Newsweek: EPA Takes Steps To Regulate 'Forever Chemicals' In Drinking Water, Consumer Products
A new strategy from the White House to regulate toxic industrial compounds linked to serious illness was announced Monday, putting everything from cookware and carpets to firefighting foams under revised standards, the Associated Press reported. Environmental Protection Agency (EPA) head Michael Regan said his agency is taking a series of steps to reduce pollution from "forever chemicals," or PFAS, long-lasting chemicals that are contaminating public drinking water, wells and even food. (Cagnassola, 10/18)

AP: EPA Unveils Strategy To Regulate Toxic 'Forever Chemicals'
The Biden administration said Monday it is launching a broad strategy to regulate toxic industrial compounds associated with serious health conditions that are used in products ranging from cookware to carpets and firefighting foams. Michael Regan, the head of the Environmental Protection Agency, said his agency is taking a series of actions to limit pollution from a cluster of long-lasting chemicals known as PFAS that are increasingly turning up in public drinking water systems, private wells and even food. (Daly, 10/19)

Philadelphia Inquirer: Biden's EPA Announces Plan To Regulate PFAS Chemicals, Which Have Caused Drinking Water Contamination
The Environmental Protection Agency pledged Monday to take steps to regulate a group of toxic chemicals used in everyday products that have contaminated drinking water nationwide, outlining a sweeping plan that prompted both hope and skepticism in the Philadelphia region, where many have waited years for federal action. The Biden administration’s strategy includes creating enforceable standards that limit the chemicals in drinking water and designating some as hazardous substances, which could help hold polluters accountable for cleanup costs. Its new “road map” will also create a national strategy for testing for the chemicals and take other steps to curb pollution caused by per- and polyfluoroalkyl substances, or PFAS — highly persistent compounds linked to cancer, infertility, and other health problems. (McDaniel and McCrystal, 10/19)

The New York Times: F.D.A. To Allow ‘Mix And Match’ Approach For Covid Booster Shots 
The Food and Drug Administration is planning to allow Americans to receive a different Covid-19 vaccine as a booster than the one they initially received, a move that could reduce the appeal of the Johnson & Johnson vaccine and provide flexibility to doctors and other vaccinators. The government would not recommend one shot over another, and it might note that using the same vaccine as a booster when possible is preferable, people familiar with the agency’s planning said. But vaccine providers could use their discretion to offer a different brand, a freedom that state health officials have been requesting for weeks. (LaFraniere and Weiland, 10/18)

The Washington Post: FDA To Allow ‘Mix-And-Match’ Approach On Coronavirus Booster Vaccines
A key matter of debate: If Moderna is used as a booster for Johnson & Johnson, what should be the correct dose? Some officials say it should be a half dose of the regular shot — the dosage that will be authorized for Moderna boosters in general — while others say it should be a full dose, which was the amount tested as part of a National Institutes of Health study released last week. (McGinley, 10/18)

AP: Why COVID Boosters Weren't Tweaked To Better Match Variants
More COVID-19 booster shots may be on the way -- but when it’s your turn, you’ll get an extra dose of the original vaccine, not one updated to better match the extra-contagious delta variant. And that has some experts wondering if the booster campaign is a bit of a missed opportunity to target delta and its likely descendants. “Don’t we want to match the new strains that are most likely to circulate as closely as possible?” Dr. Cody Meissner of Tufts Medical Center, an adviser to the Food and Drug Administration, challenged Pfizer scientists recently. (Neergaard, 10/18)

In related news about vaccines —

Oklahoman: COVID-19 Vaccine Trials Recruiting Oklahoma Participants, Including Young Children
Several COVID-19 vaccine trials are recruiting participants in Oklahoma, including a trial for young children, booster shot trials for adults, and a study aimed at people with autoimmune conditions who didn’t mount a strong response to their initial vaccinations. Slots are still open to participate in trials through the Lynn Health Science Institute, though they’re being filled quickly, said Carlos Blanco, chief executive officer of the institute, which also ran some of the initial COVID-19 vaccine trials last year. “Oklahomans have just been incredible in the way they have responded," Blanco said. "They want to help, and they want to do something to bring about the end of this pandemic." (Branham, 10/18)

The Atlantic: What If MRNA Vaccines Could Cure Cancer?
The fact that mRNA technology had never delivered an authorized therapy before the coronavirus pandemic could tell us one of two things. Perhaps synthetic mRNA is like a miraculous key that humankind pulled out of our pockets in this pandemic, but it was so perfectly shaped for the coronavirus that we shouldn’t expect it to unlock other scientific mysteries any time soon. Or perhaps mRNA is merely in the first chapter of a more extraordinary story. This month, BioNTech announced that it had initiated Phase 2 trials of personalized cancer vaccines for patients with colorectal cancer. It is working on other personalized cancer vaccines and exploring possible therapies for malaria using a version of the mRNA technology that had its breakout moment in 2020. (Thompson, 10/18)

NBC News: Age, Underlying Health Condition Were 'Double Blow' To Colin Powell, Experts Say
Fatal breakthrough Covid-19 infections among people who have been fully vaccinated, like former Secretary of State Colin Powell, are rare. But experts say such deaths show the need for society as a whole to protect its most vulnerable: those of advanced age and those with compromised immune systems. Powell, who died Monday of Covid complications, met both criteria. The trailblazing public servant was 84 years old and had multiple myeloma, a blood cancer in which malignant plasma cells overtake the space usually reserved for normal plasma cells that fight off infections. (Chuck, 10/8)

CBS News: Myeloma May Have Made Colin Powell More Vulnerable To Dying Of COVID-19 
After former Secretary of State Colin Powell's death from complications of COVID-19, experts pointed out that the 84-year-old Powell had a history of medical conditions that significantly raised his risk of severe COVID-19, though he was fully vaccinated. Among them, Powell had multiple myeloma, a form of blood cancer that, both by itself and as a result of treatments given for the disease, can weaken the immune system. "Myeloma patients, they make a lot of antibodies. But, they only make one type. So their ability to make normal antibodies to fend off infections is impaired. They also have T-cell, or cellular immunity, defects that contribute to their inability not only to fight off infections, but mount effective responses to vaccines," said Dr. James Berenson, medical and scientific director of the Institute for Myeloma and Bone Cancer Research. (Tin, 10/19)

Bloomberg: Colin Powell’s Death From Breakthrough Covid Is Rare Event 
Colin Powell died at age 84 from Covid-19 complications despite being fully vaccinated, his family announced on Monday. A decorated former general and chairman of the Joint Chiefs of Staff, he was being treated at the Walter Reed National Medical Center. Powell, who previously underwent surgery for prostate cancer in 2003, had been diagnosed with multiple myeloma prior to falling ill with Covid-19. The available data show that such deaths are exceptionally rare. Out of the more than 187 million people who had been fully vaccinated in the U.S. as of Oct. 12, 7,178, or 0.004%, had died from a breakthrough infection, according to the U.S. Centers for Disease Control and Prevention. Of that group, 85% were over the age of 65. (Court, 10/18)

The New York Times: What Scientists Know About The Risk Of Breakthrough Covid Deaths
Although Mr. Powell’s death is a high-profile tragedy, scientists emphasized that it should not undermine confidence in the Covid-19 vaccines, which drastically reduce the odds of severe disease and death. “Nothing is 100 percent effective,” said Dr. Paul A. Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “The point of getting a vaccine is that you want to know that the benefits clearly and definitively outweigh the risks. And we know that for this vaccine.” (Anthes, 10/18)

The Washington Post: Colin Powell’s Death Is A Reminder That Vaccination Is About Every Person, Not Just One Person
Former secretary of state Colin L. Powell died Monday morning from complications related to covid-19. Powell’s disease resulted from a breakthrough infection; he was fully vaccinated against the coronavirus. But instead of demonstrating that the vaccine isn’t 100 percent effective in preventing death, which was known, his death better serves to show the need to tamp down on coronavirus cases more broadly to help protect those most at risk. That group included Powell. He was 84 years old when he died, well into the elderly age group that has been most ravaged by the virus. He had also been diagnosed with multiple myeloma, which can reduce the body’s ability to fight infections. (Bump, 10/18)

The Washington Post: ‘Don’t Feel Sorry For Me,’ Powell Said As The End Approached 
As death approached, Colin L. Powell was still in fighting form. “I’ve got multiple myeloma cancer, and I’ve got Parkinson’s disease. But otherwise I’m fine,” he said in a July interview. And he rejected expressions of sorrow at his condition. “Don’t feel sorry for me, for God’s sakes! I’m [84] years old,” said Powell, who died Monday. “I haven’t lost a day of life fighting these two diseases. I’m in good shape.” (Woodward, 10/18)

In related news —

CNN: Seniors Are Particularly Vulnerable To Covid-19 But Just 1 In 7 Have Taken A Booster Shot 
As the US tries to bring Covid-19 under control before a potential winter spike, health experts are encouraging vulnerable people to get a booster vaccine dose. So far, about 15% of seniors have done so. Overall, about 10.7 million people have received an additional booster dose and more than half were people over 65, according to data from the US Centers for Disease Control and Prevention. (Holcombe, 10/19)

CIDRAP: Hospital COVID Patients May Owe Thousands As Insurance Waivers End
COVID-19 patients hospitalized in 2021 could be on the hook for thousands of dollars in bills  for hospital, physician, and paramedic care after insurance companies started charging members for these costs again, an analysis of 2020 US data today in JAMA Network Open suggests. In 2020, most health insurers voluntarily waived copays, deductibles, and other cost sharing for hospitalized COVID-19 patients, but many did away with those waivers in early 2021. (Van Beusekom, 10/18)

Modern Healthcare: COVID Hospitalization Could Cost Patients Thousands Out-Of Pocket
While most COVID-19 hospitalizations don't leave patients with out-of-pocket charges, approximately one in 20 commercially insured or Medicare Advantage patients will rack up thousands of dollars in bills, according to a new study. In an analysis of 4,300 COVID-19 hospitalizations, 4.6% of privately insured patients were billed an average of $3,800 stemming from "facility" services charged by hospitals between March and September 2020, according to a study published Monday in JAMA Network Open. Approximately 1.3% of Medicare Advantage patients saw bills of more than $1,500. The research shines a light on the huge health cost burden facing Americans as most cost-sharing waivers from insurers come to an end. (Ross Johnson, 10/18)

In updates about the spread of the coronavirus in schools —

Indianapolis Star: More Indiana Schoolchildren Have Had COVID-19 This Fall Than All Of Last School Year
Roughly a quarter of the way through the current school year and Indiana has already topped last school year's total number of COVID-19 cases reported among the state's K-12 students. The number of newly reported cases in students dropped for the sixth straight week and was likely depressed by the fall break, which many schools started last week, but still pushed the school year-to-date total above the total number reported last school year. (Herron, 10/18)

AP: 3 Montana School Districts Go Virtual Or Close Due To COVID
At least three Montana school districts are taking advantage of a two-day school break for statewide educator conferences this week to hold remote classes or close for a few days to help prevent further cases of COVID-19. The Darby school district also announced it was switching to remote learning on Tuesday and Wednesday due to staff shortages. (10/18)

Carroll County Times: Carroll County Schools Consider Take-Home COVID Testing As Procedure To End Quarantines 
Carroll County’s health officer and school superintendent have proposed that students use take-home COVID-19 tests when they are in quarantine. County health officer Ed Singer said the idea is to have students take the test on day five and seven of quarantine, and then allow them to return to school if both tests are negative. He said the Maryland Department of Health is working to get testing kits. (Griffith, 10/19)

KHN: Children With Disabilities Face Special Back-To-School Challenges 
Christopher Manzo, a boy with curly brown hair and bright-blue-and-yellow glasses, has lived a third of his five years at home because of the pandemic. nd he is more than ready for kindergarten. Hand in hand with his mother, Martha Manzo, he walks into the Blind Children’s Center, a low-rise building nestled among apartment complexes in East Hollywood. In the brightly colored hallway, filled with paintings of animals, Manzo kneels to hug Christopher before he scurries unsteadily to his cubby. “God take care of you and be with you,” she says. “And have fun.” (de Marco, 10/19)

In other covid news —

AP: New Mexico Clears Way For Hospitals To Ration Care If Needed
New Mexico on Monday cleared the way for hospitals to ration care if necessary, saying the state’s health care system has yet to see a reprieve as the nursing shortage continues and as many patients with non-COVID-19 illnesses and those who have delayed care over the last year are now filling hospital beds. Health and Human Services Secretary Dr. David Scrase said hospitals already have been juggling patients with fewer resources since the pandemic began, and the order he signed sets up an “equitable procedure” for making tough decisions. (Bryan, 10/18)

Modern Healthcare: Rural Reckoning: COVID-19 Highlights Long-Standing Challenges Facing Rural Hospitals. Will It Create Momentum For Change?
For a small, rural hospital in Louisiana, the COVID-19 pandemic brought new strains on the workforce. With the delta wave, clinicians intubated patients sometimes two or three times per week or even per day, said Mary Ellen Pratt, CEO of St. James Parish Hospital, a critical-access hospital in Lutcher, Louisiana, about 35 miles from New Orleans. Before the pandemic, maybe one person per month needed intubation. Medical professionals have decided to retire early, take breaks from the field or leave the business completely as the stresses of the past 19 months weighed on them. That in turn puts pressure on the employees who remain, who are already working long hours to deal with a surge driven in large part by people who aren’t vaccinated. Her hospital is about 20% short on nursing staff, Pratt said. (Hellmann, 10/19)

Georgia Health News: Hospital Musicians Ease The Stress On Weary Workers  
Guitarist Chuck Beckman was inspired to pursue a career in live therapeutic music for hospital patients after he played at the bedside of a dying friend. His goal, he says, “was to play for patients in the last moments of their lives.” And he founded a program to do just that at Northeast Georgia Health System’s Gainesville hospital two years ago. But the music stopped at the start of the pandemic. Beckman and his fellow therapeutic musicians could no longer play their instruments at patients’ bedsides because of the infection risk. (Grapevine, 10/18)

The Washington Post: Nick Rolovich Fired By Washington State Because Of Covid-19 Mandate 
In perhaps the most striking case to date of a public employee being terminated because of a coronavirus vaccine mandate, Washington State football coach Nick Rolovich was dismissed Monday, the school announced, after not adhering to a statewide order issued by Gov. Jay Inslee (D) in August. He was the state’s highest-paid employee at $3.2 million per year, and he had remained unvaccinated up to the state’s vaccination deadline of Monday. “Nick is not eligible to be employed at Washington State University, through noncompliance,” Athletic Director Pat Chun summarized Monday night. (Culpepper, 10/18)

AP: Seattle Touts 99% Compliance With Employee Vaccine Mandate
The city of Seattle reported Monday morning that 99% of its employees are in compliance with the mayor’s COVID-19 vaccine mandate. By 11:59 p.m. Monday, all Seattle city employees have to be vaccinated against COVID-19, per an August order by Mayor Jenny Durkan. As of Monday morning, 94% of the city’s 11,000 employees had been vaccinated and an additional 5% have filed paperwork for an exemption, The Seattle Times reported. The remaining 150, or about 1%, had not yet complied. (10/18)

And tension grows at police departments —

Chicago Tribune: Chicago, Police Union Sue Each Other Over Vaccine Mandate 
A judge late Friday issued a temporary restraining order against the Chicago police union president, prohibiting him from making public statements that encourage members not to report their COVID-19 vaccine status to the city. Cook County Circuit Judge Cecilia Horan ruled there was potential irreparable harm if local Fraternal Order of Police President John Catanzara persisted in making such statements. City attorneys argued they were tantamount to him advocating “sedition” and “anarchy” because he was directing members to disobey an order from their superiors. (Yin, Pratt, Byrne, Crepeau, Petrella and Turner, 10/18)

The Washington Post: Trooper Robert LaMay Leaves Washington State Patrol After Refusing Vaccination 
At the end of his final shift as a trooper with the Washington State Patrol, Robert LaMay reached for his radio. In a parting message broadcast across the agency’s dispatch system, he announced that he was “being asked to leave because I am dirty,” referring to his defiance of the state’s coronavirus vaccine mandate for government employees. The 22-year veteran thanked his colleagues — and offered some choice words for the governor. “This is the last time you’ll hear me in a state patrol car,” said LaMay, 50, who recorded his remarks. “And Jay Inslee can kiss my a--.” (Shammas, 10/18)

In updates on health worker mandates —

Fox News: Nearly 100 Unvaccinated Staff At Yale New Haven Health Lose Their Jobs
Nearly 100 employees in the Yale New Haven Health system lost their jobs Monday because they failed to get a COVID-19 vaccine, officials said. The employees were on suspension and had until Monday to get vaccinated following a June 30 mandate announcement by Yale New Haven Health, and other hospital-based health systems in Connecticut, according to reports. "We did pretty well, I think, all things considered," Associate Chief Clinical Officer Dr. Ohm Deshpande told the New Haven Register. "We’re at 94 at this moment who are subject to termination. They’re getting notified today that they’re being separated from the organization." (Aaro, 10/19)

The Boston Globe: Mass General Brigham Employees Sue Hospital System For Denying COVID-19 Vaccination Exemptions
A group of Mass General Brigham employees are suing the health care system for denying their medical or religious exemptions for getting a COVID-19 vaccine, arguing that the denials are discriminatory and violate protections under the Americans with Disabilities Act, according to court documents. The lawsuit was filed Sunday in US District Court as Mass General Brigham, the state’s largest hospital system, nears its Wednesday deadline for employees to show they have received at least one shot or be placed on unpaid leave. Employees who have not received at least their first shot by Nov. 5 will be terminated. (Stoico, 10/18)

Anchorage Daily News: Two Major Alaska Health Care Providers Say More Than 98% Of Employees Are Meeting COVID-19 Vaccine Mandates
Two major Alaska health care providers are reporting high levels of employee compliance with vaccine mandates, refuting predictions of a significant exodus of shot-opposed workers from city officials, including from Anchorage’s mayor. The operators of both Providence Alaska Medical Center, the state’s largest hospital in Anchorage, and Alaska Native Medical Center on Monday were reporting more than 98% compliance with vaccine requirements. The Alaska Native Tribal Health Consortium, which operates the Native Medical Center, says more than 98% of about 3,000 employees are in compliance with the vaccine mandate that went into effect Friday. (Hollander and Krakow, 10/18)

Bangor Daily News: 9 In 10 Maine Paramedics Are Vaccinated, But Mandate Squeezes Some Rural Areas
Nine in 10 Maine paramedics have been vaccinated against COVID-19 with a mandate going into effect later this month, but the requirement could further squeeze rural areas that have long faced shortages of emergency medical services workers. The Maine Emergency Medical Services Board was skeptical of Gov. Janet Mills’ vaccine mandate, voting in August to give workers two additional weeks to get vaccinated beyond what the Democratic governor initially proposed. It also exempted dispatchers from the requirement, saying only those who worked directly with patients should be covered. (Piper, 10/19)

Also —

AP: Federal Judge Rejects Bid To Block Oregon Vaccine Mandate
A federal judge on Monday denied a last-minute bid by more than three dozen state employees, health care providers and school staff to temporarily stop the state’s COVID-19 vaccination mandate. U.S. District Judge Michael H. Simon rejected their motion for a temporary restraining order, marking the first federal judge’s ruling after several state court decisions thwarting similar efforts to block Oregon Gov. Kate Brown’s and the Oregon Health Authority’s power to require that certain workers to get the vaccines or risk losing their jobs, The Oregonian/OregonLive reported. (10/19)

Los Angeles Times: Parents Protest California Student COVID-19 Vaccine Mandate 
Groups of parents and children kept out of school in protest lined the sidewalk outside Birmingham High School in Lake Balboa on Monday, part of statewide demonstrations against California’s mandate requiring all K-12 students to get vaccinated against COVID-19. Parents, children and some school district employees held signs including “Our kids are not lab rats” and “Our children our choice.” Similar scenes played out in Huntington Beach and Sacramento, where the state Capitol protest appeared to be the largest. (Gomez and Blume, 10/18)

The Washington Post: Miami School Says Vaccinated Students Must Stay Home For 30 Days To Protect Others, Citing Discredited Info
In April, a Miami private school made national headlines for barring teachers who got a coronavirus vaccine from interacting with students. Last week, the school made another startling declaration, but this time to the parents: If you vaccinate your child, they’ll have to stay home for 30 days after each shot. The email from Centner Academy leadership, first reported by WSVN, repeated misleading and false claims that vaccinated people could pass on so-called harmful effects of the shot and have a “potential impact” on unvaccinated students and staff. (Peiser, 10/18)

AP: NHL Suspends Evander Kane 21 Games For COVID Violations
The NHL has suspended San Jose Sharks forward Evander Kane for 21 games for submitting a fake COVID-19 vaccination card. The league on Monday announced the suspension without pay and said Kane will not be eligible to play until Nov. 30 at New Jersey. Kane will forfeit about $1.68 million of his $7 million salary for this season with the money going to the Players’ Emergency Assistance Fund. (Dubow, 10/18)

The Washington Post: Fake Vaccine Cards, Will Travel: People Confess To Using Counterfeit Cards To Their Travel Advisers
A travel adviser, once known as a travel agent, can easily become a client’s confidant over years of trip planning. ... The Ocean Reef Club travel adviser Stephanie Fisher said she has had three people ask her about using fake vaccination cards. She declined to book their trips. “It’s not something I’m willing to touch,” Fisher said. Instead of being shy about the admission, Fisher said, the prospective clients have seemed proud. “There’s a weird glee about trying to find a way to short-circuit the system,” she said. (Compton, 10/18)

The Hill: Senate Democrats Ditch Hyde Amendment For First Time In Decades
Senate Democrats on Monday for the first time in decades left out an amendment from their annual government funding bills that blocks people from using Medicaid or other federal health programs to cover abortion services. The provision, also known as the Hyde amendment, was omitted from legislation to fund the Labor, Health and Human Services, and Education departments. The bill was unveiled by Senate Appropriations Committee Chairman Patrick Leahy (D-Vt.) on Monday afternoon. The Hyde amendment bans the use of federal funds for abortions in most cases and has been included in annual government funding bills since it was introduced by then-Rep. Henry Hyde (R-Ill.) in the 1970s. (Folley, 10/18)

And in updates on the Texas abortion law —

The Texas Tribune: Texas Abortion Law: Supreme Court Considers Taking Case
The U.S. Supreme Court is considering whether to take up abortion providers’ challenge to Texas’ near-total abortion ban sooner than the high court usually would hear arguments. The lawsuit has not been heard by a federal appellate court, but the Supreme Court agreed Monday afternoon to expedite providers’ request that the justices consider the case. Texas, one of the defendants in the suit, has until Thursday to respond to the petition asking that the case be fast-tracked. (Waller and Pollard, 10/18)

Dallas Morning News: Supreme Court Speeds Review Of Texas Abortion Law After Feds Seek Freeze On Enforcement
The U.S. Supreme Court signaled interest Monday in providing a quick review of Texas’ six-week abortion ban, giving abortion providers and the state until Thursday to argue whether they should or not. The order came shortly after the Justice Department filed an emergency application asking the court to halt enforcement of Senate Bill 8, which outsources enforcement to anyone willing to sue doctors or others who help a woman obtain an abortion after a fetal heartbeat is detected. The court already plans oral arguments Dec. 1 on a Mississippi ban that kicks in at 15 weeks — also long before the threshold set in Roe vs. Wade, the 1973 landmark that stemmed from a Dallas County prosecution. (Caldwell and Gillman, 10/18)

USA Today: Abortion: Justice Dept. Case At Supreme Court One Of Many On Texas Ban
But the high-profile case is just one row in a Rubik's Cube of lawsuits that may signal where the Supreme Court is heading on the thorny issue of abortion, and whether it will continue to uphold the landmark Roe v. Wade decision that established the right to the procedure. Texas' ban has prompted a flurry of overlapping and difficult-to-follow lawsuits in different courts, any one of which may decide its fate. The justices, meanwhile, are also considering challenges to other state abortion laws that could affect the Texas case. (Fritze, 10/19)

In other news —

AP: Group Decries Sentencing Of Oklahoma Woman For Miscarriage
A national advocacy group for women on Monday blasted the sentencing of a 21-year-old Oklahoma woman to prison for a manslaughter conviction after she suffered a miscarriage while using methamphetamine. Brittney Poolaw, of Lawton, was sentenced to four years in prison this month after a jury convicted her of first-degree manslaughter. An autopsy of Poolaw’s fetus showed it tested positive for methamphetamine. But there was no evidence that her meth use caused the miscarriage, which the autopsy indicated could have been caused by factors including a congenital abnormality and placental abruption, a complication in which the placenta detaches from the womb, said Lynn Paltrow, executive director of the National Advocates for Pregnant Women. (Murphy, 10/18)

Stat: UnitedHealthcare Launches A Virtual-First Health Insurance Plan
The pandemic prompted a mad dash to figure out how to deliver health care virtually. As the dust settles, UnitedHealthcare, the country’s largest insurer, is laying the foundation for the future with a health plan built primarily around telemedicine services designed to be more affordable and accessible. (Aguilar, 10/18)

NPR: Telehealth Is OK, Patients Say, But Most Prefer In-Person Appointments
New Yorker Charlie Freyre's sinuses had been bothering him for weeks last winter, during a COVID-19 surge in the city. It was before vaccines became widely available. "I was just trying to stay in my apartment as much as possible," Freyre says, so checking in with his doctor via an online appointment "just seemed like a more convenient option. And you know, it was very straightforward and very easy." The $20 copay was well worth it for the 26-year-old ad salesman, whose girlfriend also routinely relies on telehealth to see her nutritionist. "It's a very easy way to get an expert opinion without having to necessarily leave your apartment," fill out forms or spend idle time in waiting rooms, Freyre says. "We all know what going to the doctor can be like." (Noguchi, 10/18)

In news about Medicare and Medicaid —

Modern Healthcare: Insurers Want CMS To Toss Rule On 'Breakthrough' Technology Coverage
Insurers are backing the Centers for Medicare & Medicaid Services plan to repeal a Trump-era rule allowing Medicare to cover medical devices designated as "breakthrough" technology by the U.S. Food and Drug Administration, according to public comments on the proposed rule. Payers, patient safety advocates and independent experts had recommended that President Joe Biden's administration walk back the rule, citing concerns over patient safety and questions about the value of automatically providing Medicare coverage for unproven technologies. If the original rule had taken effect, CMS would have lost its ability to withdraw approval for devices later found to be harmful to people on Medicare. (Brady, 10/18)

In other health care industry news —

Stat: Amazon Is Beefing Up Its Health Care Lobbying Operation 
Amazon is bulking up its efforts to influence health care policy at the federal and state levels. The tech giant recently hired Claire Winiarek, a top policy official from the trade association for pharmacy benefit managers, as its director of health policy. And Amazon has started a search for three additional health care policy advocates who will focus on federal health care policy, health devices and services, and state-level health policy, according to postings on LinkedIn this month. (Cohrs, 10/19)

Philadelphia Inquirer: Tower Health Is Denied Property-Tax Exemption For Three Chester County Hospitals
A Chester County judge rejected Tower Health’s bid for property tax exemptions for Brandywine, Jennersville, and Phoenixville Hospitals, saying those operations had become too similar to for-profit companies and didn’t deserve to be free of property taxes. The decision strikes another blow to Tower, which vowed to appeal as it struggles to reverse large losses. It represents a rare loss for any nonprofit hospital. The ruling also shows how health care is becoming more complicated and far removed from its philanthropic roots, at least according to one judge. (Brubaker, 10/19)

Stat: Doctor On Demand, Grand Rounds Venture Begins To Take Shape
In May, two privately held health tech startups — Doctor on Demand and Grand Rounds — said they would merge, creating a new company focused on both managing how patients receive healthcare and providing that care, virtually. On Monday, the combined firm unveiled a new name: Included Health. (Herper, 10/18)

Detroit Free Press: CVS Health Names Khaldun Its First Chief Health Equity Officer
Dr. Joneigh Khaldhun, who led Michigan through the first 18 months of the coronavirus pandemic as the state's chief medical executive, has been named vice president and chief health equity officer of CVS Health, the company announced Monday. “Her expertise in creating solutions to help improve health outcomes will help us continue addressing health inequities for the customers and communities we serve," said Dr. Kyu Rhee, CVS senior vice president and Aetna CMO, in a statement. (Jordan Shamus, Boucher and Hall, 10/18)

Modern Healthcare: Expect A Permanent Boost To Healthcare Wages, Experts Say
Healthcare workforce labor costs will remain higher than pre-pandemic levels, which has prompted new recruitment and retention strategies. Nearly all of the 73 health system administrators surveyed have had trouble filling vacancies as more clinical staff burn out, according to a new poll from Kaufman Hall. Nearly three-quarters of executives have raised clinicians' wages as a result, while around 90% have boosted pay for support staff. (Kacik, 10/18)

KHN: Hygienists Brace For Pitched Battles With Dentists In Fights Over Practice Laws 
This year, the Illinois legislature was considering measures to expand oral health treatment in a state where millions of people live in dental care deserts. But when the Illinois State Dental Society met with key lawmakers virtually for its annual lobbying day in the spring, the proposals to allow dental hygienists to clean the teeth of certain underprivileged patients without a dentist seemed doomed. (Bruce, 10/19)

And in news about the spread of MRSA —

CIDRAP: Elbow Bumps May Transfer MRSA Just As Much As Fist Bumps
Researchers from the Cleveland VA Medical Center reported that both a fist bump and an elbow bump are associated with frequent transfer of methicillin-resistant Staphylococcus aureus (MRSA). Elbow bumps have been increasingly used as greetings over fist bumps and handshakes with the idea that they lessen the potential for pathogenic microorganism transfer. To test this hypothesis, the researchers enrolled 40 patients in isolation for MRSA colonization and paired them with a research staff member wearing sterile gloves and a piece of cotton cloth over their elbows. Each MRSA-colonized patient performed one greeting with a staff member using their right fist or elbow, and one greeting using their left fist or elbow, with the order of the greetings alternating among consecutive participants. The researchers then analyzed the fists and elbows of the MRSA-colonized patients, along with the gloves and elbow cloth from the staff members, for the presence of MRSA. (10/18)

Stat: FDA Approves Interchangeable Humira Biosimilar, But Savings Are Dubious
For the first time, U.S. regulators have approved an interchangeable, biosimilar version of Humira, a hugely popular medicine used to treat rheumatoid arthritis, among other ailments. But the extent to which the approval might make a real difference to the U.S. health care system is uncertain, because availability is a long way off and the dosing regimen may not be competitive. (Silverman, 10/18)

Stat: An FDA Rejection Derails Omeros, Exposing The Empty Promises Of Its CEO
It’s remarkable to watch Omeros CEO Greg Demopulos and his executive team dissolve into a pool of obfuscation and incompetence when the truth finally arrives. The company said Monday that the Food and Drug Administration rejected its drug called narsoplimab meant to treat patients with a rare but often-deadly complication of bone marrow transplants. The denial finally revealed what many Omeros critics — myself, included — have known for years. The clinical development of narsoplimab was built on shaky, often nonsensical clinical data and a mountain of misleading statements about FDA agreements. (Feuerstein, 10/18)

Axios: This Arthritis Drug Cost $198 In 2008. Now It's More Than $10,000 
In 2008, a box of 30 anti-inflammatory rectal suppositories that treats arthritis, called Indocin, had a price tag of $198. As of Oct. 1, the price of that same box was 52 times higher, totaling $10,350. As federal lawmakers continue to waver on drug price reforms, Indocin is another example of how nothing prevents drug companies from hiking prices at will and selling them within a broken supply chain. (Herman, 10/18)

In other pharmaceutical and biotech news —

Bloomberg: Covid Led To Closer Work Between FDA, Pharma, Genentech CEO Says
Close collaboration between U.S. drugmakers and regulators in the pandemic is speeding the way for new therapies in other areas including Alzheimer’s disease, the head of Roche Holding AG’s Genentech unit said. The Food and Drug Administration’s flexibility in terms of data submission and clinical trials endpoints “offers so much possibility to bring treatments, meaningful treatments, to patients sooner,” Genentech Chief Executive Officer Alexander Hardy said Monday in an interview with Bloomberg Television from the HLTH conference in Boston. (Tozzi, 10/18)

Axios: The System Of Recalling Flawed Medical Devices Is Broken 
Recalling ineffective or even potentially lethal medical devices is a slow process that jeopardizes patient care, a new report from MedTech Dive explains. "Unless you're hands-on dealing with recalls — even at a hospital — a lot of people don't realize just how broken the process is," the founder of a company that works with providers to process recalls told MedTech Dive. (Herman, 10/19)

Stat: ‘I Don't Know Anybody Who Wants Their Health Disrupted’: Ken Frazier Steps Out In New Venture Capital Role 
Former Merck CEO Ken Frazier, famous for building the drugmaker into one of the world’s biggest cancer companies, shed his pharma garb in his first public appearance since starting a new role with the venture capital giant General Catalyst. In July, General Catalyst appointed Frazier, who remains the executive chairman of Merck, as head of the firm’s “health assurance initiatives,” which seek to create equitable and affordable health care through consumer-centric offerings. The splashy hire of Frazier, who is leading the firm’s newly created $600 million Health Assurance Fund, rocketed General Catalyst to prominence in the health care space. (Aguilar and Herper, 10/18)

Bloomberg: Theranos Elizabeth Holmes Trial: Claims Of Military Use Haunts Fraud Case
Of the numerous lies Elizabeth Holmes is accused of telling, her claim that Theranos Inc. blood analyzers were used by the military, in helicopters and on the battlefield, is one of the most outlandish -- and it’s now rebounding at her criminal fraud trial. A former Theranos employee who worked closely with the startup founder is expected to testify Tuesday that her attempt to win military contracts morphed into bluster to attract investors and partners, including Safeway Inc. and Walgreens. (Rosenblatt, 10/19)

Also —

Houston Chronicle: Houston Doctor Who Prescribed More Than 1.3 Million Doses Of Opioids Faces Lengthy Prison Term
A federal jury found a Houston physician guilty on Monday of prescribing more than 1.3 million doses of opioids through a strip mall clinic on Gessner in Spring Branch, according to a Justice Department news release. On a busy day, the doctor sometime doled out more than 90 unlawful prescriptions to “patients,” prosecutors said. Dr. Parvez Anjum Qureshi, 56, a geriatric and family medicine specialist from Houston, was convicted of unlawfully prescribing controlled substances between 2014 and 2016 to patients at Spring Shadows Medical Clinic of Houston. A fellow clinic employee, Rubeena Ayesha, 52, of Houston, previously pleaded guilty to aiding in the pill mill scheme. (Banks, 10/18)

AP: NYC's Board Of Health Calls Racism A Public Health Crisis
New York City’s Board of Health on Monday passed a resolution that names racism as a public health crisis, joining the growing list of state and local governments around the country that have done so in recent years. The resolution calls on the city’s Department of Health and Mental Hygiene to take steps including reviewing the city’s health code to look for structural racism, and find ways to make changes as necessary. (10/19)

In other news from across the U.S. —

The Wall Street Journal: Texas Passes Sports Ban For Transgender Students 
Lawmakers in Texas passed a bill Sunday that bans transgender public-school students from competing in interscholastic sports leagues that are designated for a gender other than the one listed on their birth certificates. Republican Gov. Greg Abbott is expected to sign the bill, after adding it to the agenda of a special legislative session intended to address redistricting. The University Interscholastic League, which oversees K-12 sports in Texas, has the responsibility for enforcing the law in public or charter schools. (Findell, 10/18)

Chicago Tribune: Lax Regulation Of Illinois Nursing Homes Cited In Report 
For years, including the early months of the COVID-19 pandemic, Illinois officials failed to properly oversee nursing homes, including not enforcing staffing requirements and not imposing penalties sufficient to deter inferior operations, a consultant’s investigation concluded. As a result, nursing home residents lodged an increasing number of complaints and faced ongoing dangers. Some facilities were cited repeatedly for the same violations, including abuse and neglect of residents, the report found. (McCoppin and Mahr, 10/18)

Los Angeles Times: Congresswoman Calls For Emergency Declaration Over Foul Odor In Carson
Calling it an “issue of health and environmental injustice,” Rep. Nanette Barragán (D-San Pedro) on Monday asked Gov. Gavin Newsom to declare a state of emergency over an overpowering foul smell that has sickened residents of Carson and surrounding communities for more than two weeks. The ongoing stench — which Los Angeles County officials say is caused by hydrogen sulfide coming from decaying vegetation in the Dominguez Channel — was first reported to the South Coast Air Quality Management District on Oct. 3 .It took 12 days for county crews to begin treating the flood control channel to mitigate the odor. (Branson-Potts, 10/18)

AP: Organizations Launch Yearlong Campaign On Lung Health
A coalition of organizations are launching a yearlong educational campaign about lung health issues in Kentucky. The Kentucky Medical Association, the Kentucky Foundation for Medical Care and the Anthem Foundation aim to educate residents through the campaign called “Breathe Better Kentucky,” the organizations said in a joint statement. (10/19)

St. Louis Post-Dispatch: Man Dies After Waiting 38 Minutes For St. Louis Ambulance, Family Seeks Answers 
Rodney LaRue waited for an ambulance while in pain on a south St. Louis street for 38 minutes last month. Now, his family wants to know why help took so long to arrive. LaRue, 60, was riding his electric scooter on the afternoon of Sept. 27 when he collided with a minivan and was flung across the pavement at the intersection of Arsenal Street and Ivanhoe Avenue. A nearby St. Louis traffic patrol officer who saw the crash about 3:40 p.m. arrived almost immediately, and a firetruck was on scene within a few minutes, according to a video of the crash and police records provided through a public records request to the Post-Dispatch. (Heffernan, 10/18)

WJCT News: Doctor Warns Jacksonville's City Council About An Uptick In Fentanyl Overdoses 
Just one pill can kill. That was the message emphasized by Dr. Raymond Pomm when he spoke Thursday at a special Jacksonville City Council committee on drug overdoses and mental health. Overdoses have been on the rise in the past few years throughout the country, despite a significant decrease in opioid prescriptions. "There has to be an educational push," Pomm said. "They're taking pills that look like opioids; they're taking pills that look like Xanax. It's fentanyl. They're dying from fentanyl." (Troncoso, 10/18)

In obituaries —

AP: Activist Shawn Lang, Former Leader At AIDS Connecticut, Dies
Shawn Lang, a longtime Connecticut activist for people living with HIV and AIDS, as well as those impacted by opioid addiction and domestic abuse, has died. She was 65. Lang’s unexpected death on Sunday , confirmed to the Hartford Courant by her 24-year-old son Corbett Lang, was met with both shock and sadness by friends, associates and Connecticut politicians on Monday. A cause of death has not yet been released. (10/19)

Reuters: WHO-Led Program Aims To Buy Antiviral COVID-19 Pills For $10 
A World Health Organization-led programme to ensure poorer countries get fair access to COVID-19 vaccines, tests and treatments aims to secure antiviral drugs for patients with mild symptoms for as little as $10 per course, a draft document seen by Reuters says. Merck & Co's experimental pill molnupiravir is likely to be one of the drugs, and other drugs to treat mild patients are being developed. (Guarascio, 10/19)

Stat: 'Make A Gesture Of Humanity': Pope Francis Urges Drug Makers To Release Covid-19 Vaccine Patents 
Amid controversy over global access to Covid-19 vaccines, Pope Francis lent his moral authority to the debate and urged drug makers to make their intellectual property available so that other companies can manufacture enough shots for low and middle-income countries. In a video address to the World Meeting of Popular Movements, the Pope made a simple, straightforward plea: “I ask all the great pharmaceutical laboratories to release the patents. Make a gesture of humanity and allow every country, every people, every human being, to have access to the vaccines. There are countries where only 3% or 4% of the inhabitants have been vaccinated.” (Silverman, 10/18)

In other global news about covid —

The New York Times: Russia's Low Vaccination Rates Leads To Record-Breaking Toll 
After Sofia Kravetskaya got vaccinated with Russia’s Sputnik V vaccine last December, she became a pariah on the Moscow playground where she takes her young daughter. “When I mentioned I volunteered in the trials and I got my first shot, people started running away from me,” she said. “They believed that if you were vaccinated, the virus is inside you and you’re contagious.” (Hopkins, 10/18)

Houston Chronicle: Australia Responds To Sen. Ted Cruz's Criticism Of Vaccine Mandate: 'Glad We Are Nothing Like You'
A top Australian official called out U.S. Sen. Ted Cruz on Twitter over the weekend after the Texas Republican accused the country of “COVID tyranny” as it imposes new vaccine requirements. “I love the Aussies. Their history of rugged independence is legendary; I’ve always said Australia is the Texas of the Pacific,” Cruz tweeted. “The COVID tyranny of their current government is disgraceful & sad.” Australia’s Northern Territory rolled out new vaccine mandates last week, which require workers who interact with the public to be fully vaccinated by Dec. 24 or face a $5,000 fine. Michael Gunner, the chief minister for the region, responded to Cruz in a statement posted last Sunday, saying the Texas Republican knows “nothing about us.” (Wermund, 10/18)

In news about polio —

The Washington Post: U.N. To Launch A Polio Vaccination Campaign In Afghanistan With Taliban Permission 
U.N. agencies will launch a nationwide effort next month to vaccinate children in Afghanistan against polio with the permission of the Taliban, the United Nations announced Monday. The campaign, slated to start Nov. 8., will mark the first polio immunization drive since the Taliban took control of the country in August — and the first in more than three years to reach all children in Afghanistan, according to a news release from UNICEF, the U.N. children’s agency. (Parker, 10/18)

Stat: On Covid-19 Booster Shots, The FDA Has Overstepped Its Role 
Booster shots for all adults six months after being vaccinated against Covid-19 are safe, effective, and badly needed. The United Kingdom and the European Union have authorized them for all adults. Israel won’t let anyone enter the country without one. In the U.S., however, the FDA authorized a booster dose of the Pfizer/BioNTech Covid-19 vaccine only for individuals over age 65, those who face elevated risk due to their health conditions, or who work in jobs that put them at higher risk of infection. In imposing these limits, the FDA overstepped its role for vaccine approvals. (Bernard Black and David Thaw, 10/18)

Bloomberg: Rich Countries Need To Share Covid Vaccines Faster 
Manufacturers of Covid-19 vaccines say they’re now producing 1.5 billion doses a month and will have made 12 billion doses by the end of the year. In theory, that would be enough to meet the World Health Organization’s goal of vaccinating 70% of the global population. The challenge is to ensure these vaccines go where they’re needed. Most of the doses coming off production lines appear headed for wealthy countries that will soon have more than enough. (10/18)

The Washington Post: Biden Administration Should Share Moderna Vaccine Recipe With The World 
As wealthy countries swimming in coronavirus vaccines begin to approve booster shots for their populations, the poorer nations of the world are left to struggle. More than 50 countries, many of them in Africa, have not been able to vaccinate even 10 percent of their people, according to the World Health Organization. When speaking of vaccination disparities between richer and poorer countries, those in the West love to use neutral-sounding, global-development jargon such as “vaccine access” and “vaccine equity.” Those on the other side of the global power dynamic describe the same reality in different ways: “vaccine nationalism” or, more harshly, “vaccine apartheid.” (Karen Attiah, 10/18)

Bloomberg: Colin Powell's Death Argues For Vaccines, Not Against Them
Vaccine opponents are seizing on the death of former Secretary of State Colin Powell, who was fully vaccinated yet died of Covid-19 complications, to cast doubt on the vaccination effort against the virus. As usual, these people are dangerously wrong. The death of someone like Powell, who was 84 and fighting multiple myeloma, a blood cancer that significantly hampers the immune system, is a potent argument to vaccinate as broadly as possible. (Max Nisen, 10/18)

The New York Times: What We Know About Covid-19, The Flu And The Air We Breathe 
Covid-19 is not the only respiratory infection the globe has been fighting, especially in the colder months. Last winter, the flu nearly disappeared worldwide because precautions taken against Covid-19, including masks and social distancing, also worked to prevent it. These precautions may have been especially powerful against the flu because they were layered upon some protective immunity people had built up from years of prior exposure to various flu viruses. There was no such protection from Covid-19, which was novel. (Linsey Marr, 10/19)

Bloomberg: Covid Cases Are Soaring In Britain Again, More Than In Europe. Why? 
Once again Britain has one of the highest rates of Covid infection anywhere. The U.K. just reported its biggest single day Covid case increase in three months and a 16% increase in confirmed cases in the week to Oct. 18. The government has warned of a bad winter. Even in the era of vaccines, the risks aren’t trivial. (Therese Raphael, 10/19)

The Atlantic: What If MRNA Vaccines Could Cure Cancer? 
Two years ago, approximately nobody on Earth had ever heard of mRNA vaccines. This was for the very good reason that no country had ever authorized one. As a scientific experiment, synthetic mRNA was more than 40 years old. As a product, it had yet to be born. (Derek Thompson, 10/18)

CNN: Texas Doctor: What Abortion Law Is Doing To My Patients
I am an Ob-Gyn who has been providing abortions in Texas for eight years. Since September 1, my staff and I have been forced to comply with an extreme abortion ban -- SB 8 -- that has blocked patients from getting an abortion at approximately six weeks of pregnancy, before many patients know they are pregnant. Every day working under this cruel law has been heartbreaking and unjust. One of my patients -- who I had to turn away because she was more than six weeks pregnant -- curled up and started to cry uncontrollably. All I could do was hold her hand. (Amna Dermish, 10/18)

The New York Times: Why The Pro-Life Movement Hasn’t Gone Away 
In yet another challenge to Roe v. Wade, the Supreme Court will hear oral arguments in December on whether Mississippi can restrict abortion access to the first 15 weeks of pregnancy. There are few greater constants in American life than legal challenges to Roe, which is remarkable in a country where so much else has changed. (Jon A. Sheilds, 10/19)

USA Today: Mental Health Care Has Improved, But Our Job Is Not Done: Tipper Gore
The COVID-19 pandemic has had dramatic effects on the health and wellness of all Americans. Just as disruptive – and more often overlooked – is the effect the pandemic has had on Americans’ mental health. We are experiencing a national collective trauma on the scale of hundreds of thousands of deaths, widespread illness, lockdowns, significant disruption in employment, and difficulty raising families and caring for loved ones. During this extremely challenging time, people with mental health conditions have faced reduced access to health care providers, in-person counseling and community support networks. (Tipper Gore, 10/18)

East Bay Times: How You Can Fight Back If Denied A Prescribed Medical Treatment 
Has your insurance company ever denied treatment or medication prescribed by your doctor? But does this happen very often? According to a recent poll of Californians conducted in late August by the Healthcare Consumer Rights Foundation, insurance companies denied access to a medication or treatment deemed necessary by their doctor to 30% of Californians. That amounts to approximately 11.8 million Californians not receiving the healthcare treatment they were prescribed—a number higher than the total populations of 44 states. (Steve Poizner, 10/16)

The Boston Globe: If The Legislature Wants To Contain Health Care Costs, It Should Empower The Health Policy Commission 
Massachusetts is a leader in health care reform. Its pioneering coverage expansion in 2006 achieved near-universal health insurance in the state and served as a basis for the Affordable Care Act of 2010. We still enjoy the nation’s highest level of insurance coverage, at 97 percent. In 2012, the Commonwealth again pioneered with legislation establishing the Health Policy Commission to track health care spending and cajole the payers and providers to restrain cost increases. Both sets of reforms are well resourced and expertly led. Yet, while coverage expansion remains robust, cost containment seems to be stalling. These divergent results suggest the need for yet a third round of reform. (John Kingsdale, 10/18)

Modern Healthcare: Helping Communities Target The Social Determinants Of Health
In the congressional district I serve, Peoria, Illinois, offers a vibrant community, a growing restaurant and bar scene and a beautiful riverfront. It’s also the home of the 61605 ZIP code, dubbed one of the “most distressed” ZIP codes in the nation. Parts of the Peoria area have a poverty rate three times the national average, limited access to pharmacies and an enduring food desert. (Rep. Cheri Bustos, 10/19)