NPR: Justice Department To Appeal Recent Mask Ruling 
The U.S. Justice Department said it's appealing the ruling by a federal judge that voided the mask mandate for public transportation. DOJ spokesperson Anthony Coley said a notice of appeal had been filed in light of the determination by Centers for Disease Control and Prevention that wearing a mask "remains necessary to protect the public health. "The CDC said it had asked the DOJ to appeal. The public health agency continues to recommend that people wear masks in all indoor public transportation settings and says "wearing masks is most beneficial in crowded or poorly ventilated locations, such as the transportation corridor." (Diaz, 4/20)

NBC News: Justice Department Appeals Ruling Lifting Transit Mask Mandate After CDC Request
The Justice Department has not asked the appeals court to block the judge's order that lifted the federal mask mandate on transit systems, meaning passengers will be able to continue traveling maskless while the decision is litigated. (Richards, 4/20)

The Hill: Biden Appeal Of Judge’s Mask Mandate Ruling Risks Backfiring 
Legal experts who criticized a judge’s controversial decision this week striking down the federal mask mandate for travel say the Biden administration faces a grave risk if it moves forward with an appeal. These court watchers warned that a conservative-leaning Supreme Court, which has already upended several pandemic-era health measures, could use the Trump-appointed judge’s narrow view of the government’s public health powers to create a far-reaching precedent. (Kruzel and Gangitano, 4/20)

More on the transit ruling —

AP: Most People In US Want Masks For Travelers: AP-NORC Poll 
A majority of people in the United States continue to support a mask requirement for people traveling on airplanes and other shared transportation, a poll finds. A ruling by a federal judge has put the government’s transportation mask mandate on hold. The poll by The Associated Press-NORC Center for Public Affairs Research finds that despite opposition to that requirement that included verbal abuse and physical violence against flight attendants, 56% of those surveyed favor requiring people on planes, trains and public transportation to wear masks, compared with 24% opposed and 20% who say they are neither in favor nor opposed. (Kolpack, 4/20)

KHN: Judge’s Ruling On The CDC Mask Mandate Highlights The Limits Of The Agency’s Power
The role that the federal government plays in containing future epidemics will hinge on the outcome of an appeal of this week’s court ruling that overturned the mask mandate for travelers on airlines, trains, and the nation’s mass transit systems. A federal court judge in Florida said the Centers for Disease Control and Prevention had overstepped its authority in requiring masks on public transportation, a mandate that legal experts considered well within the bounds of the agency’s charge to prevent the spread of covid-19 across the nation. (Whitehead and Appleby, 4/21)

The Atlantic: The End Of Airplane Masking Feels Momentous
Whether or not masking on buses keeps community spread in check, it has other benefits. “For me, the mask mandate is not simply a tool to control transmission, but rather one that makes our essential spaces safer and accessible for everyone,” Anne Sosin, a public-health researcher at Dartmouth, told me. People who are at risk because they are very elderly, or who get a bit less benefit from the vaccines because they’re immunocompromised, or who have small children, can generally avoid bars and concert venues if they want to. Buses and metros are much harder to steer clear of. Black and Hispanic Americans, who have gotten sick and died at higher rates than their white peers throughout the pandemic, are more likely to use public transportation—and more likely to support mask mandates there. (Gutman, 4/20)

NBC News: Delta To Allow Passengers Banned For 'Mask Non-Compliance' Back On Airplanes
Delta Air Lines will begin allowing passengers who were banned from flying for “mask non-compliance” back on its airplanes after a federal judge struck down the Biden administration’s mask mandate for air, rail and other travel, the company said Wednesday.     In a statement, Delta said it will restore flight privileges for customers who demonstrate “an understanding of their expected behavior when flying with us.” (Stelloh and Blackman, 4/20)

The Wall Street Journal: As Americans Shed Their Masks, Asia Largely Stays Covered Up
Chie Matsuda learned from a morning TV show here on Wednesday that passengers on U.S. airplanes had just been allowed to take off their masks. It was a moment of celebration for some Americans, but Ms. Matsuda didn’t like the sound of it. “I’d be uncomfortable if the person next to me on the plane was unmasked,” said the 64-year-old retiree as she ate a sandwich outside a Tokyo shopping mall. “We haven’t figured out yet how we could live with the coronavirus. At this phase, we’d better take a more conservative approach.” (Inada, 4/21)

In other news about mask mandates —

NBC News: Vaccines, Antibodies, Antivirals: How Some Immunocompromised Can Cut Covid Risk
As more and more Americans doff their masks, immunocompromised individuals may be concerned about their risk levels among largely unmasked crowds. ... But experts say that while immunocompromised individuals do remain at a greater risk of Covid, the landscape looks much different than it did even a year ago, with a number of tools available to provide the extra protection they need. (Lovelace Jr. and Syal, 4/20)

San Francisco Chronicle: BART No Longer Requires Masks To Be Worn, But Board Members Want To Reinstate A Mask Mandate
Passengers no longer have to wear face coverings to ride BART, but the regional rail agency’s Board of Directors will consider reinstating a mask mandate at its April 28 meeting. The agency announced shortly before 5 p.m. Wednesday that masks are optional to wear on BART trains and stations, effective immediately, after the state’s Department of Public dropped its mask requirement on public transit earlier in the day. That decision came after a judge in Florida overturned the federal masking policies for public transportation and airplanes. (Cano, 4/20)

Philadelphia Inquirer: COVID Science Supports The Philadelphia Mask Mandate, But It's Complicated
Two years into the COVID-19 pandemic, the public debate on masks is as heated as ever — especially in Philadelphia, which earned national attention for once again requiring masks in indoor public spaces. Yet in the realm of science, there is plenty of evidence to support using the face coverings. Researchers who study airborne transmission of viruses say there is no question that masks — even the cloth variety — reduce the spread of the coronavirus. Exactly how much depends on the type of material, how well the mask fits, and how many virus particles an infected person is shedding, among other factors. No mask is bulletproof, but that’s not a reason to reject them entirely. No infection-control measure is absolute, short of complete isolation. (Avril, 4/20)

CNN: CDC Advisers Mull What's Next For Covid-19 Boosters 
Vaccine advisers to the US Centers for Disease Control and Prevention continue to mull over what the future of Covid-19 booster shots might look like – and they acknowledge that entirely different vaccine formulations could be needed. At their meeting Wednesday, the members of the CDC’s Advisory Committee on Immunization Practices discussed their next steps around recommending additional booster doses of Covid-19 vaccines for the general public. (Howard, 4/20)

Bloomberg: Should I Get A Covid Booster? Most Under 50 Should Wait, Says CDC Panel
Most Americans under 50 should wait for the next generation of booster shots rather than getting a fourth dose now to prevent Covid-19 infections, according to several members of a panel of advisers to the U.S. Centers for Disease Control and Prevention. The goal of booster shots should be to limit severe outcomes rather than to prevent transmission of the virus, the advisers said in a meeting Wednesday. That means people with high risk of grave illness from an infection should consider an extra shot, but most people should hold out for better vaccines later this year, they said. (Rutherford and Castronuovo, 4/20)

CIDRAP: CDC Advisers Discuss Future Of COVID-19 Booster Shots 
ACIP members voiced concerns about booster fatigue, and creating the impression that a vaccination program that required large swathes of the population to get boosted every 4 to 6 months would be viewed as unsuccessful. They also emphases that the primary series of vaccines, the first two doses, remained the most important in terms of preventing deaths. No votes were cast today as ACIP members discussed these questions. (Soucheray, 4/20)

NBC News: Should People Wait Until The Fall For A Second Booster? CDC Panel Weighs In
"My sense is that omicron [and its subvariants] BA.2, 3 and 4 will be major players this fall," Moderna's chief medical officer, Paul Burton, said Tuesday during a meeting of the World Vaccine Congress in Washington, D.C. The company is working on a redesign of its vaccine to specifically target the omicron family of variants. (Edwards, 4/20)

In other news about vaccines and covid treatments —

Bangor Daily News: Nearly 1,000 Volunteers Were Key To Vaccinating Thousands At Northern Light’s Mass Clinics
Nearly 1,000 volunteers were a key part of the effort last year to set up and staff COVID-19 vaccination clinics across the 10-hospital Northern Light Health network. The health care system this week said 925 volunteers helped at the vaccination clinics that formed a cornerstone of the state’s early vaccination strategy last spring when demand for the shots was at its highest. Northern Light released the figure in conjunction with National Volunteer Week, which is this week. (O'Brien, 4/21)

KHN: Anti-Vaccine Ideology Gains Ground As Lawmakers Seek To Erode Rules For Kids’ Shots 
Not long ago, Kansas showed strong bipartisan support for vaccines as a tool to support a robust public health system. But bills with language expanding religious exemptions for childhood vaccine requirements were passed by the state Senate in March and now face the House when the legislature reconvenes April 25. (West, 4/21)

Stat: Pfizer Faces Criticism For Arguing That IP For Covid-19 Pill Is A Human Right
Numerous advocacy groups and institutional shareholders are chiding Pfizer for arguing that its intellectual property is a human right and would be violated if the Dominican Republican government issues a compulsory license for its Covid-19 pill. Advocates say the company invoked human rights in a recent hearing in which it attempted to convince the Dominican government not to issue such a license for its pill, Paxlovid. A petition to issue a license was filed in December after the country was excluded from a licensing deal to make the medicine available in mostly poor countries. A decision could come by next week. (Silverman, 4/20)

Las Vegas Review-Journal: Nevada COVID-19 Hospitalizations At ‘Record Low,’ Association Says
Clark County’s COVID-19 metrics stayed relatively flat for the second straight week, as the Nevada Hospital Association reported “record low” statewide hospitalization numbers. The disconnect between state and county case totals for Clark County continued, with the state reporting about 1,000 new cases for Clark County over the past week. The two-week moving average of daily new cases in the county increased slightly to 98, up from 91 last week. (Dylan, 4/20)

Des Moines Register: Iowa COVID Cases Up, Hospitalizations Down In Weekly Update
New reported COVID-19 cases in Iowa increased slightly and the number of people hospitalized with the disease in Iowa decreased slightly in Wednesday's coronavirus data release from the Iowa Department of Public Health and the U.S. Department of Health and Human Services. As the state of the pandemic has changed throughout the country — masks are no longer required on airplanes and other forms of mass transportation, while some people are now eligible for a second booster shot — COVID-19 data has remained relatively static in Iowa over the past month. (Webber, 4/20)

San Francisco Chronicle: COVID Hospitalizations Fall In California Despite A Rise In Infections
The number of Californians hospitalized with COVID-19 has dipped below an average of 1,000 this week — the first time that’s happened since the pandemic’s summer lull last June. Patients hospitalized with coronavirus infections numbered 964 as of Tuesday, according to state data. Hospitalizations are continuing to fall despite a recent statewide rise in cases. The case growth follows months of declines since the peak of the omicron surge in January. California is now averaging about 2,800 confirmed cases per day, up from about 2,300 at the beginning of the month. (Vaziri and Ho, 4/20)

Anchorage Daily News: Alaska Reports 1,526 New COVID-19 Cases In Past Week As Increase Continues
The Alaska Department of Health and Social Services on Wednesday reported 1,526 cases of COVID-19 in Alaska over the prior seven days. That’s a slight increase from last week, and averages around 218 cases per day. This data does not include at-home tests. The state reported 13 more deaths linked to the virus. In total, 1,215 COVID-19 deaths among Alaska residents and 33 among nonresidents have been reported since March 2020. Many of the deaths reported by the state in recent weeks occurred weeks to months earlier. (4/20)

The Hill: Hochul Warns Of COVID Spike In New York, But ‘Not Panicking’ 
New York Gov. Kathy Hochul (D) on Wednesday said that the state was seeing rising COVID-19 cases but added that there was no reason for New Yorkers to panic. “We’ve had a rising tide of cases. My health department has been embedded in constant communication with our local health departments here,” Hochul said at a press conference. (Beals, 4/20)

The Boston Globe: COVID Levels In Waste Water In Eastern Mass. Climb — But At A Slower Pace
The levels of coronavirus in Eastern Massachusetts waste water, considered an early warning for future COVID-19 case increases, continued to climb through the weekend, but the pace of increase appeared to slow. Virus levels were nearly flat Sunday through Tuesday in both the northern and southern regions of the Massachusetts Water Resources Authority, which released the data. The levels have fallen precipitously from heights reached early this year as the Omicron wave peaked. They bottomed out around the beginning of March. They have been rising gradually since, though they are still just a fraction of their peak. (Finucane and Huddle, 4/20)

In testing news —

CapRadio: California Will Close Its Central COVID-19 Lab, Cancel $1.7 Billion Contract With PerkinElmer 
The Newsom administration has quietly ordered the closure of its central COVID-19 testing laboratory, cutting short a controversial no-bid contract worth up to $1.7 billion with global health care giant PerkinElmer. In a letter obtained by CapRadio, dated March 31, the California Department of Public Health notified the company that it would terminate the contract in 45 days, as allowed under the agreement. The letter thanked PerkinElmer for its partnership and noted the increased availability of antigen testing and expanded commercial testing options as the reasons for terminating the contract. (Rodd, 4/20)

The Washington Post: How To Use Biden's Free Coronavirus Tests For International Travel 
When the Biden administration began distributing free coronavirus tests, the special deliveries did not help international travelers fulfill requirements to enter the United States because they did not offer the option to test under virtual supervision or receive a report to show border officials. As is the case with many things during the pandemic, that has changed within a couple of months. Depending on which brand of free test you receive, you may be able to use it on your next international trip, after all. (Compton, 4/20)

In other news about the spread of covid —

CIDRAP: COVID-19 Infection May Offer Similar Immunity As Vaccination
In the pre-Omicron variant era, previous symptomatic COVID-19 infection in unvaccinated patients conferred a level of protection against subsequent infections on par with that of mRNA vaccines but longer-lasting, according to a US study of more than 121,000 participants published today in JAMA Network Open. The findings, of course, do not suggest that infection is preferred over vaccination, which is the much safer alternative. (Van Beusekom, 4/20)

The Texas Tribune: Texas Hospitals Prepare To Pick Up The Tab For Uninsured COVID-19 Patients
More than $3 billion in federal money has flowed to Texas health care providers in recent months to help pay for COVID-19 treatments, tests and vaccines for patients without health insurance, according to national health officials. Of that, a tiny fraction — some $2.2 million — went to the local independent hospital in rural Titus County for treating patients during wave after overwhelming wave of the devastating virus in an area where 1 in 3 residents are uninsured. (Harper, 4/20)

In covid news from Spain and China —

Press Association: Healthcare Worker Gets Covid-19 Twice in Record Time of 20 Days
A healthcare worker was infected with Covid-19 twice in the space of 20 days in what is believed to have been the shortest time between two infections since the pandemic began. The 31-year-old woman from Spain became infected with the Delta variant followed by the Omicron variant of the virus in under three weeks. Researchers said the case shows that even vaccinated people who have had Covid-19 "cannot assume they are protected against reinfection." (Pickover, 4/20)

Houston Chronicle: Prominent Wuhan Lab Can Ask UTMB To Destroy ‘Secret Files’ And Other Records, Memo States
A prominent research lab in China can ask its partner institution in Galveston to destroy records of their joint work, including “secret files, materials and equipment,” according to a memorandum obtained by the nonprofit news organization U.S. Right to Know and shared with the Houston Chronicle. Dr. James Le Duc, the director of the Galveston National Laboratory at the University of Texas Medical Branch, signed the nine-page memorandum of understanding, which lays out the terms of collaborative efforts with the Wuhan Institute of Virology, in 2017. The two research labs, which study some of the most dangerous pathogens in the world, have had a relationship since 2013 and announced a formal cooperative agreement in 2018. (Gill, 4/21)

Modern Healthcare: HHS Warns Of 'Exceptionally Aggressive' Ransomware Threat
A cybersecurity center at the Health and Human Services Department is warning healthcare and public health organizations to guard against an "exceptionally aggressive" ransomware group that encrypts and steals data from its victims. "Hive is an exceptionally aggressive, financially-motivated ransomware group known to maintain sophisticated capabilities who have historically targeted healthcare organizations frequently," according to an analyst note published this week by the Health Sector Cybersecurity Coordination Center, a center in HHS' Office of Information Security. (Kim Cohen, 4/20)

In other news from the federal government —

Modern Healthcare: Feds Release First-Of-Its-Kind Data On Healthcare Consolidation
The Health and Human Services Department released its first quarterly tranche of hospital and nursing home merger and acquisition transaction data, which marks a major step forward in the government's effort to track the impact of consolidation across the industry, policy experts said. Hospitals with the lowest profit margins were sold more than twice as often as those with the highest profit margins, according to the analysis of 347 hospital transactions from 2016 to 2021. Long-term care hospitals changed ownership at substantially higher rates than other hospitals and more hospital transactions occurred in the South, where many for-profit chains are based. (Kacik, 4/20)

Modern Healthcare: 5 Ways CMS' Proposed Hospital Rule Could Affect Patient Safety And Quality
Through its proposed Hospital Inpatient Prospective Payment System rule, the Centers for Medicare and Medicaid Services is building on administration-level priorities to better assess disparities in healthcare quality and improve patient outcomes. The recommended rule, released on Monday, discusses potential increases to inpatient hospital payments and cuts to Medicare disproportionate share hospital payments, as well as how certain reporting requirements were affected by the pandemic. (Devereaux, 4/20)

And more developments from the health care industry —

Bloomberg: Humana Said In Advanced Talks To Sell Hospice Business To CD&R
Humana Inc. is in advanced talks to sell an arm of Kindred at Home to private equity firm Clayton Dubilier & Rice in a deal that would value the business at about $3 billion, according to people with knowledge of the matter. A deal between the health insurer and CD&R for the hospice, palliative and personal care business could be announced within days, said the people, who asked not to be identified because the information isn’t public. Humana plans to retain a stake in the business, the people said. (Davis, 4/21)

Houston Chronicle: Texas Got Millions To Boost Pay For Strapped Health Care Attendants. It Left Out The Largest Group
Like many states, Texas is struggling to attract and retain home health workers to care for people with intellectual and developmental disabilities, a crisis that has swelled amid the pandemic and after years of low wages. So when state health officials announced last summer that they planned to use federal pandemic money for one-time bonuses, it seemed like relief was on the horizon for a few hundred thousand beleaguered employees. But even that small gesture is now in question, as the Health and Human Services Commission omitted the largest single group of health attendants, who serve about 130,000 low-income Texans. (Blackman, 4/21)

Crain's New York Business: Mount Sinai Accused By Top Academic Leader Of Unlawful Retaliation
An academic leader at Icahn School of Medicine at Mount Sinai claims that it slashed her salary by six figures after she expressed concerns about discrimination within the Arnhold Institute for Global Health, according to a lawsuit filed last week in Manhattan federal court. Dr. Ann Marie Beddoe, director of the medical school's Division of Global Women's Health and an associate professor in the department of obstetrics, gynecology and reproductive science, is accusing Mount Sinai and the Icahn School of unlawful retaliation after she opposed the hiring of Dr. Prabhjot Singh as director of the Arnhold Institute and flagged concerns about his treatment of women. (Kaufman, 4/20)

Detroit Free Press: Candida Auris Outbreak Reported At DMC Sinai-Grace Hospital In Detroit
A  36-bed specialty recovery hospital that operates on the seventh floor of DMC Sinai-Grace Hospital in Detroit is no longer admitting new patients because of an outbreak of a drug-resistant, highly contagious and often deadly fungal infection called Candida auris. Select Specialty Hospital - Northwest Detroit is voluntarily pausing admission of new patients as it works with the state health department and the city of Detroit's health department to address the outbreak. Fifteen cases of Candida auris have been detected in Michigan since 2021 — seven of which have been identified in the last five weeks in patients at Select Specialty Hospital – Northwest Detroit. Prior to 2021, there had been no known cases of C. auris in Michigan in at least five years. (Jordan Shamus, 4/20)

Modern Healthcare: Louisiana Sues UnitedHealthcare, OptumRx For Alleged Medicaid Drug Overcharging
Louisiana's attorney general sued UnitedHealth Group's OptumRx and UnitedHealthcare businesses, alleging the pharmacy benefit manager and insurer overcharged the state's Medicaid department by billions of dollars through inflated prescription drug prices. In a suit filed in the Nineteenth Judicial District Court in East Baton Rouge Parish on April 13, Attorney General Jeff Landry alleged UnitedHealth Group was paid more money from the state because its Medicaid managed-care and PBM business arms gave it a "perverse incentive structure" to balance its medical loss ratio. State and federal government laws require that insurers spend a certain portion of every premium dollar on patient care through MLRs. (Tepper, 4/20)

Stat: Louisiana Accuses UnitedHealth And Its OptumRx PBM Of Inflating Drug Costs For Its Medicaid Program
Notably, the lawsuit contended the companies engaged in spread pricing, which refers to the difference between the dispensing fees that pharmacy benefits managers pay pharmacies and the higher rates they bill to state Medicaid programs. Although spread pricing is very much a behind-the-scenes issue, it has gained increasing attention. Dozens of states have proposed or passed 160 laws to tighten oversight of PBMs over the past few years, according to the National Academy for State Health Policy, a group of state policy experts that has been active in proposing legislation to control prescription drug spending. (Silverman, 4/20)

In other news about health care costs and medical bills —

CBS News: Americans Often "Forced" To Pay Medical Bills They Don't Owe, Feds Say 
It may come as little surprise that many Americans are besieged by medical bills, especially as the COVID-19 pandemic grinds on. Perhaps more eye-opening is that this is often for debt they have already paid or do not actually owe. In a new report, the Consumer Financial Protection Bureau found that people's most common debt collection complaints last year had to do with efforts to collect on a bill that they said did not belong to them. (Sherter, 4/20)

Houston Chronicle: Houston Doctors Weigh In On How Mounting Medical Debt, Bills Affect Patient Health
Medical debt and financial burdens of paying for health care can drastically increase stress, reduce quality of life and, in some cases, lead to earlier deaths for insured and uninsured alike, experts said at a presentation at Rice University’s Baker Institute for Public Policy on Wednesday. Dr. Khurram Nasir, a cardiologist at Houston Methodist, shared a story about a friend, a small business owner, who was uninsured and suffered from a heart attack. To his and his family’s relief, he survived. But that relief didn’t last long. (Carballo, 4/21)

Modern Healthcare: Surprise Bill Resolutions' Path Forward Hinges On Final Rule
The portal to file surprise billing independent dispute resolution claims opened on Friday, but there's a chance the process through which claims are resolved could shift in the coming months. The Centers for Medicare and Medicaid Services released revised guidance on the resolution process last week after a Texas federal judge ruled in February that previous policy couldn't stand, in part because it unfairly advantaged insurers. But between other litigation and a final rule coming this summer, CMS still has opportunities to tweak the process. (Goldman, 4/20)

KHN: Is My Drug Copay Coupon A Form Of Charity — Or A Bribe? 
Before my insurer had even preapproved coverage of the new injectable medicine my doctor had prescribed, I got a voicemail from its manufacturer informing me that I might qualify for its copay assistance program. That meant the company would cover at least the lion’s share of my copay, leaving me with a minimal, if any, out-of-pocket contribution. My antennae were up: If a drugmaker is offering copay assistance, you can assume the list price of the drug is high, but I wasn’t sure how high. Did this outwardly kind offer represent, essentially, a kind of bribe? (Rosenthal, 4/21)

ABC News: Almost Half Of Americans Breathing More Unhealthy Air Than Ever Before: Report 
Almost half of Americans -- 137 million people -- are experiencing more days of "very unhealthy" and "hazardous" air quality than in the previous two decades combined, according to a report published this week by the American Lung Association. The annual "State of the Air" report looked at Americans' exposure to two types of air pollution: ozone, also known as "smog," and particle pollution, also known as "soot." It found that over 63 million Americans are now impacted by deadly particle pollution, an increase of nearly 9 million people from previous years. (Meltzer, 4/21)

The Hill: 137 Million In US Live With Unhealthy Levels Of Air Pollution: American Lung Association 
More than 40 percent of the U.S. population — or 137 million people — are living in areas with unhealthy levels of particle pollution or ozone, according to the American Lung Association’s newest “State of the Air” report card. That’s 2.1 million people living in counties with unsafe air compared to last year’s report card — and 8.9 million more people impacted by daily spikes in potentially deadly particle pollution, the authors found. (Udasin, 4/21)

NPR: Wildfires Are Increasingly Contributing To Unhealthy Air
Despite decades of environmental efforts, over 40% of Americans — more than 137 million people — live in cities and states with poor air quality, a new report says. And, in addition to cars and factories, wildfires are increasingly contributing to unhealthy air. For the past 22 years, the American Lung Association has produced its annual State of the Air report, which analyzes the air quality on a local level for communities across the country. This year's study found that more Americans were exposed to unhealthy air, at times deemed hazardous, compared to previous years. (Jones, 4/21)

Also —

CIDRAP: Air Pollution May Raise Risk Of Positive COVID-19 Test 
An observational JAMA Network Open study today involving young adults in Sweden suggests that short-term exposure to even relatively low levels of air pollution is tied to a higher risk of later testing positive for COVID-19, likely by worsening symptoms in those already infected. (Van Beusekom, 4/20)

Press Association: Aggressive Prostate Cancer Linked To Five Types Of Bacteria In Study
Researchers have identified five types of bacteria that are linked to aggressive prostate cancer. The bacteria was common in urine and tissue samples from men with the condition, a new study found. It is hoped the findings could help pave the way for treatments that could target this bacteria and slow or prevent the development of aggressive disease. Scientists do not yet know how people pick up the bacteria, or whether they are causing the disease. Project lead Professor Colin Cooper from the University of East Anglia's (UEA) Norwich Medical School, said: "We already know of some strong associations between infections and cancer. (Massey, 4/20)

In news about Alzheimer's disease —

The Boston Globe: Brigham, Children’s Hospital Researchers Find Increased Mutations In Alzheimer’s Patient Brain Cells
Alzheimer’s disease patients had a greater number of mutations in their brain cells than people who were normally aging, a new study by researchers at Brigham and Women’s Hospital and Boston Children’s Hospital found. “We know these mutations increase with age. Now we’ve found that with Alzheimer’s disease, there’s even more of them,” said one of the lead authors, Dr. Michael B. Miller of the Department of Pathology at the Brigham. The study was published Wednesday in the journal Nature. Miller said neurons in the brain die in Alzheimer’s disease and the new findings “help us better understand ways in which the cells might be dying.” (Finucane, 4/20)

In pediatric health news —

San Francisco Chronicle: EPA Must Reconsider Approval Of Pet Flea-Collar Pesticide, S.F.-Based Appeals Court Orders
A federal appeals court on Wednesday ordered the Environmental Protection Agency to reconsider its approval of a widely used flea-collar pesticide known as TCVP, saying the agency ignored evidence of potential neurological dangers to children. Tetrachlorvinphos, developed from nerve warfare chemicals used in World War II, was approved by the EPA in 2006 to protect dogs and cats from fleas and ticks. It was challenged in 2009 by the Natural Resources Defense Council, which said it posed particular dangers to children who touched their pets and then put their hands in their mouths. The group cited evidence that TCVP can affect youngsters’ neurological development and cause mental, physical and behavioral problems. (Egelko, 4/20)

ABC News: FDA Issues Warning About False Results With Prenatal Genetic Screening Tests 
Common prenatal tests done to test for genetic abnormalities are the subject of a new warning from the U.S. Food and Drug Administration (FDA). The FDA issued a notice Tuesday warning people about the risk of "false results, inappropriate use and inappropriate interpretation of results" from non-invasive prenatal screening tests, also called non-invasive prenatal tests and cell-free DNA tests. (Kindelan, 4/20)

ABC News: Baby Born At 23 Weeks Gets Special Surgery To Fix Incomplete Esophagus 
A 1-year-old girl is back at home in Nebraska after receiving life-saving treatment in Colorado, including a surgery with magnets that helped connect a large gap in her esophagus. Harper and her fraternal twin sister, Gabriella, were born prematurely on Feb. 22, 2021, at 23 weeks. The newborns were delivered by emergency cesarean section at Box Butte General Hospital in Alliance, Nebraska, and were immediately flown to Rocky Mountain Hospital for Children in Denver, about 250 miles southwest, for treatment. (Yu, 4/21)

The Wall Street Journal: Rising Marijuana Use Presents Secondhand Risks 
The risks marijuana can pose to people—and even pets—near users is getting more attention from researchers, as consumption rises along with legalization efforts in parts of North America. ... New research examines the possible health effects of wider use. Bong smoke contains tiny pollutants that can linger indoors for up to 12 hours, one study showed. Secondhand marijuana smoke may harm people outdoors or children in adjacent rooms, other research has suggested. And the legalization of marijuana in parts of North America has coincided with an increase of cannabis poisonings in dogs and other pets, a study published on Wednesday in the scientific journal PLOS ONE reported. (Onque, 4/20)

And concerns are rising about the risks to children and pets —

CNN: Copycat Packaging Of Marijuana Edibles Poses Risk To Children, Study Says
At first glance, it looks like a single serving bag of Nerds Rope that your child might eat as a treat. But take a closer look. See the word “medicated” and the small white box at the bottom that says 600 milligrams of THC? Those three letters stand for tetrahydrocannabinol, the part of the marijuana plant that makes people high. Eating even a small fraction of that bag would “overwhelm a child,” said Danielle Ompad, associate professor of epidemiology at NYU School of Global Public Health and senior author of a new study investigating copycat packaging in cannabis sales. The study was published Tuesday in the journal Drug and Alcohol Dependence. (LaMotte, 4/19)

CNN: Marijuana Pet Poisonings Are On The Rise, Study Says
More pets are being poisoned by marijuana plants and edibles than in the past and some even die, a new study finds. A survey of veterinarians found cases of poisoning occurred most frequently in dogs, but cats, iguanas, ferrets, horses and cockatoos also fell victim to the hallucinogenic effects of marijuana. ... Veterinarians reported a rise in poisoning cases, which could be due to increased access to legal marijuana products in some US states and Canada, which legalized cannabis in 2018. (LaMotte, 4/20)

In other news about marijuana use —

Politico: Cannabis Sinks Amid Weed Glut, Congress' Inaction
The nation’s marijuana industry has boomed during the pandemic. So far, 2022 is looking like a bust. Weed sales hit $27 billion last year, nearly doubling figures from just two years earlier — and revenues are projected to double again over the next six years. Even pot supporters in Congress seemed well-positioned to dismantle decades-old restrictions. (Demko, 4/20)

The New York Times: A Mayor Dispenses Pardons As Alabama Holds Fast To Marijuana Laws 
Wearing a bright yellow shirt emblazoned with the words “Legalize Alabama,” the mayor of Birmingham, Ala., said in a video posted on Twitter on Wednesday that he had pardoned anyone in the city who had been convicted of misdemeanor marijuana possession charges in the last eight months of 2021. The announcement from Mayor Randall Woodfin — which fell on April 20, or 4/20, the unofficial holiday for marijuana celebrations — came a year after he pardoned about 15,000 people in the city who had criminal convictions for possession of the drug from 1990 through 2020. (Medina, 4/20)

Milwaukee Journal Sentinel: Wisconsin Medical Marijuana Bill Gets A Hearing At State Capitol
Republican lawmakers who control the state Legislature for the first time allowed a Capitol debate on legislation that would legalize marijuana use, but the step forward for proponents won't result in a new cannabis law in Wisconsin anytime soon. A public hearing in the Wisconsin State Capitol was held Wednesday on a bill that would create a state-run medical marijuana program. But the committee hearing was scheduled weeks after GOP leaders concluded the Legislature's work for the year — prompting some Democrats who have long supported legalization to accuse Republican bill authors of using the hearing as a "political ploy" in an election year. (Beck, 4/20)

The Washington Post: Cannabis Quiz: How Much Do You Know About The Science Of Marijuana?
The seedy reputation of weed is changing — quickly. First of all, the correct name is cannabis, and most states have legalized it in some way. Earlier this month, the House passed a bill that would decriminalize it across the entire country. Legal sales around the world are expected to top $35 billion this year, according to industry tracker BDSA. But the science lags behind the movement, largely because studying cannabis is so difficult. Truth is, there’s a lot science doesn’t know. (Berkowitz and Steckelberg, 4/20)

The New York Times: Scientists Find No Benefit To Time-Restricted Eating 
The weight-loss idea is quite appealing: Limit your eating to a period of six to eight hours each day, during which you can have whatever you want. Studies in mice seemed to support so-called time-restricted eating, a form of the popular intermittent fasting diet. Small studies of people with obesity suggested it might help shed pounds. But now, a rigorous one-year study in which people followed a low-calorie diet between the hours of 8 a.m. and 4 p.m. or consumed the same number of calories anytime during the day has failed to find an effect. (Kolata, 4/20)

And more on weight loss —

CNN: We Need To Stop Complimenting Weight Loss. Here's What To Say Instead
If your friend has recently lost weight, you might want to tell her how great she looks. Maybe you also say that you wish you had her body or self-control or you ask her how she did it. Perhaps you’ve been on the receiving end of such a “compliment” in the past. Such comments are well meaning but can have unintended negative consequences. “In that case, we are unintentionally exacerbating or affirming the thin ideal that our society tends to emphasize and idolize,” said Alvin Tran, an assistant professor of public health at the University of New Haven in Connecticut, who does research on eating disorders and body image. “We need to be very cautious when we do approach conversations around someone’s physical appearance, especially their weight.” (Rogers, 4/20)

The Washington Post: Man Lost 85 Pounds In A Bid To Get Taco Bell To Revive His Favorite Menu Item 
The goal of his workout antic is twofold: While his primary objective is to bring back his beloved Grilled Stuft Nacho, when he began his Taco Bell challenge more than one year ago, Chris Sandberg — who weighed close to 300 pounds before the pandemic — was also seeking to lose weight. He decided to merge the two missions. Although Sandberg initially executed the idea in jest, he quickly realized “it resonates for people,” as losing weight can be a stressful struggle for many. He wanted to find a way to make his experience lighthearted. (Page, 4/20)

In other food news —

The Wall Street Journal: Lucky Charms Sickness Complaints Spread Rapidly, Adding Complexity To Safety Probe 
Federal regulators formalized an investigation into the safety of Lucky Charms cereal, adding the probe Wednesday to the agency’s list of ongoing food-safety outbreaks. The Food and Drug Administration said it has received complaints from 231 consumers reporting illnesses after eating Lucky Charms recently, according to the agency’s outbreak investigation website and a person familiar with the matter. The FDA said it has initiated an inspection of the cereal’s production operations. (Gasparro and Walker, 4/20)

Fox News: Single Tick Bite Can Cause A Life-Threatening Meat Allergy: Report
Have you ever eaten steak at dinnertime and then developed hives at midnight? As tick season kicks into gear, it’s a good idea to know about a potentially life-threatening food allergy called alpha-gal syndrome that may occur after certain tick bites – especially the lone star tick, according to the Centers for Disease Control and Prevention (CDC). "An allergy to ‘alpha-gal’ refers to having a severe and potentially life-threatening allergy to a carbohydrate molecule called galactose-alpha-1,3-galactose that is found in most mammalian or ‘red meat,’" according to the American Academy of Allergy Asthma & Immunology. (Sudhakar, 4/20)

The New York Times: Gut Healing Is TikTok’s Latest Trend. Does It Work? 
Every few months, like clockwork, hundreds of videos promising tips and tricks to “hack” your gut flood TikTok. In March, influencers pushed shots of aloe vera juice: “My digestive system, like my gut health? Never been better,” one gushed in a video with one million likes while tapping on a purple bottle of the drink. Another, with the username “oliveoilqueen,” advocated drinking extra virgin olive oil every day in a video viewed more than 3.5 million times, claiming that doing so cleared her skin, made her periods less painful and fixed her frequent bloating. Videos tagged with #guttok have garnered nearly 400 million views. They’re crammed with suggestions for cucumber-ginger juices and boiled apples, bone broth in the morning and sludgy sweet potato soups at night. (Blum, 4/20)

The Washington Post: Ohio Doctor William Husel Acquitted Of Killing 14 Patients With Fentanyl In Murder Trial
William Husel, an Ohio doctor who was accused of killing 14 patients with what prosecutors described as “wildly excessive” doses of fentanyl between 2015 and 2018, was acquitted on all counts of murder Wednesday, concluding one of the most significant murder cases of its kind against a health-care professional. Husel, a onetime physician of the year trained at the Cleveland Clinic, faced one count of murder for each of the 14 critically ill patients he was accused of killing. The jury deliberated for seven days before finding him not guilty on all 14 counts in what was one of the largest murder trials in Ohio history. (Shammas and Bella, 4/20)

Columbus Dispatch: Lawyers Say Husel Must Answer To Families In Civil Court
Lawyers representing families whose civil suits are still pending against former Mount Carmel Health doctor William Husel say he will be held accountable for medical malpractice, despite his acquittal Wednesday in criminal court. After a seven-week-long criminal trial on Wednesday, a jury found Husel not guilty on all 14 counts of murder in connection with patients who died under his care after he prescribed high doses of fentanyl and other pain killers. Civil lawyer Gerry Leeseberg said in a news conference Wednesday afternoon that the families in this case are frustrated and disappointed, but Leeseberg said he expected this outcome. (Laird and Narciso, 4/20)

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

Los Angeles Times: Inflation Brings California Food Banks A Surge In First-Time Users On 'Razor’s Edge' 
More than a dozen people stood in the rain last week before the gates at the Sacramento Food Bank & Family Services distribution center had even opened. Parked cars wrapped around the block. “Our walkup line is growing. We’re hearing from people that they don’t want to waste their gas sitting in the drive-through line while waiting for their boxes,” said spokesperson Kevin Buffalino. “People are on that razor’s edge right now, and the cost of gas is eating into their food budgets.” Food banks across the state are seeing an influx of new faces as spikes in the cost of groceries and gas have some Californians seeking help for the first time. The numbers of those receiving services dipped at the start of the year as the spread of the COVID-19 virus waned, but are now rising in the face of the highest inflation in 41 years. (Mays, 4/20)

CalMatters: California Bill Would End Coroner Investigations Of Lost Pregnancies
A bill that would abolish the requirement that coroners investigate stillbirths passed the Assembly Health Committee on an 11-3 vote late Tuesday, while hundreds of anti-abortion activists protested against the proposed change on the Capitol steps. Under current law, all fetal deaths at or after 20 weeks, with the exception of abortions, are treated as “unattended deaths” in California, requiring a coroner to investigate. In 48 of 58 California counties, the sheriff is also the coroner, which means that law enforcement becomes involved and the person who is pregnant could face potential prosecution. That, say groups representing obstetricians and gynecologists, is dangerous and could make pregnant people less likely to seek medical care. (Duara, 4/20)

CBS News: Doctors Facing Challenges To Provide Abortion Access "Even When Roe Is Still The Law Of The Land" 
Dr. Sarah Traxler works at the only abortion clinic in the state of South Dakota, but she lives hours away in Minnesota. Her trip involves a flight from Minneapolis to Sioux Falls, an escort at the airport for security reasons and a 20-minute drive to the clinic — all before her first patient. It's a commute she's done monthly for the past seven years. (Shamlian, 4/20)

Cincinnati Enquirer: Fentanyl-Laced Counterfeit Prescription Drugs Flood Greater Cincinnati
Jaime Puerta walked into his teenage son’s bedroom to wake him on what seemed to be a routine Wednesday morning.But Daniel was still. "His eyes were half open and there was a tinge of blue on his upper lip," Puerta said. "I immediately knew something terrible had happened." The distraught father called paramedics. They got Daniel's heart beating and rushed him to a hospital. Five days later, on April 6, 2020, Daniel Puerta-Johnson, 16, of Santa Clarita, California, was pronounced dead. His death was among those counted in a spike in teenagers and young adults who died from an unintentional overdose that year. (Nyerges, 4/21)

Dallas Morning News: ACLU: Federal Prisons System Ordered To Provide First Surgery To Transgender Inmate
The federal prison system has been ordered to schedule what’s believed to be the first gender-affirming surgery for a transgender inmate in its custody. A federal judge on Monday said the U.S. Bureau of Prisons must find a surgeon who can perform Cristina Nichole Iglesias’ vaginoplasty before her scheduled release in December. Iglesias, a transgender woman serving a 20-year sentence for threatening the British government, has been fighting for years to receive the surgery while behind bars. (McGaughy, 4/20)

In news from Florida —

Politico: Florida Releases Guidance Clashing With HHS Advice On Transgender Kids 
The Florida Department of Health on Wednesday offered new guidance on transition-related medical care for young people, bucking advice given by the U.S. Department of Health and Human Services Department and medical experts including the American Medical Association. Florida’s health department published a memo claiming that minors should not receive hormone therapies, puberty-blocking drugs or gender reassignment surgery. Instead, Florida’s health agency states that children and adolescents should be provided social support by peers and family and counseling from a licensed provider. The memo serves as guidance and is not a rule or regulation. (Sarkissian, 4/20)

And more updates on LGBTQ+ health care —

UPI: Parents Ask Court To Overturn Alabama Law Denying Their Transgender Children Healthcare
Parents of four transgendered children in Alabama have asked a federal judge to overturn a controversial state law criminalizing doctors for providing minors with gender transition-related healthcare before it goes into effect next month. Senate Bill 184 is considered one of the most restrictive bills in the nation affecting transgender people as it aims to prohibit medical procedures or prescriptions of medication to minors intended to alter their gender or delay puberty by penalizing their doctors with up to 10 years' imprisonment. (Coote, 4/21)

Dallas Morning News: Log Cabin Republicans Of Texas Support Blocking Certain Medical Treatments For Transgender Youth
The Log Cabin Republicans’ national organization publicly criticized the Biden administration for supporting gender-affirming care weeks ago. LCR of Texas Chairman Marco Roberts said the group carefully considered the issue after members asked for direction. It did not characterize gender-affirming care as “child abuse” in its statement. “We did not come out with a statement immediately after the governor’s policy was announced because we felt that we needed to do our due diligence, review the science, and not throw something out that was not carefully considered, regardless of political pressures on different sides,” Roberts told The Dallas Morning News. “But gay and trans conservatives and allies do look to us for leadership on these issues, and we aim to do our best to provide it.” (McGaughy, 4/19)

NBC News: Texas Child Welfare Workers Quit Over Governor's Transgender Directive
An increasing number of child welfare workers in Texas are quitting because of a directive from Gov. Greg Abbott that requires them to investigate child abuse claims against parents suspected of providing gender-affirming care to their transgender children. Morgan Davis, a transgender man, put in his two-week notice with the Child Protective Services office in Travis County this month because he “couldn’t morally continue” his job after investigating the family of a trans teen, he told KXAN-TV, an NBC affiliate in Austin. (Yurcaba, 4/19)

Deseret News: How Many Utah Residents Actually Support Transgender Girls Sports Ban?
The bill’s sponsor, Rep. Kera Birkeland, R-Morgan, said during committee and floor debate that she sponsored HB11 to preserve the integrity of girls athletics. Some lawmakers said they supported the final version of the legislation to protect their daughters. “Standing up for Utah’s female athletes has always been my goal, and I am encouraged that a majority of Utahns feel similarly,” Birkeland said in a statement responding to the poll results. The results revealed that more than half of the men polled — 51% — strongly supported the legislation, compared to 37% of women. Sixty-one percent of men either strongly or somewhat supported the law while 47% of women were in support. Nearly as many women — 46% — said they somewhat or strongly opposed HB11. (Cortez, 4/21)

The Hill: Missouri Lawmaker Goes Viral For Impassioned Speech Against Transgender Sports Bill
A Missouri state representative has gone viral on social media for an impassioned speech he made this week against a proposed measure in his state to ban transgender girls from competing on girls’ sports teams. The speech from Democratic state Rep. Ian Mackey, who is gay, started when he confronted state Rep. Chuck Basye (R) on the Missouri House floor Monday. Mackey asked Basye, who sponsored the proposed amendment, about the moment Basye’s brother came out as gay to his family, to which Basye said his brother initially “thought that we would hold that against him and not let my children be around him.” (Prieb, 4/20)

CIDRAP: Study Suggests Worse Outcomes For Awake COVID Patients In Prone Position
A nonrandomized controlled trial yesterday in JAMA Internal Medicine shows worse outcomes for hospitalized COVID-19 patients with low oxygen levels placed in the prone (chest-down) position while awake, although a commentary cautions about study design shortcomings. (Van Beusekom, 4/19)

New England Journal of Medicine: Intramuscular AZD7442 (Tixagevimab–Cilgavimab) For Prevention Of Covid-19 
The monoclonal-antibody combination AZD7442 is composed of tixagevimab and cilgavimab, two neutralizing antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that have an extended half-life and have been shown to have prophylactic and therapeutic effects in animal models. Pharmacokinetic data in humans indicate that AZD7442 has an extended half-life of approximately 90 days. (Levin, M.D., et al, 4/20)

CIDRAP: Androgen Suppression Not Tied To Better COVID-19 Outcomes In Men
A randomized controlled trial found that suppressing androgen hormones in male COVID-19 patients hospitalized with the virus did not improve outcomes. The study was published yesterday in JAMA Network Open. (4/20)

The Lancet: Comparing The Human Milk Antibody Response After Vaccination With Four COVID-19 Vaccines: A Prospective, Longitudinal Cohort Study In The Netherlands 
Vaccination of lactating women against COVID-19 may protect not only themselves but also their breastfed infant through human milk. Therefore, it is important to gain insight into the human milk antibody response after immunization with the various vaccines that are currently widely used. The aim of this study is to determine and compare the antibody response in human milk following vaccination with mRNA- and vector-based vaccines up to over two months post-vaccination. (Juncker, et al, 4/20)

Nature: A Golden Era Of Cancer Clinical Trials 
Cancer immunotherapy is generating huge excitement, but the future may lie elsewhere, in antibody–drug conjugates, proteolysis-targeting chimeras, and liquid biopsy for early detection. (Webster, 4/19)

ScienceDaily: Genetic Analysis Provides Insights Into The Cause Of Hydrocephalus, Or 'Water On The Brain'
Genetic studies of children with hydrocephalus ('water on the brain') combined with mouse models indicate that in certain genetic subtypes, the condition arises due to abnormal neurodevelopment that disrupts mechanical stability of the brain. Treatment strategies need to optimize brain development beyond the current standard of simply draining brain fluid. (Massachusetts General Hospital, 4/18)

ACP Internist: PDE5 Inhibitors Didn't Increase Cardiovascular Events In Men On Nitrates For Heart Disease 
Men with heart disease who took both nitrates and a phosphodiesterase type 5 (PDE5) inhibitor did not have a statistically significant increase in cardiovascular risk, a study found. Researchers from Denmark collected patient data from the country's health registries to observe trends of coprescription of nitrates and PDE5 inhibitors and to measure any association with cardiovascular outcomes. (4/19)

The New York Times: How To Stop Superspreader Events Without Masks 
At every stage of the pandemic, a disproportionate number of infections have been traced to a relatively small number of gatherings, also known as superspreader events. The recent Gridiron dinner, after which over 70 people tested positive including members of the Biden administration, is just the latest example. Some public health experts argue that tolerating these events is what living with Covid looks like. As far as we know, no one who tested positive after the Gridiron dinner became severely ill, but we don’t know if these cases also spread to workers and beyond. There’s little reason to accept this as a new normal. (Donald K. MIlton, Edward A. Nardell adn David Michaels, 4/21)

The Boston Globe: Biden Administration Should Appeal Federal Court Decisions Invalidating Airline Mask Mandate
When a federal judge struck down the nationwide transportation mask mandate, the news was quick to reach travelers across the country. Pilots announced the judge’s ruling mid-flight, allowing their passengers to remove their masks if they so pleased. Some cheered and waved their face coverings in the air. And one after another, airlines began releasing statements announcing that they would no longer require their customers to wear masks on flights. Delta Airlines even took some creative liberty with their announcement, declaring that COVID-19 had “transitioned to an ordinary seasonal virus” — a statement so premature that the airline had to walk it back. (4/21)

The New York Times: The Mask Mandate May Be Gone. Here Are Other Covid Policies To Support
When a federal judge struck down the mandate for mask wearing on planes, buses and other modes of public transportation on Monday, most major airlines wasted no time in ending their requirements. Passengers even cheered midflight when they were told they could take off their masks. The science on masking did not change this week, yet public health experts and policymakers are now forced to acknowledge what many will no longer do to protect others. (Aaron E. Carroll, 4/20)

Bloomberg: The Airline Mask Mandate Has Ended. Should You Still Wear One? 
After a judge overturned a CDC mandate that U.S. airlines require passengers to wear masks on airplanes, the TSA immediately stopped enforcing masking in airports. One viral video even showed a flight attendant walking down an airplane aisle asking people to throw their masks away. But with Covid cases on the rise again, what does mask-abandonment mean for public health? Even if you don’t have to wear a mask on a plane, should you? (Faye Flam, 4/20)

Kansas City Star: KS, MO Senators Do Nothing As Veterans Exposed To Toxins Die
One by one, U.S. military veterans walked to a podium at Kansas City’s VFW headquarters Tuesday, describing the brutal effects of exposure to toxic smoke while in the service. Headaches. Cancers. Difficulty breathing. Broken families and lost friends. Death. The vets have endured years of illness — and a government that too often seems indifferent to their suffering. “These veterans who are looking for care are being betrayed,” said William Wisner, who works with Burn Pits 360, an advocacy group for veterans dealing with toxic poisoning. “It’s not right,” he said. (4/20)

The Boston Globe: Primary Care Is On Life Support 
We have been receiving announcements about colleagues leaving primary care on a regular basis. Though a smattering of reasons are given, they usually fall into a few buckets: pursuing new ventures outside of health care, “needing a break” without any clear plan of returning, or early retirement. Their departures are both heartbreaking and unsurprising. And the gaps they leave threaten the entire health care system. A 2021 National Academy of Sciences, Engineering and Medicine report emphasized that primary care is the only health care component where an increased supply is directly associated with better population health, lower mortality rates, and more equitable health outcomes. (Katherine Gergen Barnett, 4/21)

Also —

Cincinnati Enquirer: Give Terminally Ill Options With A Medical Aid In Dying Law
My father took his life in November 2019. He was 83, of sound mind and terminally ill with Stage 4 cancer complicated by COPD. He’d been treated for melanoma a decade earlier and knew what that entailed. Fiercely independent, he considered what lay ahead as his condition progressed, weighed the pros and cons of the choices available to him and eventually decided to take matters into his own hands. In the note he left behind, my father wrote that he saw no point in seeing his cancer through to the end. So he shot himself. I'm at peace with my father's decision. I am not at peace with his means of dying. (Ann Schuur, 4/20)

Dallas Morning News: I Lost My Dad To Suicide. Shining A Light On Such Tragedy Can Help Prevent More Trauma
It’s been 10 years. More than 10, and it still hurts. Maybe not as frequently as it once did, but the grief is there. It lingers on, waiting to pop up at the most inconvenient moments. Suicide is a complex type of grief. There’s the classic guilt. Doubt. Confusion. Betrayal. Sorrow. Shock. Trauma. All combined with the slow realization that what we’re grieving isn’t just the person. We grieve our former selves. I’m not who I was, but I sure do wish I were. It feels as though my very DNA has changed, and no matter what I do, I can’t get it to go back. (Kelly O'Malley, 4/21)

The Tennessean: Begin End Of Life Care Dialogue Before Conversation Is Necessary
Talking about the end of our lives may be considered taboo, but it’s an important discussion to have with loved ones. In the decade I worked as a practicing nurse, I saw the struggle and grief of families who had to make end-of-life decisions without knowing what their loved ones wanted. It can be traumatizing to guess at these choices, especially following unexpected events. (Laura Templeton, 4/20)