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The pause on Texas’ near-total abortion ban lasted only two days before a federal appeals court reinstated the ban Friday night at Texas Attorney General Ken Paxton’s request. The Republican AG had asked a three-judge panel of the 5th Circuit, which leans conservative, to lift an injunction from U.S. District Judge Robert Pitman. Last week, Pitman sided with the Justice Department when he ordered Texas to halt its ban on abortions after six weeks—before many people know they’re pregnant. But now, with the ban temporarily back as litigation continues, some abortion-rights activists have had enough and want the Supreme Court to get involved. (Klein, 10/10)

Almost as quickly as it was stopped, the infamous Texas abortion law was back again. The Fifth Circuit Court of Appeals blocked a temporary injunction on Texas’ controversial six-week abortion ban Friday, once again barring most pregnant people in Texas from accessing the service. ... The court back-and-forth sent abortion clinics in the state—some of which have stopped providing abortions altogether since the law took effect Sept. 1—into a state of confusion, unsure of how long the reprieve from the restrictive law would last. Planned Parenthood and Whole Woman’s Health, the two largest providers in the state, were both waiting to see what the Fifth Circuit would do before deciding if they would resume abortions past six weeks. (Shugerman, 10/8)

A federal appeals court Friday night quickly allowed Texas to resume banning most abortions, just one day after clinics began racing to serve patients again for the first time since early September. A one-page order by the 5th U.S. Circuit Court of Appeals reinstated the nation’s strictest abortion law, which bans abortions once cardiac activity is detected, usually around six weeks. It makes no exceptions in cases of rape or incest. “Patients are being thrown back into a state of chaos and fear,” said Nancy Northup, president of the Center for Reproductive Rights, which represents several Texas clinics that had briefly resumed normal abortion services. (Weber, 10/9)

The Department of Justice now has until Oct. 12 to reply to the ruling, and the ban remains in effect until then. Before a lower court intervened, Texas was allowed to keep its abortion law, Senate Bill 8, in effect for roughly five weeks. In that time, providers say they were forced to turn away hundreds of people seeking abortions. (Lopez, 10/8)

Foes of Texas’ strict abortion ban are taking aim at companies that donated money to the bill’s sponsors, hoping consumers will pressure corporate America to join the fight against a surge of restrictions. The television and digital ads begun this past week by the groups Corporate Accountability Action and American Bridge 21st Century, the Democratic Party’s opposition research arm, highlight AT&T’s contributions to Texas Republican lawmakers. There are plans to expand the campaign to Florida, where a similar abortion proposal has been introduced. (Whitehurst, 10/10)

Now that a Texas law has banned abortion in the state after six weeks, more states are expected to follow suit, making access to women’s health care in certain parts of the country even harder than it already is. Large areas of the U.S. — particularly in the central region of the country — already have no options within a 250-mile drive, and some counties are at least 350 miles from the nearest abortion provider. (Reed, Oide and Wise, 10/9)

After calling more than a dozen clinics across the state, only one doctor agreed to talk to us on the record. Others declined, expressing outrage over the new law but concerns about possible litigation. We traveled to Houston to meet Dr. Bhavik Kumar inside Planned Parenthood. He told us he typically performs 20 to 30 abortions a day. But the first day the law went into effect, on Sept. 1, he saw six patients and had to turn half of them away. (Scott, 10/10)

It is perilous for a person to become a political symbol. Norma McCorvey, the plaintiff at the center of Roe v. Wade, knew perhaps better than anyone the difficulties of representing something much larger than herself. When she stepped into public view, identifying herself as Jane Roe, she became an important voice in the pro-choice movement—the woman who carried her own unwanted pregnancy to term in order to secure the rights of millions of women not to. Later, she made a shocking conversion, transforming herself into a crusader for the pro-life cause. All along, she courted the attention: She told her story countless times to journalists and filmmakers, to the co-writers of her memoirs (one published before she switched sides, one after), to almost any organization willing to pay her to speak. What did she think she was doing? (Cogan, 10/11)

Pope Francis met on Saturday with U.S. House Speaker Nancy Pelosi, a Catholic who has come under criticism from some bishops in the United States for her support for abortion rights. Their meeting took place several weeks before Joe Biden is expected to meet the pope while the U.S. president is in Rome for talks between leaders of the Group of 20 major economies. (Pullella, 10/9)

Parents can safely allow their children to trick-or-treat outdoors this Halloween, Dr. Anthony Fauci said Sunday. "You can get out there," the nation's premier infectious diseases expert said on CNN’s “State of the Union." "You're outdoors for the most part ... (so) enjoy it." Kids who can get vaccinated for the coronavirus should do so for an “extra degree of protection," he added. The vaccines have been authorized for children 12 and up by the Food and Drug Administration. The FDA could provide similar emergency authorization for children ages 5 through 11 in the days before Halloween. "It's a good time to reflect on why it's important to get vaccinated," Fauci said. "Go out there and enjoy Halloween as well as the other holidays that will be coming up." (Bacon, Santucci and Ortiz, 10/10)

Children can partake in trick-or-treating and other traditional Halloween activities, the country’s top infectious-disease expert Anthony S. Fauci said — a recommendation that could reassure parents as the United States gears up to distribute millions of doses of the Pfizer-BioNTech pediatric vaccine to school-age kids as soon as early November, pending regulatory approval. The White House’s chief medical adviser said Sunday on CNN’s “State of the Union” that trick-or-treating is safe, “particularly” for children who are already vaccinated, because it mostly takes place outdoors, where the airborne coronavirus does not spread as easily. It’s a sign of how health recommendations for Americans are evolving with the uptake of vaccines, as traditional Halloween celebrations last year were discouraged by federal health agencies. (Pannett and Timsit, 10/11)

Covid-19 cases are trending in the “right direction,” but people should be careful to not “declare victory,” the president’s top medical adviser, Anthony Fauci, said Sunday. The seven-day average shows cases below 100,000, hospitalizations below 10,000 and deaths below 2,000, he noted. “If you look at the history of the surges and the diminutions in cases over a period of time, they can bounce back,” the director of the National Institute of Allergy and Infectious Diseases said on CNN’s “State of the Union.” Plus, he mentioned there are roughly 68 million people eligible for vaccination who have not gotten it. (Farrow, 10/10)

COVID-19 rates are finally falling again after a wave nearly as bad as the one last winter. Hopefully, we are through the worst of the pandemic. But experts warn that if we start acting as if COVID-19 is over, we definitely won't be. Behavior has a major impact on what happens with the virus, and if people stop taking precautions, start gathering in large numbers and not getting vaccines or boosters, another wave could strike this winter. (Weintraub, 10/10)

The Centers for Disease Control and Prevention released statistics of a disturbing trend on Thursday, highlighting the sharp rise in MIS-C cases in children who recently had COVID-19.According to the health agency, there has been a 12% increase in cases of the multisite, inflammatory syndrome in children since late August. At children’s hospitals across the country, many doctors are saying that they are treating more cases of the rare disease than ever before. (Sapienza, 10/8)

While cases increased across all age groups in the latest wave of COVID, kids have been testing positive for COVID-19 more often than adults, adjusted for population. The increase is due to the highly contagious delta variant, relaxed restrictions and ineligibility for children under 12 to get vaccines. "Definitely over the last eight weeks we’ve seen dramatic increases in COVID-19 cases and hospitalizations in kids," said Dr. Donna Tyungu, a pediatric infectious disease physician at OU Health in Oklahoma City. "It started right when we started school." (Santucci, 10/9)

Each day in the last week, more than 375 children younger than 12 were infected with the coronavirus in Michigan, a new state analysis shows. Coronavirus cases in K-12 schools accounted for 56% of all known new outbreaks statewide last week — more than in every other setting combined, according to state health department data. In all, new and ongoing outbreaks and clusters affected at least 104 schools, causing children to lose instruction time because of illness or quarantine. Each outbreak was estimated to affect as many as 87 students and school staff members. (Jordan Shamus, 10/8)

Black Covid patients are less likely to receive medical follow-ups after being hospitalized and more likely to experience longer waits until they can return to work, according to a University of Michigan study published Tuesday. The study surveyed the health outcomes of 2,217 Covid patients in Michigan 60 days after hospitalization. The results found that more than 50 percent of patients of color were readmitted to the hospital within 60 days after being released. Patients of color were also more than 65 percent more likely to experience moderate to severe financial impact because of Covid-19. (Phillips, 10/8)

Covid-19 hospitalizations are rising again in Colorado even with more than 70% of those eligible in the state vaccinated, health officials said Friday. The recent daily average has been around 900 hospitalizations, one of the highest readings since the pandemic started in March 2020, according to data from the Colorado Department of Public Health and Environment. Two weeks ago, the average was running around 875. (Del Giudice, 10/8)

The Nevada State Public Health Laboratory has identified a rare case of COVID-19 reinfection occurring just 22 days after the patient first tested positive. The patient, an unvaccinated 31-year-old Mineral County man with no underlying health conditions, first tested positive for the delta variant and then, three weeks later, for a different strain that evolved from the delta variant, Mark Pandori, director of the lab at the University of Nevada, Reno’s School of Medicine, told the Review-Journal this week. (Hynes, 10/8)

While driving recently, Cliff Morrison suddenly found himself lost in a forest. He pulled over, looked around and realized he was actually on a tree-lined street half a mile from his home in the Oakland hills, heading to the post office. Morrison, 70, did not have dementia. He had COVID-19. Since his diagnosis in April 2020, Morrison, a health care administrator, has experienced a mysterious and mercifully brief loss of orientation four or five times, most recently around Labor Day, and always near home. It no longer frightens the bejeezus out of him. Now, he’s just curious. So are his doctors. (Asimov, 10/10)

Sen. Ron Johnson on Friday said hospital overcrowding in Wisconsin due to COVID-19 is no worse than what happens during "a bad flu season” — contrary to what data shows and what hospital workers and health care systems have been saying. Johnson, who is unvaccinated and had COVID-19 in 2020, made the comments at a town hall meeting in Boulder Junction, as reported by Wisconsin Public Radio. "Just because it happens with COVID doesn't mean there’s some massive crisis in terms of our health care system," he said. (Bentley, 10/9)

There is no memorial to the estimated 675,000 people killed in the U.S. in the 1918 Influenza pandemic on the National Mall. But if there were, some think, the country would have done a better job handling Covid-19. "I think we could have been much better prepared had we been more culturally aware about what happened in 1918," said Spencer Bailey, the author of a recent book about memorials who has an unusually personal connection to memorials. "One of the reasons that we've found ourselves in our scrambled response to Covid is there are barely any memorials to the flu of 1918."Many now intend to make sure this pandemic doesn't get lost to history like the last one. While it will most likely be years before anyone builds a Covid memorial in Washington, architects, artists and people touched by the pandemic from around the world are already thinking about ways to remember it, which might require reinventing the idea of memorials. (Seitz-Wald, 10/11)

Merck & Co. and its partner Ridgeback Biotherapeutics LP sought emergency use authorization in the U.S. for molnupiravir, moving the pill closer to becoming the first oral antiviral treatment for Covid-19.An application was submitted with the Food and Drug Administration for molnupiravir to treat mild-to-moderate Covid-19 in adults at risk of developing a severe illness that may require hospitalization, the companies said in a statement Monday. Submissions to regulatory authorities worldwide are expected in the coming months after interim analysis of clinical trial data found that it cut the risk of hospitalization for such patients by half. (Gale and Griffin, 10/11)

Merck said on Monday that it had submitted an application to the Food and Drug Administration to authorize what would be the first antiviral pill to treat Covid. An approval for the drug, molnupiravir, would be a milestone in the fight against the coronavirus, experts said, because a convenient, relatively inexpensive treatment could reach many more high-risk people sick with Covid than the cumbersome antibody treatments currently being used. (Robbins, 10/11)

The pharmaceutical firm Merck announced last week that an antiviral pill it’s developing can cut hospitalizations and deaths among people with COVID-19 by half. The results haven’t yet been peer reviewed. But if the drug candidate, molnupiravir, is authorized by regulators, it would be the first oral antiviral treatment for COVID-19. By contrast, the other currently authorized drugs must be delivered intravenously or injected. A pill could make treating patients earlier on in their infection much easier — and more effective. It could also keep hospitals from overflowing, especially in places where vaccination rates are still low, such as many low- and lower-middle-income countries. Molnupiravir was so effective in a phase 3 trial involving COVID-19-positive people at risk of severe illness that clinicians halted enrolment early. (Willyard, 10/8)

When Merck and Ridgeback Biotherapeutics announced on Oct. 1 that their new antiviral pill reduced Covid hospitalizations by roughly half, some in the media blamed Donald Trump. An Axios headline: “Before Merck backed COVID antiviral, Trump admin turned it down.” In fact, Trump officials pushed for government funding to accelerate the development of the drug, molnupiravir. They were opposed by a career official, Rick Bright, whom Democrats praised as a “whistleblower.” Mr. Bright joined the Biomedical Advanced Research and Development Authority in 2010 and became Barda’s director in 2016. The authority, part of the Health and Human Services Department, is charged with preparing for and responding to public-health threats. After Mr. Bright repeatedly clashed with HHS officials, he was reassigned in April 2020 to a lower-level job at the National Institutes of Health. Mr. Bright then filed a complaint accusing Trump officials of pressuring him to fast-track unsafe drugs and award contracts “based on political connections and cronyism.” (Finley, 10/10)

Two Indian drugmakers have requested permission to end late-stage trials of their generic versions of Merck & Co's (MRK.N) promising experimental oral antiviral drug molnupiravir to treat moderate COVID-19, a week after Merck said its own trial had succeeded for mild-to-moderate patients. Merck earlier this year suspended its own development of molnupiravir as a treatment for hospitalized COVID-19 patients since many of them have reached a phase of the disease that is too late for an antiviral drug to provide much help. The Indian companies - Aurobindo Pharma Ltd (ARBN.NS) and MSN Laboratories - did not exclude hospitalized patients in designing their moderate COVID-19 trials, according to study documents, although it was not known if the trials ultimately included people in the hospital. (Singh, Kumar Mitra and Arora, 10/8)

AstraZeneca's experimental COVID-19 antibody drug cocktail succeeded in reducing severe disease or death in non-hospitalised patients in a late-stage study, the British drugmaker said on Monday. The drug, called AZD7442, reduced the risk of developing severe COVID-19 or death by 50% in patients who had been symptomatic for seven days or less, meeting the main goal of the trial. (10/11)

People who both had Covid-19 and are vaccinated don’t need to rush to get the boosters now rolling out across the U.S., health experts say. Millions of Americans who have received Pfizer Inc. and partner BioNTech SE’s Covid-19 vaccine now qualify for an additional dose, under the Centers for Disease Control and Prevention’s recommendation of shots for seniors and certain at-risk adults. Some of those who qualify are people who have been infected with the disease, either before they were vaccinated or after. (Schwartz, 10/10)

KHN: New California Law Bans Harassment At Vaccination Sites, But Free Speech Concerns Persist

It’s now illegal in California to harass people on their way into a vaccination clinic, under a law signed Friday by Gov. Gavin Newsom. But First Amendment experts continue to raise legal questions about the law’s constitutionality, including its definition of harassment. The new law, which takes effect immediately, makes it a misdemeanor to harass, intimidate, injure or obstruct people on their way to get a covid-19 or any other kind of vaccine, punishable by a maximum $1,000 fine and/or up to six months in jail. (Bluth, 10/8)

“In the first four days after 12- to 15-year-olds were eligible for the Pfizer vaccine, we had nearly 28,000 vaccine doses given in the state,” reaching more than 7% of all the adolescents eligible, said Dr. Umair Shah, Washington’s secretary of health. With the expanded authorization, almost double that many children will be able to get in line – a full 8.5% of the U.S. population – and there is pent-up demand as many parents are eager to get their kids vaccinated now that they are back at school. “We’ve already had families inquire when they come in or calling and asking if we’re going to be giving the pediatric dose,” said Dr. Sharon Marshall, a professor of pediatrics at Wayne State University and pediatrician at Wayne Pediatrics at Children’s Hospital of Michigan in Detroit. (Weise, 10/8)

Los Angeles County on Saturday reported 28 new deaths from the coronavirus, bringing the death total to 26,308 countywide since the pandemic began, with total reported infections around 1.5 million. Black and Latino residents who remain unvaccinated have Los Angeles County’s highest rate of COVID-19 infections, while unvaccinated white residents have the highest death rates, the public health department said. Between late August and late September, unvaccinated Black and Latino residents in LA County together had a rate of about 590 cases per 100,000 people, the county said in a news release. (Goffard, 10/9)

National Institutes of Health director Francis Collins said Saturday on CNN that it's "truly heartbreaking" to see fellow evangelical Christians hesitant to get vaccinated against COVID-19 due to disinformation. "We see still more than 1,000 people [per day] losing their lives to this disease — almost all of those unvaccinated and, therefore, didn't have to happen," said Collins, who's due to retire at the end of 2021. (10/10)

Unvaccinated Californians were between 15 and 20 times more likely to die of COVID-19 than vaccinated ones when deaths from the disease most recently peaked at the start of September, according to state data. The California Department of Public Health publishes data on the vaccination status of people who test positive for coronavirus as well as people who are hospitalized with, and die from, COVID-19. Their data shows that the death rate among unvaccinated Californians aged 16 and older soared in early September, reaching a peak of 13 average daily deaths per million on Sept. 6. (Neilson, 10/9)

KHN: Community Clinics Shouldered Much Of The Vaccine Rollout. Many Haven’t Been Paid. 

Community clinics in California say they haven’t been paid for at least 1 million covid-19 vaccine doses given since January, creating a “massive cash flow problem” for some and complicating efforts to retain staff. Clinics in other states, including Michigan and Mississippi, are also awaiting payment. The delays stem from the distinct way federally qualified health centers are reimbursed for care under Medicaid, the joint federal-state program providing health coverage for low-income people. Some centers are not even billing for the shots because they say it’s too complicated. Clinics are owed tens of millions of dollars, at minimum, for shots they’ve given since the vaccines received emergency authorization. (Pradhan and Bluth, 10/11)

KHN: Journalists Examine Vaccination Rates Among Student Nurses And In Covid Hot Spots 

Contributing writer and former KHN correspondent Michelle Andrews discussed difficulties in providing clinical training to student nurses who refuse to get vaccinated on CBS News on Thursday. (10/9)

Heavy marijuana users who are also vaccinated may be more susceptible to breakthrough cases of COVID-19, a new study found.The study, published last Tuesday in World Psychology, found that those with a substance use disorder (SUD) — a dependence on marijuana, alcohol, cocaine, opioids and tobacco — were more likely to contract the coronavirus after receiving both of their vaccination shots. Those without a SUD saw a 3.6 percent rate of breakthrough infections, compared to a 7 percent rate in those with a SUD. At 7.8 percent, those with marijuana use disorder were most at risk for breakthrough infections, the study found. (10/11)

The U.S. Food and Drug Administration reiterated its stance that the benefits of Moderna’s COVID-19 vaccine outweigh its risks on Friday after several Nordic countries began restricting its use for certain age groups due to concerns about a rare heart-related side effect. The FDA responded after health officials in Finland said Thursday that males under age 30 should not receive the Moderna vaccine due to a slightly higher risk of developing myocarditis, an inflammation of the heart. A day earlier, Sweden said it would pause use of Moderna’s vaccine for people under 30, while Denmark paused use for people under 18 and Norway recommended people receive the Pfizer vaccine. (Barrabi, 10/10)

Hundreds of thousands of U.S. service members remain unvaccinated or only partially vaccinated against the coronavirus as the Pentagon’s first compliance deadlines near, with lopsided rates across the individual services and a spike in deaths among military reservists illustrating how political division over the shots has seeped into a nonpartisan force with unambiguous orders. Overall, the military’s vaccination rate has climbed since August, when Defense Department leaders, acting on a directive from President Biden, informed the nation’s 2.1 million troops that immunization would become mandatory, exemptions would be rare and those who refuse would be punished. Yet troops’ response has been scattershot, according to data assessed by The Washington Post. (Horton, 10/10)

President Joe Biden says his sweeping Covid-19 vaccination and testing mandate will boost the economy and save lives, but as businesses prepare for the new requirement, they’re wondering not only what will be in the regulation, but how it will be enforced. The mandate, which will apply to organizations with at least 100 employees and cover an estimated 80 million workers, has already drawn threats of lawsuits from two dozen Republican attorneys general and prompted some people to vow to quit their jobs. But a greater challenge for the administration could lie within the agency tasked with ensuring compliance. (Przybyla and Strickler, 10/11)

For a brief moment this summer, it seemed like small businesses might be getting a break from the relentless onslaught of the pandemic. More Americans, many of them vaccinated, flocked to restaurants and stores without needing to mask up or socially distance. But then came a surge in cases due to the delta variant, a push for vaccine mandates and a reluctant return to more COVID-19 precautions. Now, small business owners are left trying to strike a balance between staying safe and getting back to being fully open. (Anderson, 10/10)

As Montana intensive care units fill with critically ill, mostly unvaccinated COVID-19 patients, hospital leaders there are caught between two laws that dictate whether they can require their employees to get immunized against the coronavirus. A state law that Republican Gov. Greg Gianforte signed in May prohibits Montana employers from requiring workers to get vaccinated. But President Joe Biden plans to require health care employers to mandate worker vaccinations at facilities that treat patients with public health insurance. Facilities that don’t comply risk losing federal reimbursement. “It has put, particularly hospitals, in a very difficult position of having a state law that says, ‘You can’t vaccinate,’ and a federal rule that says, ‘If you want to be paid [by the federal government], you have to vaccinate,’” said Rich Rasmussen, president and CEO of the Montana Hospital Association, a Helena-based trade group. (Quinton, 10/8)

A dozen state employees in their six-month probationary period were fired Friday for refusing to comply with Gov. Ned Lamont’s order to either get vaccinated against COVID-19 or begin weekly testing for the disease. While other non-compliant employees face being placed on unpaid leave for 45 days before losing their jobs, those still in the probationary period required of every new hire can be immediately dismissed, state officials said. “We reached out to them more than once, said, ‘You get vaccinated or you get tested. And if you say no, you can’t work here. It’s unsafe,’” Lamont said. (Pazniokas, 10/8)

Texas gubernatorial candidate Allen West, who is currently recovering from a case of COVID-19, said his hospitalization with the virus has made him “more dedicated to fighting against vaccine mandates.” West, who announced Saturday night that he has coronavirus-related pneumonia, advocated for monoclonal antibody infusion therapy as a way to combat COVID-19 instead of vaccines. “I can attest that, after this experience, I am even more dedicated to fighting against vaccine mandates. Instead of enriching the pockets of Big Pharma and corrupt bureaucrats and politicians, we should be advocating the monoclonal antibody infusion therapy,” Allen said on Twitter from the hospital Sunday morning. (Schnell, 10/10)

The only Georgia physician known to be fired for defying a COVID vaccine mandate insisted he’s not an anti-vaxxer. Dr. William "Tommy" Redwood, 63, was terminated last week from his job as an emergency room doctor at Piedmont Healthcare in Atlanta. Redwood is well known in the Atlanta medical community. He spent 16 years as medical director of emergency services for Wellstar Kennestone in Marietta. He worked for four years as an emergency room physician at Piedmont. (Travis, 10/8)

Thousands of students and educators are pleading with college, state and federal leaders for tighter Covid-19 safety measures in response to campus deaths, widespread outbreaks and growing fears of both. Some professors in Georgia are refusing to teach under lax Covid-19 rules. Students and faculty at the two largest universities in Mississippi asked the state for tougher measures. From petitions in Utah to "die-in" protests in Iowa, thousands are pushing for stricter rules at their institutions. "Nobody else has to die," Neo Koite, who organized the protest after Ahuero’s death and met with campus administrators about Covid-19 safety measures, said in an interview. (Payne, 10/10)

Nearly 90% of students, faculty and staff at Michigan State University have been vaccinated for COVID-19, according to university officials. The school issued a requirement in July for everyone expected on campus this fall to be vaccinated by the end of August. Most of the approximately 67,000 students, faculty and staff have filled out a vaccine verification form. (10/10)

Researchers at Louisiana State University have created a cellphone app to track exposures to COVID-19.The Advocate reports the GeauxTrace contact tracing app uses the signal strength from Bluetooth software available on most cellphones and computers to assess the distance between cellphones. Users who were in the vicinity of someone who recently tested positive for COVID-19 are informed of the possible exposure. (10/10)

Nevada Joint Union High School District Superintendent Brett McFadden expects the vast majority of his students and staff to abide by the COVID-19 vaccine mandate issued by Gov. Gavin Newsom on Oct. 1. But he also expects around 10 of his employees to quit out of personal or political opposition to it. “It’s a really small number, but the individuals who are upset about it are vocal,” said McFadden, whose district in Nevada County is about 65 miles northeast of Sacramento. “The silent, vast majority of educators are saying, ‘OK, we’ll get vaccinated.’” (Hong, 10/10)

When Lizzie Rothwell, an architect in Philadelphia, sent her son to third grade this fall, she stocked his blue L.L. Bean backpack with pencils, wide-ruled paper — and a portable carbon dioxide monitor. The device gave her a quick way to assess how much fresh air was flowing through the school. Low levels of CO2 would indicate that it was well-ventilated, reducing her son’s odds of catching the coronavirus. But she quickly discovered that during lunch, CO2 levels in the cafeteria rose to nearly double those recommended by Centers for Disease Control and Prevention. (Anthes, 10/10)

School outbreaks over the last month have been heavily concentrated in Maine counties with lower vaccination rates and more COVID-19 transmission, highlighting the challenge that community spread poses to children’s learning. The trend fits with predictions from epidemiologists who warned that rising case levels would challenge schools as they looked to bring back students for a fully in-person schedule. It highlights that the COVID-19 situation in communities cannot be delinked from virus outcomes in schools, which affect many students who are too young to get vaccines. (Piper, 10/11)

Fewer women are uninsured (10.5%) nationally than men (13.4%), due in large part to Medicaid providing pregnancy coverage for low-income women. 16.1% of women are on Medicaid, compared with 12.7% of men, according to census data analyzed by the Kaiser Family Foundation. Large swaths of the South still have restrictive Medicaid coverage or didn't expand Medicaid under the Affordable Care Act, leaving 1 in 5 women without insurance in states like Oklahoma and Texas. (Herman, 10/9)

Nearly an hour into the August meeting of Macon County’s board of commissioners, Casey Cooper approached the podium. Cooper is the CEO of the Cherokee Indian Hospital. In addition to running the hospital, Cooper serves on a handful of different boards and has three kids — in other words, he’s busy. “In the interest of efficiency, I will just jump right to the punchline,” he began. “It’s my hope that at the conclusion of this presentation tonight that you will feel compelled to support a resolution to help close the coverage gap in North Carolina.” (Donnelly-DeRoven, 10/11)

Nine out of 10 Medicare Advantage members are enrolled in plans that earned the government's highest quality marks for 2022, according to new federal data. Health insurers were quick to tout the quality scores in press releases. But the federal government went easy on the grades during the pandemic, and experts have long considered MA's quality system to be "flawed and inconsistent." (Herman, 10/11)

Nearly four times as many Medicare Advantage plans scored the highest quality rating possible for 2022 as compared with the year before, according to data released by the Centers for Medicare and Medicaid Services on Friday. Seventy-four Medicare Advantage plans with prescription drug coverage earned five out of five stars, up from 21 in 2021, CMS said. Plans with a five-star rating are allowed to market their product all year, giving them a leg-up on competitors limited to advertising their product during open enrollment, which runs from Oct. 15 to Dec. 7. By earning a rating of four stars or higher, these highly ranked health insurers also receive a 5% quality bonus increase to their benchmark payment, which is the maximum amount the federal government will pay plans and accounts for about $6 billion in Medicare expenditures each year, according to the Medicare Payment Advisory Commission. (Tepper, 10/8)

With Medicare Advantage revenue “significantly lower” than fee-for-service reimbursement, a new Zimmet Healthcare Services Group analysis says, skilled nursing facilities need to weather today’s “reimbursement storm” in order to make it to the incoming wave of baby boomers that will need facility services. In the meantime, Zimmet suggests operators utilize facility data to improve MA performance. “Most MA claims were submitted by SNFs with at least a three-star rating, but in areas with less bed-saturation, two-stars were not uncommon,” the report said. “There was no correlation between 5-Star rating and episodic revenue, while the 30-day hospital readmission rate explained less than 20% of payment variation.” (Stulick, 10/10)

If you’re one of the 64 million Americans enrolled in Medicare, what you decide in the next two months could make a huge difference in your wallet and your healthcare. Open enrollment, the time for changing plans, runs Oct. 15 -Dec. 7. “We know from Open Enrollment that a very small percentage actually change,” said Jane Sung, senior strategic policy adviser with AARP. In fact, 57 percent of recipients don’t even review their coverage annually, reports the Kaiser Family Foundation. That could leave you unable to see your favorite doctor or paying hundreds of dollars more for a vital prescription drug. “It’s in their interest to take a look at their options,” Sung said. (Foster, 10/10)

While most providers say they agree with the intent of the price transparency law, smaller hospitals are struggling to gather the data and present them in a useful format. Hospitals were required as of Jan. 1 to post machine-readable files of the rates they negotiate with payers, gross charges and discounted cash prices, which the Centers for Medicare and Medicaid Services hopes will curb higher-than-average prices. CMS recently sent a second round of warning letters to hospitals that haven't disclosed the rates of 300 "shoppable services" in a consumer-friendly form, threatening a maximum yearly fine of more than $2 million for larger hospitals and almost $110,000 for those with fewer than 30 beds. (Kacik, 10/8)

A quiet but intense lobbying effort is hitting Congress for a one-time spend of billions of dollars on Medicare Physician Fee Schedule clinician pay raises. It would be a short-term fix to what medical groups and some lawmakers say is a flawed system of paying physicians, but if Congress doesn't act by the end of the year, some specialties will see cuts to their rates. Physicians are once again taking issue with the PFS' budget neutrality requirement. Pay increases authorized by the Centers for Medicare and Medicaid Services for one group of clinicians can mean decreases for others. (Hellmann, 10/8)

The Office of the National Coordinator for Health Information Technology on Friday launched a new effort to support federal agencies in standardizing data. The new initiative, dubbed USCDI+, builds on the U.S. Core Data for Interoperability, a standardized set of data elements developed by ONC. USCDI+ will set standards that can be helpful for federal agencies who have domain- or program-specific needs, but that ONC doesn't think need to be included in the core USCDI. (Kim Cohen, 10/8)

Healthcare hiring nosedived in September as it declined for the third time this year, according to the latest federal jobs report. Employment in the healthcare sector fell by an estimated 17,500 jobs last month, preliminary data from the U.S. Bureau of Labor Statistics show. The decline is the second-biggest this year, overshadowed only by January, when hiring contracted by 80,500 jobs. (Christ, 10/8)

KHN: ‘Are You Going To Keep Me Safe?’ Hospital Workers Sound Alarm On Rising Violence 

The San Leandro Hospital emergency department, where nurse Mawata Kamara works, went into lockdown recently when a visitor, agitated about being barred from seeing a patient due to covid-19 restrictions, threatened to bring a gun to the California facility. It wasn’t the first time the department faced a gun threat during the pandemic. Earlier in the year, a psychiatric patient well known at the department became increasingly violent, spewing racial slurs, spitting toward staffers and lobbing punches before eventually threatening to shoot Kamara in the face. (Sable-Smith and Miller, 10/11)

For the first time, New Hampshire’s only state-run psychiatric treatment facility has negotiated contracts with all major insurance carriers in the state. Carriers now under contract with New Hampshire Hospital include Aetna, Ambetter, Anthem, Cigna, Harvard Pilgrim and United Health Care, state officials said. “Over the past few years, we have made significant strides to rebuild New Hampshire’s mental health system, and those critical efforts will continue,” Gov. Chris Sununu said in a statement. (10/10)

Tampa General Hospital is renaming its pediatric inpatient services and undergoing a major renovation, the first phase of which is projected to begin in spring 2022. The first phase of the renovation involves a $7.5 million remodel of two of the three wings of what is now known as the TGH Children’s Hospital. “Our vision is to be the safest and most innovative academic health system in America and that applies to our youngest patients as well. Through our partnership with USF Health and our private practice physicians across the community, we are well on our way to making that vision a reality,” John Couris, president and CEO of Tampa General Hospital, said in a prepared statement. (Miller, 10/10)

A Dartmouth-Hitchcock research team has been approved for $32.7 million for a colorectal cancer prevention study of older adults. The study will compare colonoscopy and stool-based testing for the prevention of the cancer in adults 70 and older with prior small colon polyps, said Audrey Calderwood, who leads the research team. (10/10)

It is an extraordinary amount of money at an extraordinary time. Devoted Health, a startup using technology to provide better care for older Americans, raked in $1.23 billion in Series D funding, the company said Friday, marking a record haul for a health tech business and one of the largest sums raised by any venture at such an early stage. The company is now valued at about $12.7 billion and planning to expand its services nationwide. (Ross, 10/8)

A growing part of the U.S. will face an increased risk of critical infrastructure, like emergency services and hospitals, being rendered inoperable due to severe flooding linked to climate change over the next 30 years, a report out Monday from the First Street Foundation shows. Hospital systems are increasingly being disrupted due to climate-fueled weather disasters like superstorms, flooding, heatwaves and cold snaps and have to harden their infrastructure. (Fernandez, 10/11)

During Dr. Robert Hsun-Piao Yuan’s long career as a neurosurgeon, a younger colleague once asked why he took on cases for which success seemed beyond reach. “You must always give patients hope,” he replied. Buoyed by his Christian faith, and guided by his commitment to healing, Dr. Yuan traveled from boyhood in 1920s China to serving as chief of neurosurgery at three Greater Boston hospitals. He was 99 when he died Oct. 3 in his Newton Centre home while in hospice care for failing health. (Marquard, 10/10)

Addressing a whistleblower's warning that users should not trust Facebook, the company is working on several changes in the way Instagram affects its younger users, one of Facebook's top executives said Sunday. In addition to current tools like hiding specific words, blocking specific people and automatically prompting users away from harmful material — like content related to eating disorders — Nick Clegg, Facebook's vice president for global affairs and communications, said Instagram plans to introduce controls for parents to supervise what their teens view, “nudge” teens away from content that “may not be conducive to their well-being” and encourage users to “take a break” periodically while using the app. (Farrow, 10/10)

Rates of depression and anxiety climbed globally by more than 25% in 2020, a devastating ripple effect of the Covid-19 pandemic that has particularly affected women and young people, according to a new study. “We knew Covid would have an impact on these mental disorders, we just didn’t know how big the impact was going to be,” said Alize Ferrari, a lead researcher at the Queensland Center for Mental Health Research in Australia and co-author of the study, published Friday in the Lancet. (Gaffney, 10/8)

Exercise is well-known to benefit a person's physical and mental well-being, and research also suggests exercise may lower the risk of developing breast cancer. According to the Cleveland Clinic, one study demonstrated that increasing exercise and decreasing body fat lowered the risk of breast cancer for postmenopausal women. The findings, published in JAMA Oncology in 2015, involved a 12-month long randomized trial, and ultimately found that 300 minutes per week of moderate-to-vigorous exercise was more effective than 150 minutes per week in reducing total fat among postmenopausal women. (Lencki, 10/9)

The Florida Department of Health in Collier County has issued a mosquito-borne illness alert after confirming three cases of West Nile virus Thursday. Health officials are concerned that additional residents may become ill. According to the Centers for Disease Control, most people infected with West Nile virus don't develop symptoms, but symptoms of severe illness can include high fever, headache, neck stiffness, disorientation, and muscle weakness. Residents are advised to "drain and cover" to protect themselves from mosquitos. (10/8)

Health officials said Friday that people recently inside Children’s Hospital of Philadelphia may have been exposed to measles, but the exposure was limited to the hospital and there was no outside threat to the public. The people with possible exposure were receiving notifications, officials said. No further details about the measles case were provided. “We believe there is no threat to the public associated with this case of measles,” acting Philadelphia Health Commissioner Cheryl Bettigole said in a statement. (Moran, 10/9)

A new study shows that accidental burn injuries among children increased during the coronavirus pandemic compared to 2019. According to Dr. Christina Georgeades, a pediatric surgery research fellow at Children's Wisconsin, stay-at-home orders "created a new dynamic between their social environment." "Understanding specific factors that contributed will be key in minimizing the risk of future burn injuries as we continue to navigate the pandemic environment," Georgeades said in an American Academy of Pediatrics (AAP) study. U.S. News reports that most burns occurred with unsupervised children. The study shows that fireworks share some of the blame too. (Jones, 10/9)

Before the COVID-19 pandemic, one in three families in the U.S. struggled to afford to buy enough diapers for their young children. But while "diaper need," as it's referred to, has long been a condition of living in poverty, it has become even more pervasive over the course of the pandemic, according to the National Diaper Bank Network (NBDN), a coalition of 240 member diaper banks — sites that distribute diapers to community organizations — across the U.S. "The issue of diaper need has existed for a long time," Joanne Goldblum, chief executive of NDBN, told CBS MoneyWatch. "But during COVID, some of our member diaper banks have seen upward of a 500% increase in people asking for product." (Cerullo, 10/8)

The Environmental Protection Agency (EPA) will soon unveil a plan to address what it sees as “inadequate” regulations on a class of toxic chemicals that disproportionately affects vulnerable groups, according to documents obtained by The Hill. The agency’s forthcoming effort to crack down on the chemicals called PFAS, which have been linked to health problems such as kidney and testicular cancer, were previewed in a slideshow recently obtained through a Freedom of Information Act request. (Frazin, 10/10)

The pandemic has exacerbated economic disparities in America, taking a heavier toll on women, people of color and those who don’t have a college education. But millions without health insurance have benefited during the public health emergency — by getting new coverage, paying less for it or simply not being thrown off their existing Medicaid plan. Through August, just over 1.4 million Texans had enrolled and paid for insurance through HealthCare.gov, the federal marketplace for individuals and families. That’s an increase of nearly half a million customers since 2019, and it is easily the state’s highest enrollment yet. (Schnurman, 10/8)

California Gov. Gavin Newsom signed a bill Friday to require public schools to stock their restrooms with free menstrual products. The legislation comes after many women's rights advocates have pushed nationwide for affordable access to pads, tampons and other women's hygiene products. The requirement follows in the footsteps of many other states, like Washington and Illinois, which passed similar laws this year. (Frazier, 10/9)

California became the first state in the nation Saturday to adopt a law requiring large retail stores to provide gender-neutral toy sections under a bill signed by Gov. Gavin Newsom. The new law, which takes effect in 2024, says that retail stores with 500 or more employees must sell some toys and child-care products outside of areas specifically labeled by gender. Retailers can continue to offer other toys and child-care goods in traditional boys and girls sections if they choose to. (Luna, 10/9)

The Tennessee Department of Correction now has a suicide prevention hotline which friends and family of inmates can call if they are concerned about their loved one, the department announced. Calls will be will be routed to the department’s Central Communication Center, which is staffed 24 hours a day, 7 days a week. Analysts at the center will notify the facility where the inmate is housed so intervention can take place immediately. (10/11)

Maryland officials moved another step forward with plans for a large new mental illness and substance abuse treatment center for certain nonviolent offenders in Baltimore. The Department of General Services has issued a request for proposal for a design and construction consultant who would oversee various aspects of the planned Baltimore Treatment and Therapeutic Center, which officials say is expected to take around 10 years and cost more than $450 million to complete. (Davis, 10/9)

Alachua County Fire Rescue is now the proud owner of three Lund University Cardiopulmonary Assist Systems (LUCAS), lifesaving devices that can apply nonstop mechanical chest compressions to cardiac arrest victims. “Time is tissue,” said Rescue Lt. Sam Harper, a firefighter with 13 years of experience, “the more time we have good compression on a patient, the better the outcome for that patient.” ACFR usually sees about 150 to 190 cardiac arrest cases each year, however in the past year the community has seen an increase in cases due to COVID-19 and limited hospital space, said Assistant Chief Michael Cowart. (Rickard, 10/10)

More than 100 families who arrived in Massachusetts in recent weeks after surviving turmoil in Haiti have been left with no resources or legal assistance, according to advocates and officials, setting off a scramble to provide essentials such as housing and medical care. The crisis facing the Haitian arrivals — many of whom were trapped in squalid conditions near a bridge along the US border with Mexico — is compounded by federal efforts to send them back to Haiti despite that country’s social unrest and poverty, advocates said. If not for grass-roots efforts to provide for these people, the advocates said, many would have found themselves living on the street. The aid has included access to medical care, as well as housing, food, clothing, and pro-bono legal assistance. (Hilliard, 10/10)

Civil rights activists are condemning the arrest of a Black man with paraplegia in Dayton, Ohio, who was seen in newly released body-camera video being pulled from his car during a traffic stop last week as he yelled for help and told officers he cannot use his legs. (Bellware, 10/9)

Sydney hairdressers, gyms, cafés and bars reopened to fully vaccinated customers on Monday for the first time in more than 100 days after Australia’s largest city achieved a vaccination benchmark. Sydney planned to reopen on the Monday after 70% of the New South Wales state population aged 16 and older were fully vaccinated. By Monday, 73.5% of the target population was fully vaccinated and more than 90% have received at least one dose. (McGuirk, 10/11)

Singapore is pressing ahead with plans to reopen its borders despite battling a record Covid-19 outbreak, saying it will allow vaccinated travelers from nine more countries including the U.S. and U.K. to enter without having to quarantine. The other places to qualify are Canada, Denmark, France, Italy, the Netherlands and Spain with travel to Singapore to start from Oct. 19 and South Korea from Nov. 15, the government said Saturday. The number of Covid tests will be cut from four to two, helping to reduce cost and inconvenience, according to authorities. (Heijmans, 10/9)

Pfizer will vaccinate everyone over age 12 in the Brazilian city of Toledo as part of a study measuring the safety and effectiveness of its COVID-19 vaccine, Reuters reports. Researchers in the study hope to monitor viral transmission in a real-life scenario after the population has been inoculated. The study will be in conjunction with Brazil's National Vaccination Program, local health authorities, a hospital and a federal university, per Reuters. (Saric, 10/10)

When Russian regulators approved the country’s own coronavirus vaccine, it was a moment of national pride, and the Pavlov family was among those who rushed to take the injection. But international health authorities have not yet given their blessing to the Sputnik V shot. So when the family from Rostov-on-Don wanted to visit the West, they looked for a vaccine that would allow them to travel freely — a quest that brought them to Serbia, where hundreds of Russian citizens have flocked in recent weeks to receive Western-approved COVID-19 shots. (Gec and Litvinova, 10/9)

While Western Europe celebrates the results of successful vaccination campaigns, a very different picture is emerging in Central and Eastern Europe as a wave of coronavirus cases and deaths threatens to overwhelm already overstretched health systems. A summer of sluggish vaccination, the relaxation of most restrictions and, in some countries, political upheaval have created a perfect storm for the highly infectious Delta variant. And unlike in previous waves, there is no appetite for further restrictions, leading some experts to warn that some countries are headed for Lombardy-like scenes. (Furlong, 10/8)

Irene Castilho didn’t even have a day to grieve after her husband died of COVID-19. She was sick, too, coughing and struggling to breathe; he was barely gone when she started using his oxygen mask. The same day, on March 22, she was admitted to a hospital in Sao Paulo. The 71-year-old had followed doctors’ instructions to the letter – dutifully taking her doses of hydroxychloroquine. She also took ivermectin and a battery of anti-inflammatories and vitamins in the so-called “COVID kit” that her health care company, Prevent Senior, mailed to her home. (Alvares, 10/10)

Like many who work in public health, especially in sub-Saharan Africa, I’ve been waiting my whole career for a malaria vaccine. And even longer than that: I suffered from severe malaria when I was 10. The World Health Organization has now endorsed the first vaccine as a complementary tool for widespread use among children in at-risk areas, including my country, Senegal. This announcement, hailed as “historic” by the W.H.O. and global health experts worldwide, is indeed cause for celebration. Malaria is a preventable disease that has been virtually eliminated in wealthy countries and yet kills around 400,000 people a year, mostly African children. (Yacine Djibo, 10/10)

Over the last year and a half, our mental health was universally affected as we dealt with the trauma, isolation, radical change and intense powerlessness brought on by the pandemic. Though challenging, these experiences have also led to open and empathetic conversations about the struggles we all face with our mental health and the resources available to those most in need. With this heightened awareness about our collective well-being, it’s time we confront a complicated and difficult reality that has gone ignored for too long: Thousands of individuals suffering from mental health crises end up in our criminal court system, a system that cannot adequately address their needs. (Alexa James, 10/11)

Listening to hospital executives lament the "nursing shortage" is beyond infuriating. Nurses know the United States is not feeling a true nursing shortage, only a shortage of nurses willing to risk their licenses or their patients’ lives by working in unsafe conditions. Except for a few states, plenty of registered nurses are available to meet this country’s needs, according to a 2017 U.S. Department of Health and Human Services report on the supply and demand of the nursing workforce from 2014 to 2030. (Bonnie Castillo, 10/11)

Every now and then, a sliver of sanity seeps through the barricade of national lunacy. This past week, a handful of bipartisan lawmakers introduced two bills aimed at ending one of our nation’s most-barbaric practices — mandatory animal testing of new pharmaceuticals destined for human trials. It’s been a while since I’ve performed a midair, double-heeled click, but I managed a reasonable facsimile upon hearing this news. The Senate’s “FDA Modernization Act” and the House’s H.R. 2565 set the stage for a groundbreaking move to end animal suffering while also advancing timelier and more efficient drug development. (Kathleen Parker, 10/8)

As some nurses across the country choose to stop working rather than comply with vaccine mandates, some hospitals are recruiting nurses in the Philippines to fill their staffing gaps. That will only further heighten the burden borne by Filipinx nurses, and other Filipinx health care workers, in the United States. Since the outset of the pandemic, it has become abundantly clear that social and economic factors shaped by the U.S.’s history of structural racism have caused disproportionate numbers of deaths among racial and ethnic minority groups due to Covid-19. Lost in the conversation have been the experiences of Asian American communities, and Filipinxs in particular. (Carlos Irwin A. Oronce, 10/11)

We’re now more than two decades out from the initial announcement of the National Nanotechnology Initiative (NNI), a federal program from President Bill Clinton founded in 2000 to support nanotechnology research and development in universities, government agencies and industry laboratories across the United States. It was a significant financial bet on a field that was better known among the general public for science fiction than scientific achievement. Today it’s clear that the NNI did more than influence the direction of research in the U.S. It catalyzed a worldwide effort and spurred an explosion of creativity in the scientific community. And we’re reaping the rewards not just in medicine, but also clean energy, environmental remediation and beyond. (Chad Mirkin, 10/9)

We can credit clinical trials for great improvements made in cancer care in recent years. Death rates for 11 of the 19 most common cancers in men and 14 of the 20 most common cancers in women decreased between 2014 and 2018. But there's a large hole in these improvements: a lack of diversity. (Dr. Richard Barakat, 10/8)

We knew this moment would come eventually: Pfizer/BioNTech has applied to the Food and Drug Administration for authorization of its vaccine in children 5 to 11 years old. The good news is that many kids will soon be protected against covid-19, along with their families and communities. The bad news is that we’re eventually in for a hell of a fight over whether to mandate those vaccines as a condition of school attendance. (Megan McArdle, 10/8)

Masks are a final useful barrier against the spread of a highly contagious respiratory virus like SARS-CoV-2, but their effectiveness is limited, especially when there is a lot of virus around. The best way to limit spread with the easily transmitted variants is not masks alone; it is a high rate of vaccination combined with home testing with rapid antigen tests. If you never go out of the house carrying the coronavirus in the first place, you won't be able to spread it, mask or no mask. If you find out you have it early enough, you can avoid spreading it to others. This is a basic principle of public health. (Marc Siegel, 10/9)

As a pediatrician and a grandmother, I have followed news of the clinical trials for the Covid-19 vaccines in younger children with great anticipation. My two grandchildren, ages 5 and 8, returned to in-person school this fall and while they wear their masks, I still feel an undercurrent of anxiety as they lack the best protection of all: vaccination. I have practiced pediatrics for 41 years, and know well the power of vaccines in stopping the spread of disease and suffering, both for individual children and for entire families and communities. We've all seen this unfold in real time over the past few months. (Moira Szilagyi, 10/9)

The two things that patients want—reassurance that they won’t get COVID-19 and permission to engage in life—I cannot deliver, and I never will be able to. SARS-CoV-2 is here to stay. The virus will be woven into our everyday existence much like RSV, influenza, and other common coronaviruses are. The question isn’t whether we’ll be exposed to the novel coronavirus; it’s when. (Lucy McBride, 10/10)

When COVID-19 emerged in the U.S. in late 2019 and early 2020, the public health community responded in a manner similar to how its members did in prior influenza epidemics. Two prior coronavirus outbreaks, SARS and MERS, affected virtually no one in the U.S., and influenza was the best bet for the next major pandemic. That’s what the public health community geared up for. This was an understandable approach. Alas, like Leo Tolstoy’s unhappy families, each pandemic is different in its own way. (Cory Franklin and Robert A Weinstein, 10/11)

Time is tissue. As surgeons, we live by this fact across a range of diseases and injuries, including heart attack, stroke, diabetes and, in my specialty as a vascular surgeon, limb preservation versus limb loss. The spike in COVID cases across California, dominated by the unvaccinated, is dramatically degrading the precious time health care providers have to treat the widest range of patients. Time is not on our side. (Misty Humphries, 10/9)