for the long term," Bright Health said in a statement. "Nothing will change for members or providers in 2022 and we will work to ensure all impacted members are transitioned to new plans during the next open enrollment cycle." (Devereaux, 4/15)

In other health care industry developments —

Bay Area News Group: Sutter Health Nurses, Staff Plan To Strike Monday At Some Bay Area Facilities
More than 8,000 Sutter Health nurses and health care workers are planning a one-day strike Monday at more than a dozen Northern California healthcare facilities for better health and safety standards amid the COVID-19 pandemic they say has led to “moral distress” among workers. After 10 months of contract negotiations, the workers are urging management to invest in “pandemic readiness protections” including adequate stockpiles of personal protective equipment, increased nursing staff and an equal voice on health and safety committees. (Jimenez, 4/16)

Atlanta Journal-Constitution: VA Proposes Massive Changes To Health-Care System In Georgia
The Department of Veterans Affairs has proposed replacing problem-ridden and crumbling clinics and hospitals across the Southeast, including the four major hospitals in Georgia. The multi-billion dollar demolition and rebuilding proposal would transform how veterans health care is delivered in Georgia, Alabama and South Carolina. The plan is subject to revision by federal lawmakers and budget writers and will take decades to complete, but it would mark a sea change for a federal agency criticized for years for substandard and delayed care for the nation’s veterans. (Quinn, 4/18)

Modern Healthcare: Federal Physician Malpractice Database May Not Work As Intended
Hospitals appear to be skirting federal requirements to report clinician malpractice or hospital privilege revocations to a national database designed to keep patients safe. Congress created the National Practitioner Data Bank in 1986 to prevent clinicians from moving to a new state or employer without disclosing previous damaging performance. Health systems are required to report to the Health and Resources Services Administration-operated database when they revoke a physician's hospital privileges or conduct investigations into physician performance that last over 30 days. Other entities must report medical malpractice payments, or licensure suspensions from medical boards. (Gillespie, 4/15)

The Colorado Sun: Colorado Pushes Again For Hospitals To Lower Their Prices
Colorado’s top health officials think the prices charged by large hospital systems in the state are too high. This is not exactly news; Kim Bimestefer, the executive director of the state’s Medicaid department, has been making this argument for years. But a new report and new comments made by Bimestefer during a virtual policy summit in recent weeks show the state is preparing to relaunch its fight against hospital prices, after the battle largely fell silent during the COVID pandemic. “We still have got a lot of work to do,” Bimestefer said. (Ingold, 4/15)

Modern Healthcare: Former CMS Administrator Resigns From Centene Board Over Governance, Leadership Dispute
Leslie Norwalk resigned this week from Centene Corp.'s board of directors over a disagreement about the governance process and committee leadership. Her resignation letter was made public by Centene Friday in a filing with the U.S. Securities and Exchange Commission. Norwalk, former administrator of the Centers for Medicaid and Medicare Services, was appointed to the insurer's board in January. She is strategic counsel to law firm Epstein Becker Green. (Tepper, 4/15)

KHN: Battle Lines Are Drawn Over California Deal With Kaiser Permanente 
California counties, health insurance plans, community clinics, and a major national health care labor union are lining up against a controversial deal to grant HMO giant Kaiser Permanente a no-bid statewide Medicaid contract as the bill heads for its first legislative hearing Tuesday. The deal, hammered out earlier this year in closed-door talks between Kaiser Permanente and Gov. Gavin Newsom’s office and first reported by KHN, would allow KP to operate Medi-Cal plans in at least 32 counties without having to bid for the contracts. Medi-Cal’s other eight commercial health plans must compete for their contracts. (Wolfson, 4/18)

Also —

C-HIT.org: Interpreter Shortage Challenges Appropriate Medical Care For Deaf Patients
Deaf residents report frequent issues with sign language interpretation at Connecticut hospitals and health care facilities, hindering their ability to understand medical care fully. And though video remote interpreting (VRI) services are widely available at Connecticut hospitals, patients have reported mixed experiences with the technology. The issues persist more than 30 years after passage of the Americans with Disabilities Act (ADA), which requires interpretation for patients and family members under the “effective communication” section of the law. In the last three years, the U.S. Attorney’s Office has negotiated four settlements with medical facilities in Connecticut for complaints related to communication with deaf patients. (Gil, 4/16)

CIDRAP: US Flu Activity And Hospitalizations Still On The Rise
Flu activity rose again last week, up in most regions, but at the highest levels in the central and south central parts of the country, the US Centers for Disease Control and Prevention (CDC) said today in its latest weekly update. Overall, the percentage of outpatient visits rose slightly again, from 1.9% to 2%, but is still below baseline. One state—New Mexico—reported high flu activity, another marker of clinic visits. Three reported moderate activity: Massachusetts, New York, and Oklahoma. (4/15)

WWMT: Michigan Has First Pediatric Flu-Related Death In Kalamazoo 
A child from Kalamazoo County died after contracting the flu, the Michigan Department of Health and Human Services announced April 15. This is the first influenza-associated pediatric death in Michigan for the 2021 to 2022 flu season, the Michigan Department of Health and Human Services confirmed. The child had Influenza A/H3, the strand confirmed in nearly all positive confirmed cases this flu season. ... There have been at least 16 flu-related pediatric deaths this flu season. (Reed, 4/17)

RochesterFirst.com: Flu Cases Up In Abnormal Spring Spike
After COVID-19 headlines, the flu is now spreading. Monroe County [New York] is reporting more than 1,500 influenza cases within the last few week, which far surpasses the flu numbers over the winter. Making the trend particularly unusual is the timing – the flu rarely appears in significant numbers in the spring. (Chodak, 4/15)

In other health news from across the U.S. —

KBIA: Missouri Struggles To Process Medicaid Applications 
Missourians who apply for Medicaid are now waiting nearly four months on average to get those applications processed. Since the state implemented Medicaid expansion in October — opening the door for most Missourians making less than 138% of the federal poverty level — wait times have ballooned. As of February, Missourians were waiting more than two and a half times the 45 days the federal government says states should take to determine if someone is eligible. (Valdivia, 4/18)

Montana Public Radio/Billings Gazette: Emergency Responders In Montana Making House Calls To Reduce 911 Calls
It's not an emergency, it's a house call. Madison Valley Medical Center first responder Corey Siders recently knocked on the front door of an Ennis home, just to check on 91-year-old Robert Kensinger. Kensinger sat with his walker near the kitchen table as Siders took readings for heart rate and blood pressure. "Sometimes in the morning, it starts to hurt; the whole leg. My left foot is swollen," Kesninger tells the medic. Some Montana emergency responders, like those in the Madison Valley, are trying something new. Instead of only responding to 911 calls, they are working with patients in their homes to prevent unnecessary medical emergencies. Community paramedicine services can range from home check-ins between doctor visits to follow-up care with discharged hospital patients. (Bolton, 4/17)

San Francisco Chronicle: Oakland’s First Big Experiment In Diverting 911 Calls To Mental Health Teams Has Launched. Will It Help People On The Streets?
Nearly three years after Oakland first contemplated creating a new program to replace police in handling some mental health, homelessness and disturbance calls, the teams fanned out for the first time across parts of the city this month. City leaders are optimistic that the launch of a new program that sends trained civilian staff to respond to emergency mental health crises will free up police to focus on violent crime, boost the number of 911 responses and de-escalate difficult situations. (Ravani, 4/16)

KHN: Washington State Retools First-In-The-Nation Long-Term Care Benefit 
Patricia Keys, 71 and a stroke survivor, needs help with many everyday activities, such as dressing and bathing. Her daughter Christina, who lives near her mom in Vancouver, Washington, cares for her in the evenings and pays about $3,000 a month for help from other caregivers. Christina Keys, 53, was thrilled three years ago when Washington state passed a first-in-the-nation law that created a long-term care benefit for residents who paid into a state fund. She hoped it would be a resource for others facing similar challenges. (Andrews, 4/18)

New Hampshire Public Radio: How A N.H. Mental Health Worker's Lived Experience Informs His Expertise At A Manchester Program 
Two small, state-funded mental health programs, one in Manchester and the other in Northwood, re-opened their doors a month ago, after both programs were closed due to staffing shortages. Step Up Step Down is a transitional program staffed 24/7 by people who use their lived experience of mental health challenges to support their clients. Short-term residents can “step up” into the program while managing mental health challenges, or “step down” from an intensive care setting like a psychiatric hospital. It’s a part of the state’s push to improve mental health care, and reduce the acuity of the crisis in emergency rooms across New Hampshire. The program in Manchester has found five new staff members for its team of nine, and the Northwood program is still hiring for several part-time positions. These locations are two of four in New Hampshire. (Fam, 4/18)

In abortion news —

NBC News: ‘Heartbeat Bills’: Is There A So-Called Fetal Heartbeat At Six Weeks Of Pregnancy?
As states become increasingly bold in restricting access to abortion, many have drawn the line at around six weeks of pregnancy — the point at which, the laws say, a so-called fetal heartbeat can be detected. But according to experts, the term “fetal heartbeat” is misleading and medically inaccurate. “While the heart does begin to develop at around six weeks, at this point the heart as we know it does not yet exist,” said Dr. Ian Fraser Golding, a pediatric and fetal cardiologist at Rady Children’s Hospital San Diego.  (Sullivan, 4/17)

Axios: The Red States That Have Passed Abortion Bans
The Supreme Court is likely to clear the way for new anti-abortion laws in just a few months — but red states aren't waiting. Conservative legislatures are passing a raft of controversial new laws, many of which push the envelope further than the courts have ever allowed. But with the court poised to significantly weaken Roe v. Wade, if not overturn it altogether, red states appear confident that these new measures will stand. As of April 14, 86 bills to restrict or outright ban the procedure have been introduced in 31 states this year alone, according to Guttmacher Institute data provided to Axios. Six bans have been enacted in 2022, with one being blocked by lower courts. (Gonzalez, 4/16)

San Francisco Chronicle: COVID Death Rates Globally Seen Dropping To 2-Year Low Point, But There’s A Caveat
As the world climbs its way out of two years of coronavirus pain, one measure offering hope is that the global rate of COVID deaths appears to be at a level not seen since the early pandemic days of March 2020, the COVID-19 data monitoring site Our World in Data indicates. Although based on available official death tallies that are widely seen as undercounts, the overall trendline nonetheless shows that the number of people losing their lives to COVID is heading in a positive direction — “something to celebrate,” in the words of Dr. Eric Topol, head of Scripps Research Translational Institute, who recently tweeted Our World in Data’s chart showing the steep drop-off in global deaths since February. (Hwang, 4/17)

AP: Rate Of New COVID Infections Across Africa Has "Tanked" To Lowest Level Since Early In Pandemic
The number of coronavirus cases and deaths in Africa have dropped to their lowest levels since the pandemic began, marking the longest decline yet seen in the disease, according to the World Health Organization. In a statement on Thursday, the U.N. health agency said COVID-19 infections due to the Omicron surge had "tanked" from a peak of more than 308,000 weekly cases to fewer than 20,000 last week. Cases and deaths fell by 29% and 37% respectively in the last week; deaths decreased to 239 from the previous week. (4/14)

Bloomberg: Almost All Indonesians Have Covid Antibody, March Survey Shows
Almost all Indonesians have developed antibodies against Covid-19, according to the latest government survey conducted in March. About 99.2% of the population in the survey had antibody against the virus, due to vaccination or past infections, Health Minister Budi Gunadi Sadikin said in his weekly briefing on Monday. That’s higher than almost 87% recorded in the previous survey in December. Antibody levels were also higher among respondents in the March survey, he added. (Permatasari, 4/18)

The New York Times: India Is Stalling The W.H.O.’s Efforts To Make Global Covid Death Toll Public 
An ambitious effort by the World Health Organization to calculate the global death toll from the coronavirus pandemic has found that vastly more people died than previously believed — a total of about 15 million by the end of 2021, more than double the official total of six million reported by countries individually. But the release of the staggering estimate — the result of more than a year of research and analysis by experts around the world and the most comprehensive look at the lethality of the pandemic to date — has been delayed for months because of objections from India, which disputes the calculation of how many of its citizens died and has tried to keep it from becoming public. (Nolen and Singh, 4/16)

In covid updates from China —

AP: Shanghai Reports First Deaths In Current COVID-19 Outbreak 
Shanghai authorities on Monday reported the first COVID-19 deaths in the latest outbreak in China’s most populous and wealthiest city.All three people who died were elderly, had underlying diseases such as diabetes and hypertension and had not been vaccinated against the coronavirus, city Health Commission inspector Wu Ganyu told journalists. (4/18)

The Wall Street Journal: Inside A Shanghai Mass Quarantine Center: No Showers, Lights On 24/7 
Jane Polubotko didn’t see darkness for almost three weeks. After testing positive for Covid-19, she was forced to live under 24/7 lighting in a Shanghai exhibition center along with thousands of strangers and the din of their chatter and mobile phones. The 30-year-old Ukraine national was released from the makeshift government quarantine facility Friday, after three negative tests in the past week. The experience, she said, made her feel like a “Covid criminal.” (Khan, 4/17)

Politico: Biden Covid Chief Dismisses Utility Of Lockdowns Like China's 
White House Covid czar Ashish Jha said Sunday that onerous lockdown policies like those being instituted in China are unlikely to work and should not be a model for places like the U.S. “We don’t think that this zero-Covid strategy that China is pursuing is one that is likely to work,” said Jha, whom Biden tapped last month to succeed Jeff Zients, on “Fox News Sunday.” “I think it’s very difficult at this point with a highly contagious variant to be able to curtail this through lockdowns.” (Niedzwiadek, 4/17)

In other developments from around the world —

CIDRAP: Study Finds More Than 1 In 5 European Potatoes Harbors C Difficile
European scientists report a 22.4% Clostridioides difficile contamination rate on potatoes sampled from 12 European countries, according to a report yesterday in Eurosurveillance. C difficile causes one of the most common healthcare-associated infections and is predominantly associated with hospital stays. It is considered an urgent antibiotic resistance threat. ... The researchers conclude that the findings "indicate potatoes can serve as a vector for introducing C. difficile spores in the household environment, where the bacterium can then multiply in sensitive hosts." (4/15)

CIDRAP: Acute Pediatric Hepatitis Cases Raise Flags In UK, US, Spain 
Clusters of acute hepatitis in kids—many resulting in liver failure—in Europe and the United States are triggering investigations from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), as the illnesses appear to be linked to infections with adenoviruses. Nine children in Alabama, 3 in Spain, and at least 74 in Scotland and Northern Ireland have been sickened with acute hepatitis since January. (Soucheray, 4/15)

The Washington Post: Headache Disorders Afflict 50 Percent Of People Worldwide 
Migraines, sinus headaches, tension pain. Sound familiar? Almost everyone has experienced a headache at some point in their life. New research quantifies how many people worldwide have headache disorders — and it’s a lot. When a group of researchers trawled through over 350 scientific publications on headaches, they found that 52 percent of people worldwide have experienced a headache disorder in the past year. (Blakemore, 4/17)

Los Angeles Times: We Weren’t Supposed To Get Anywhere Near 1 Million COVID Deaths In The U.S. Then We Did 
At the start of the pandemic, in late March 2020, President Trump held a White House briefing at which his top advisors presented their official COVID-19 death projections. In somber tones, they forecasted that between 100,000 and 240,000 Americans would die from the disease if we followed reasonable social-distancing and other mitigation guidelines. Two hundred and forty thousand! That was an inconceivable amount of death. Four times the number of Americans who died in Vietnam. Eighty times the number who died in the 9/11 attacks. (Nicholas Goldberg, 4/18)

The Washington Post: The Pandemic Statistics From China Are Too Good To Be True 
Judging by the numbers, China appears to be experiencing a far different pandemic than the rest of the world. In the latest surge in Shanghai, its largest city with a population of 25 million, China has reported more than 300,000 cases since early March and no deaths. By contrast, the world as a whole has experienced about 195 deaths for every 100,000 population as of last November. Can China’s statistics be believed? (4/16)

Bloomberg: China Coronavirus Outbreak: Xi Jinping's Covid Zero Is Failing 
W. Somerset Maugham’s 1925 novel “The Painted Veil” features a harrowing description of a cholera outbreak in a provincial Chinese city. “The great city lay in terror; and death, sudden and ruthless, hurried through its tortuous streets … The people were dying at the rate of a hundred a day, and hardly any of those who were attacked by the disease recovered from it; the gods had been brought out from the abandoned temples and placed in the streets; offerings were laid before them and sacrifices made, but they did not stay the plague.” (Niall Ferguson, 4/17)

Stat: Research Must Account For Sex Differences In Vaccine Responses 
Two days after getting my second dose of the Moderna mRNA vaccine as part of a clinical trial, my body was still mounting a robust immune response when, from the floor of my son’s bathroom, I frantically telephoned the clinical research site at the University of Illinois. The region of my brain that controls thermoregulation, the hypothalamus, likely detected the flood of vaccine-induced copies of viral proteins in my bloodstream and cranked up my internal thermostat to 104.7 degrees F, a fever high enough to make me feel delirious. The trial’s principal investigator called in a prescription for an anti-nausea medication and two bags of IV fluid, which a mobile service gave me at home to stabilize me. (Dawn Sinclair Shapiro, 4/18)

The Boston Globe: COVID Isn’t Making A Comeback — It Never Left 
As many people have largely moved on, a new concern has moved in. After a significant drop in COVID cases, BA.2, a subvariant of Omicron that is said to be even more highly transmissible than its predecessor, is causing an increase in new infections. In Boston, the proportion of COVID tests coming back positive surpassed 6 percent last week, beyond what Boston Public Health Commission officials deemed the “threshold of concern,” 5 percent. In early March, the city’s rate was 2.2 percent. (Renee Graham, 4/17)

Also —

Scientific American: New Cases Of Childhood Diabetes Rose During The Pandemic 
The little girl felt poorly, but both she and her mom thought they knew the reason. Aliyah Davis, just nine years old, was battling COVID. Fatigued, repeatedly sick to her stomach, with no sense of smell or taste and some shortness of breath, she seemed to have a near-textbook case of the virus. Aliyah had a history of asthma, so her mother, Christina Ortiz, took her to the emergency department, where she was told the symptoms were likely COVID-related. But two and a half weeks later, Aliyah became sick again during the middle of the night, and Christina noted that her daughter had been experiencing insatiable thirst and frequent urination ever since that first ED visit. This time, a urine dip tested positive for ketones. Further workup revealed the issue: Aliyah had new-onset diabetes. (Carolyn Barber, 4/15)

The CT Mirror: History Tells Us The Pandemic Mental Health Crisis Is Far From Over
In 1918, as the world collapsed under the weight of a different pandemic, a simultaneous mental health toll rose from underneath. While the influenza pandemic of that era infected 500 million people — taking  the lives of 50 million globally and 675,000 in the United States – many survivors suffered a “post-influenzal depression.” Historians noted how their lives became “unbearable, even after the infection had passed.” Today, we are seeing similar trends among COVID survivors. When pandemic flu took hold, a novel clinical entity called “encephalitis lethargica” also surged. Despite unclear evidence, doctors connected it to influenza. The syndrome’s constellation of vague neuropsychiatric symptoms sounds eerily similar to long COVID. (Sandhira Wijayaratne, 4/18)

Chicago Tribune: We Should Crack Down On Middlemen That Inflate Drug Costs
U.S. Sen. Raphael Warnock just introduced a bill that would cap Americans’ out-of-pocket spending on insulin at $35 a month. The legislation would be a godsend to patients battling diabetes. ... It’d be political malpractice for my fellow Democrats to not pass this much-needed bill — but it’d also be a huge mistake to stop there. Hundreds of common medicines — not just insulin — are unaffordable for ordinary Americans because middlemen in the drug supply chain inflate patients’ out-of-pocket costs. Shining sunlight on these middlemen’s practices would help all patients, not just those with diabetes. (Howard Dean, 4/18)

Newsweek: We Need An All-Of-The-Above Strategy To Fight The Opioid Crisis 
The U.S. remains mired in an opioid crisis, with dangerous synthetic opioids such as fentanyl dominating the illicit drug market and driving steep increases in overdose deaths. Last month, the Centers for Disease Control and Prevention reported that over 106,000 Americans died from drug overdoses in the last 12 months, another record number and a grim reminder that the decades-long opioid epidemic rages on. Today, fentanyl is the leading cause of death for Americans aged 18 to 45—more than car accidents, firearms and COVID-19. (Jim Crotty, 4/18)

The Baltimore Sun: Important Unsung Legislative Actions Matter To Your Health 
I served in the Maryland House of Delegates for 24 years, from 1995 to 2019. At the end of each General Assembly session, I’d send a letter to my constituents summarizing the bills that passed or failed. The media covered the high profile and controversial issues, so my report included a section of “Unsung Legislative Actions.” These were items that didn’t get headlines but were important. These two bills — both enacted in the 2022 session — initially may seem remote or technical in nature, but they will impact the health and well-being of every Marylander with minimal cost and substantial benefit. You should know about them. (Dan Morhaim, 4/18)

The Colorado Sun: As Pediatricians, We Are Oath-Bound To Give Gender-Affirming Care
As pediatricians in Colorado, we are appalled by the tidal wave of radical and harmful anti-LGBTQ+ – and specifically, anti-trans – policies being implemented around the country. Like all young people, LGBTQ+ youth should be made to feel welcome and supported in their communities, not ostracized. Given our role as health care providers, we feel strongly that all transgender youth deserve access to gender-affirming medical care that is comprehensive, developmentally appropriate, safe, and inclusive. We work closely with individual children and their caregivers to do what is best for each child, and importantly, we do so free of political interference. (Drs. Matt Guerrieri and Lucas Morgan, 4/18)

The Texas Tribune: Analysis: Texas’ New Standard Of Abortions Doesn’t Include Everyone 
Texas hasn’t outlawed abortion for everyone — just for those who can’t afford to travel to other states and countries where the decision about whether to have a child is left to the person who’s pregnant. The state’s new restrictions on abortions, effectively outlawing them after about six weeks of pregnancy, have been in effect for almost eight months. A fetus’ initial cardiac activity is detectable at about that time — often before a person knows they’re pregnant. Under current Texas law, abortion is illegal after those pulses can be detected. It’s still legal in other states, however, if a pregnant Texan has the means to get there. (Ross Ramsey, 4/18)

Los Angeles Times: Why I'm Telling My Abortion Story Now 
The United States is facing the most consequential year for abortion rights since Roe vs. Wade was decided in 1973. And it isn’t just a matter of the pending Supreme Court decision in Dobbs vs. Jackson Women’s Health Organization, the Mississippi case that is likely to overturn Roe. When the Supreme Court allowed Texas’ SB 8 to remain in effect last year, the floodgates opened at the state level. More than 500 abortion restrictions have been introduced in more than 40 states so far this year. Idaho recently copied Texas’ ban. Arizona followed Mississippi and Florida in passing a 15-week ban. And just last week Kentucky’s Legislature effectively outlawed abortion in the state by setting new regulations but providing no mechanism to fulfill them. (Jodi Hicks, 4/18)