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A Covid-19 breathalyzer test with the ability to provide diagnostic results in three minutes has won emergency-use authorization from the U.S. Food and Drug Administration, the agency announced Thursday. The test, made by Frisco, Texas-based InspectIR Systems, is authorized for those 18 and older and in settings where samples are both collected and analyzed, such as doctor’s offices, hospitals or mobile testing sites. The device is about the size of a piece of carry-on luggage, the FDA said, and works by detecting chemical compounds in breath samples associated with SARS-CoV-2 infection. (Muller, 4/14)

The test, designed for use in hospitals, doctors offices or mobile testing sites, requires a piece of equipment around the size of a piece of carry-on luggage. The FDA says the company will be able to produce around 100 instruments per week. Each test can evaluate around 160 samples every day. In a study of 2,409 people with and without symptoms, the FDA says the device was able to spot 91.2% of cases — and yielded false positives in only 0.7% of results. The company announced kicking off clinical trials back in 2020, though the FDA says a follow-up study also found the tests had similar accuracy at detecting the Omicron variant. (Tin, 4/14)

The Breathalyzer test uses a technique called gas chromatography gas mass-spectrometry, which separates and identifies chemical mixtures to detect five compounds associated with the coronavirus in exhaled breath. If a test comes back positive on the Breathalyzer, it should be confirmed with a molecular test, such as a P.C.R. lab test. (Paz, 4/15)

According to InspectIR, the test is performed by exhaling into a tube in a similar manner to blowing up a balloon and produces results within three minutes. (Santucci, 4/14)

The White House is publicly arguing that the country has finally arrived at a promising new stage in the pandemic fight — one that a recent spike in Covid cases won’t spoil. Infections may be rising across the Northeast, but top Biden officials note that vaccines and tests are widely available and new therapeutics are capable of staving off severe illness. After a year consumed by the public health crisis, the administration says this time it actually is okay to stay calm and carry on. (Cancryn, 4/14)

Life in a COVID world is getting awkward again as Americans rush headlong back to their old ways of life even as case counts rise and new variants threaten to dash their hopes. We can't say we're in a post-pandemic period yet. But large segments of the public are embracing pre-COVID norms, a fact that's maddening for those who are — or must — continue taking precautions. "It's definitely weird," said Bob Wachter, chairman of the University of California, San Francisco Department of Medicine. (Reed, 4/15)

The Biden administration, along with other nations and health organizations, is monitoring two emerging Omicron subvariants: BA.4 and BA.5. The two newest subvariants worry some scientists because of a single mutation that could make vaccines less effective against infection. The WHO said it hasn’t seen epidemiological changes in the little data available. (Payne and Banco, 4/14)

KHN: How The Test-To-Treat Pillar Of The US Covid Strategy Is Failing Patients

The federal “test-to-treat” program, announced in March, is meant to reduce covid hospitalizations and deaths by quickly getting antiviral pills to people who test positive. But even as cases rise again, many Americans don’t have access to the program. Pfizer’s Paxlovid and Merck’s Lagevrio are both designed to be started within five days of someone’s first symptoms. They’re for people who are at high risk of developing severe illness but are not currently hospitalized because of covid-19. Millions of chronically ill, disabled, and older Americans are eligible for the treatments, and Dr. Anthony Fauci of the National Institutes of Health said April 11 that more people may qualify soon. (Recht, 4/15)

When the highly transmissible Omicron variant of the coronavirus arrived in the United States last fall, it pushed new case numbers to previously unseen peaks. Even then, the record wave of recorded infections was a significant undercount of reality. In New York City, for example, officials logged more than 538,000 new cases between January and mid-March, representing roughly 6 percent of the city’s population. But a recent survey of New York adults suggests that there could have been more than 1.3 million additional cases that were either never detected or never reported — and that 27 percent of the city’s adults may have been infected during those months. (Anthes, 4/14)

The first clues appear in sewer water. And those clues are piling up. As the United States enters year three of the coronavirus pandemic, disease trackers are trying to stay one step ahead of the constantly evolving virus — by hunting for it in feces. In Maine, hospitals are on alert for a potential surge of patients, tipped off by consistently rising levels of the coronavirus in wastewater. In Ohio, which has used sewage surveillance to identify new variants, authorities are tracking substantial increases at a dozen of the state’s 71 monitoring sites, including south of Columbus. In Houston, steady increases have not been accompanied by a rise in hospitalizations, the first time in almost two years, suggesting that vaccinations and previous infection may be keeping people out of hospitals. (Sun and Keating, 4/14)

Utah reported 740 new coronavirus cases in the past seven days and six more deaths, the Department of Health reported Thursday. The number of new cases increased by 40, compared to the weekly total released last Thursday. The state reported a 9% increase in the seven-day average of new cases, moving from 100 to 109. The weekly rate of positive tests rose slightly as well, to 3.16%. However, state officials are focusing less on new cases to track COVID-19 spread, since fewer people are being tested. The seven-day average for the number of tests has fallen from 3,492 as of April 7, to 2,288 on Wednesday. (Harkins and Pierce, 4/14)

State health officials on Wednesday reported nearly 2,000 new coronavirus cases, yet another increase from last week as COVID-19 hospitalizations ticked up across the region. The state Department of Public Health’s report of 1,969 cases was a 52 percent jump from last Wednesday’s total of 1,296 infections. The omicron BA.2 “stealth” variant is now the dominant strain in the U.S., according to the CDC. The subvariant has sparked a rise in virus cases, as more people gather indoors without masks. The Boston-area COVID wastewater data are going up. (4/14)

Georgia is joining a growing number of states scaling back on the daily public reports of COVID-19 cases. The move comes just as widely used home test kits have made it harder to follow rising cases and questions have been raised about the best way to track the spread of new variants. Some public health officials say moving away from the regular reporting of new cases could leave Georgia in the dark about emerging outbreaks. A new subvariant of omicron, BA.2, is picking up steam in many states. (Oliviero, 4/15)

The Wisconsin Department of Health Services made several changes to its public COVID-19 data pages Thursday, most notably by adopting the U.S. Centers for Disease Control and Prevention's system for indicating risk and community-level spread of the virus. The CDC breaks down COVID-19 levels into high, medium and low tiers, taking into account both local disease spread and hospital capacity. The new levels replace the states COVID-19 activity levels that the state used to feature on its site by region and county. (Shastri, 4/14)

A recent report found that Florida families continue to struggle with many hardships caused by the COVID pandemic, such as unstable housing, food insecurity, loss of health care coverage and mental health issues. The report is based on data from the U.S. Census Bureau’s Household Pulse Survey which was conducted between January and February of this year and focused on employment, housing, health, food and education. These issues are surfacing as the government aid provided during the pandemic begins to expire. The report shows that the pandemic is having lasting effects on people’s budgets, education and mental health. (Bruner, 4/14)

New research to be presented at the end of the month at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) meeting suggests that people with elevated risk of developing a stroke or heart attack over the next 10 years are nearly three times as likely to be hospitalized and require intensive care unit (ICU) treatment, and six times as likely to die from COVID-19 compared with those at low cardiovascular risk. (4/14)

By this fall, pharmaceutical giant Pfizer and its partner BioNTech could potentially have a COVID-19 booster that specifically addresses the omicron variant as well as its subvariants and other known strains of the virus, CEO Albert Bourla said during a panel Wednesday. "It is a possibility that we have it by then; it's not certainty," Bourla said. "We are collecting data right now, and as far as I know, Moderna, as well as us, we are working on omicron or different enhanced vaccines." (Mitropoulos, 4/14)

Compared with a third vaccine dose, a fourth dose of the Pfizer/BioNTech COVID-19 vaccine lowered the risk of infection, symptomatic infection, hospitalization, severe illness, and death 52% to 76%—depending on the measure—amid the Omicron surge among older adults, finds a new Israeli study. Protection against infection waned, however, after 5 weeks, but not protection against severe COVID-19. The findings were published yesterday in the New England Journal of Medicine. (Van Beusekom, 4/14)

Immunity from a bout of COVID-19 may provide some protection against the virus, but a new study suggests it may not be enough to keep you out of the hospital. The Centers for Disease Control and Prevention partnered with Epic Research, which shares data to advance medicine and public health, to determine how effective vaccines and boosters are against hospitalization from reinfection. Researchers looked at electronic health records from over 50,000 patients during both the delta and omicron waves who tested positive for COVID-19 more than three months after a previous infection. (Rodriguez, 4/14)

Connecticut certainly saw one of the strongest responses to the nationwide vaccination effort that began in early 2021 — as evidenced by the state’s 78.7 percent vaccination rate — but whether it was the leader in that effort depends on several factors, and who you ask. For one, several states and territories, including Vermont, Maine and Rhode Island, currently have overall vaccination rates that are slightly higher than Connecticut, according to the Mayo Clinic. (Moritz, 4/14)

As vaccinations were rolled out across the country last year to combat COVID-19, public health experts raised concerns about low uptake in communities of color, based on historic distrust with the health care system. But a new study of vaccination data in Massachusetts has found that educational level is a much stronger predictor than race, and could find no evidence that vaccine hesitancy played a role in people’s decisions. “Although ‘vaccine hesitancy’ dominates media coverage, in fact, language barriers, lack of regular health providers, absence of paid time off to get vaccinated and recover, and lack of trust in the health system all play a role in undermining vaccine coverage,” noted the team of researchers from Boston University’s School of Public Health and the city’s Public Health Commission. (Lazar, 4/14)

California will not require schoolchildren to be immunized for COVID-19 after Gov. Gavin Newsom announced Thursday that he is pausing a state mandate set to go into effect before the upcoming academic year while an influential Democratic lawmaker said he will drop his bill pushing even stricter inoculation rules. Newsom made headlines in October when he announced California would be the first state to mandate the vaccine in schools once shots were fully approved by the U.S. Food and Drug Administration for children ages 12 and older, with the requirement going into effect by July 1. On Thursday, the California Department of Public Health announced that the timeline will be pushed back to at least July 1, 2023, since the FDA has not yet fully approved the vaccine for children and the state will need time afterward to initiate its rule-making process. (Gutierrez and Gomez, 4/14)

A California state senator has dropped a bill that would have required all students to get vaccinated against COVID-19 to attend school by eliminating the state’s existing personal belief exemption. The bill is the second major piece of vaccine legislation to die at the State Capitol in the past two weeks. Legislators earlier shelved a separate bill that would have required California businesses to vaccinate employees against the virus. (Gardiner, 4/14)

It’s not just JPMorgan Chase & Co. that’s hiring unvaccinated workers again. Nearly a third of employers who previously required Covid shots have dropped or plan to drop the requirement, according to a forthcoming survey. Yet as virus rates appear to ebb and companies loosen rules, often in an effort to attract new hires in a tight labor market, they could be alienating employees who dutifully got their shots. Covid-cautious workers and customers as well may take umbrage at the idea of sharing space with the unvaccinated, complicating the return-to-office push. (Court, 4/14)

In a historic moment for the anti-abortion movement, Gov. Ron DeSantis on Thursday signed a measure banning most abortions after 15 weeks of pregnancy. The measure, House Bill 5, contains the strictest prohibition passed in Florida during the Roe v. Wade era. It does not come with exceptions for pregnancies that are the result of rape, incest or human trafficking. Under the law, women can still obtain an abortion if their health is threatened or if their baby has a “fatal fetal abnormality.” Although DeSantis’ signature came more than a month after the Legislature passed the bill in early March, there was never any doubt he would approve the measure. (Wilson, 4/14)

DeSantis signed the bill on the last day of Lent, which ends 40 days of prayer and fasting that Christians go through ahead of Easter. One Planned Parenthood official said the fight over preserving access to abortion is not over. Stephanie Fraim, president and CEO of Planned Parenthood of Southwest and Central Florida, wrote a statement that stopped short of threatening all-out legal action.“If these politicians think the fight against this abortion ban is over they are sadly mistaken,” Fraim wrote. (Sarkissian, 4/14)

Planned Parenthood is renting medical office space in the town of Ontario, on the Oregon-Idaho border. It’s the latest strategic move by pro-abortion rights groups in Oregon. Earlier this year, in a quiet campaign, they successfully lobbied the legislature to set aside $15 million in an unrestricted fund for reproductive health equity. (Templeton, 4/14)

"I have been angry and anxious about reproductive rights for a long time," says Kate Chin Park, a custom furniture maker from Oakland. "And unfortunately, because abortion services have been made so scarce in many places, donations from private individuals are a really important way to try and get people access to the care they need." Chin Park is one of four Bay Area creatives who constructed crossword designs for These Puzzles Fund Abortion Too, a pack of 16 puzzles created to raise money for reproductive rights, which launched on March 1. Chin Park describes her fellow puzzle-builders on the project as "the most interesting, envelope-pushing, brilliant, and funny people writing crosswords today." (Alexandra, 4/13)

As Republican-led states move to restrict abortion, The Post is tracking legislation across the country on 15-week bans, Texas-style bans, trigger laws and abortion pill bans, as well as Democratic-dominated states that are moving to protect abortion rights enshrined in Roe v. Wade. (Kitchener, Schaul and Santamarina, 4/14)

As many Texas women are turning to neighboring states to receive abortion services, Oklahoma Governor Kevin Stitt signed a near-total ban on performing abortions this week. The Oklahoma law, which is set to take effect later this year, would make performing an abortion a felony punishable by up to $100,000 and ten years in prison. It does not penalize a woman receiving an abortion. The move is drawing strong reactions from both pro-life and pro-choice advocates in Central Texas. (Lamparski, 4/14)

KHN: KHN’s ‘What The Health?’: News You Might Have Missed 

It’s been extra busy on the health policy beat lately, so a congressional recess provides a chance to explore some of the important stories that people might have missed, like Medicare’s decision to dramatically limit coverage of Aduhelm, the controversial new drug to treat Alzheimer’s disease. And even with Congress out, states are rushing to either restrict or expand access to abortion, ahead of a key Supreme Court ruling expected later this spring or summer. (4/14)

Adrian Gallo’s interest in better birth control methods for men began about 10 years ago, when he was an undergraduate student with a female roommate. “She told me about the many trials and tribulations of being a woman,” including taking birth control pills, Gallo recalled. “I remember thinking, ‘Oh my God, hormonal pills sound awful, like, truly awful,’” which made him wonder why contraceptive responsibilities weren’t distributed more equitably and why there weren’t broader choices for men other than condoms or vasectomies. (Chiu, 4/14)

As the nation recognizes Black Maternal Health Week this week, experts want to keep the stories of women and birthing people at the forefront. They want them to feel supported, their child bearing experiences celebrated and protected, and systems to be improved and held accountable. The first year of the pandemic saw a surge of maternal deaths, particularly among women of color, according to the Centers for Disease Control and Prevention, with the mortality rate of Black moms in 2020 increasing from 44 deaths to 55 deaths per 100,000. (Hassanein, 4/15)

In the age of rapid advancements in healthcare and treatments for all manner of ailments, women’s health has been relatively overlooked as we’re routinely told to “just deal with it”. However, the rise in FemTech is, thankfully, radically changing how we respond and view female reproductive health. ... Included under the term FemTech are the likes of savvy period products which offer tailored solutions to make pain more manageable in a natural way. There are also a whole host of digital FemTech products such as hormone tracking apps. (Rufo, 4/15)

The cosmetics section of the luxury department store Isetan offered a retail experience last month that no doubt prompted a double take from Tokyo shoppers: a pop-up store with a sprawling display of colorful menstrual cups, vibrators, kegel balls and period underwear. It was a jarring sight in the storied institution, which for decades has offered a sanitized version of what it means to be a woman. A shopper-friendly chart of each menstrual cup’s capacity, down to the milliliter, and a diagram illustrating pelvic-floor muscle training showcased women’s health issues in a rare, in-your-face way in male-dominated Japan. (Lee and Inuma, 4/9)

In its first evaluation of COVID-19 exposures among US healthcare professionals (HCPs) over the first year of the pandemic, the Centers for Disease Control and Prevention (CDC) reports that most HCPs were likely infected at work rather than in the community. The study, published yesterday in the American Journal of Infection Control, used national surveillance data on 83,775 HCPs with information on where they were likely infected with COVID-19 from Mar 1, 2020, to Mar 31, 2021. (4/14)

The head of the Oklahoma Fraternal Order of Police is crying foul after the chairwoman of the Senate Judiciary Committee declined to hear a bill that would have given workers' compensation benefits to first responders suffering from post-traumatic stress disorder. FOP President Mark Nelson said it was disappointing that Sen. Julie Daniels, R-Bartlesville, declined to give a hearing to the bill from Rep. Chris Kannady, R-Oklahoma City, that they have been trying to pass for six years. Daniels chalked up the issue to a policy disagreement. (Forman, 4/14)

Seven-year-old Phil Will still recognizes where the tape that split his house into two sides was glued to the ground. The kitchen and shelves where his mom stores board games were on one side, and the staircase leading to the basement was on the other side. That tape stayed there for more than four months before his parents ripped it off. It did not leave much of an imprint on the ground, but it left a big one on Phil’s mental health. In March 2020, when most people felt a knot in their stomachs as they watched COVID-19 news coverage, Phil had a front row seat to the pandemic’s most uncertain and scariest moments, because his dad is a doctor at a hospital in Indianapolis. (Yousry, 4/15)

KHN: It’s Not Just Doctors And Nurses. Veterinarians Are Burning Out, Too

At the park near Duboce Triangle in San Francisco, 5 p.m. is canine happy hour. About 40 dogs run around, chasing balls and wrestling, as their owners coo and ’90s hip-hop bumps out of a portable speaker. One recent afternoon, a Chihuahua mix named Honey lounged on a bench wearing a blue tutu and a string of pearls. Her owner, Diana McAllister, fed her homemade treats from a zip-close bag, then popped one into her own mouth. (Dembosky, 4/15)

A group of Houstonians has created one of Texas’ only cooperatives for home care workers aimed at creating a self-sustaining community care network and providing higher wages amid a growing national shortage of at-home care providers. The new collaborative gives its care providers a $15 minimum hourly wage, a share in annual profits and a say in business and budgetary decisions. Many graduates of the co-op’s five-week training sessions are single mothers who live in Houston’s Third and Fifth wards, where they say there is a desperate need for access to higher-wage jobs and affordable, long-term elderly care. (Downen, 4/15)

For more than a year, Texas CPS employees have been sounding alarm bells over the state’s practice of lodging dozens of foster children with acute needs in hotels and other temporary housing, overseen by caseworkers who are not trained to care for them and cannot discipline them. The problem hit a high point last summer, with 416 foster children lacking a permanent place to stay. Since then, the number has dropped dramatically — 184 kids didn’t have a placement in all of March, and 69 were awaiting placements early this week. (Harris and McKinley, 4/15)

The Federal Trade Commission and Justice Department asked for input as they rework their horizontal and vertical merger guidelines. Most speakers claimed that mergers and acquisitions involving hospitals, physicians, pharmacy benefit managers and insurers have increased prices, stifled wages and reduced care quality. "One thing that we often hear from hospital executives that are trying to get their deal through is that the merger will be efficient, it will lower costs and let them improve quality," FTC Chair Lina Kahn said after hearing commentary from nurses, physicians, pharmacists and patients. "As we've heard from several of you, sometimes that cost cutting can come at the expense of quality of care." (Kacik, 4/14)

KHN: Readers And Tweeters Sound Alarm Over Nurse’s Homicide Trial 

KHN gives readers a chance to comment on a recent batch of stories. (4/15)

CMS still has not opened the portal providers will use to file dispute resolution claims, even though the surprise billing rule has been in effect since Jan. 1. The agency previously said the utility would open the week of April 11, which ends Friday. The updated guidance comes in response to a federal judge vacating part of the dispute resolution process laid out in the interim final rule implementing the surprise billing ban. That regulation required independent dispute arbiters to begin with the assumption that the median contracted rate is the appropriate out-of-network amount to pay the items or services in question. (Goldman, 4/14)

Federal officials severed critical funding from San Francisco’s Laguna Honda Hospital and Rehabilitation Center on Thursday, a move that threatens to shut down one of the largest skilled nursing facilities in the country and displace more than 700 patients with complicated medical or psychiatric needs. The hospital does not have to immediately close. But after a round of inspections this week, state officials found new deficiencies on the Laguna Honda campus “primarily having to do with hand hygiene, documentation and infection prevention and control,” according to a statement by the San Francisco Department of Public Health, which runs the hospital. (Swan and Whiting, 4/14)

Ahead, an online provider of ADHD treatment, is shutting down, its top investor said Thursday. The company will immediately stop taking new patients and will continue to provide current patients with care through June 24, said Sid Viswanathan, the chief executive officer of Ahead backer Truepill. As Truepill has shifted its focus to serving corporate and business customers, “we made the difficult decision to no longer invest in Ahead,” Viswanathan wrote in an email to Bloomberg. (Davalos and Melby, 4/14)

A top state officials said the Glenwood Resource Center will close because the state is unable to comply with federal requirements. At a Council on Human Services meeting Thursday, Kelly Garcia, the director of the Department of Human Services, called the decision to close Glenwood "devastating." But Garcia said she and Gov. Kim Reynolds determined no financial investment would be enough to get the facility in compliance with federal demands. "Neither one of us, at any point, have had a desire to get to this point. But ultimately, I have to assure her and everyone out there that we are able to provide safe care and I can't do that right now," she said. (Krebs, 4/14)

Before Banner Health agreed to shore up a pair of financially struggling medical schools, leaders framed such partnerships as a “must” for Arizona. It’s come with a hefty price tag. Financial statements show the Phoenix-based health system has dedicated roughly $2 billion to the schools and a faculty medical group it bought as part of the deal, which closed in 2015. Meanwhile, Banner’s operating margin has slipped from 5% before the deal to 1%. Health systems nationwide are in similar situations. They see a lot of benefit from partnering with medical schools, it’s just that the value is harder to capture in numbers. The prestige of an academic affiliation draws patients and the promise of breakthrough cures. The doctors they’re training will one day save lives. (Bannow, 4/14)

The effort to build a medical facility with enhanced medical services in Fremont County took a major step forward. Monday, the Riverton Medical District announced that it received a $37 million U.S. Department of Agriculture Rural Development grant that will be put towards the effort of creating a locally owned and governed health care facility. The project came about over three years ago after services from the current hospital were either being eliminated or moved out of town. Medical district treasurer Vivian Watkins said that’s when the community decided to take control of its health care options. “It’s something we felt we were not willing to accept…for our community to lose significant medical services,” said Watkins. (Beck, 4/12)

The owners of an aging northwest Georgia hospital want to replace it with a smaller state-of-the-art facility about 5 miles away and closer to I-75. Under the state’s regulatory certificate-of-need (CON) system, other hospitals can contest CHI Memorial Hospital Georgia’s bid to get state approval for the replacement hospital, which would be located in Ringgold. No Georgia hospital system has objected. But the road to construction has an unusual obstacle. (Miller, 4/14)

Kaiser Permanente plans to double the size of its efforts to address housing instability with another $200 million, the integrated health system said Thursday. Since the Thriving Communities Fund's inception in 2018, the initiative has preserved or produced more than 7,000 affordable housing units across the U.S. and is on track to hit 15,000 by 2025. Kaiser also worked with SDS Capital Group to create 1,800 supportive housing units in California using $50 million from its initial investment, the health system said in a news release. (Abrams, 4/14)

Northwell Health, the largest health system in New York, and Aegis Ventures, an investment group that builds and launches startups, announced the creation of a jointly owned healthcare AI platform company, Ascertain. Ascertain will have $100 million in seed funding to develop and commercialize healthcare AI solutions and emerging companies on its platform. The solutions on this platform will focus on improving quality and access to care, while closing health equity gaps, the companies said. The companies developing solutions on Ascertain’s platform will be given access to Northwell’s datasets, as well as access to the health system’s clinical and technical teams. (Perna, 4/14)

Cigna's health services division, Evernorth, and Behavioral Health Center of Excellence are collaborating to develop treatment standards to ensure patients with autism receive services that meet clear quality and efficacy metrics. The organizations will work together to improve access to autism treatment, advance patient-centered and value-based care using patient and provider input, increase transparency surrounding care quality and incentivize more providers to deliver high-quality services to people with autism. Around one in 44 children have been diagnosed with autism spectrum disorder, and the rate has been steadily increasing over the past decade, according to a Centers for Disease Control and Prevention study released in 2021. (Devereaux, 4/14)

Laura Andrus, who has battled cancer and lung problems for years, told her doctor it felt like she was slipping into a depression worse than she had ever felt before. As inconclusive medical tests piled up, offering no information about why Andrus wasn’t feeling well and whether the cancer was back or if she had an autoimmune disease, her mood deepened. Then Andrus’ doctor suggested she speak to the psychologist who works in the same Littleton family medicine practice. After a few weeks, including a virtual visit with a psychiatrist who prescribed medication, Andrus was “feeling more positive and able to deal with life,” she said. By the time she learned a couple of months later that she had a rare lung disease, Andrus was ready to cope with it. (Brown, 4/14)

After three years of squabbling, Bristol Myers Squibb has agreed to pay up to $11 million to settle a lawsuit that accused several drugmakers of conspiring to block generic competition to HIV medicines. The lawsuit described an unusual scheme concerning fixed-dose combinations of different HIV medicines, which have been widely used for several years to combat the virus. The complaint also cited Gilead Sciences and Johnson & Johnson, whose medicines are useful components in these combinations, which are sometimes referred to as cocktail treatments. (Silverman, 4/14)

The economic cost of multiple sclerosis, or MS, was about $85.4 billion in the U.S. in 2019, according to research published Wednesday in the online issue of Neurology. According to the report, MS has a direct medical cost of $63.3 billion and indirect and non-medical costs of $22.1 billion. Retail prescription medication (54%), clinic administered drugs (12%), medication and administration and outpatient care (9%) were the three largest components of the direct costs. (Reed, 4/14)

As the U.S. health care system braces for expensive gene therapies, a new analysis suggests that a forthcoming treatment for a rare disease called beta thalassemia would be cost-effective — even if priced at $2.1 million. The therapy, which is being developed by Bluebird Bio, is still being reviewed by the U.S. Food and Drug Administration and approval is not expected for several months. Although a formal price has not been disclosed, the company has previously indicated it was looking to charge $2.1 million for its treatment using a five-year installment plan. (Silverman, 4/13)

Biotech has long been the little sibling of big pharmaceutical companies. ... But the following charts show two amazing clues that biotech revenue soon may rival that of big pharma. (Cimino, 4/13)

Type 2 diabetes is widespread in many parts of Tallahassee. Now, the Care Point Health & Wellness Center, run by Big Bend Cares, has a powerful new tool to detect the disease early. The Retina Vue device resembles an overgrown set of binoculars. Big Bend Cares board Chair Stanley Kahn II said it's a welcome addition to the center's diagnostic toolbox "to be able to provide retinal scans that can be essential to our diabetic patients here at Care Point." That means treatments can begin earlier and therefore be more effective. The device was made possible by a grant from the Florida Blue Foundation. Ashley Rousseau, who manages Florida Blue's Tallahassee office, said the whole idea is to expand preventive patient care. (Flanigan, 4/12)

Orange County clinics that cater to the LGBTQ community are stocking up on meningitis vaccines due to an outbreak that’s only been detected so far in men who have sex with men.  The CDC says the best prevention against meningitis is getting vaccinated. Hope & Help’s Medical Director Dr. Trey Vanderburg says that’s why his Winter Park clinic, which usually provides HIV, STI and hepatitis C testing, has ordered the meningitis vaccine. “We are currently out of the vaccine right now. And we have contacted the health department and we are in the process of getting more vaccines delivered to our facility.” (Prieur, 4/14)

How do you catch meningococcal disease? These bacteria are not as contagious as germs that cause the common cold or flu. People do not catch the bacteria through casual contact or by breathing air where someone with meningococcal disease has been, according to both the CDC and Department of Health. It requires close contact over a period of time, or direct contact such as kissing or sharing drinks. (McCloud, 4/13)

A trio of papers published this week in The Lancet Infectious Diseases make the case that meningitis vaccines could play a role in preventing gonorrhea infections. ... While no gonorrhea-specific vaccines are currently available, two of the studies published in The Lancet found that the four-component serogroup B meningococcal (4CMenB) vaccine, designed against Neisseria meningitidis, showed some cross-protection against N gonorrhoeae. And a third study suggests that the use of the 4CMenB vaccine in those at greatest risk of infection could be the most impactful and cost-effective method of averting gonorrhea. (Dall, 4/14)

Marine veteran Chandler Rand has struggled with various eating disorders since she was a child. Though she says she's healthy now, she describes her recovery as an ongoing process. She still has to fight off negative thoughts about her body image and weight. "It's basically like walking a tightrope," Rand says. In 2016, Rand was a Marine. She was successfully treated for anorexia as a teenager, but after boot camp, she began to binge eat and became bulimic. "I don't think I saw that as part of my eating disorder at the time," Rand says. "I think I just saw it as part of being a good Marine." (D'Iorio, 4/15)

A popular way to save for out-of-pocket medical expenses might be contributing to health-care inequality, new research suggests. Health savings accounts are tax-advantaged accounts available to Americans with high-deductible health insurance policies. Federal law established them in 2003. Since then, HSAs have grown quickly as employers have adopted high-deductible plans for their workforces to save money. HSAs offer a three-tiered break on income taxes: contributions are tax-free, as are investment earnings and withdrawals for eligible medical expenses. (Iacurci, 4/14)

Federal Reserve policy makers and researchers who have been puzzled by the slow return of U.S. workers to the labor force during the Covid-19 pandemic may have found a new explanation: alcohol and drug abuse. Increased substance abuse accounts for between 9% and 26% of the decline in prime-age labor-force participation between February 2020 and June 2021, according to a new study by Federal Reserve Bank of Atlanta researcher Karen Kopecky, Jeremy Greenwood of the University of Pennsylvania and Nezih Guner of the Universitat Autonoma de Barcelona. (Matthews, 4/14)

Get up and move -- even small doses of physical activity, such as brisk walking, may substantially lower the risk of depression, according to a new data analysis. "Most benefits are realized when moving from no activity to at least some," the study authors wrote. Recommended levels of exercise in the United States, according to the US Centers for Disease Control and Prevention, include aerobic activity at moderate levels (such as a brisk walk) for 2.5 hours a week, along with a workout of all major muscle groups twice a week. Alternatively, a person can choose a vigorous aerobic exercise, such as running, for 1.25 hours each week, along with the same amount of strength training. (LaMotte, 4/14)

A piece of Marine veteran John Rubino is keeping 8-month-old Ariany alive. ... Ariany was suffering for months from a potentially deadly and very rare disease, Biliary Atresia. It is a blockage in the tubes (ducts) that carry bile from the liver to the gallbladder. Ariany needed an implant right away, so Dr. Nadia Orchinsky got her on the national donor waitlist immediately, but there was no match. This is Rubino’s second time giving someone a second chance. The first was a kidney given to a woman named Jessica in Connecticut. (4/1)

The neurologist said Pam Stevens' cognitive impairment couldn't be treated. After suffering a stroke in 2014, the 85-year-old wasn't responding to medication. She and her husband, Pete Stevens, were told to give up hope. "On two separate occasions, over a two-year period, the neurologist said there was nothing we could do," said Pete Stevens. "He said 'just take her home and be prepared that she's gonna die.'" But he refused to accept that grim prognosis. He was willing to try anything — including an experimental video game therapy — to restore Pam's brain. (Gordon, 4/15)

Most of society shuns registered sex offenders, but Drew Doll has a different solution — befriending people convicted of high-risk sex crimes. “By forming friendships … we get to know people really well,” said Doll, who is the reentry and reconciliation coordinator at the Religious Coalition for a Nonviolent Durham. “We hold them close.” The Religious Coalition for a Nonviolent Durham is one of several groups in North Carolina exploring ways to reduce sex crimes independent of the sex offender registry, through methods ranging from restorative justice practices to cognitive behavioral therapy. (Thompson, 4/15)

Recreational cannabis sales in New Jersey will start April 21, the state’s Cannabis Regulatory Commission said Thursday. For the uninitiated, that’s one day after 4/20, a day many have long celebrated as an unofficial holiday for weed lovers. Specific locations where sales will start were not identified. Regulators said they would post on the CRC’s website a list of which locations will open next Thursday as soon as the medical marijuana companies notify the commission of their opening date. The commission on Monday said seven of the state’s medical cannabis companies, with 13 locations, could expand into recreational cannabis as soon as they paid an expansion fee and passed final inspections. (Brubaker, 4/14)

Democratic senators leading a push to legalize marijuana say they are now on track to introduce legislation before recess in August, after initially announcing plans to file a comprehensive reform bill later this month. Senate Majority Leader Charles Scumer (D-N.Y.) — who is heading the effort along with Sens. Cory Booker (D-N.J.) and Ron Wyden (D-Ore.) — said in a statement on Thursday that he’s proud of the progress senators have made in “bringing this vital bill closer to its official introduction” before the recess in early August.  (Folley, 4/14)

Dr. Nish Pandya, a pediatric resident at Yale New Haven Health, remembers the 10-year-old boy who came to the emergency room five times with breathing difficulties. “His breathing improved when he received the necessary medication and treatment,” Pandya said Thursday. “He started to feel better. The look of fear started to come off of his face.” Pandya asked the boy’s mother what type of medications he was taking at home. “She bowed her head and said, ‘We don’t have medications. We don’t have insurance. We are undocumented,’” Pandya recalled. “This patient had been cared for in the emergency room five times in the past year. His asthma was not managed properly because his family could not afford the medication he needed to be able to breathe comfortably. His family was not able to access care or to afford health insurance.” (Carlesso and Phaneuf, 4/14)

More than a year after the passage of a state law that broadened access to telehealth and mandated higher insurance reimbursements for several types of telephonic and virtual visits, the Division of Insurance has issued draft regulations that give insurers and providers more clarity on how to put the law into practice. The regulations, issued Tuesday, came after the state’s largest insurer, Blue Cross Blue Shield of Massachusetts, put into effect its own state-approved policy interpreting the law. On Monday, the Boston Globe reported that the absence of regulations had created uncertainty among providers and threatened to undo gains the health care industry had made in adopting telehealth over the course of the pandemic. (Bartlett, 4/14)

The transport of an anteater from one zoo to another may have exposed more than a dozen people to rabies, researchers said Thursday, serving as a warning that such transfers can expand what are considered “rabies zones.” Thirteen people had to undergo rabies treatment for possible exposure, and no human cases were ultimately reported, according to the report, published Thursday in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. Rabies, which is almost universally fatal if untreated, is sometimes underestimated as a threat, recent research suggests. A CDC report from earlier this year described the cases of three people who died from rabies contracted from bats, all whom could have survived had they sought or accepted post-exposure care. (Joseph, 4/14)

Four parents have filed a lawsuit against the Ludlow School Committee and several school officials claiming they have violated their rights by choosing not to tell parents when children seek to establish a new gender identity at school, court records show. Stephen Foote and Marissa Silvestri, parents of two children in Ludlow schools, and Jonathan Feliciano and Sandra Salmeron, who also have two children in the district, claim the district’s policy affirming transgender students’ identities violates the US and Massachusetts constitutions, according to the lawsuit filed Tuesday in US District Court in Springfield. The lawsuit does not identify the policy. (Fox, 4/14)

When cardiac patients visit the East Carolina Heart Institute in Greenville, they see the usual providers – internal medicine doctors, cardiologists and nurse practitioners. They also might sit down with a cardiac psychologist, a mental health professional who specializes in supporting people as they navigate the complicated emotions that arise with cardiac issues such as heart attack, heart failure and open heart surgery. At the facility, prospective psychologists and cardiologists train alongside each other and then go on to work side by side, co-treating patients. A new article in the Journal of Health Psychology explores how the facility’s partner school — East Carolina University — has grown its cardiac psychology training program into one of the best in the country. (Donnelly-DeRoven, 4/14)

Jack Kersey, a gay activist who was instrumental in opening a hospice facility for homeless HIV/AIDS patients in the Louisville area during the height of the epidemic, died Wednesday at age 90, according to his husband. Kersey, originally from Washington, D.C., spent the majority of his life in Louisville and was one of the city’s most prominent HIV and AIDS advocates in the 1980s and 1990s. In 1986, he helped establish Glade House, the first group home in the area for patients who were diagnosed with the virus. The facility started with six rooms where patients went to die, but it now comprises two housing programs — an emergency shelter and short-term housing — and the virus is no longer a death sentence. (Johnson, 4/15)

Dozens of USAID employees — working to get Covid-19 vaccines in arms and strengthen health systems around the world — are looking to leave the agency after Congress failed to provide additional funding for their programs, according to three people familiar with the matter. As employees look for new opportunities, the programs themselves are in flux while agency leaders consider consolidating Covid-19 programs at the United States Agency for International Development. (Payne and Banco, 4/15)

Britain approved on Thursday Valneva's COVID-19 vaccine, making it the first European country to give a nod to the French firm's coronavirus shot, that is easier to store and involves a process widely used in making flu and polio vaccines. (Grover and Morland, 4/14)

Taiwan reported a record number of Covid cases as multiple outbreaks across several cities overwhelmed health authorities’ efforts to contain the virus. Local infections rose to an all-time high of 1,209, health minister Chen Shih-chung said at a briefing in Taipei on Friday. It was the first time since the global pandemic began that Taiwan has reported more than 1,000 cases in a day. Chen also warned that the daily case figures are likely to get much worse. (Ellis and Hou, 4/15)

The Clinton Health Access Initiative selected Dr. Neil Buddy Shah as its new CEO Thursday, a sign of the global health organization’s move towards growth in low- and middle-income nations and use of new philanthropic efforts to help fund the expansion. Shah is currently managing director of global health and development research and funding organization GiveWell and previously co-founder and CEO of data analytics and advisory firm IDinsight. Also a leader in the “Effective Altruism” movement, Shah will start in his new role at Clinton Health Access Initiative (CHAI) on June 14. (Gamboa, 4/14)

Public health officials in the United States and the United Kingdom are investigating a number of unusual cases of serious hepatitis in young children, the cause or causes of which are currently unknown. Evidence from the U.K. and from Alabama — where nine cases have been recorded since last fall — points to the possible involvement of an adenovirus. Adenoviruses generally attack the respiratory tract, causing cold-like illnesses. But they have been linked to bladder inflammation and infection, and occasionally to hepatitis, though rarely in children who are not immunocompromised. (Branswell, 4/14)

World Health Organization (WHO) director-general Tedros Adhanom Ghebreyesus hit the global community Wednesday for its focus on the war in Ukraine, questioning "if the world really gives equal attention to Black and White lives." In a press briefing, the agency chief said that ongoing emergencies in Ethiopia, Yemen, Afghanistan and Syria have garnered only a "fraction" of the global concern for Ukraine. In March, Tedros – who is from Ethiopia – said there is "nowhere on Earth where the health of millions of people is more under threat" than the country's Tigray region. Thousands have been killed since the civil war began in November 2020, and the UN Refugee Agency reports that more than 3,000 people have been fleeing from Tigray each day into eastern Sudan. (Musto, 4/13)

When coronavirus variants emerged in full force in late 2020, the news suddenly turned into alphanumeric soup. Remember? The U.K. variant, B.1.351, GR/501Y.V3. After this initial period of chaos, the World Health Organization came up with a sanity-preserving system that renamed those variants, respectively, Alpha, Beta, and Gamma. And down the Greek alphabet we went, until we got to Omicron. The system worked. Lately however, the post-Omicron news landscape is turning into alphanumeric soup again. An Omicron subvariant called BA.2 is now globally dominant. BA.4 and BA.5 have just been discovered. And a cornucopia of new recombinants have names that seem to follow some inscrutable logic: XD (a recombinant of Delta and BA.1), XE (a recombinant of BA.1 and BA.2), XF (a different recombinant of Delta and BA.1), and so on, all the way down to XS (a recombinant of Delta and BA.1.1). (Zhang, 4/14)

Russian President Vladimir Putin’s decision to invade Ukraine probably sabotaged any further aspirations for the Sputnik coronavirus vaccine, the first injection approved by any country. Manufacturing of the vaccine has slowed, further research is stalled and a much-anticipated March 7 visit by the World Health Organization to Russia’s Sputnik manufacturing plants, the last step in its long-awaited international approval process, was once again delayed — this time indefinitely. (Hoffman, 4/9)

Lucy Esparza-Casarez thinks she caught the coronavirus while working the polls during California’s 2020 primary election, before bringing it home to her husband, David, her sister-in-law Yolanda, and her mother-in-law, Balvina. Though Lucy herself developed what she calls “the worst flu times 100,” David fared worse. Lucy took him to the hospital on March 20, the last time she saw him in the flesh. He died on April 3, nine days before their wedding anniversary, at the age of 69. Lucy said goodbye over Skype. During that time, Yolanda fell ill too; after two months in the hospital, she died on June 1. Balvina, meanwhile, recovered from her bout with COVID-19, but, distraught after losing two children in as many months, she died on June 16. Lucy found herself alone in her home for the first time in 23 years. Because the hospital never returned David’s belongings, she didn’t even have his wedding ring. (Yong, 4/13)

In a recent editorial in JAMA, two neurologists called for doctors and patients to abandon the term transient ischemic attack. It’s too reassuring, they argued, and too likely to lead someone with passing symptoms to wait until the next morning to call a doctor or let a week go by before arranging an appointment. That’s dangerous. Better, they said, to call a T.I.A. what it is: a stroke. More specifically, a minor ischemic stroke. (Almost 90 percent of strokes, which afflict 795,000 Americans a year, are ischemic, meaning they result from a clot that reduces blood flow to the brain.) (Span, 4/9)

When considering problems with the heart, you might first think of clogged arteries that lead to heart attacks. But the heart has an electrical system, which guides how it beats, that can separately go haywire. When that happens, the heart can’t pump in a rhythmic manner and blood flow to organs may be compromised. If this arrhythmia goes undetected or isn’t managed properly, it can cause strokes, heart failure and death. The most common — and frequently undiagnosed — arrhythmia is atrial fibrillation (AF), also known as AFib. An estimated 3 million to 6 million Americans have it, and studies show that the number will balloon to 12.1 million by 2030 as the population gets older. Recent studies also found that people who had covid-19 have a higher risk of AFib and other heart diseases, even among those without a prior history of heart problems. And there is growing evidence that AFib significantly increases the risk of cognitive impairment and dementia. That is why it’s important to know the warning signs of atrial fibrillation and to get treatment early: It could save a person’s life. (Das, 4/12)

An algorithm may hold the key to saving your life in the emergency room. Hospitals are making a bet that artificial intelligence can help identify and treat patients at highest risk in their ERs, inpatient wards and intensive-care units, for dangers including the deadly infection sepsis and an impending cardiac arrest or stroke. (Landro, 4/10)

When Britney Spears announced her third pregnancy in an Instagram post on Monday, she also made another disclosure: She said she suffered from perinatal depression during a previous pregnancy. “I have to say it is absolutely horrible,” Spears wrote. Spears, 40, has two children — Sean Preston, 16, and Jayden James, 15 — with ex-husband Kevin Federline. She didn’t specify when she suffered from perinatal depression, what her symptoms were or how long they lasted. But her post resonated, with more than 2 million people leaving likes and comments. (McShane, 4/12)

Contaminated spinach last fall made people sick in 10 states, and sent three people into kidney failure, but the agency reacted too slowly to get to the bottom of it. There was no recall. That was just one of many examples in recent years of foods that sound like the diet of a healthy eater but instead sent hundreds of people to the hospital or the morgue: Romaine lettuce contaminated by E.coli bacteria, cucumbers tainted by salmonella, cantaloupes infected with listeria. And so on, with such regularity that many outbreaks no longer even make much news. (Harris, 4/14)

This week marked a major victory for truth in wine advertising. The days of bandying about "clean wine," a poorly defined term that has been widely exploited as of late, have come to an end. The federal government issued official guidance warning wine companies against using this term on their labels or in their ads because it constitutes a misleading health claim. (Mobley, 4/14)

From the outset, mystery has shrouded the COVID-19 pandemic in China. The origin of the virus remains unknown, important Chinese journalists and key scientists have been muted, and case and death totals reported by China’s government have been unbelievably low — the United States and most of Western Europe have reported 500 to 1,000 times as many per capita deaths as China. (Cory Franklin and Robert A. Weinstein, 4/14)

In a shocking turn of events, the World Health Organization warned United Nations agencies against procuring Covaxin, India’s indigenously developed and manufactured Covid-19 vaccine, just five months after granting approval to the made-in-India vaccine. The warning came after a WHO inspection of a manufacturing facility owned by Bharat Biotech International Ltd. revealed “deficiencies in good manufacturing practices.” The WHO has not revealed the extent or nature of the deficiencies at Bharat Biotech’s facility; but given its recent instructions to U.N. agencies, the deficiency must have been significant from a public health perspective. (Dinesh Thakur, 4/15)

A resigned sigh is the adult response to this week's announcement that air travelers must continue donning face masks amid the ongoing COVID-19 pandemic. What's not welcome: entitled bellyaching. Continued masking is a minor inconvenience as leisure and business travelers return, especially for the shorter flights domestic travel involves. Just deal with it like a grown-up. Any complaints should be stuffed into the overhead bin next to carry-on luggage instead of being hurled at flight crews. (4/14)

Children and adolescents in our country are in crisis. The Centers for Disease Control and Prevention (CDC) recently released a comprehensive survey that chronicled a startling decline in adolescent mental health from 2009 to 2019. According to that report, more than 1 out of every 3 high school students had experienced persistent feelings of sadness or hopelessness in 2019 — a 40% increase since 2009. This is not an occasional bad day. (Harsh K. Trivedi, 4/15)

Investigators are continuing to pore through the extensive library of YouTube videos created by Frank James, the 62-year-old man accused of shooting 10 people on a New York City subway train, searching for clues about his motive. But those videos and his case have also refocused America's attention on the acute mental health crisis that is gripping this country, from the vast number of untreated people in need of psychological help to the difficulty that Congress will face if they actually try to fix what has long been a broken system. (Maeve Reston, 4/15)

As the nation marks Black Maternal Health Week, founded by the Black Mamas Matter Alliance to deepen the national conversation about Black maternal health, it is important to recognize the urgency to curb this unacceptable but persistent disparity by prioritizing community-driven care solutions. The circumstances Black people face are not simply a matter of an economic or education system, but of a system that reinforces inequitable and discriminatory practices. There’s no clearer example than that of Serena Williams, who despite being one of the world’s greatest athletes and a successful businesswoman, faced life-threatening failures in her care in the time surrounding childbirth. In her own words, Williams said, “Being heard and appropriately treated was the difference between life or death for me; I know those statistics would be different if the medical establishment listened to every Black woman’s experience.” (Allison Bryant, Makeeba McCreary and Elsie Taveras, 4/14)

Last week, Texas gave us a glimpse of the future. It was not pretty. It seems that on Thursday, a 26-year-old woman was arrested and charged with murder. Specifically, according to a statement from the Sheriff’s Department in tiny Starr County on the Mexican border, Lizelle Herrera “intentionally and knowingly” caused “the death of an individual by self-induced abortion.” (Leonard Pitts Jr., 4/14)

Sometime before its session ends this summer, the Supreme Court is likely to either eliminate the federal right to abortion or, at a minimum, significantly scale it back. That ruling will be made in the case of Dobbs v. Jackson Women’s Health Organization, which is expected to overturn precedent to find that banning abortion after 15 weeks doesn’t violate the Constitution. Currently, it is unconstitutional to ban abortion before viability, which occurs around 24 weeks of pregnancy and marks the point at which a fetus can survive outside the uterus. (Caroline Mala Corbin, 4/14)

Of all the terms that have been redefined during the past two years, perhaps none has undergone more change than “disaster.” The definition has been stretched in nearly every direction possible. Tasks like business travel that might have seemed normal before prolonged isolation and lockdown are now described as unbearable ordeals; weeks where only 900 Covid patients die per day are tolerable. Our response to “disaster” has also changed as Covid has revealed whose crises matter and whose do not. In the early months of the pandemic, when the public learned about thousands of deaths in understaffed and poorly run nursing homes around the country, an optimist might have expected extensive and immediate change to that industry. (Jay Caspian Kang, 4/14)

We all carry the memory of our mistakes. For health care workers like me, these memories surface in the early morning when we cannot sleep or at a bedside where, in some way, we are reminded of a patient who came before. Most were errors in judgment or near misses: a procedure we thought could wait, a subtle abnormality in vital signs that didn’t register as a harbinger of serious illness, an X-ray finding missed, a central line nearly placed in the wrong blood vessel. Even the best of us have stories of missteps, close calls that are caught before they ever cause patient harm. (Daniela J. Lamas, 4/15)

Patients and their caregivers expect the chains that own Connecticut’s non-profit hospitals to invest in healthier communities. Women’s health, maternity services, housing, childhood immunization programs, lead abatement, transportation, and other needs that are identified by those directly impacted in the facility’s service area should be prioritized. How can we get there?  By strengthening S.B. 476 — the Governor’s proposal for improving community benefit laws — by clarifying what hospitals report on and implementing a spending floor. (John Brady, 4/15)

An antibiotic known as carbadox can damage genes and cause cancer. The European Union, Canada, Australia, and the United Kingdom have banned its use for years. So why does the U.S. Food and Drug Administration allow pork producers to keep using it? Carbadox is fed to more than half of the pigs raised in the U.S. for food. It promotes growth and controls gut infections. But it poses significant safety risks to consumers who unknowingly consume carbadox residues when eating pork. It can also harm farm workers who are exposed to the drug when mixing feed or working in buildings where carbadox is used. (Harry Rhodes, 4/15)