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The director of the Centers for Disease Control and Prevention on Thursday formally endorsed the use of Covid-19 booster shots from Moderna and Johnson & Johnson for some adults, clearing the way for millions of Americans to receive additional doses. “These recommendations are another example of our fundamental commitment to protect as many people as possible from COVID-19," CDC Director Rochelle Walensky said in a statement. "The evidence shows that all three COVID-19 vaccines authorized in the United States are safe — as demonstrated by the over 400 million vaccine doses already given. And, they are all highly effective in reducing the risk of severe disease, hospitalization, and death, even in the midst of the widely circulating Delta variant.” (Gardner, 10 /21)

Americans are now free to get a free booster dose of all three COVID-19 vaccines, and can even choose to mix and match their vaccines, after the director of the Centers for Disease Control and Prevention signed off on new recommendations Thursday night. At the same time, CDC recommended boosters for certain people who got Moderna vaccine and all 15 million Americans who got the Johnson & Johnson vaccine. Clinics, doctors and pharmacies can begin giving boosters as soon as Friday. (Weise, 10/21)

Tens of millions of Americans can sign up to get Moderna and Johnson & Johnson boosters beginning Friday after the nation’s top public health official endorsed recommendations from expert advisers that the shots are safe and effective at bolstering protection against the coronavirus. The green light from Rochelle Walensky, director of the Centers for Disease Control and Prevention, means that eligible Americans at risk of severe disease can choose any of the three boosters now authorized in the United States regardless of their original shot. (Sun and Shepherd, 10/21)

Researchers found 109 cases of symptomatic Covid-19 among study subjects who received a placebo shot, compared with five cases in people who took the vaccine, resulting in 95.6% efficacy, the companies said. The additional dose was safe and tolerable, and consistent with what was known about the vaccine, the companies said. (Hopkins, 10/21)

Fully vaccinated people who received the Pfizer-BioNTech booster shot in a large trial were at a 95.6% lower risk of COVID-19 infection than fully vaccinated people who received a placebo, the companies said Thursday. The news came on the same day a CDC advisory panel voted unanimously to allow booster shots of the Moderna and Johnson & Johnson COVID-19 vaccines and to permit the extra doses to be of a different brand than the original shots. Put together, Thursday's developments figure to accelerate the nation's booster program, which the Biden administration has promoted. The Pfizer-BioNTech booster shots were authorized for certain populations in the U.S. last month. (Ortiz and Bacon, 10/21)

Pfizer and BioNTech said Thursday that a late-stage trial of the drugmakers' COVID-19 vaccine booster showed it restored full protection against the disease. In a test involving 10,000 participants, the additional shot was 95.6% effective against the disease, according to the companies. ... The companies said the trial involved people who were 16 and older, and represents the first efficacy results from any randomized, controlled COVID-19 vaccine booster test. The results demonstrate the benefits of booster shots to fight the disease, Pfizer CEO Albert Bourla said in a statement. (Picchi, 10/21)

The Centers for Disease Control and Prevention on Thursday published data listing the most common side effects people reported after receiving boosters of Pfizer’s or Moderna’s two-dose Covid vaccine or a second dose of Johnson & Johnson’s single-dose vaccine. The data, presented to the agency’s Advisory Committee on Immunization Practices, is based on submissions to the agency’s text messaging system v-safe and the Vaccine Adverse Event Reporting System, a national vaccine safety surveillance program. (Lovelace Jr., 10/21)

COVID-19 vaccination does not increase the risk of miscarriage during the first trimester of pregnancy, according to a Norwegian case-control study that involved 13,956 women, 5.5% of whom were vaccinated against the virus. The results were published yesterday as a letter to the editor in the New England Journal of Medicine. The study consisted of 13,956 pregnant women, 5.5% of whom were vaccinated. In total, 4,521 women had miscarriages, and 5.1% of those were vaccinated. A median of 19 days occurred between vaccination and either miscarriage or confirmation of ongoing pregnancy. (In Norway, pregnant women are not recommended to receive any vaccinations during their first trimester, but the researchers reason that some women may have gotten vaccinated against COVID-19 before they knew they were pregnant.) (10/21)

Science appears to increasingly show, however, that those who have previously been infected and are subsequently vaccinated exhibit a combined immunity that may be the strongest protection against coronavirus reinfection. Researchers emphasize that these studies, which examine how and why hybrid immunity provides such strong protection, are key. “We don't want people to become infected and vaccinated. But if you can elicit this kind of immunity by not getting infected, that's what we're super interested in investigating," said Nadia Roan, a UCSF immunologist and investigator at Gladstone Institutes in San Francisco. (Echeverria and Allday, 10/21)

President Biden on Thursday said police officers and first responders who refuse the COVID-19 vaccine should stay home and be fired. Speaking during a presidential CNN town hall, moderator Anderson Cooper noted that as many as one in three emergency responders in some major cities are refusing to comply with city vaccine mandates. "I'm wondering where you stand on that," Cooper said. "Should police officers, first responders be mandated to get vaccines? And if not, should they be mandated to stay at home, let go?" "Yes and yes," Biden replied, going on to suggest that he implemented his controversial vaccine mandate only as a last resort. (Brown, 10/21)

The Chicago police union’s first vice president has issued a blistering attack on Mayor Lori Lightfoot’s vaccine mandate, likening it to "The Hunger Games," and warned younger officers not to give in to pressure. The remarks came in a nearly 10-minute video posted by Fraternal Order of Police First Vice President Michael Mette on his Facebook page. "Welcome to day three of ‘The Hunger Games,’ where we find out who the city is going to offer up as tribute," Mette says in the video, invoking the book and film series about a dystopian world in which children must fight to the death for the entertainment of wealthy residents. (Betz, 10/21)

With thousands of Chicago police officers at odds with the city’s new COVID-19 vaccine mandates, officials in the neighboring state of Indiana are trying to recruit disgruntled cops, some of whom are being punished for not complying. ... “Hey Chicago police officers, we’re hiring!” an Indiana State Police spokesman said in a tweet on Thursday. “No vaccine mandate … lower taxes, great schools, welcoming communities.” (Willetts, 10/20)

A vaccine mandate once directed at new Oklahoma City Police Department recruits has been rescinded, city officials announced Wednesday. The hiring prerequisite instituted this summer for both new police hires and fire recruits required applicants either to be already vaccinated or be willing to be vaccinated upon hiring. "The Oklahoma City Police Department has dropped its COVID-19 vaccine mandate for all new hires and recruits. So neither the vaccine nor a negative test are required to become a police recruit," read a brief statement released to the media by Oklahoma City Police Dept. spokesman Gary Knight. (Gore, 10/21)

A trade group for air cargo giants like UPS and FedEx is sounding the alarm over an impending Dec. 8 vaccine deadline imposed by President Joe Biden, complaining it threatens to wreak havoc at the busiest time of the year — and add yet another kink to the supply chain. “We have significant concerns with the employer mandates announced on Sept. 9, 2021, and the ability of industry members to implement the required employee vaccinations by Dec. 8, 2021,” Stephen Alterman, president of the Cargo Airline Association, wrote in a letter sent the Biden administration and obtained by POLITICO. (Korecki, 10/21)

Airlines say they don’t anticipate having to immediately fire employees not vaccinated by a federal deadline in December, another challenge for carriers managing travel’s rocky recovery from the coronavirus pandemic. Major airlines, which conduct business with the federal government, must require their workers to be vaccinated by Dec. 8 under an executive order signed by President Joe Biden in September pertaining to federal contractors. (Sider, 10/21)

Just over 1 percent of Beaumont Health System's workforce, or 370 of its roughly 33,000 workers, were suspended this week for not receiving the COVID-19 vaccine, the system told Crain's Thursday. The Southfield-based health system announced all employees, contractors and vendors had to receive the vaccine for continued employment in late July with a later established Oct. 18 deadline. The 370 workers have until Nov. 16 to receive the vaccine or their employment will be terminated, Mark Geary, head of communications for Beaumont, told Crain's in an email. (Walsh, 10/21)

Just over 100 Hartford HealthCare employees — representing 0.3% of the health system’s workforce — have left the organization as of Thursday after refusing to get vaccinated for COVID-19, according to Dr. Ajay Kumar, Chief Clinical Officer. “We don’t even use the term ‘termination,’” Kumar said. “The individual decided to choose a different path in their career. … We’re very respectful of people’s choices.” (Pananjady, 10/21)

In the broadest sense, President Joe Biden’s vaccine requirement for the more than 17 million U.S. health care workers will alleviate the strain on all health centers and clinics by boosting the country’s overall vaccination rate—and by reducing the number of health care workers who are forced to take sick leave because they contract COVID-19. Big-city hospitals have brushed aside some workers’ protests and lawsuits, implementing vaccine mandates without a significant effect on staffing or patient care. About 41% of U.S. hospitals already have a vaccine mandate, according to the American Hospital Association. But the story may be more complicated in rural America, where resistance to the vaccine remains strongest. Some rural hospital leaders worry the vaccine mandate will exacerbate a labor shortage that was profound even before the pandemic. There are predictions that some hospitals will have to close their doors. (Wright, 10/21)

Gov. Ron DeSantis on Thursday called for a special legislative session to block the Biden administration’s vaccine mandates, taking the most aggressive action yet in his ongoing fight with the White House over Covid restrictions. The GOP governor, who has built a national reputation fighting against coronavirus-related lockdowns and mandates, said during a news conference in Pinellas County that the special session will yield a set of protections that will prevent Biden’s vaccine mandates from being enacted in Florida. (Sarkissian, 10/21)

Michigan will not order employers to adhere to a COVID-19 vaccination and testing requirement that is stricter than one planned by the Biden administration. Gov. Gretchen Whitmer’s administration released its stance this week following questions from the business community. (Eggert, 10/21)

Unvaccinated Apple workers will have to get daily COVID-19 tests in order to enter the office, according to Bloomberg. Under the new rules, the Cupertino-based tech giant will require that vaccinated workers get tested weekly. The daily tests will also apply to employees who refuse to disclose their vaccination status. Bloomberg also reported that retail workers at Apple stores will be tested more regularly than is currently the case: twice a week for unvaccinated store workers and once a week for those who are vaccinated. While the new regulations signal a tightening of COVID-19 rules for Apple, the company’s new regulations will still be more lenient than those at Google, Microsoft and Facebook, all of which require in-person workers to be vaccinated. (Dineen, 10/21)

It took defiance of Bay Area pandemic restrictions for some Californians to admit that In-N-Out is, after all, just a fast food corporation and not a unifying state identity. One location’s refusal to mandate indoor masks — and its subsequent closure by San Francisco health officials last week — set off a flurry of debates about both Covid restrictions and the quality of french fries. The issue turned some Democrats against the beloved Southern California-based burger chain and again brought the liberal state's strict pandemic approach to the fore. (Mays, 10/21)

Some 115,000 health care workers died from Covid-19 from January 2020 to May of this year, according to a new World Health Organization estimate, as the agency pushed once again for efforts to address vaccine inequity. Globally, 2 in 5 health care workers are fully vaccinated, WHO Director-General Tedros Adhanom Ghebreyesus said at a briefing Thursday. But, he added, “that average masks huge differences across regions and economic groupings.” (Joseph, 10/21)

Members of Minnesota’s teachers union are calling on school leaders to do more to protect students and staff after the state Department of Health reported the first student death from COVID-19 this school year. Health officials said the student and two staff members died last week. That increased the total number of school fatalities since the start of the pandemic to two students and 13 school employees, including five workers this year. (10/21)

Since the Mitchems’ deaths have made headlines, Mike Mitchem said, almost a dozen people have reached out to tell him they have been vaccinated because they heard Kevin and Misty’s story. Yet he’s also noticed that others online have called the story “fake news.” “Why would the media make up a story this tragic?” he said. “I would give anything for it to not be true, just to have my brother back.” (Mark, 10/21)

Alaska set a record for coronavirus-related hospitalizations and reported 1,024 new COVID-19 cases Thursday, reflecting stubbornly high virus transmission within the state and the ongoing impacts of a surge driven by the highly contagious delta variant. By Thursday, there were 235 people hospitalized with COVID-19 around the state — a higher count than at any point during the pandemic, state data showed. The previous hospitalizations record was 223 on Sept. 25. The new cases bumped Alaska back up to the top spot among U.S. states for seven-day case rates per 100,000 people, according to data from the Centers for Disease Control and Prevention. (Berman and Krakow, 10/21)

Since August, as the pandemic’s delta variant caused a surge in cases, rural Georgians have been dying of COVID-19 at more than twice the rate of their urban counterparts, according to an Atlanta Journal-Constitution analysis of state health data. COVID-19 has claimed more than 19,000 lives in urban counties like Fulton, DeKalb, Muscogee and Bibb, the type of counties where 80% of the state’s population resides. But in the quiet small towns that make up much of the state, the per-capita toll is even greater, especially during this latest surge. In Pierce County, with a population of 19,000 located a dozen miles northeast of Waycross, a resident was 10 times more likely to die of COVID-19 than someone in 1 million-strong Fulton County, home of the state Capitol, the analysis found. (Oliviero, Hart and Perry, 10/22)

Kentucky Gov. Andy Beshear (D) on Thursday urged his constituents to remain vigilant in the fight against COVID-19, saying “let’s not punt on the third down.” Beshear, during a news conference, said that while hospitalizations, intensive care capacities and ventilator use are all down, Kentuckians must not become complacent in the fight against COVID-19. (Schnell, 10/21)

Three African lions at the Indianapolis Zoo have tested positive for the Delta variant of COVID-19 and have been taken off exhibit, officials said Thursday. The lions — females Zuri and Sukari, and male Enzi — tested positive on Oct. 14 after the females showed respiratory and digestive symptoms, officials said. (10/21)

A newly-discovered mutation of the delta variant is being investigated in the U.K. amid worries that it could make the virus even more transmissible and undermine Covid-19 vaccines further. Still, there are many unknowns surrounding this descendent or subtype of the delta variant — formally known as AY.4.2 — which some are dubbing the new “delta plus” variant. (Ellyatt, 10/21)

They came from across Massachusetts and around the country to celebrate the start of summer and the loosening of pandemic restrictions. But, before long, the revelers learned they had unwittingly triggered the first known major outbreak of COVID-19 among a highly vaccinated group of people. Now a new study confirms what researchers had suspected, that the gathering in Provincetown, despite its ideal circumstances for triggering a massive number of infections, did not become a super-spreader event around the country. Moreover, the study is the first to trace how the outbreak started in Provincetown, where more than 1,000 people in Massachusetts were infected. (Lazar, 10/21)

Viewing Covid-related memes can boost your mood and help cope with pandemic-related stress, according to a recent study. The study, published Monday, shed light on how different kinds of posts can affect a social media user’s emotions, which can influence overall mental health.  (Sung, 10/21)

President Biden said Thursday that expanding Medicare to include hearing, dental and vision benefits would be a “reach” amid ongoing negotiations with Democrats over his sweeping economic agenda. During a CNN town hall, Biden told anchor Anderson Cooper that Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.) — two key moderates at the center of ongoing negotiations about how to scale back Democrats’ reconciliation bill — are opposed to the expansion. (Chalfant, 10/21)

President Biden said definitively on Thursday that his proposal for paid family and medical leave has been reduced from 12 weeks to four weeks in a compromise reconciliation bill being negotiated by the White House and lawmakers on Capitol Hill. “It is down to four weeks,” Biden said at a CNN town hall Thursday evening when asked about the proposed program. “The reason it’s down to four weeks is I can’t get twelve weeks.” (Chalfant, 10/21)

The Democrats’ social spending and climate change bill would put the United States back on a path to reducing its persistent pool of uninsured people, with estimates ranging from 4 million to 7 million Americans gaining health coverage. Those getting covered would include about one-third of uninsured Black Americans, according to an analysis by the Urban Institute and the Commonwealth Fund, nonpartisan research groups that support the goal of expanding health insurance. Other estimates from the Congressional Budget Office and the center-right American Action Forum project a similar overall trend. (Alonso-Zaldivar, 10/21)

Democratic lawmakers and their allies are moving quickly to dull a dagger aimed — from the left, of all places — at their much-touted plan to make child care more affordable for American families. The party is in the throes of negotiating what will and won't make it into its multitrillion-dollar social spending package. On the table: A multibillion-dollar program that would funnel money to states to expand their child care industries and provide parents with child care subsidies. The proposal is one of the package's most popular: A September poll found that nearly 8 in 10 voters support it. (Mueller, 10/21)

When a powerful Democratic Senate chairman assembled his Special Committee on Aging to confront what he called a “crisis of affordability” for prescription drugs, he proposed a novel solution: allow the government to negotiate better deals for critical medications. The year was 1989, and the idea from that chairman, former Senator David Pryor of Arkansas, touched off a drive for government drug-price negotiations that has been embraced by two generations of Democrats and one Republican president, Donald J. Trump — but now appears at risk of being left out of a sprawling domestic policy bill taking shape in Congress. (Weisman, 10/21)

The fate of the Democratic party’s ambitious goal of allowing Medicare to negotiate drug prices rests with a handful of key moderate senators. Negotiations on the exact scope of the reforms heated up this week after months of stalemate. But as lawmakers push to compile an outline of the massive domestic spending package that forms a cornerstone of President Biden’s domestic agenda, solid consensus on drug pricing policies has proved elusive. (Cohrs, 10/22)

Physician legislators from both parties said that expanding access to medication and therapy for obesity is crucial to turning the tide in one of America’s great public health challenges. Rep. Raul Ruiz (D-CA) and Rep. Brad Wenstrup (R-OH), who are both medical doctors, discussed their proposal to increase prevention and modernize health policy at The Hill’s “Improving Obesity Care” event on Wednesday.  (Wilson, 10/21)

KHN: KHN’s ‘What The Health?’: Dems Agree To Agree, But Not On What To Agree On

Negotiations over what to include in — and cut from — the domestic spending package on Capitol Hill are reportedly making progress, but so far all Democrats have to show for their efforts to enact President Biden’s health and other social spending agenda is a continuing promise to keep trying. Meanwhile, Biden administration officials unveil plans to provide covid-19 vaccines to younger children without looking like they are prejudging the science, in an attempt to avoid the mixed messaging that presaged the rollout of booster doses for adults. (10/21)

Texas on Thursday urged the Supreme Court to turn away a Biden administration effort to halt enforcement of the state's six-week abortion ban but broached the possibility that justices could also opt to use the matter to more broadly consider decades-old precedents affirming abortion rights. A pair of filings from the state marked the latest salvo over the state's law after the Justice Department this week asked the Supreme Court to take emergency action that would block Texas’ novel abortion ban from being enforced while litigation over its constitutionality goes forward. (Ollstein, 10/21)

Texas on Thursday responded to the Justice Department’s emergency request for the U.S. Supreme Court to block the state’s six-week abortion ban while federal courts sort out its constitutionality, saying the federal government should butt out. The state’s argument essentially is that the Justice Department has no authority to sue Texas over its abortion law, known as Senate Bill 8, because it’s enforced by private citizens rather than public officials. (Caldwell and O'Hanlon, 20/21)

The Supreme Court should reconsider decades-old precedent protecting abortion rights if it decides to take up a legal challenge to a Texas law that starkly curtails the procedure, Texas officials argued Thursday in briefs to the high court. The arguments were filed in response to separate petitions challenging the restrictive Texas law, which bans most abortions after as early as the sixth week of gestation, a time when many women are not yet aware they are pregnant. (Breuninger, 10/21)

Less than 48 hours after Texas’s abortion law went into effect, banning almost all abortions, West Virginia state delegate Josh Holstein was reminded of the promise that got him elected in 2020. Holstein ran as a “100 percent pro-life” Republican alternative to the two-term Democratic incumbent. He would pursue a “heartbeat bill” that would ban abortion once cardiac activity is detected, around six weeks of pregnancy. On Sept. 2, the day after Texas became the first state to successfully implement a six-week ban without court interference, a West Virginia resident called Holstein and other state delegates to task in a private post on his Facebook page. He wanted to know: Can we do the same thing in West Virginia? (Kitchener, 10/19)

Amid national furor over abortion access, a new survey found most women were satisfied with obtaining an abortion pill from a mail-order pharmacy, leading the researchers to argue that a regulatory program restricting such access is unnecessary. Specifically, 97% of 227 women surveyed had a complete abortion by using only the medication, which is generally known as mifepristone. Notably, 95% reported being very or somewhat satisfied with receiving the pill by mail and most participants received the medication by mail within three days, according to the survey published in Contraception, a medical journal. (Silverman, 10/21)

A top official with the Centers for Medicare and Medicaid Services questioned the future of Medicare Advantage payments Thursday, pointing to studies from government watchdogs and experts. The Office of Inspector General for the Health and Human Services Department suggested Medicare Advantage plans may be making their beneficiaries look sicker than they really are to maximize payments from the federal government. "We too are very concerned with the overall trend lines for code growth in the MA program versus the overall fee-for-service program," said Jonathan Blum, principal deputy administrator of CMS, at an event in Washington, D.C. Thursday. (Hellmann, 10/21)

Tennessee's Medicaid program did not comply with federal requirements for claiming uncompensated care at public hospitals as certified public expenditures, exceeding the allowed claim amount by $1.1 billion, according to a recent audit. The Health and Human Services Department's Office of Inspector General report found that for state fiscal years between 2009 and 2014, Tennessee claimed a total of $2 billion in certified public expenditures. Of this amount, only $909.4 million was allowable and supported. TennCare claimed $482.1 million in excess certified public expenditures that it did not return after calculating the actual care costs for Medicaid enrollees and uninsured patients at public hospitals. (Devereaux, 10/21)

In harsh tones, U.S. regulators warned a Minnesota hospital and two of its physicians for violating regulations on human research in studies that tested antipsychotics and the potent anesthetic ketamine on patients in emergency rooms or prior to their arrival. The warnings were issued by the Food and Drug Administration after its inspectors found Hennepin County Medical Center and the physicians failed to obtain consent from subjects for trials that involved testing the safety and effectiveness of the medications for managing agitation. The inspections took place in April 2019 and the FDA letters were sent last May, but only became publicly available this week. (Silverman, 10/21)

UNC Hospitals on Wednesday said 719 patients might be at risk for identity theft after an employee misused their personal information. The Chapel Hill, North Carolina-based system said it mailed letters to affected patients after finding out a now former employee was using patients' demographic and financial information to illegally obtain goods and services. UNC Hospitals learned of the misconduct Sept. 10, and its police department has launched a criminal investigation, the system said. (Christ, 10/21)

The chief executive of biotech Athira Pharma has permanently left the company after papers she published as a graduate student were found to contain altered research. Leen Kawas was suspended in June, after STAT asked the Alzheimer’s research company to comment on the allegations, and Athira announced her resignation as president, chief executive, and member of the board of directors today. (Goldhill, 10/21)

KHN: ‘No Mercy’ Bonus Episodes: More From Fort Scott, Kansas

Host Sarah Jane Tribble sets out on a mission to learn more about the Sisters of Mercy, the nuns who founded Fort Scott’s Mercy Hospital and were once prominent leaders of the community. Tribble’s first glimpse into their lives takes her to an old convent. To learn more about the founding of Fort Scott’s hospital, listen to Episode Four. (Tribble, 10/22)

Prospect Medical Holdings Inc., the for-profit owner of Crozer Health’s four hospitals in Delaware County since 2016, has put them up for sale, according to four industry sources. The Los Angeles company and its former controlling owner, private-equity firm Leonard Green & Partners, have come under criticism for buying struggling hospitals — usually hospitals that few others want to buy — and then extracting money from them for investors. Officials at Prospect did not respond to a request for comment about the letters sent Wednesday to potential buyers. Peter Adamo, chief executive officer of Crozer Health, did not respond to a text seeking comment. (Brubaker, 10/21)

The organizations behind Amita Health, one of the largest hospital systems in Illinois, have decided to go their separate ways, splitting the system. AdventHealth and Ascension have decided to unwind the partnership under which they’ve been operating Amita Health, which has 19 hospitals in Illinois. Some of the hospitals will operate under AdventHealth and others under Ascension. (Schencker, 10/21)

A Texas company that develops micro-hospitals is proposing a $13 million project on Milwaukee's far south side. Houston-based Nutex Health Inc. wants to develop a 22,073-square-foot hospital at 1801 W. Layton Ave., just west of I-94. That's according to information filed with the Milwaukee Department of Neighborhood Services, which oversees building inspections. Nutex is seeking a preliminary plan review to determine if the hospital would meet the site's zoning requirements, according to department records. It would have six to eight inpatient beds and eight to 10 emergency room beds, according to a separate filing with the Board of Zoning Appeals. (Daykin, 10/21)

Leaders at Tenet Healthcare Corp. chalked up their strong third quarter performance in part to an uptick in high-acuity surgeries, a major focus area the for-profit hospital chain. Dr. Saum Sutaria, Tenet's new CEO as of September 1, told investors on a call Thursday that cardiac interventions are recovering to 2019 levels. Orthopedic cases across the company's ambulatory surgery centers grew 22% year-over-year, and ambulatory joint replacements have more than doubled from 2020. (Bannow, 10/21)

Alphabet’s Google is “still all in on health,” according to its chief health officer, despite the demise of its recent attempt at a formalized business unit for the health-care sector. The tech giant founded Google Health in 2018 and at one point grew it to 500 employees, but dissolved the unit in August. The department was established to head the tech company’s health strategy but Google faced backlash in recent years over the intersection of Google, AI and health data. (Doniger, 10/21)

Federal health officials have concluded that a 2018 outbreak of infections in three states was caused by the improper storage, handling and administration of flu and other common vaccines. The CDC said about 100 patients were affected during workplace vaccination events. The vaccines were administered by a third party provider, “Location Vaccination” in Indiana, Kentucky and Ohio over several months from late 2018 to 2019. (10/21)

Months before putting one of its units into bankruptcy, Johnson & Johnson offered $4 billion to settle with victims of its talc-based powder -- twice the amount it’s now proposing to pay through a forced resolution, according to people familiar with the matter. The $4 billion offer was aimed at ending more than seven years of litigation over claims its iconic baby powder caused different types of cancers. J&J faces nearly 40,000 suits targeting its talc-based products, and has agreed to about $3.5 billion in settlements so far, according to court filings. (Feeley, 10/21)

Sequencing company Illumina is planning to launch Galleri — the much-hyped cancer detection test from liquid biopsy company Grail, which it acquired in August — in Asian and African countries, according to the company’s CEO, Francis deSouza. It’s a lofty goal with good intentions; deSouza said, speaking this week at the 2021 Milken Institute Global Conference, that the company hopes Illumina’s existing infrastructure will make the introduction of the $950 test far broader and far more rapid. But he declined to provide any other details about what rollouts in Asian and African markets might look like — or when they might start, or even offer more details. (Sheridan, 10/22)

An unlikely team of engineers and mobility researchers has developed an experimental set of small, wearable sensors intended to make it easier to diagnose infant neuromotor disorders like cerebral palsy or muscular dystrophy. Neuromotor conditions are most effectively treated when caught early, but diagnosing them can be expensive. (Bender, 10/22)

Riding a wave of consolidation in virtual care, home diagnostics brand Everly Health on Thursday acquired fertility startup Natalist, becoming the latest home testing business to bulk up its lineup with services geared at women and families. While financial details of the deal were not disclosed, the all-cash transaction parallels an earlier deal between digital pharmacy Ro and testing startup Modern Fertility that brought services including hormone testing and prenatal vitamins into Ro’s broader virtual fold, which was originally focused around treatments for erectile dysfunction and hair loss. (Brodwin, 10/21)

Lyft collected more than 4,000 reports of sexual assault on its app dating from 2017 through 2019, in its long-promised first safety report showing the extent of the safety problems on it app. The company quietly released its safety report on Thursday — nearly two years after rival Uber released a similar set of data for its app — which tabulated five categories of sexual assault in an effort to make clear the extent of the dangers on the ride-hailing app. It included data for nonconsensual kissing, touching and penetration, as well as attempted sexual penetration and nonconsensual kissing of nonsexual body parts. (Siddiqui, 10/22)

It was New Year’s Eve. Devin Lyall sat in the back bedroom of her drug dealer’s house. Her thin fingers fumbled with the syringe. Her fingers weren’t the only frail thing about her—in the past few months she had lost about 40 pounds, leaving her practically skin and bones. She was using Opana, a strong narcotic, melting the small, circular pills into a liquid that she could inject. (Mudd, 10/22)

KHN: ‘Down To My Last Diaper’: The Anxiety Of Parenting In Poverty 

For parents living in poverty, “diaper math” is a familiar and distressingly pressing daily calculation. Babies in the U.S. go through six to 10 disposable diapers a day, at an average cost of $70 to $80 a month. Name-brand diapers with high-end absorption sell for as much as a half a dollar each, and can result in upwards of $120 a month in expenses. One in every three American families cannot afford enough diapers to keep their infants and toddlers clean, dry and healthy, according to the National Diaper Bank Network. For many parents, that leads to wrenching choices: diapers, food or rent? (Gold, 10/22)

Books and movies have long conveyed the image of people slumbering in transparent pods as they hurtle through space. That future is far away, but a Houston research institute is providing $4 million in grants to bring that vision a little closer. Four teams of researchers will investigate clues to hibernation. One group will look to squirrels; another to prehistoric humans for clues about hibernation. A third team will put volunteers into 20-hour-per-day cold sleeps, and the final group will submerge liver tissues to test the notion of submerging astronauts in a below-freezing liquid to halt all bodily functions. The research could have immediate practical implications on Earth as well as for future space travel. (Leinfelder, 10/21)

Gov. Kevin Stitt and GOP members of the Oklahoma Legislature want to prevent the State Health Department from issuing gender neutral birth certificates after the agency issued this month the state's first nonbinary birth marker. Members of the LGBTQ community rejoiced after an Oregon resident who was born in Oklahoma successfully petitioned the State Health Department to reissue on Oct. 7 their birth certificate with their sex now identified as nonbinary. Nonbinary people do not identify as strictly male or female. (Forman, 10/21)

A new bill would prohibit children under age 18 from obtaining hormones treatments, puberty blockers and surgery to transition genders, even with parental consent. House Bill 454, called the Save Adolescents from Experimentation (SAFE) Act, is sponsored by a quarter of the Ohio House. All are Republicans. There are two sponsors — Reps. Gary Click of Sandusky County and Diane Grendell of Geauga County. Twenty-three Republicans are cosponsoring the bill. (10/19)

At ONE Colorado, Nadine Bridges works to change the lives of LGBTQ Coloradans. “We just want folks to live their lives and thrive and survive in this world," the executive director said. In 2023, Bridges said living will get a little easier for some because of a change in Colorado's Essential Health Benefits that will require insurance carriers to cover gender affirming care and surgeries for transgender patients. (Eastman, 10/19)

A 78-year-old woman is suing a Jonesport assisted living facility for allegedly denying her a room because she is transgender. The woman said Sunrise Assisted Living in Jonesport discriminated against her on the basis of gender identity, transgender status and sex in violation of the Maine Human Rights Act after an administrator allegedly said she wouldn’t admit her after finding out she was transgender. (Marino Jr., 10/21)

Utah’s rates of suicides and drug overdoses have not changed significantly since the COVID-19 pandemic began, the state’s health department reported — though, with one Utahn dying by suicide every 13 hours, the rate remains high. In an annual report, the Utah Department of Health said Thursday that the number of Utah deaths due to suicide and accidental drug overdoses stayed constant from March 2020 — when the pandemic started in Utah — through June 2021. And those rates, roughly between 50 and 70 deaths by suicide every month, are consistent with levels going back to 2015, said Michael Staley, suicide prevention research coordinator for UDOH. (Means, 10/21)

KHN: Montana Tribes Want To Stop Jailing People For Suicide Attempts But Lack A Safer Alternative 

When Maria Vega was a senior in high school in 2015, she found the body of one of her closest friends, who had died by suicide. A few days later, devastated by the loss, Vega tried to take her own life. After the attempt failed, she was arrested and taken to juvenile detention in Poplar, a remote town on the Missouri River a short drive from the North Dakota oil fields. She was put in a cell and kept under observation for several days until a mental health specialist was available to see her. Her only interaction was with the woman who brought food to her cell. (Reardon, 10/22)

A Northern California family who were found dead in August died from heat and dehydration during their hike in Sierra National Forest, officials said Thursday. Mariposa County Sheriff Jeremy Briese said at a news conference that investigators considered environmental and other factors before they determined that exposure to the elements killed the family of three. Briese said the cause of death was "hyperthermia and probable dehydration." (Madani and Fitzsimons, 10/21)

Hundreds of free water filters were handed out Thursday to residents in Hamtramck, where recent water samples show high levels of lead. About 700 filters from the state Department of Health and Human Services were distributed, City Manager Kathleen Angerer said. Not everyone who showed could get a filter because of limited supplies and high demand. On Tuesday, 900 more filters will be distributed at the same location — Hamtramck Town Center parking lot, 9521 Jos. Campau, Hamtramck. (Warikoo, 10/21)

Florida could save up to $150 million in the first year that a prescription drug importation program from Canada is fully in place, Agency for Health Care Administration Secretary Simone Marstiller told a House panel Wednesday. Lawmakers in 2019 approved pursuing a plan to import lower-cost drugs from Canada for government health care programs. The state, which continues to wait for a key approval from the U.S. Food and Drug Administration, expects to import drugs to treat asthma, chronic obstructive pulmonary disease, diabetes, hepatitis C, HIV and AIDS and mental health conditions. (10/21)

For the first time in more than 30 years, Silver Springs, now a state park, has a new glass-bottom boat. The green-and-white bus-shaped aluminum vessel looks a lot like the others at Silver Springs. But on the inside, it has room for large wheelchairs and foldaway seats allowing people with disabilities to enjoy underwater views with loved ones. (Byrnes, 10/21)

China’s capital Beijing has begun offering booster shots against COVID-19, four months before the city and surrounding regions are to host the Winter Olympics. Anyone 18 or older who have received two-dose Chinese vaccines and belong to at-risk groups, including those participating, organizing or working on games facilities, would be eligible for the additional shot, state media reported Friday. (10/22)

In mid-September, Marcel Schliebs, a disinformation researcher at the University of Oxford who had been tracking messaging that Chinese diplomats and state media spread on Twitter for 18 months, spotted the emergence of a surprising coronavirus origin theory.  Zha Liyou, the Chinese consul general in Kolkata, India, tweeted an unfounded claim that Covid-19 could have been imported to China from the United States through a batch of Maine lobsters shipped to a seafood market in Wuhan in November 2019. It marks the latest in a series of theories that have been pushed by pro-China accounts since the start of the pandemic. (Solon, Simmons and Perrette, 10/21)

The U.K., in an experiment watched by the world, lifted most Covid-19 restrictions in the summer, wagering that immunity from vaccinations and prior infections would keep the virus at bay. Three months later, the British experience shows that, in the face of the highly transmissible Delta variant of the coronavirus, herd immunity is elusive. Covid-19 cases and deaths have risen in recent weeks as winter has begun to close in. The bottom line: Reliance on immunity, which is imperfect to begin with and wanes over time, doesn’t guarantee a quick victory over Delta. (Roland, 10/21)

The first malaria vaccine will likely not reach children at risk of dying from the disease in the next year. Euphoria over having a vaccine that would prevent kids under age 2 from ending up in hospitals with severe symptoms — even if that’s only in 30 percent of cases — is giving way to the cold realities of rolling out shots to scores of mostly poor countries in sub-Saharan Africa. (Paun, 10/21)

There’s a quote from “Anne of Green Gables” that I’m already sick of hearing. “I’m so glad I live in a world where there are Octobers,” said Anne. “It would be terrible if we just skipped from September to November, wouldn’t it?” No disrespect to one of literature’s most beloved protagonists, but actually, that sounds pretty great. October is National Breast Cancer Awareness Month and I am a person who’s had breast cancer, which means for me October is basically 31 days of low-key PTSD. My inbox is crammed with marketing emails featuring other survivors’ stories. My hummus suddenly has a pink lid. I appreciate the focus on fund-raising, but the spotlight is a double-edged sword. And with 3.8 million breast cancer survivors in the United States, I’m not alone. (Burns, 10/15)

For a long time, Olivia Bowser relied on exercise to manage her mental health. Throughout college, and after moving to Los Angeles for her first job managing digital and e-commerce for a consumer packaged goods start-up, Bowser, 27, wrestled with anxiety, stress and feelings of loneliness. She tried to find a sense of calm and happiness by going to Pilates, Barry’s Bootcamp and SoulCycle six days a week. It didn’t work. ... Looking for answers, Bowser started attending yoga classes at night, using a meditation app and Googling journal prompts. As she began to find relief through these practices, she had an idea. What if she could take what she loved about her fitness classes and focus on strengthening the mind? (Achauer, 10/19)

For nearly a decade, Sherrill Franklin battled an elusive foe. She lost 22 pounds without trying. Her face was flushed, her neck felt sweaty and clammy, and she felt inexplicably jittery. At times Franklin, who lives in a rural community an hour west of Philadelphia, endured bouts of dizziness. It wasn’t until a worrisome new problem landed her in the hospital that a specialist, one of nearly two dozen doctors she consulted, ordered a blood test that revealed the reason she felt so sick. (Boodman, 10/16)

Chagas disease, a parasitic and chronic illness, has infected approximately 6 million people and kills about 12,000 every year in North and South America, according to the Pan American Health Organization. Despite its high numbers, there is a lack of knowledge in the U.S. about the life-threatening disease, which has been called "the New AIDS of the Americas." Fewer than 1% of those with Chagas in the U.S. are diagnosed and treated due to low awareness of the infection among health providers. (Gonzalez and Franco, 10/14)

Trying to figure out if you’re pregnant is probably as old as humanity itself. People had some pretty weird methods, like urinating on wheat and barley seeds (which kind of worked!), or mixing urine with wine for divination by a “wine prophet,” or shoving an onion into a patient’s vagina to see if it gave her bad breath. (This does NOT work, Gwyneth Paltrow. Do not recommend this.) These days, people who think they might be pregnant can pee on testing sticks that check for the hormone human chorionic gonadotropin (HCG). But nearly a century ago, when reliable HCG testing was being developed, it looked about as bizarre as the “wine prophet” and was so expensive only wealthy people could afford it. (Brockell, 10/17)

In 2017, a team of scientists successfully extracted the DNA of members of a Pueblo community who were buried starting around 1,300 years ago in what is now Chaco Canyon in New Mexico. The DNA suggested that these people had lived in a matrilineal society, with power passed down through generations of mothers. The paper was a powerful example of how ancient DNA could illuminate the lives of people who died long ago. It was also a case study in poor ethics, some researchers contended at the time. They alleged that the scientists had failed to consult with local tribes and used culturally insensitive terms, such as referring to a tribal ancestor as “cranium 14.” (Imbler, 10/20)

When a previously unrecorded illness erupted in Madrid in 1981, many people in Spain panicked. It took five weeks and dozens of deaths to understand the cause: adulterated cooking oil. The illness — which came to be known as “toxic oil syndrome” — killed hundreds and left thousands with chronic conditions, many severe. Four decades later, feeling that their grievances were not being heard, a few of those victims occupied a premier Madrid art museum, the Prado. If their demands were not met, they said, they would kill themselves within hours by ingesting pills. Six protesters were seen Tuesday standing before Diego Velázquez’s famous painting “Las Meninas”; they held a sign that read: “40 years poisoned and condemned to live as in 1981 because of the abandonment of the government.” (Westfall, 10/19)

As noted in part 1, not all facepieces designed to protect against respiratory diseases like COVID-19 are created equal, and they must be considered as only one tier in a hierarchy of protective steps. Here in part 2 we spell out why not all studies involving cloth face coverings or surgical/medical masks warrant equal consideration. We'll detail the necessary elements of a rigorous study and explore some recent studies that, though highly touted by both scientists and the lay press, fell quite a bit short of the ideal.Again, at the outset, we underscore that we are not "anti-mask." Rather, we are in favor of wearing the most protective type of facepiece for the setting—such as a non-fit tested respirator when spending more than a few minutes in a crowded, indoor space—and only in combination with other interventions. (Brosseau et al, 10/15)

On Jan. 9, 2020, about a week after the world first learned of a mysterious cluster of pneumonia cases in central China, authorities announced that scientists had found the culprit: a novel coronavirus. It was a sobering announcement, and an unnervingly familiar one. Nearly two decades earlier, a different coronavirus had hurdled over the species barrier and sped around the world, causing a lethal new disease called severe acute respiratory syndrome, or SARS. The virus, which became known as SARS-CoV, killed 774 people before health officials contained it. (Anthes, 10/12)

“I feel like I’m getting the silent treatment and it’s killing me,” Pamela Bishop confided in me about her months-long interactions with physicians as she tried to get answers about a strange array of symptoms that have plagued her since recovering from Covid-19. As Covid-19 survivors and families careen into the months and years ahead, those with long Covid — long-haulers, as they’ve come to be known — face uncertainty and confusion given the array of unexplained and fluctuating symptoms that are remote from their original illness. (E. Wesley Ely, 10/22)

In August, Mayor Eric Garcetti and the Los Angeles City Council decided that all city employees absolutely, positively had to be fully vaccinated against COVID-19 by Wednesday. Well, the deadline came and went, and nearly 30% of city workers hadn’t complied, either because they refused to get vaccinated or wouldn’t disclose their vaccination status. And what happened? Nothing. So much for consequences. (10/21)

It’s time we afford individuals who are injured from the COVID-19 vaccine the same recourse we provide individuals harmed by other vaccines. Under The National Childhood Vaccine Injury Act of 1986, vaccine manufacturers and parties who administer vaccines cannot be sued. In exchange for immunity, vaccine companies pay a 75-cent tax on every vaccine they sell. These funds become part of the National Vaccine Injury Compensation Program (NVICP). If a person is injured by a covered vaccine, they can file a NVICP claim. (Daniel Alholm, 10/21)

A friend in need is, as Beijing well knows, a friend indeed. In the early days of the Covid-19 pandemic, as the West turned inward, China sent African nations protective equipment and test kits, enlisting support from Alibaba Group Holding Ltd. co-founder Jack Ma. Beijing promised vaccines and economic support, and President Xi Jinping said Africa’s shots would be a priority. Today, though, the continent accounts for just 8% of China’s global bilateral vaccine deliveries, according to figures compiled by Bridge Consulting, and those are not evenly distributed. That total is a third of what Beijing has provided to Latin America. The same data suggest no African country makes it into the 10 most significant bilateral sale or donation destinations. (Clara Ferreira Marques, 10/21)

Can’t find a role model when it comes to getting workers vaccinated against COVID-19 without a mandate? Maybe you’ve been looking in the wrong places. Sunday’s conclusion of the dramatic WNBA playoffs offers a pointed reminder not only of the growing success of the women’s pro basketball league, but also of its triumph way back in June in getting 99 percent of players fully and voluntarily vaccinated. (10/20)

Although we don’t know how the covid-19 pandemic started, it’s now clear there were serious gaps in oversight of U.S.-government-funded projects around the world that focused on digging up dangerous viruses in the wild. Why, then, is the U.S. government barreling forward with a new, huge project to expand this very research, before those problems have been properly addressed? (Josh Rogin, 10/21)

When I first told you about United States Mask Company of Tarrant County back in January, they couldn’t find customers for their high-quality N95 face masks. Too many fake N95 masks had flooded the market. So major sellers including Amazon and Google banned the sale of all N95s as a matter of consumer protection. You couldn’t find them.In the next three days, after The Watchdog’s story ran, the new company quickly sold 250,000 masks through its website. Overnight, company owners John Bielamowicz and David Baillargeon went from standing in line to ship a couple of boxes at a UPS Store to filling tractor trailers with pallets for shipment. (Dave Lieber, 10/21)

Criminalizing a woman for suffering a miscarriage seems unfathomable and even barbaric. But that is exactly what happened earlier this month in a Lawton, Okla., courtroom. When Brittney Poolaw, a Oklahoma woman, miscarried at her home in January 2020, she was taken to a hospital where she told staff that she had used methamphetamine and marijuana during her pregnancy. Two months later, she was charged with first-degree manslaughter. Her pregnancy was 17 weeks along. (10/22)

­Not long ago, the Centers for Disease Control and Prevention ran alarming news about the outbreak of lung injuries associated with vaping. It confirmed in 2020 that at least 68 people who used e-cigarettes, both legally and illegally, had died. According to Johns Hopkins Medicine, electric cigarettes are bad for your heart and lungs and just as addictive as traditional cigarettes. Yet last week, the U.S. Food and Drug Administration for the first time authorized the sale of electronic tobacco-flavored cigarettes. What is most shocking is that the government is allowing this to happen during a pandemic in which smokers and vapers may be at higher risk for getting severe coronavirus disease. (Susan Shapiro, 10/21)

If years could be assigned a dominant feeling (1929: despair; 2008: hope), 2021’s might be exhaustion. As the coronavirus pandemic rumbles through its 20th month, many of us feel like we are running a race we didn’t sign up for, and it’s getting longer every mile we run. (Jamil Zaki, 10/21)

Death rattle. That’s the sound some dying people make, caused by a buildup of mucus and other secretions in the throat as the body begins to slowly lose its life force. It can sound wet and crackling, or like a soft moan or snoring or gargling. No one knows if a dying person finds the death rattle disturbing or distressing, as no one can pretend to know with certainty the inner subjective experience of anyone too ill to express it. The common medical assumption, though, is that they are not distressed by it. But the death rattle is disturbing to family members and loved ones who are with their loved ones as they are dying. (Joel B. Zivot and Ira Bedzow, 10/21)

I have never died. But as an oncologist, I have witnessed many patients’ last breaths. When I attend in the hospital, I am sometimes called to “pronounce” a death. The ritual surpasses strange. (Tyler Johnson, 10/21)

The tragedies that unfolded in the Michigan cities of Flint and Benton Harbor should serve as a wake-up call for Chicago to replace the over 400,000 lead service lines that bring drinking water to homes every day. If Chicago continues at its current pace, it’ll take us over 600 years to get those lead pipes out of the ground. We can’t afford to have one more generation of Chicagoans threatened by toxic lead in their drinking water. (Jeremy Orr and James Coyne, 10/21)

The tech world has revolutionized nearly everything we do—from the way we work, shop and travel to the way we consume news and information. Yet transforming the way we access healthcare—one of the most essential services in our lives—continues to elude the tech giants. (Dr. Rod Hochman, 10/21)