The New York Times: Patients Must Be Warned Of Breast Implant Risks, F.D.A. Says 
Federal regulators on Wednesday placed so-called black box warnings on breast implant packaging and told manufacturers to sell the devices only to health providers who review the potential risks with patients before surgery. Both the warnings and a new checklist that advises patients of the risks and side effects state that breast implants have been linked to a cancer of the immune system and to a host of other chronic medical conditions, including autoimmune diseases, joint pain, mental confusion, muscle aches and chronic fatigue. (Rabin, 10 /27)

AP: FDA Sets Stronger Safety Warnings For Breast Implants
In the biggest shift, plastic surgeons and other health professionals who work with the implants must give their patients a checklist detailing possible side effects, such as scarring, pain, rupture and even a rare form of cancer. The checklist also explains that breast implants often require repeat surgeries and they should not be considered lifelong devices. The doctors must sign the document and confirm that the recipient was given an opportunity to review it before surgery. Companies that sell implants to doctors who don’t comply could face fines and other penalties from regulators. The rules begin to take effect in 30 days. (Perrone, 10/27)

CNN: FDA Adds Boxed Warning To Breast Implants
After hearing testimony in 2019 from women who said their doctors did not adequately warn them about the potential health complications of breast implants, the FDA said it decided to restrict the sale of breast implants to only health care providers who offer patients a standardized checklist that explains the risks. The changes require doctors to walk patients through these potential problems and to give the patient an opportunity to sign off on the checklist to show they were properly informed about the risks to their health. The older the implants are, the more health risks they pose, and those risks could require additional surgery. (Christensen, 10/27)

The Wall Street Journal: Antidepressant Significantly Reduces Covid-19 Hospitalization 
A widely available antidepressant holds promise as a treatment for Covid-19, according to a new study. Covid-19 patients who received fluvoxamine were significantly less likely to require hospitalization than those who didn’t, in the largest clinical trial evaluating the antidepressant’s effect on Covid-19 to date. Fluvoxamine belongs to a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. It is commonly used to treat obsessive compulsive disorder and is also prescribed for depression. (Toy, 10/27)

CNN: Cheap, Generic Anti-Depressant May Reduce Severe Covid-19 Disease, Study Finds
A cheap, generically available anti-depressant may reduce the risk of severe Covid-19 disease by close to a third in people at high risk, researchers reported Wednesday. A trial among about 1,500 patients in Brazil showed those who took the drug, known as fluvoxamine, were less likely to progress to severe disease and to require hospitalization. The drug, sold under the brand name Luvox, is a selective serotonin reuptake inhibitor (SSRI) most often used to treat obsessive compulsive disorder (OCD) and depression. But it can affect inflammation, said Dr. Angela Reiersen, an associate professor of psychiatry at Washington University in St. Louis who worked on the study, published in The Lancet Global Health. (Fox, 10/28)

AP: Cheap Antidepressant Shows Promise Treating Early COVID-19
The pill, called fluvoxamine, would cost $4 for a course of COVID-19 treatment. By comparison, antibody IV treatments cost about $2,000 and Merck’s experimental antiviral pill for COVID-19 is about $700 per course. Some experts predict various treatments eventually will be used in combination to fight the coronavirus. (Johnson, 10/27)

Axios: COVID Cases, Deaths At Meat Plants Far Higher Than Previously Thought 
Cases and deaths from COVID-19 among workers at the five largest U.S. meatpacking companies were nearly three times higher than previously thought, according to a memo from the House panel probing the response to the pandemic. At least 59,000 workers contracted COVID-19 and 269 workers died at Tyson Foods, JBS USA, Cargill, National Beef and Smithfield Foods — which together make up more than 80% of the beef market and 60% of the pork market in the U.S. — according to counts through January of this year. (Doherty, 10/27)

In other news about the spread of the coronavirus —

Axios: COVID Cases Fall By 20% 
The number of new COVID-19 cases continues to plummet all across the U.S. The U.S. is now averaging roughly 70,000 new cases per day, a 20% drop over the past two weeks. Deaths fell 15% over the same period, to an average of 1,400 per day. That's still a lot, equivalent to a 9/11 roughly every two days. But that number has been steadily coming down throughout the fall, and likely will continue to drop. (Baker and Beheraj, 10/28)

Detroit Free Press: Michigan's Delta Variant Surge Might Be On Its Way Out, Experts Say
Michigan's fourth coronavirus surge, driven by the highly contagious delta variant, may be starting to retreat after more than three months of a steady rise in cases, hospitalizations and deaths. The seven-day average of new daily cases fell to 3,210 on Monday — about 500 new daily cases fewer than at the Oct. 13 peak, when the seven-day average topped out at 3,745 daily cases. Though the trends are encouraging, it may be too soon to declare it over just yet, said Dr. Natasha Bagdasarian, the state health department's newly appointed chief medical officer. (Jordan Shamus, 10/27)

USA Today: Only 40% Of Americans Know Vaccinated People Less Likely To Get Virus
A new Axios/Ipsos poll finds Americans are uncertain about how well the COVID-19 vaccines work, despite reams of data about their ability to protect people from severe disease, hospitalization and death, and to a lesser extent infection. That lack of knowledge is likely contributing to the continued vaccine holdout of 60 million people who are eligible for the shots, and to diminished faith in the Biden administration. Confidence that his government can make sure the economy recovers quickly after the pandemic dropped from 52% in late January to 44% in the latest poll. Some of that eroding confidence may be rooted in how little Americans know about the vaccines, which are central to Biden's plan for the U.S. to escape the pandemic. In the poll, only slightly more than 25% of respondents correctly said that a vaccinated 80-year-old is at greater risk of dying of COVID-19 than an unvaccinated 30-year-old. And only 40% knew that vaccinated people are less likely to test positive for the coronavirus than those who haven't been inoculated. (Ortiz and Bacon, 10/27)

What about trick-or-treating? —

AP: Is It OK To Go Trick-Or-Treating During The Pandemic?
Is it OK to go trick-or-treating during the pandemic? It depends on the situation and your comfort level, but there are ways to minimize the risk of infection this Halloween. Whether you feel comfortable with your children trick-or-treating could depend on factors including how high the COVID-19 transmission rate is in your area and if the people your kids will be exposed to are vaccinated. (Tobin, 10/28)

Deseret News: Here’s How To Avoid COVID This Halloween
In addition to getting the shots, the state advises wearing a face covering. “Not only your grim reaper mask, but also your COVID-19 mask. If you’re headed somewhere indoors, like a haunted house or a wild witching party, put on a mask and don’t be the creature that spreads COVID,” the site says. Other tips include washing hands, staying home if you’re sick and getting tested for the coronavirus, holding any Halloween parties outdoors and making sure trick-or-treaters avoid traffic when they’re making their neighborhood rounds with some likely to go out on Saturday night rather than Sunday. (Roche, 10/27)

AP: Not A Trick: No White House Treats For Halloween This Year
Ghosts and goblins can scratch the White House from their trick or treating routes this year. President Joe Biden and first lady Jill Biden will be in Europe on Halloween and won’t be at the White House to help hand out candy and other treats. Instead, the Pennsylvania Avenue side of the White House will be lit up in orange light to celebrate the spooky holiday, said the first lady’s spokesperson, Michael LaRosa. (Superville, 10/28)

The Washington Post: Vaccine Eligibility For Mood Disorders Underscores Elevated Covid Risk
When the Centers for Disease Control and Prevention added mood disorders to the list of conditions that put people at high risk for severe covid-19 recently, clinicians were not surprised. The mind-body connection, they say, is long-settled research. But the scientific seal of approval is still critical: It makes millions of people eligible for booster shots based on their mental health diagnosis alone and gives vulnerable groups more reason to protect themselves. (Portnoy, 10/27)

In more news about booster shots —

Modern Healthcare: New Jersey Hospital Mandates Boosters For J&J Vaccine Recipients
University Hospital workers who received the Johnson & Johnson COVID-19 vaccine will be required to get a booster shot by Christmas Eve. The one-shot Johnson & Johnson vaccine has been shown to offer a lower level of protection against the novel coronavirus than the two-shot inoculations from Moderna and Pfizer-BioNTech. The leaders of the 519-bed Newark, New Jersey-based state-owned academic medical center decided that employees who opted for the Johnson & Johnson vaccine need a stronger shield against the virus, University Hospital President and CEO Dr. Shereef Elnahal said. (Devereaux, 10/27)

Bay Area News Group: COVID: Newsom, Schaaf, Get Boosters, Urge Jabs Ahead Of Holidays
Gov. Gavin Newsom, Oakland Mayor Libby Schaaf and other leaders rolled up their sleeves Wednesday for extra COVID-19 vaccine shots as they called for eligible Californians to get boosters and made plans to inoculate young kids as early as next week, hoping to keep the virus in check over the coming holidays. Citing concerns about another possible winter surge of infections even with California’s high vaccination rates and cautionary measures such as requiring face masks in schools, Newsom and others urged people to get the vaccine or a booster and get their kids the shots when they become available. (Woolfolk, 10/27)

The New York Times: How To Decide Which Covid Booster Shot To Get 
Deciding which booster shot to get can feel a lot like a choose-your-own-adventure book — you’ve got three options, but don’t have a clue which one leads to the best outcome. The Food and Drug Administration recently authorized a mix-and-match booster shot strategy that now allows eligible adults to pick a booster from one of three Covid-19 vaccines — Pfizer-BioNTech, Moderna or Johnson & Johnson — even if it’s different from the one they initially received. (Parker-Pope, 10/27)

CNN: Most Parents Don't Plan To Vaccinate Young Children Against Covid-19 Right Away, KFF Survey Finds 
A Covid-19 vaccine could be available for little kids soon, and public health leaders say vaccinating them could help end the pandemic -- but only if parents actually get them vaccinated. A new survey suggests that's uncertain at best. The majority of parents say they will not get their younger children vaccinated right away, according to the survey published Thursday from the Kaiser Family Foundation. (Christensen, 10/28)

NBC News: Why Even Some Vaccinated Parents Aren't Planning To Rush To Give Kids Covid Shot
Sarah Beth Burwick, a lawyer in Los Angeles, said she and her husband both got their Covid-19 vaccinations at “the earliest possible opportunity” and their two children received all of their childhood vaccinations “on the schedule, without even questioning it." But she's not planning to rush out to get the children, ages 5 and 2, vaccinated against Covid, even though one of them could be eligible as soon as next week. “There would need to be information out there to convince us it was necessary first," Burwick, 37, said. “I would say I think it’s unnecessary. And I’m uncomfortable with how quickly it’s rolling out with such a small study." (Silva, 10/27)

Axios: Fauci: "I Would Vaccinate Them In A Second" 
NIAID director Anthony Fauci tells Axios even though the chances of young children getting seriously ill from COVID-19 are small he urges parents to immunize them once a vaccine is authorized. An FDA expert panel on Tuesday endorsed an emergency use authorization for a lower dose of Pfizer's COVID-19 vaccine for 5 to 11-year-olds, paving the way for another swath of the U.S. population to be vaccinated. (O'Reilly, 10/28)

In related news about covid vaccines for children —

CNBC: Covid Vaccines For Kids Ages 5 To 11: Safety, Side Effects, Other FAQs
Covid vaccines for young children are almost here — a critical step toward ending the pandemic. But plenty of American parents don’t plan on signing their kids up right away. On Tuesday, a Food and Drug Administration advisory committee recommended a low dosage of Pfizer’s Covid vaccine for children ages 5 to 11, setting the stage for roughly 28 million kids to become eligible for the vaccine as soon as next week. The FDA will likely approve the committee’s recommendation later this week and then send its findings to the Centers for Disease Control and Prevention for a final decision. (Stieg, 10/27)

Los Angeles Times: COVID-19 Risk In Kids Is Small, But Vaccines Can Save Lives
Although the chances of serious illness and death from COVID-19 are exceedingly slim for children, experts say there’s a very good reason for parents to get their kids vaccinated. COVID-19 has become one of the leading causes of death in children nationwide. There were 66 COVID-related deaths among children ages 5 to 11 in the yearlong period that ended Oct. 2, according to data from the U.S. Centers for Disease Control and Prevention, making COVID-19 the eighth-leading cause of death in that age group. (Lin II and Money, 10/27)

The Atlantic: The Next Big Questions About Kids' COVID Vaccinations
Some good news finally—finally—appears to be on the horizon for roughly 28 million of the United States’ youngest residents. On the heels of an advisory meeting convened yesterday, the FDA is likely on the cusp of green-lighting a kid-size dose of Pfizer’s COVID-19 vaccine for Americans ages 5 to 11, a move that’s been months in the making. After the agency’s expected emergency authorization, Pfizer’s formulation will need a recommendation from CDC Director Rochelle Walensky, who’s expected to weigh in next week, after her own advisory committee holds a vote. But the nation is ready: Already, 15 million pediatric doses of Pfizer’s vaccine—which will be administered at a third of the amount doled out to adults—have become available for states to order in advance. (Wu, 10/27)

USA Today: States Expecting Pfizer COVID Vaccine Doses For Kids Ahead Of Approval
Some states are preparing to receive hundreds of thousands of doses of the Pfizer COVID-19 vaccine for children ages 5 to 11 next week, ahead of full authorization by regulatory bodies. The vaccines for children, which will be at lower doses than the adult vaccines, were backed by an FDA advisory committee earlier this week, and could receive full approval by as early as next week. The FDA will decide whether to authorize the child vaccines, and then the CDC will make a decision on whether to recommend the shots. (Santucci, 10/28)

Los Angeles Times: California Plans Ambitious Effort To Vaccinate Young Children
California health officials said Wednesday that they are prepared to pull out all the stops to vaccinate children ages 5 to 11 against COVID-19 as the country draws closer to authorizing eligibility for that age group. Though a number of federal and state hurdles remain, state officials said they are preparing to offer doses to the roughly 3.5 million children in that age group by the end of next week, as the holiday season approaches. (Money and Lin II, 10/27)

Bloomberg: NYC Police Union Fails To Get Judge To Block Vaccine Mandate
New York City’s largest police union failed to persuade a state court judge to block Mayor Bill de Blasio’s vaccine mandate from taking effect next week. State Supreme Court Judge Lizette Colon on Wednesday denied a request by the 40,000-member Police Benevolent Association of the City of New York for a temporary restraining order, citing a 2019 state appellate ruling that upheld a vaccine mandate for measles. The New York mandate requires all municipal workers, including cops and firefighters, to have gotten at least one dose of a coronavirus vaccine by Nov. 1. The police union sued to block the mandate on Monday, asking the court to bar it from being enforced while its suit is pending. (Burnson, 10/28)

Reuters: NYC Firefighters Union Says Members Should Defy Vaccine Mandate
The head of the New York City firefighters union said on Wednesday he had told unvaccinated members to report for duty regardless of an order by Mayor Bill de Blasio to place them on unpaid leave if they fail to get the COVID-19 shot. New York City firefighters who have risked their own health to save lives during the coronavirus pandemic felt "insulted" by de Blasio's order to get the shot or face suspension, said Andrew Ansbro, president of the Uniformed Firefighters Association. (Clifford and Whitcomb, 10/27)

Fox News: FDNY Union Leader Warns COVID Vaccine Mandates Will Spike Emergency Response Times, Send City Into 'Chaos'
New York City’s municipal workforce has been warned by Mayor Bill de Blasio to be vaccinated by Nov. 1 or face unpaid leave which FDNY Firefighter Association President Andrew Ansbro argues will only cause chaos. In an appearance on Fox News Radio’s "Brian Kilmeade Show," the firefighter expressed how the department refuses to go down without a fight which will only lead to fewer workers on duty and more emergencies waiting to be responded to. "The staffing just is not there, there’s no way to do it," he said. "The response times are going to go through the roof. We’re just not going to be able to get to the emergencies in time." (Stabile, 10/27)

Gothamist: FDNY: 1 In 5 Ambulances, Fire Companies Could Be Offline Monday As NYC Workers Fight Vaccine Mandate 
The head of the New York City Fire Department says staffing shortages could shutter up to 20% of firehouses next Monday, once the city’s COVID-19 vaccine mandate goes into effect. FDNY Commissioner Daniel A. Nigro said he would also predict 20% fewer ambulances on the road. Nigro said FDNY is bracing for the potential shortages by canceling all vacation days starting November 1st, requiring people to work overtime and reassigning uniformed employees who typically work desk jobs back into the field at firehouses across the city. Municipal employees are required to get at least one dose of COVID-19 vaccine by Friday at 5 p.m. and enforcement will start Monday morning. (Hogan, 10/27)

AP: Republican Attorneys General Criticize Biden Vaccine Order
Twenty-one Republican state attorneys general sent a letter to President Joe Biden on Wednesday saying they think his COVID-19 vaccination mandate for federal contractors “stands on shaky legal ground,” is confusing to contractors and could exacerbate supply-chain problems. They wrote that companies could be blacklisted for federal contracts unless they get their workers vaccinated on “an unworkable timeline.” (Pettus, 10/27)

The Washington Post: White House Suggests Flexibility In Vaccine Mandate For Federal Employees, Contractors 
The White House coronavirus response coordinator, Jeff Zients, indicated that the Biden administration could be flexible as it enforces the president’s executive order requiring federal workers and government contractors to vaccinate their workers. The vaccine mandate aims to protect as many people from the coronavirus as possible — not to punish them by getting them fired from their jobs should they be unvaccinated by the due dates, Zients said Wednesday. (Jeong and Suliman, 10/28)

In other news about vaccine mandates —

Salt Lake Tribune: Intermountain Healthcare Will Require Its Caregivers To Be Vaccinated Against COVID-19
Intermountain Healthcare has announced it will require “all of its caregivers” to be fully vaccinated against COVID-19 in order to comply with pending federal rules. Federal officials are moving forward on vaccine requirements for large employers — and previously have said government insurers like Medicare and Medicaid will only cover services from health care providers whose employees all are vaccinated. That would eliminate coverage for about four in every 10 of Intermountain’s patients, if the network did not require vaccines, said Dr. Mark Briesacher, chief physician executive for Intermountain. (Alberty and Pierce, 10/27)

AP: Bill Would Remove 'Conscience' As Basis For Refusing Vaccine
Illinois law has for more than four decades protected those who oppose providing or receiving medical treatment because of their religious beliefs. Now Democrats want an exception to allow repercussions for those who refuse vaccinations in the battle against COVID-19. Long considered a shield for physicians whose religious beliefs precluded their performing abortions, the Illinois Health Care Right of Conscience Act has become a pandemic lightning rod. Lawsuits invoking it are challenging employers trying to enforce rules requiring testing for or inoculation against the coronavirus. (O'Connor, 10/28)

CNBC: Covid Vaccine: Some 5% Of Unvaccinated Adults Have Quit Their Jobs Over A Mandate, Survey Shows
Five percent of unvaccinated adults say they have left a job due to a vaccine mandate, according to a survey released Thursday by the Kaiser Family Foundation. This early read on whether workers will actually quit their jobs over mandates comes as more employers are requiring shots. One-quarter of workers surveyed by KFF in October said their employer has required them to get vaccinated, up from 9% in June and 19% last month. (Rattner, 10/28)

In news about mask mandates —

New Orleans Times-Picayune: New Orleans To Lift Mask Mandate, Tweak COVID Vaccine Rules Ahead Of Halloween
Mayor LaToya Cantrell on Wednesday loosened New Orleans's COVID-19 restrictions, ending the city's requirement that residents and visitors wear masks in public spaces and tweaking the city's vaccine mandate to allow a wider variety of negative coronavirus tests as an alternative to getting a shot. The new rules, which take effect Friday and will be in place for Halloween, follow the decision by Gov. John Bel Edwards earlier this week to end the statewide mask mandate. They also come amid a sharp decline in coronavirus cases in the city that has made city officials more willing to relax what have stood as the most stringent rules on vaccines and masks in Louisiana. (Myers, 10/27)

AP: Flouting White House, Florida Penalizes School Districts
The state of Florida has withheld funding from two school districts over their coronavirus mask mandates, flouting threats from White House officials who warned that such penalties would violate federal law. School officials in Alachua and Broward counties on Wednesday said the state docked school board salaries and overall funding in amounts equal to federal aid packages meant to blunt the state’s sanctions on mask requirements. This month, more than $164,000 was withheld from the Alachua school district and more than $455,000 was withheld from Broward. (Izaguirre, 10/27)

AP: Judge: Colorado Parents Can't Exempt Kids From School Masks
A federal judge has issued a restraining order against a suburban Denver county’s policy allowing parents to opt their children out of a mask mandate at school, finding that the rule violates the rights of students with disabilities who are vulnerable to COVID-19.U.S. District Judge John L. Kane on Tuesday called the Douglas County Board of Health order that allowed parents to opt their children out of mask-wearing a violation of the Americans with Disabilities Act, which guarantees equal access to education for all. (10/27)

AP: Biden To Head To Capitol To Push Agenda, Unite Democrats
President Joe Biden heads to Capitol Hill early Thursday to push his revised domestic policy bill and a related bipartisan infrastructure plan with fractious House Democrats after days of prolonged negotiations over his ambitious social and climate policies and how to pay for them. Biden will then make remarks from the White House, a possible signal that agreement might be within reach after a paid family leave proposal fell out and a billionaires’ tax appeared scrapped to win over pivotal senators in the 50-50 Senate. (Mascaro, Madhani and Fram, 10/28)

The Hill: Biden To Announce New Framework On Spending Deal
Specifics of Biden's agenda were not immediately clear, making it difficult to know what will make it into his final proposal for an ambitious spending package that would cover funding for climate programs, education, family and child care and more. Democrats have spent months haggling over details, including how to pay for the package. (Samuels and Wong, 10/28)

ABC News: Family Leave Hangs In The Balance As Democrats Scramble To Close Social Spending Deal 
Democrats on Wednesday scrambled to close the deal on President Joe Biden's landmark social spending legislation, focusing on new ways to pay for the package, including a billionaires tax the White House said the president supports. At the same time, they were hoping to make enough progress that House progressives would agree to vote for a separate Senate-passed bipartisan infrastructure bill before Biden heads overseas Thursday. (Cathey, Turner, Khan and Pecorin, 10/27)

Roll Call: Pelosi Aims To Light Fire Under Budget Package Negotiators
House Democratic leaders sought to increase pressure for a deal on their mammoth spending and tax package that would allow a vote this week on a bipartisan infrastructure bill that faces a Halloween deadline.Speaker Nancy Pelosi, D-Calif., said the House Rules Committee would hold a "hearing" Thursday on the still-unfinished Democratic budget reconciliation package to expand the social safety net and combat climate change. Progressives have said they would not vote for the infrastructure bill, offering $550 billion in new public works money, without a vote on the broader social spending bill. (McPherson, Shutt, Weiss, and Lerman, 10/28)

The New York Times: Hunting for Money, Democrats Rush to Rewrite Tax Code
As they hunt for revenue to pay for their sprawling spending bill and try to unite a fractured caucus, Democrats are attempting to rewrite the United States tax code in a matter of days, proposing the kind of sweeping changes to how America taxes businesses and individuals that would normally take months or years to enact. The effort has effectively discarded trillions of dollars of carefully crafted tax increases that President Biden proposed on the campaign trail and that top Democrats have rolled out in Congress. Instead, lawmakers are throwing a slew of new proposals into the mix, including a tax on billionaires, hoping that they can pass muster both legally and within their own party. (Rappeport and Tankersley, 10/27)

Also —

CNBC: Medicare Expansion Hangs In The Balance As Democrats Race Towards Deal
A major expansion of Medicare that Democrats proposed as part of the Build Back Better initiative is in danger of being trimmed or even taken out of the legislation as lawmakers scramble to make a deal. In their original $3.5 trillion budget proposal, Democrats included a revision of Medicare that would add coverage for dental, hearing and vision. The plan was expected to cost around $350 billion over a decade. But now, those parts of the expansion may be dropped as lawmakers look to trim the overall cost and rework pieces of the legislation to appease centrist Democratic Sens. Joe Manchin, D-W. Va., and Kyrsten Sinema, D-Ariz. (Reinicke, 10/27)

The Washington Post: Vulnerable Democrats Worried About What Is Not In Reconciliation Bill 
The House Democrats at most risk of losing their seats in the 2022 midterm elections are urging their colleagues not to jettison a set of popular programs from President Biden’s economic and social spending package, warning that failing to deliver on these promises to voters could pave the way for Republicans to regain control of Congress. These vulnerable Democrats argue that expanding Medicaid into certain states, allowing the government to negotiate prescription drug prices, expanding Medicare coverage and providing for paid family leave are key to both motivating Democrats to vote in the midterm elections and to winning over the small but key group of independent voters who could otherwise back their Republican challengers. (Sotomayor, 10/27)

Roll Call: ‘Pride In Product’ Colors Lawmakers’ View Of Budget Negotiations 
House and Senate Democrats are engaged in a policy and process war over unresolved tax and health care provisions of the budget reconciliation package on which Democrats are trying to reach a “framework” agreement this week. Most of the major open issues fall under the jurisdiction of the House Ways and Means and Senate Finance committees. Final decisions have yet to be made on tax increases, prescription drug price negotiation, expansions of Medicare and Medicaid and a paid leave program. Aides have said paid leave is out, but lawmakers are still pushing for a solution. (McPherson, 10/27)

KHN: Democrats’ Plans To Expand Medicare Benefits Put Pinch On Advantage Plans’ Funding
“Did you think we wouldn’t notice?” an older woman says, speaking into the camera. “You thought you could sneak this through?” an older man later adds. Others warn that Washington is “messing with” their Medicare Advantage health coverage and trying to raise their premiums. But the television ad, paid for by Better Medicare Alliance, a research and advocacy group for Medicare Advantage plans, doesn’t spell out what cuts congressional lawmakers might be trying to slip past unsuspecting seniors. (Andrews, 10/28)

In other news from Capitol Hill —

Las Vegas Review-Journal: House Passes Bill To Get Mental Health Support For First Responders
Bipartisan legislation modeled after Nevada laws to provide confidentiality to law enforcement officers and first responders who seek and participate in mental health counseling was passed overwhelmingly in the House on Wednesday. The House voted 424-3 to pass the legislation that Sen. Catherine Cortez Masto, D-Nev., said would get law enforcement officers the “mental health support they need and deserve.” The bill, introduced by Cortez Masto and Sen. Chuck Grassley, R-Iowa, was passed in the Senate in June by unanimous vote. Following the House vote, it now goes to the White House for the president’s signature (Martin, 10/27)

The Washington Post: Supreme Court: Texas, Justice Dept. Argue Over Role Of Federal Courts In Abortion Law Dispute
The Biden administration told the Supreme Court on Wednesday that intervention is required to keep Texas from “nullifying” the constitutional right to abortion that the court established nearly 50 years ago. The brief was submitted in advance of Monday’s hastily scheduled hearing on the Texas law that has virtually shut down abortion within the state’s borders. Texas, the federal government, abortion providers and individual citizens who want to enforce the law called S.B. 8 each made their cases. (Barnes, 10/27)

Roll Call: High Court Told Texas Abortion Law Model Could Spread To Guns, Free Speech
The Supreme Court faces arguments that a novel enforcement scheme Texas created for its abortion law could be used by states to neutralize other constitutional rights related to guns, protests, campaign finance and more. The warning comes from not only the Justice Department and the abortion providers that have challenged the Texas law but also constitutional scholars, states, former prosecutors and law enforcement officials and a California-based nonprofit group that pushes for gun rights. (Ruger, 10/28)

ABC News: With Abortion, Some Women Feel Like They're Stuck Between Arguments
Cessilye Smith said she's surrounded by inequality. She opened her clinic, Abide Women's Health Services, in south Dallas to help eliminate some of the disparities seen in maternal and infant health care. "Having these awful disparities that go beyond birth means there is a systemic issue here, so our little part of creating a better world -- a better environment -- for families is Abide," Smith said. Texas' controversial abortion bill, SB8, which effectively bans abortions as early as six weeks, has put the state in legal limbo this fall and has heightened conversations around the issue. (Smith, Lefferman, Coburn and Yamada, 10/27)

In abortion news from Oregon and Ohio —

CNBC: Workers In These Cities Will Get Bereavement Leave For Pregnancy Loss, Including Abortions
Portland, Oregon, is the latest city to provide bereavement leave for people experiencing pregnancy loss, including abortions. The city’s amended bereavement leave policy allows city employees to take up to three days of paid leave if they’ve had a miscarriage, stillbirth or any other type of pregnancy loss. The policy covers time off for people to recover from an abortion “irrespective of whether deemed medically necessary,” according to the text. (Liu, 10/27)

AP: Bill: Doctors Must Care For Babies Born Alive After Abortion
Doctors would be required to report cases of babies born alive after abortions or attempted abortions, under legislation approved Thursday by the GOP-controlled Ohio Senate. The bill would also ban abortion clinics from working with doctors who teach at state-funded hospitals and medical schools. (10/27)

The Washington Post: State Department Issues First Passport With ‘X’ Gender Marker 
The State Department has issued its first passport with an “X” gender marker for Americans who do not identify as male or female, in a step that the Biden administration views as an expansion of the rights of gay Americans. “We look forward to offering this option to all routine passport applicants once we complete the required system and form updates in early 2022,” Ned Price, a spokesman for the department, said Wednesday. He added, “I want to reiterate, on the occasion of this passport issuance, the Department of State’s commitment to promoting the freedom, dignity and equality of all people — including LGBTQI+ persons.” (Scott, 10/27)

In other public health news —

USA Today: Fast Food From Domino's, McDonald's Contained Chemicals In Plastics
A new study shows that chemicals known as phthalates, which have been linked to health problems, have been detected in food from popular chains like McDonald’s, Chipotle and more.  The peer-reviewed analysis was published this week in the Journal of Exposure Science & Environmental Epidemiology by researchers from George Washington University, the Southwest Research Institute (San Antonio, Texas), Boston University and Harvard University. The research includes items from McDonald’s, Burger King, Pizza Hut, Domino’s, Taco Bell and Chipotle locations in San Antonio, Texas. Researchers obtained 64 food samples of hamburgers, fries, chicken nuggets, chicken burritos and cheese pizza from the chains. (Pitofsky, 10/27)

Georgia Health News: Link Confirmed Between Georgian’s Death And Aromatherapy Spray 
CDC testing has confirmed that an aromatherapy spray or one of its ingredients caused melioidosis infections in four people, including a Georgian who died of the rare disease. The bacteria found in the spray in the Georgian’s home genetically matched the strains found in that individual, as well as patients in Kansas, Minnesota and Texas, the Atlanta-based public health agency said Tuesday. All four contracted melioidosis, which is caused by Burkholderia pseudomallei bacteria. The DNA fingerprint of the bacteria in the Better Homes & Gardens spray and in the patients was the same, the CDC said. (Miller, 10/27)

CIDRAP: Infant Formula Linked To More Antibiotic Resistance Genes
Formula feeding is associated with a 70% increase in antibiotic resistance gene (ARG) abundance in the gut microbiome of infants compared with breast milk, US and Finnish researchers reported this week in the American Journal of Clinical Nutrition. (10/27)

Modern Healthcare: UnitedHealthcare Sues TeamHealth, Alleges Fraud
UnitedHealthcare is suing emergency care provider TeamHealth, alleging the company deliberately and systematically tricked the health insurer into paying more than $100 million in fraudulent claims. The lawsuit, filed in the U.S. District Court for the Eastern District of Tennessee on Wednesday, accuses private-equity-owned TeamHealth of violating state and federal laws governing fraud, insurance regulation and consumer protection by upcoding hundreds of thousands of emergency department bills. (Tepper, 10/27)

In other corporate news —

Columbus Ledger-Enquirer: St. Francis-Emory Hospital In Columbus GA Getting New Owner
The owner of St. Francis-Emory Healthcare is merging with a hospital chain to create a new healthcare company by the end of 2021. LifePoint Health, owner of the hospital, and Kindred Healthcare announced plans Tuesday to establish ScionHealth, a new national health system that will launch at the close of LifePoint’s acquisition of Kindred. (Mixon, 10/27)

Louisville Courier Journal: Kosair Charities Gives $6.4M To UofL Children's Spinal Injury Program
On Tuesday, Kosair Charities, an organization focused on children's health, announced a $5.5 million grant for U of L's Kosair Charities Center for Pediatric NeuroRecovery, founded in 2014 to help children regain movement and mobility after a spinal cord injury. The award was among four totaling $6.4 million Kosair Charities announced for programs to identify and prevent child abuse, treat pediatric cancer and monitor infants in U of L Hospital's neonatal intensive care unit. (Yetter, 10/27)

Philadelphia Inquirer: Tower Health Records Massive Loss On St. Chris And Other Hospitals It Bought In Philadelphia Region
Tower Health has officially recognized what has long been obvious: The hospitals, urgent care centers, and other businesses that it bought for at least $480 million from 2017 to 2019 are not worth nearly what the system paid. That’s why the Berks County nonprofit, anchored by Reading Hospital, in West Reading, recorded a $370.7 million loss on those businesses in its audited financial statements for the fiscal year ended June. 30, which were released Wednesday. (Brubaker, 10/27)

Modern Healthcare: Former HHS Official Eric Hargan To Advise Digital Health Startup Amino 
Eric Hargan, former deputy secretary of the Department of Health and Human Services, will advise Amino, a digital health platform that helps workers at self-insured employers find and book appointments with providers, the company announced Wednesday. Hargan will help Amino navigate surprise billing and price transparency regulations under the auspices of his new consulting firm, The Hargan Group. Amino plans to update its platform to comply with the new rules. (Brady, 10/27)

Also —

The Boston Globe: Boston Medical Center Surgeon Fined For Leaving Operating Room To Eat In His Car, Then Falling Asleep And Missing The Procedure
The longtime head of spine surgery at Boston Medical Center has been reprimanded by state regulators and fined $5,000 for leaving an operating room before the start of an emergency ankle surgery to go eat in his parked car, where he fell asleep and missed the procedure. Dr. Tony Tannoury, 54, admitted that he woke up in his car that November night in 2016, called the teaching hospital, and was told that a chief resident had performed the operation he was supposed to oversee, according to a consent order released Monday by the Massachusetts Board of Registration in Medicine. Tannoury didn’t return to the hospital until the following day. (Saltzman, 10/27)

Axios: The Next Pandemic Will Need New Communication Strategies 
"Be first, be right, be credible" is the mantra of public health experts in a crisis. It's difficult to argue that the health community has regularly managed to be any of those three during COVID-19. A pandemic isn't just a medical emergency — it's also a communications emergency. The U.S. public health establishment, hamstrung by bad data and political interference, has struggled with the latter. It may be too late to repair the bad messaging that has marred the COVID-19 response, but better communication strategies will be needed for the inevitable next pandemic. (Walsh, 10/28)

KHN: Medicare Punishes 2,499 Hospitals For High Readmissions 
The federal government’s effort to penalize hospitals for excessive patient readmissions is ending its first decade with Medicare cutting payments to nearly half the nation’s hospitals. In its 10th annual round of penalties, Medicare is reducing its payments to 2,499 hospitals, or 47% of all facilities. The average penalty is a 0.64% reduction in payment for each Medicare patient stay from the start of this month through September 2022. The fines can be heavy, averaging $217,000 for a hospital in 2018, according to Congress’ Medicare Payment Advisory Commission, or MedPAC. Medicare estimates the penalties over the next fiscal year will save the government $521 million. Thirty-nine hospitals received the maximum 3% reduction, and 547 hospitals had so few returning patients that they escaped any penalty. (Rau, 10/28)

KHN: Look Up Your Hospital: Is It Being Penalized By Medicare?
Under programs set up by the Affordable Care Act, the federal government cuts payments to hospitals that have high rates of readmissions and those with the highest numbers of infections and patient injuries. For the readmission penalties, Medicare cuts as much as 3 percent for each patient, although the average is generally much lower. The patient safety penalties cost hospitals 1 percent of Medicare payments over the federal fiscal year, which runs from October through September. Maryland hospitals are exempted from penalties because that state has a separate payment arrangement with Medicare. Below are look-up tools for each type of penalty. You can search by hospital name or location, look at all hospitals in a particular state and sort penalties by year. (Rau, 10/27)

Modern Healthcare: Aetna To Cover Multi-Million Dollar Gene Therapies
Aetna debuted a network focused on curbing the rising costs of the growing gene therapy market, the insurer announced on Thursday. Structured like a Center of Excellence program, the company's Gene-based Cellular and Other Innovative Therapies network includes more than 75 providers who treat inherited retinal disease—which impacts approximately 2 million people worldwide—and spinal muscular atrophy, which impacts an estimated 9,000 Americans. Treatment for these conditions comes in the form of gene therapy, where providers manipulate genes at the cellular level. (Tepper, 10/27)

Stat: Partnership Aims To Accelerate Gene Therapies For Rare Diseases 
The National Institutes of Health and U.S. Food and Drug Administration unveiled a public-private partnership Wednesday aimed at accelerating gene therapies for the roughly 30 million Americans living with a rare genetic disease. “They’ve waited a long time for something to be focused this way to address the incredibly wrenching stories we see all around us of children and adults with rare diseases where we can do a diagnostic test to tell them what they have but beyond that haven’t had much to offer,” Francis Collins, the pioneering genetics researcher and longtime NIH director, told STAT. (Molteni, 10/27)

Stat: The Vast Majority Of Genes Have Been Tied To Cancer, Complicating Research
João Pedro de Magalhães scours the human genome for clues that might help us understand why people age and what we might do to stop that. Without fail, each time he’s done one of these studies, nearly every gene ends up having some kind of link to cancer. “Always,” he said. “You always have some cancer-related genes in there.” (Chen, 10/27)

In other pharmaceutical industry news —

Stat: Feds Probe Novartis Over Entresto Marketing And Compensation To Doctors
In what might become a new scandal for Novartis, federal investigators recently demanded information from the drug maker (NVS) about the pricing and marketing of one of its biggest-selling drugs, and the focus of the probe includes compensation paid to physicians. Last month, the U.S. Department of Justice issued a civil investigative demand about Entresto, a heart failure drug that generated $924 million in sales in the third quarter, a 46% gain. The demand was disclosed by the company in a regulatory filing, but further details were not made available (see page 36). (Silverman, 10/27)

Stat: CytoDyn Knew Its FDA Application Was Incomplete When It Filed, Docs Show
CytoDyn and its CEO Nader Pourhassan have known the company’s long-delayed HIV drug was in far more trouble with the Food and Drug Administration than was disclosed to investors, according to new documents filed this week as part of an ongoing civil lawsuit. The documents reveal that in May 2020, CytoDyn submitted a marketing application for its drug called leronlimab with the FDA, despite knowing the filing was missing crucial information and was largely incomplete. (Feuerstein, 10/28)

NPR: Attorneys General Issue Warnings For Marijuana Candy Ahead Of Halloween
As Halloween is approaching this weekend, several state attorneys general across the country have issued warnings to parents to be on the lookout for marijuana edibles that can easily pass as regular candies and snacks. Attorneys general in Ohio, New York, Illinois, Connecticut and Arkansas all released statements Tuesday, a part of a coordinated effort to advise parents about the dangers of marijuana edibles. Each attorney general warned that look-alike products may contain high concentrations of tetrahydrocannabinol (THC). THC is the main compound found in marijuana and if consumed by children, it could lead to an accidental overdose. (Franklin, 10/27)

In news about West Nile virus —

AP: Human Case Of West Nile Virus Confirmed In Vermont
The Vermont Department of Health has confirmed a human case of West Nile virus for the first time since 2017, the department said Wednesday. The Chittenden County resident was diagnosed earlier this month with a more serious form of the illness affecting the nervous system, called neuroinvasive disease, the Health Department said. (10/27)

In other news from across the U.S. —

Dallas Morning News: East Dallas County Cities Join Forces To Improve Mental Health Response By First Responders
City leaders from Balch Springs, Mesquite, Seagoville and Sunnyvale on Tuesday announced a major collaboration to address mental health response needs in East Dallas County. With financial support from a $900,000 Dallas County grant, the cities have created the Southeast Alliance Community Care Team, a partnership that city leaders call a new unified approach toward public mental health response needs in all four communities, according to a press release. The cities first announced plans to collaborate in March to address public mental health concerns. (Waters, 10/27)

Health News Florida: FSU Researchers Hope To Reduce Racism In Health Care Using Systems Science
The impacts of racism can be deadly — especially in the field of health care, where disparities highlight health inequities between white and minority communities. A group of Florida State University researchers received a $3 million grant through the National Institutes of Health to help change that. Sylvie Naar says when she found out her team had received the grant, she was in tears "because it was like we were actually getting funded to do something about racism in the world." (McCarthy, 10/27)

Health News Florida: Fried Says The Application Rules For Medical Marijuana Licenses Are Discriminatory 
Agriculture Commissioner Nikki Fried says the Florida Department of Health’s rules for applying for medical marijuana licenses are discriminatory. An emergency rule from the Department of Health covers medical marijuana treatment center (MMTC) licenses applicants who are also members of a landmark class action lawsuit, Pigford v. Glickman. That case resulted in a $1.25 billion settlement for Black farmers who faced discrimination when applying for loans from the U.S. Department of Agriculture. (Peddie, 10/27)

The Boston Globe: As Scientific Labs Replace Offices, Pushback Is Mounting From Wary Neighbors 
The rapid growth of biotech labs in Greater Boston might end up saving the region’s commercial real estate market, if not its entire economy, from the impacts of the COVID-19 pandemic. But that doesn’t mean everyone wants one next door. A common complaint revolves around the hefty HVAC systems that lab buildings need. They can be noisy and tall, sometimes 30 feet or more on a rooftop, an intrusive change for some neighbors. Some critics say they worry about safety in spaces where potentially hazardous materials are handled. Others dislike the labs’ round-the-clock operations, with foot traffic and lights at all hours. (Chesto, 10/27)

Stat: Merck Inks A Groundbreaking Licensing Deal For Covid-19 Antiviral Pill
In a notable bid to widen access to Covid-19 remedies, Merck (MRK) has agreed to license its widely anticipated antiviral pill to the Medicines Patent Pool, which in turn can now strike deals with other manufacturers to provide versions of the drug to 105 low and middle-income countries. The deal builds on a separate agreement that Merck made with eight generic companies that licensed the pill, which is called molnupiravir, in order to make knock-off copies for the same group of countries. The arrangement with the Medicines Patent Pool, however, means that still more manufacturers can now strike so-called sub-licensing deals, which would presumably increase availability more rapidly. (Silverman, 10/27)

NPR: Merck Will Allow Drugmakers In Other Countries To Make COVID Pill
U.S.-based pharmaceutical giant Merck & Co. said it will license drugmakers worldwide to produce its potentially lifesaving antiviral pill for treatment of COVID-19 in adults. The drug, known as molnupiravir, has shown promise in treating the disease, and the agreement to license its production could help millions of people in the developing world gain access to it. Merck said earlier this month that a recent study of molnupiravir showed that it cut hospitalizations and deaths from COVID-19 in half. (Neuman, 10/27)

In other global news —

Bloomberg: Novavax Files For U.K. Authorization Of Covid Protein Shot 
Novavax Inc. applied for U.K. authorization of its Covid-19 vaccine, the first submission for a protein-based shot against the disease in Europe. The company, which lost out to rivals in the initial phase of vaccine development, said in a statement Wednesday that it completed its rolling submission -- an accelerated review of trial and manufacturing data -- with the Medicines and Healthcare products Regulatory Agency and filed for a conditional marketing license. Shares of Gaithersburg, Maryland-based Novavax rose as much as 16% in New York. (Ring and Loh, 10/27)

AP: Moscow Starts Nonworking Period As Infections, Deaths Soar
The Russian capital on Thursday started a nonworking period intended to stem contagion as daily infections and deaths from COVID-19 surged to all-time highs. The government coronavirus task force reported 1,159 deaths in 24 hours, the largest daily tally since the pandemic began. It has brought the country’s official coronavirus death toll to 235,057, by far the highest in Europe. The confirmed daily infections surged to 40,096, topping a previous record reached earlier this week. (Isachenkov, 10/28)

Bloomberg: New Zealand Easing Border Restrictions For Fully Vaccinated Travelers
New Zealand will begin scaling back one of its key Covid-19 defenses by easing border restrictions for fully vaccinated people arriving from overseas. The amount of time travelers will have to spend in government-run hotel quarantine facilities will be halved to 7 from 14 days from Nov. 14, Covid-19 Response Minister Chris Hipkins said in a news conference in Wellington on Thursday. Home isolation will be introduced in the first quarter of 2022, he said. (Thomson, 10/28)

Bloomberg: Covid Rulebreakers In Beijing Targeted As Virus Spreads
China is striving to contain a fresh Covid outbreak that has spread to nearly half of the country, with police in the capital meting out punishments to those who refuse to comply with curbs. More than 200 people have been diagnosed since the latest flare-up began ten days ago, as tourists visiting scenic spots in the northwestern part of the country contracted the virus and spread it further once they returned home. A total of 34 infections, including 11 people without any symptoms, were reported on Thursday. (10/28)

CIDRAP: Study: Nearly All Severely Allergic People Tolerate COVID Vaccines
While healthcare workers at a Boston healthcare system with severe allergies reported more reactions after receiving a COVID-19 mRNA vaccine, nearly all were able to safely complete the series, according to an observational study yesterday in JAMA Network Open. (Van Beusekom, 10/27)

CIDRAP: COVID-Mitigating Behavior Didn't Change After Vaccination, Study Says
COVID-mitigating behavior such as physical distancing and mask use didn't change after receipt of vaccination prior to government exemptions, according to a research letter published yesterday in JAMA Network Open. The researchers looked at the self-reported behaviors of 80,305 people who were fully vaccinated, partially vaccinated, or not vaccinated at all from Feb 23 to Jun 1. Respondents were from Canada, Denmark, France, Germany, Israel, Italy, Norway, Singapore, Spain, Sweden, the United Kingdom, and the United States, of whom 51.8% were women. The mean age was 47.8 years. (10/27)

CIDRAP: Risk Factors Linked To Severe Pediatric COVID-19
Two recent studies in Pediatrics look at risk factors for severe pediatric COVID-19 and COVID deaths in those younger than 21 years of age. ... The younger group had increased risk associated with chronic lung disease (adjusted risk ratio [aRR], 2.2.), neurologic disorders (aRR, 2.0), cardiovascular disease (aRR, 1.7), prematurity (aRR, 1.6), and airway abnormality (aRR, 1.6), while severe COVID-19 was linked to feeding tube dependence (aRR, 2.0), diabetes (aRR, 1.9), and obesity (aRR, 1.2) in the older group. (10/22)

CIDRAP: Non-COVID Research Projects May Be Affected Most During Pandemic
Researchers who did not conduct COVID-related projects initiated 36% fewer new projects in 2020 versus 2019, according to a commentary published in Nature Communications today. The reductions were seen across all fields, particularly affecting women and those taking care of children. The study was a follow-up to an April 2020 study that surveyed about 4,500 random US and European scientists and found that scientists who relied on laboratories and equipment had a greater reduction in research hours compared with those who didn't as much. In addition, researchers with children 5 years or younger also saw a 17% decline in research hours. (10/26)

Also —

American Academy Of Pediatrics: Educational Priorities For Providing End-Of-Life Care: Parent Perspectives 
We asked parents to be partners in guiding priorities for health care education and professional development to improve pediatric EOL care. In addition to strengthening skills in communication, confidence in the team, and compassion, parents in this study identified a need for hospital staff to anticipate financial and social stressors and provide supportive resources more readily. Additionally, parents described clinical and nonclinical staff as providing support, suggesting that a multidisciplinary and interdisciplinary curriculum be developed to improve pediatric EOL care. (Arora et al, 10/21)

ScienceDaily: Undiagnosed Endometriosis Compromises Fertility Treatment 
Women with undiagnosed endometriosis will have difficulty falling pregnant without IVF, according to a new study. (University of Queensland, 10/5)

ScienceDaily: Chronic Pain Treatment Should Include Psychological Interventions 
New research examines psychological interventions for the treatment of chronic pain, including the gap between the evidence of the effectiveness of several psychological interventions and their availability and use in treatment. (Association for Psychological Science, 10/5)

New England Journal of Medicine: Trial Of Intensive Blood-Pressure Control In Older Patients With Hypertension 
In older patients with hypertension, intensive treatment with a systolic blood-pressure target of 110 to less than 130 mm Hg resulted in a lower incidence of cardiovascular events than standard treatment with a target of 130 to less than 150 mm Hg. (Zhang et al, 10/1)

CIDRAP: Urinary Antigen Testing May Help Target Antibiotics For Pneumonia
Positive pneumococcal urinary antigen testing (PUAT) results among patients hospitalized with community-acquired pneumonia (CAP) was associated with earlier time to de-escalation of antibiotics, according to a single-center study published last week in Open Forum Infectious Diseases. In the retrospective study, conducted at New York University Langone Health, researchers analyzed hospitalized CAP patients who had PUAT performed in 2019, comparing antibiotic de-escalation and outcomes in those who tested positive and negative. PUAT is a rapid, non-invasive assay that can aid in the diagnosis of CAP caused by Streptococcus pneumoniae. It has also been viewed as a potential antibiotic stewardship tool that might improve time to targeted, narrow-spectrum antibiotics and reduce use of broad-spectrum agents. (10/26)

USA Today: A Rare Foreign Bacteria In A Scented Room Spray? It Nearly Killed A Texas Girl
A scented room spray. It never occurred to Lylah Baker’s family that a seemingly innocuous product sold by one of the world’s largest retailers would be capable of delivering a deadly foreign bacteria directly into one of their Texas homes. Yet on Tuesday evening, disease detectives at the Centers for Disease Control and Prevention announced that genetic tests confirmed that Better Homes & Gardens “Lavender & Chamomile with Gemstones” aromatherapy spray or one of its ingredients caused a highly unusual outbreak of infections this year in Lylah and three others who lived in Georgia, Kansas and Minnesota. (Alison Young, 10/27)

Seattle Times: Halt The Salt — It Can Save Lives And Health Care Costs 
In my work as a registered dietitian for kidney patients on dialysis, I’ve been advocating for reduced salt intake for more than 40 years. The best way to avoid the tragedy of kidney failure is to follow a healthy, low-sodium diet. There is a strong relationship between salt intake and high blood pressure: Eating more salt raises blood pressure. Prolonged high blood pressure causes heart disease, stroke and kidney failure, tying people to a lifetime of invasive medical therapy and consuming more than $28 billion in Medicare costs for dialysis alone. (Katy G. Wilkens, 10/26)

Stat: A Physician And A Philosopher On Curating 'A Good Death' 
Americans have a tendency to fixate on what’s commonly thought of of as “a good death” — surrounded by loved ones, a peaceful, quiet passing that looks like falling asleep. But physician Joel B. Zivot and medical philosopher Ira Bedzow are cautious about how this preoccupation can shield people from the reality of death. When they read a recent report in JAMA on using medication to eliminate the “death rattle” — a soft moan or gargling sound sometimes made by people when death is near — they knew they needed to write about the dangers of curating death for the witnesses rather than focusing on those who are dying. (Patrick Skerrett, 10/27)

The Star Tribune: Teamwork Bridges Dental Care Gap 
Minnesotans who rely on Medical Assistance or MinnesotaCare shouldn't have to drive 70 miles or more to see a dentist. Or, forgo dental care altogether for themselves or their children because they can't find a provider who sees patients in either program. But for years, both scenarios have too often been a frustrating reality for the 1 in 4 Minnesotans who get their health care through these two publicly funded health programs. Medical Assistance serves low-income adults and families. MinnesotaCare aids those who make too much to qualify for medical assistance but not enough to comfortably afford private health insurance. (10/27)

Stat: Hyperthymia Helped Me For Years. Then My Mental Health Imploded 
From my teenage years on, I benefitted from what I thought was a positive personality: high levels of energy, enthusiasm, drive, extroversion, positivity, happiness, and optimism. This was the personality that led me to success as a high school student and athlete, through West Point, and during my first 24 years of Army service. It amplified my natural talents and played a major factor in all my success. All that changed in 2003 when, as a brigade commander leading thousands of troops in the Iraq War, the intense stress of combat triggered what I later learned was my genetic predisposition for bipolar disorder. I went into my first up/down cycle of true mania and depression. Fortunately, it was mostly of a high-performing nature, and the lows were serious but not crippling. (Gregg Martin, 10/28)

NBC News: Covid Cases Are Dropping In The U.S. Is The Delta Wave Over?
The delta variant of Covid-19 appears to be loosening its firm chokehold on the United States. Since Sept. 1, daily new cases have dropped by 50 percent. Hospitalizations and deaths, which lag behind new infections, are also decreasing. (Dr. Jalal Baig, 10/27)

The New York Times: Covid Vaccine Policy Should Consider ‘Hybrid Immunity’ 
As a physician in a Covid-19 care unit, I celebrate the vaccines as one of medicine’s greatest triumphs. They provide extraordinary protection against severe disease and death, and are the world’s best option for returning to a more normal life. As a scientist and lead investigator for a study on Covid-19 immunity, I have also come to appreciate the significance of so-called natural immunity acquired by those who have had Covid-19, and the power of “hybrid immunity” — the protection gained when such people also get vaccinated. (Charlotte Thalin, 10/28)