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  • Vaccine Policy in Colorado
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Morning Briefing

Summaries of health policy coverage from major news organizations

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Thursday, Feb 16 2023

Ńîąóĺú´«Ă˝Ň•îl Health News Original Stories 4

  • As Covid Grabbed the World’s Attention, Texas’ Efforts to Control TB Slipped
  • One State Looks to Get Kids in Crisis out of the ER — And Back Home
  • Republican Lawmakers Shy Away From Changing Montana’s Constitutional Right to Abortion
  • 'An Arm and a Leg' Podcast: She Sued a Hospital and Lost — But Felt She’d Won
  • Political Cartoon: 'A Soul-Sucking Experience?'

Note To Readers

Opioid Crisis 1

  • Narcan Moves Closer To Being Sold Over The Counter

Medicare 1

  • Federal Spending On Medicare, Social Security Will Outstrip Revenues: CBO

Vaccines and Covid Treatments 1

  • Moderna Says It Won't Charge Americans For Its Covid Shots

Health Industry 1

  • Several Health Facilities Accused Of Being Unsanitary, Unsafe, Neglectful

After Roe V. Wade 1

  • South Carolina Lawmakers Again Pass 'Near-Total' Abortion Ban

Public Health 1

  • Study: More With Breast Cancer Can Skip Post-Surgery Radiation Therapy

Administration News 1

  • Biden's Annual Physical Takes Place In Spotlight Of Possible 2024 Campaign

Gun Violence 1

  • As Violence Grows, 63% Of Americans Want Gun Laws To Change, Poll Finds

State Watch 1

  • Residents Search For Reassurance After Ohio Toxic Train Derailment

Pharmaceuticals 1

  • New Technique Extends Heart Transplant Window

Health Policy Research 1

  • Research Roundup: Antibiotics; Breast Cancer; Diabetes; Asthma

Editorials And Opinions 1

  • Viewpoints: Synthetic rFC Urgently Needs Approval For Pharmaceutical Testing; US Is Failing Its Children

From Ńîąóĺú´«Ă˝Ň•îl Health News - Latest Stories:

Ńîąóĺú´«Ă˝Ň•îl Health News Original Stories

As Covid Grabbed the World’s Attention, Texas’ Efforts to Control TB Slipped

Responding to covid has taken so much attention and energy that some public health workers believe it pushed tuberculosis off people’s radar. ( Colleen DeGuzman , 2/16 )

One State Looks to Get Kids in Crisis out of the ER — And Back Home

At many U.S. hospitals, children and teens are stuck in the emergency department for days or weeks because psychiatric beds are full. Massachusetts is trying a simple, promising solution. ( Martha Bebinger, WBUR , 2/16 )

Republican Lawmakers Shy Away From Changing Montana’s Constitutional Right to Abortion

Lawmakers in 14 states have passed near-total bans on abortion since the U.S. Supreme Court overturned Roe v. Wade. But in some conservative-led states where court rulings determined their constitutions protect abortion, including Montana, politicians haven’t asked voters to weigh in. ( Katheryn Houghton , 2/16 )

'An Arm and a Leg' Podcast: She Sued a Hospital and Lost — But Felt She’d Won

A listener sued a hospital in small-claims court and lost but felt as if she’d won. Now, she wants to encourage more people to take their bills to court. ( Dan Weissmann , 2/16 )

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Political Cartoon: 'A Soul-Sucking Experience?'

Ńîąóĺú´«Ă˝Ň•îl Health News provides a fresh take on health policy developments with "Political Cartoon: 'A Soul-Sucking Experience?'" by Mike Peters.

Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of Ńîąóĺú´«Ă˝Ň•îl Health News or KFF.

Note To Readers

KHN is now on TikTok! Watch our videos and follow along as we break down health care headlines and policy.

Summaries Of The News:

Opioid Crisis

Narcan Moves Closer To Being Sold Over The Counter

Two panels of addiction experts recommended Wednesday that the FDA allow naloxone, an overdose-reversing nasal spray, to be sold without a prescription. Doctors and other advocacy groups have also pressed the Biden administration to make such a move to combat the opioid epidemic.

Two federal panels of addiction experts on Wednesday unanimously recommended that Narcan, the overdose-reversing nasal spray, be made widely available without a prescription, a significant step in the effort to stem skyrocketing drug fatalities. Making Narcan an over-the-counter drug has been urged by doctors, patient advocacy groups and the Biden administration. (Hoffman, 2/15)

The positive vote, which is not binding, came despite concerns from some panel members about the drug’s instructions and packaging, which caused confusion among some people in a company study. The manufacturer, Emergent Biosolutions, said it would revise the packaging and labeling to address those concerns. The FDA will make a final decision on the drug in coming weeks. Panel members urged the FDA to move swiftly rather than waiting for Emergent to conduct a follow-up study with the easier-to-understand label. (Perrone, 2/15)

Two manufacturers are applying for nonprescription status: Emergent BioSolutions — the focus of Wednesday’s meeting — and Harm Reduction Therapeutics, a nonprofit organization. The FDA granted both companies a priority review and is likely to issue an approval decision within months. (Facher, 2/15)

“For the sake of the public and saving lives, I believe this medication should be available over the counter as soon as possible,” Dr. Katalin Roth, a professor of medicine at the George Washington University School of Medicine and Health Sciences, said following the vote. (Lovelace Jr., 2/15)

All states have standing orders that allow a person to get naloxone from a pharmacist without a doctor’s prescription, but consumers must approach a pharmacist and ask for the medication before purchasing. Dr. Bobby Mukkamala, chair of the American Medical Association's substance use and pain care task force, said a retail version of the drug would make it easier for people to access. “Making naloxone over the counter is a safe and vital step to ending the nation’s overdose epidemic," Mukkamala said.

In related news about the opioid crisis —

In October, a new clinic offering opioid addiction treatment opened in Guilford County. Patients get connected to the clinic by the post-overdose response team at an organization called Guilford County Solution to the Opioid Problem — better known as GC STOP. Now, 48 people who overdosed in the community have been connected to treatment and medication thanks to the new initiative, which was made possible by a grant using funds from a massive legal settlement with McKinsey & Company. (Knopf, 2/16)

Colorado cities could let “overdose prevention centers,” where people would be allowed to openly use illicit drugs under the supervision of health care workers or other trained staff, operate within their boundaries under a bill introduced in the state legislature Wednesday by four Democrats. (Paul, 2/15)

New Jersey lawmakers are advancing a pair of bills that would toughen sentences for fentanyl possession and dealing, which advocates for people who use drugs fear could end up deterring people from reporting overdoses and punish people struggling with addiction. (Whelan, 2/16)

A record 193 homeless people died in Oregon’s Multnomah County, home to Portland, in 2021, a 53% increase compared with the previous year, according to a new county report released Wednesday. Substances contributed to about 60% of those deaths, the report found, mirroring trends seen across the country. (Rush, 2/15)

Medicare

Federal Spending On Medicare, Social Security Will Outstrip Revenues: CBO

The Congressional Budget Office has new estimates about federal spending on Social Security and Medicare over the next decade, warning it may rise faster than revenues and the whole economy. Funds for Social Security would hit a shortfall in 2032 — a year earlier than expected.

Federal spending on Social Security and Medicare is projected to rise dramatically over the next decade, far outpacing revenues and the economy on the whole while putting new pressure on Congress to address accelerated threats of insolvency, according to new estimates from the Congressional Budget Office (CBO). The increase is driven by a variety of factors, including Social Security’s new cost-of-living adjustment, the rising cost of medical services under Medicare and greater participation rates in both programs, as the last of the baby boomers become eligible for retirement benefits. (Lillis, 2/15)

Social Security funds are set to start running a shortfall in 2032, one year earlier than previously expected, the director of the Congressional Budget Office (CBO) said on Tuesday. “The Social Security solvency date — the exhaustion date for the trust fund — is now within the budget window,” CBO Director Phillip Swagel said, referring to the 10-year period covered by the agency’s annual report. (Shapero, 2/15)

There's an inconvenient truth underneath the politics of Medicare — its finances are simply unsustainable. Medicare is one of the largest line items in the U.S. budget, and as the population ages, it's expected to only get more expensive. (Owens, 2/16)

More on Medicare —

Medicare Advantage and Medicare drug plans told the Centers for Medicaid and Medicare Services that too much regulation at once could drive up costs and result in increased premiums or fewer benefits. Public comment closed this week on on a proposal to crack down on Medicare Advantage marketing practices, impose other standards on Medicare drug plans and create requirements to increase access to behavioral health and culturally competent care. (Dreher and Goldman, 2/16)

After years of trying to squash the expansion of government-funded health care and preserve business from private payers, the health care industry is suddenly facing new threats to the revenue it receives from the Medicare. (Owens, 2/16)

Vaccines and Covid Treatments

Moderna Says It Won't Charge Americans For Its Covid Shots

Earlier reports said Moderna was planning a price of $110 to $130 per dose in a pivot to commercial distribution, but the company now says it's committed to enabling access for all. Separately, the DOJ says the government should face a patent lawsuit over covid shots — not Moderna.

In an unexpected shift, Moderna has decided not to ask Americans to pay for its Covid-19 vaccine, a move that follows intense criticism over initial plans to charge $110 to $130 per dose after the company pivots from government contracts to commercial distribution. (Silverman and Owermohle, 2/15)

Senator Bernie Sanders said on Wednesday Moderna Inc's chief executive officer Stéphane Bancel will testify next month in front of the senate on the drugmaker's plans to raise the price of its coronavirus vaccine. In January, Sanders had written to Bancel to refrain from quadrupling the price of COVID-19 vaccine, after Moderna said it was considering pricing its vaccine at $110 to $130 per dose in the United States, when it shifts from government contracting to commercial distribution. (2/15)

The U.S. government should face a patent lawsuit over COVID-19 vaccines, not vaccine maker Moderna Inc (MRNA.O), the Department of Justice told a Delaware federal court on Tuesday. The Justice Department's court filing said the United States should be liable for any infringement of Arbutus Biopharma Corp (ABUS.O) and Genevant Sciences GmbH's patents that took place under Moderna's contract to provide shots for the government's nationwide vaccination effort. (Brittain, 2/15)

On the covid antiviral pill ensitrelvir —

The U.S. National Institutes of Health (NIH) said on Wednesday that it had started a clinical trial to evaluate Japan's Shionogi & Co Ltd's experimental oral antiviral drug to treat COVID-19. The drug, S-217622 or ensitrelvir, will be tested in adult patients hospitalized with COVID-19. It is already approved for emergency use in Japan. (2/16)

More on the spread of covid —

Two studies published yesterday further reveal the extent of COVID-19's potential aftermath, with one showing residual organ damage 1 year after diagnosis—even in those who were mildly ill—and the other finding persistent lung abnormalities on chest imaging at 2 years. (Van Beusekom, 2/15)

Despite a report earlier this week in the scientific journal Nature that the World Health Organization has “quietly shelved” the second phase of its investigation into the origins of the COVID-19 pandemic due to a lack of cooperation from the Chinese government, officials from the U.N. health agency on Wednesday said their work was not done. (Vaziri, 2/15)

Also —

The time that American children spent in front of screens went up during the COVID-19 pandemic and stayed high even after many restrictions that kept people at home and limited their social interactions were lifted, according to a new study published Wednesday in JAMA Network Open. (Vaziri, 2/15)

Health Industry

Several Health Facilities Accused Of Being Unsanitary, Unsafe, Neglectful

In Illinois, a state-run facility for people with mental illnesses and developmental disabilities was accused of shocking instances of cruelty and abuse, ProPublica reported. In Florida, problems at HCA Florida Bayonet Point led to, among other problems, anesthesiology errors that resulted in patients waking up during surgery, NBC News said. Other complaints concern hospitals in D.C. and Maine.

Newly released reports from the Illinois Department of Human Services’ watchdog office reveal shocking instances of cruelty, abuse and poor care of patients who have mental illnesses and developmental disabilities at a state-run facility in rural southern Illinois. (Hundsdorfer and Parker, 2/15)

On Dec. 7, 2021, more than a dozen surgeons convened a meeting at their hospital, HCA Florida Bayonet Point in Hudson, Florida. Their concerns about patient safety at the 290-bed acute care facility owned by HCA Healthcare Inc. had been intensifying for months and the doctors had requested the meeting to push management to address their complaints. (Morgenson, Schecter and McFadden, 2/15)

St. Elizabeths Hospital patients settled a lawsuit with the District-owned psychiatric hospital and the city over allegations that the facility failed to provide needed care during an extended water outage in 2019 and the coronavirus pandemic. As part of the settlement with the three patients, filed Tuesday in federal court, the District agreed to provide a water remediation plan as well as the process for regular testing. (Silverman, 2/15)

A Muslim man has sued Central Maine Healthcare Corp. in Lewiston alleging that the company discriminated against him on the basis of race, religion, gender and national origin when it eliminated his position in 2020. Motaz El Kelani, who was born in Egypt but now lives and works in Texas, worked for Central Maine Clinical Associates Corp. as a practice manager from July 1, 2019, to May 20, 2020. (Harrison, 2/15)

In other corporate news —

The Franklin, Tennessee-based for-profit system on Wednesday reported fourth-quarter net income of $414 million, or $3.18 per share, compared with $178 million, or $1.34 per share, a year ago. The results included a $180 million gain from early debt extinguishment and $119 million from HealthTrust Purchasing Group's sale of CoreTrust Holdings, which closed on Oct. 1. Community Health Systems is a noncontrolling partner in HealthTrust. (Hudson, 2/15)

CommonSpirit said on Wednesday it will acquire Steward Health Care's Utah locations, which include more than 35 clinics and five hospitals—Davis Hospital and Medical Center in Layton; Jordan Valley Medical Center in West Jordan; Jordan Valley Medical Center-West Valley Campus; Mountain Point Medical Center in Lehi; and Salt Lake Regional Medical Center in Salt Lake City—for an undisclosed amount. (Hudson, 2/15)

Elevance Health has added specialty pharmacy BioPlus to its portfolio of businesses, the health insurer announced Wednesday. Elevance Health purchased BioPlus from CarepathRx, a private equity owned company that provides pharmacy services to hospitals, according to a news release. The company announced the transaction in November. (Berryman, 2/15)

University of Chicago Medicine’s new cancer hospital will cost $182 million more to build than expected — and have fewer beds than originally planned — because of runaway inflation and design changes. (Schencker, 2/15)

KHN: She Sued A Hospital And Lost — But Felt She’d Won 

When a patient faces an outrageous medical bill, they have two choices: Pay the balance or fight. Lauren Slemenda chose to fight. After failing to reach a consensus with the hospital on a fair price, she took the case to small-claims court. (2/16)

Also —

Advocacy groups representing clinicians, hospitals, health insurers and technology companies released a new report showing the challenges with the industry's consumer data sharing and privacy practices. (Turner, 2/15)

After Roe V. Wade

South Carolina Lawmakers Again Pass 'Near-Total' Abortion Ban

AP reports that the South Carolina House, ruled by a Republican supermajority, "shows no sign of budging" from its efforts to totally ban abortion. But in Kentucky, Republicans pushed back against a bill introduced by Rep. Emily Callaway, also Republican, to raise illegal abortion to homicide status.

For the second time since the U.S. Supreme Court ended federal abortion protections, the South Carolina House has passed a near-total abortion ban — and shows no sign of budging. The lower chamber’s Republican supermajority on Wednesday continued its efforts to make South Carolina the 13th state with a ban from conception. By a 83-31 vote largely along party lines, the House advanced a bill including exceptions for rape, incest, fatal fetal anomaly and the patient’s health and life. (Pollard, 2/16)

Newly filed legislation allowing illegal abortions to be prosecuted as homicides drew a quick pushback Wednesday from the state’s anti-abortion attorney general, who warned it would wrongly subject Kentucky women to charges for terminating pregnancies. Republican state Rep. Emily Callaway raised the stakes in the state’s bitter abortion debates when she introduced the measure Tuesday in a state where most abortions are currently banned. (Schreiner, 2/15)

For the first time since the fight over abortion access was kicked to the states after the Supreme Court overturned Roe v. Wade, newly elected legislatures around the country are coming into session and are putting the polarizing issue at the top of their agendas. Around 300 bills in 40 states have been proposed so far — with a majority seeking to restrict access to abortion, and others trying to strengthen it. Most of the bills are in the early stages, and many are not likely to survive politically divided state governments to make it into law. But if there is one thing that is evident, the legislative flurry shows that both sides of the debate agree on at least one point: Doctors are the critical link — and that has made them the most vulnerable to punishment. At least three dozen bills are aimed at doctors and other medical personnel as a way to regulate abortion. (Chen, 2/16)

Roused by voters’ recent endorsement of abortion rights — even in conservative states — Republican legislators are ramping up efforts to make it tougher for citizens to change laws or amend state constitutions through ballot measures. (Greenberger, 2/15)

KHN: Republican Lawmakers Shy Away From Changing Montana’s Constitutional Right To Abortion 

Republican lawmakers in Montana wield a supermajority that gives them the power to ask voters to approve a constitutional amendment that would break the link between abortion rights and the right to privacy in the state’s constitution. But so far, they haven’t sought to ask voters to make the change, a rewrite that would allow lawmakers to ban or further restrict abortion after the U.S. Supreme Court gave that power back to the states last year. (Houghton, 2/16)

Public Health

Study: More With Breast Cancer Can Skip Post-Surgery Radiation Therapy

A new study shows that more older women with low-risk breast cancer can skip radiation treatments after surgery, lowering both costs and also risky, painful side effects: data show the radiation didn't impact overall survival rates. Meanwhile, the WHO says it will maintain the mpox global emergency.

More older women with low-risk breast cancer could forgo radiation after surgery to avoid further side effects and costs, research showed, as some doctors work to limit tough treatments without hurting survival. Women in the study published Wednesday by the New England Journal of Medicine were 65 and older with early stage breast cancers that could respond to hormone therapy. The women all had surgery and hormone therapy and were divided into a group that underwent radiation and a group that went without it. Ten years after surgery, survival rates in the two groups were almost equal, suggesting more women could skip radiation without affecting their survival. (Abbott, 2/15)

Radiation has long been a mainstay of breast cancer treatment, and following surgery up with the therapy can reduce the risk of recurrence. The drawback of radiation, though, is a fistful of unpleasant potential side effects including pain, a slight risk of organ damage, a very small risk of secondary cancer, and the time and money needed for the procedures. Now the results of a Phase 3 trial suggests that many older patients may not need radiation and can go without it after surgery without harming their overall survival. (Chen, 2/15)

In other health and wellness news —

The World Health Organization (WHO) said today that the mpox outbreak will remain a global health emergency. ... As of Feb 14, there have been 85,860 confirmed mpox cases globally, with 93 deaths. Outside of countries in West and Central Africa, the outbreak has primarily affected men who have sex with men. (Dall, 2/15)

After nearly forty years of obscurity, the “food is medicine” movement is having a moment. Multiple federal agencies are working on food is medicine projects, major organizations have pledged hundreds of millions in research funding, and billions more are being invested in food-focused startups. Even the White House has publicly announced its support for the movement, which focuses on the use of healthy food as a medical intervention for certain chronic and diet-related diseases. (Florko, 2/16)

Elon Musk is backing up all his 420 tweets. The owner of Twitter, who sparked a media firestorm after he puffed on a spliff during an appearance on Joe Rogan’s podcast, is making good on speculation that his acquisition of the platform might make it more cannabis-friendly. The company changed its policy to allow U.S. cannabis companies to advertise on its platform Tuesday — although with numerous restrictions. (Zhang, 2/15)

Administration News

Biden's Annual Physical Takes Place In Spotlight Of Possible 2024 Campaign

President Joe Biden heads to Walter Reed National Military Medical Center Thursday for yearly physical exams. The White House promises transparency on the outcome in the shadow of an expected presidential campaign in which Biden's age is already an issue raised by opponents.

President Joe Biden, 80, will undergo a closely watched physical examination on Thursday, ahead of an expected announcement that he is seeking a second four-year term. Biden's session with the doctors at Walter Reed National Military Medical Center in nearby Bethesda, Maryland, will be his second extensive exam since he took office in January 2021. His last physical and colonoscopy, in November 2021, showed the president to be a "healthy, vigorous, 78-year-old male," his doctors said. He had a polyp removed from his colon. (Holland, 2/16)

When Barack Obama underwent a routine physical exam as president, his doctor noted that he had moved on from cigarettes to nicotine gum. Bill Clinton’s doctor included details about his fluctuating weight. Richard Nixon’s doctor complained that he didn’t exercise enough. There is no legal requirement to follow when it comes to the president’s checkups, and the amount of information released has always been up to the man himself. But President Biden’s exam on Thursday will get extra scrutiny because, at 80, he is America’s oldest president. (Kanno-Youngs, 2/15)

Nikki Haley, the newly minted Republican presidential candidate, called on Wednesday for mandatory “mental competency tests” for politicians older than 75, an implied dig at President Biden and her onetime boss, former President Trump. (Greenwood, 2/15)

Gun Violence

As Violence Grows, 63% Of Americans Want Gun Laws To Change, Poll Finds

The cycle of violence is so pervasive that some parts of the country are now coping with repeated shootings. In El Paso on Wednesday, one person was killed and three were injured in a shooting at a mall located steps away from the site of a 2019 Walmart rampage that left 23 dead.

A majority of Americans surveyed expressed dissatisfaction with current gun laws in the U.S. amid a recent string of mass shootings affecting the country, according to a new Gallup poll. The poll, published Wednesday, found that 63 percent of respondents said they are dissatisfied with the nation’s laws and policies on firearms, while 34 percent of those surveyed said the opposite. (Oshin, 2/15)

Nationwide, there have been a total of 71 mass shootings this year-to-date. "There's not been any year that we've had 67 in six weeks" this early in the year, said Mark Bryant, executive director of the Gun Violence Archive, on Tuesday morning. By Tuesday evening, the number of mass shootings reported and verified by the Gun Violence Archive, a nonprofit formed in 2013 to track gun violence in the U.S, increased to 71. (Tanner, 2/15)

Also —

One person was killed and three were wounded in a shooting at El Paso’s Cielo Vista Mall Wednesday evening—steps away from the Walmart where an attacker killed 23 people in 2019. Police in the West Texas border city said reports of an active shooter near the mall’s food court came in at 5:05 p.m. local time. An off-duty officer at the mall was at the scene of the shooting within three minutes and detained one suspect, interim police Chief Peter Pacillas said. A second suspect was later taken into custody as well. (Findell, 2/15)

A white supremacist who killed 10 Black people at a Buffalo supermarket was sentenced to life in prison without parole Wednesday after relatives of his victims confronted him with pain and rage caused by his racist attack. Anger briefly turned physical at Payton Gendron’s sentencing when a victim’s family member rushed at him from the audience. The man was quickly restrained; prosecutors later said he wouldn’t be charged. The proceeding then resumed with an emotional outpouring from people who lost loved ones or were themselves wounded in the attack. (Thompson and Peltz, 2/15)

More on the gun violence epidemic —

"Tonight we pray, tomorrow we change our culture, we change our laws," said the bishop of the Episcopal Diocese of Michigan, the Rt. Rev. Bonnie Perry, said. "I am so mad and so sad that we have yet another shooting. ... We know that gun deaths is the leading cause of death for young people in the state of Michigan and in the United States of America." (Warikoo, 2/16)

While elementary, middle and high schools in the United States have been transformed in the last generation — with only moderate success — by metal detectors, new security systems, increased screening for visitors and the installation of locks on classroom doors to evade mass shooters, the same changes have not come to colleges and universities. “What we do and what is acceptable from K through 12 is not necessarily acceptable when you get to the college level,” said Anthony Gentile, a professor at John Jay College of Criminal Justice and security adviser to the Newtown Public School District, where the Sandy Hook Elementary School massacre occurred in 2012. “Frankly, anybody can drift onto one of the campuses and do what happened the other day.” (Bosman, Jimenez and McKinley Jr. 2/15)

At 21, Zoe Beers has already survived two school shootings. The first was in California when she was 8. The second was this week, as a gunman stormed the Michigan State campus, killing three students and wounding five more. Now, she said, she’s had enough. “No one I know understands what it is like for me, what it is like for us,” she said. “Things needed to change 20 years ago, and they absolutely need to now.” (Rosenzweig-Ziff, Thebault and Khan, 2/15)

Five years later, the shooting at Marjory Stoneman Douglas High School is still very much on the mind of English teacher Sarah Lerner. Lerner was teaching at the school on Feb. 14, 2018, when gunman Nikolas Cruz killed 17 people -- 14 students and three staff members -- at the Parkland, Florida, high school. It was the second-deadliest shooting at a K-12 school at the time, a total since surpassed by the shooting at Robb Elementary School in Uvalde, Texas. She still struggles with the trauma. "Anytime the fire alarm goes off or ... even just a lockdown drill, it all comes flooding back to you," Lerner told ABC News. (El-Bawab and DiMartino, 2/14)

State Watch

Residents Search For Reassurance After Ohio Toxic Train Derailment

Hundreds of residents in East Palestine, Ohio, met with officials Wednesday to express worries and seek answers in the aftermath of the train derailment and subsequent toxic chemical problem. Staff members from railroad operator Norfolk Southern didn't show up. Train length and plastic chemical safety are in the media spotlight.

Residents of the Ohio village upended by a freight train derailment packed a school gym to seek answers about whether they were safe from toxic chemicals that spilled or were burned off. Hundreds of worried people gathered Wednesday in East Palestine, near the Pennsylvania state line, to hear state officials insist yet again that testing shows local air is safe to breathe so far and promise that air and water monitoring would continue. ... Those attending Wednesday’s informational session, which was originally billed as a town hall meeting, had many questions over health hazards, and they demanded more transparency from railroad operator Norfolk Southern, which did not attend, citing safety concerns for its staff. (Orsagos, 2/16)

East Palestine, Ohio, is the kind of town where neighbors greet each other at the store and lean on each other during hard times. Now, in the wake of a massive train derailment that expelled hazardous materials into the air, ground and water, residents are grappling with the fear that their hometown is no longer safe to reside in. (Jacobo, 2/16)

The toxic train derailment in East Palestine, Ohio, is drawing new attention to the dangers of increasingly long freight trains — part of a series of cost-savings efforts by freight railroads that have drawn scrutiny from the industry’s critics. The sheer bulk of the 150-car train that went off the rails Feb. 3 is just one factor investigators are expected to consider amid the unfolding ecological disaster near the Ohio-Pennsylvania border, which caused a massive fireball, forced an evacuation and has left a lingering odor, fears of lasting contamination and thousands of dead fish. But union officials, regulators and congressional researchers say the industry’s trend toward ever-growing train lengths is causing a host of safety concerns that regulators need to address. (Snyder, 2/16)

A Norfolk Southern Corp. train carrying hazardous materials derailed in fiery fashion on the night of Feb. 3 in East Palestine, Ohio. The risk of some of those dangerous materials exploding prompted officials to allow the train operator to run what’s called a “controlled explosion” on Feb. 6, releasing known carcinogens and a plume of black smoke into the air. Although local residents and businesses were evacuated beforehand and have since been allowed back, many remain hesitant to return home. (Hirji, 2/15)

In updates from Texas —

Adam Hernandez was volunteering at a local middle school in mid-January when a student he mentors asked about his daughter, Jacquelyn. Jacquelyn was three weeks shy of her 18th birthday when she died by suicide in 2018. She left no note, and the unrelenting question was, “Why?” There were exciting moments on her horizon — she had just graduated from high school and wanted to be an EMT, and her sister’s birthday was coming up. (Lozano, 2/16)

Black and Hispanic people and those living in low-income Texas communities are highly concerned about the quality of their drinking water, a new survey shows. Commissioned by the nonprofit organization Texas Water Trade, the survey included responses from 650 households in both rural border communities and urban areas across Houston and Dallas-Fort Worth. Among those surveyed, 61% responded that they do not think their water is safe to drink. (Lozano and Salhotra, 2/16)

KHN: As Covid Grabbed The World’s Attention, Texas’ Efforts To Control TB Slipped 

Narciso Lopez has spent more than two decades working to control the spread of tuberculosis in South Texas. He used to think that when patient traffic into the clinics where he worked was slow, that meant the surrounding community was healthy. But when the covid-19 pandemic hit in early 2020, that changed. “I would be getting maybe three to four a month,” recalled Lopez, a TB program supervisor with Cameron County’s health department. In a matter of months, patients seeking care at the county’s two clinics dropped by half. “And then I wasn’t getting any at all,” he said. (DeGuzman, 2/16)

In other health news from across the U.S. —

With North Carolina’s two legislative chambers at odds over details of a comprehensive plan for health care access, the House gave tentative approval on Wednesday to a linchpin of any agreement with the Senate by voting to expand Medicaid to more low-income adults. With robust bipartisan support, the chamber voted 96-23 to accept more Medicaid coverage available under the 2010 Affordable Care Act. It could cover potentially 600,000 people who usually make too much to qualify for conventional Medicaid but too little to benefit from subsidized private health insurance. The bill still faces one more House vote on Thursday before going to the Senate. (Robertson, 2/15)

Planned Parenthood is expanding suburban access to a treatment that can significantly reduce the risk of contracting HIV after a sexual encounter. (Laughlin, 2/15)

Shawn Blymiller spent 10 years of feeling mostly numbed while prescribed traditional anti-depressants, trudging through his day-to-day life as a suburban Salt Lake City father of two kids balancing the obligations of family and work selling technology software. When his son was diagnosed as having special needs a few years later, the stress became increasingly difficult to endure. So like many with treatment-resistant depression, Blymiller, 39, sought out alternatives and found one he said worked: Psychedelic mushrooms. (Metz, 2/15)

KHN: One State Looks To Get Kids In Crisis Out Of The ER — And Back Home 

It was around 2 a.m. when Carmen realized her 12-year-old daughter was in danger and needed help. Haley wasn’t in her room — or anywhere else in the house. Carmen tracked Haley’s phone to a main street in their central Massachusetts community. “She don’t know the danger that she was taking out there,” said Carmen, her voice choked with tears. “Walking in the middle of the night, anything can happen.” (Bebinger, 2/16)

On transgender health care —

Nationally, conservatives are pushing dozens of proposals in statehouses to restrict transgender athletes, gender-affirming care and drag shows. But in measures like Kansas’, LGBTQ-rights advocates see a new, sweeping effort to erase trans people’s legal existence, deny recognition to nonbinary or gender-fluid people and ignore those who are intersex — people born with genitalia, reproductive organs, chromosomes and/or hormone levels that don’t fit typical definitions for male or female. (Hanna, 2/15)

The author of House Bill 2177 is state Rep. Kevin West, R-Moore. He pushed back on Democrats' objections by arguing that his bill actually promotes gender-affirming health care because it affirms someone's gender assigned at birth. "You are born a male or born a female," West said. (Denwalt, 2/15)

Transgender teens, their parents and supporters protested outside the Mississippi Capitol on Wednesday, calling on legislators to kill a measure that would ban gender-affirming health care for people younger than 18. House Bill 1125 passed the Republican-led House 78-30 on Jan. 19, with all opposition coming from Democrats. It awaits consideration in the Senate, which is also controlled by Republicans. (Pettus, 2/15)

An Arkansas lawmaker shocked onlookers this week when he asked a transgender health care professional about her genitals at a hearing on a bill that would prohibit gender-affirming care for minors. Gwendolyn Herzig, a pharmacist who is a trans woman, was testifying Monday in support of the treatment for minors during a state Senate Judiciary Committee hearing. (Lavietes, 2/15)

Pharmaceuticals

New Technique Extends Heart Transplant Window

The new method "revolutionizes" heart transplants, CBS News says. It works by maintaining beats and blood flow in the donor heart during transport. Separately, a Boston Globe report says a local biotech startup has secured $10 million in funding to study techniques for regrowing lost limbs.

It was moments with his kids that made Jason Banner decide to take a chance on a new method of heart transplantation. The single father of two discovered in 2005 he had a genetic heart condition. Last year, he was hospitalized with an irregular heartbeat that causes poor blood flow. (Lapook, 2/15)

In other biotech and pharmaceutical news —

A Boston biotech startup working on technology to enable people to regrow limbs lost as a result of trauma or disease has raised about $9.7 million to advance its early efforts, including $8 million announced on Wednesday. (Saltzman, 2/15)

The End Drug Shortages Alliance (EDSA) is urging pharmaceutical manufacturers to boost manufacturing of Bacillus Calmette-Guerin (BCG), an essential drug for bladder cancer that has been in shortage since 2019. Because of the shortage, an estimated 8,333 US patients with moderate to advanced bladder cancer aren't receiving optimal care, EDSA said in a white paper based on a November 2022 survey of academic health centers, health systems, and physician practices. (Van Beusekom, 2/15)

For people managing high blood pressure, recent recalls of the carcinogen-tainted drug quinapril might sound familiar. Since 2018, more than 12 million bottles of blood pressure-lowering drugs such as valsartan and losartan have been removed from the market because they contained cancer-risk chemicals called nitrosamines. (Alltucker, 2/16)

UCLA received a $20-million gift to help establish a center dedicated to the study of microbes, which contribute to autoimmune diseases such as diabetes, rheumatoid arthritis and muscular dystrophy, the school announced Wednesday. (Martinez, 2/15)

Ongoing efforts to improve cancer therapy have turned Houston scientists’ attention to one possible solution: poop. More specifically, the complex assortment of viruses, bacteria and other bugs found in human waste. (Gill, 2/15)

“It’s night and day,” said Dr. Martin Tolar, who has been chief executive of Alzheon for 10 years. The Framingham-based company is in the advanced stages of testing a drug in people whose genes increase their risk of developing Alzheimer’s. “Even a couple years ago it was like the stupidest idea to do something in Alzheimer’s because everything has been failing.” (Cross, 2/15)

Menopause symptoms can range from disruptive to debilitating, yet health experts say many clinicians have historically shied away from hormone therapy as a treatment option. But mounting evidence shows how the benefits may outweigh the risks for most women suffering from menopause symptoms, according to a paper published Tuesday by the American College of Cardiology Cardiovascular in Women Committee. (Rodriguez, 2/15)

A new report from the National Antimicrobial Resistance Monitoring System (NARMS) highlights some concerning antimicrobial resistance (AMR) trends in Salmonella from food-producing animals. (Dall, 2/15)

Health Policy Research

Research Roundup: Antibiotics; Breast Cancer; Diabetes; Asthma

Each week, KHN compiles a selection of recently released health policy studies and briefs.

The spread of antibiotic resistance, where infectious bacteria are able to defeat the drugs intended to kill them, may not be primarily driven by antibiotic consumption, according to a new study. (eLife, 2/14)

Limited level 1 evidence is available on the omission of radiotherapy after breast-conserving surgery in older women with hormone receptor–positive early breast cancer receiving adjuvant endocrine therapy. (Kunkler, M.D., et al, 2/16)

A pair of new studies conclude that, compared with their never-infected peers, COVID-19 Omicron survivors may be at a 60% or greater risk of new-onset type 1 or 2 diabetes, a potential precursor of heart attack and stroke. (Van Beusekom, 2/14)

People with asthma in Hong Kong experienced worse control of their asthma after they had recovered from mild to moderate COVID-19, according to findings yesterday in Respiratory Research. For the case-control study, researchers with the University of Hong Kong enrolled 111 people with asthma who had experienced mild to moderate COVID-19 from 30 to 270 days before enrollment and 110 asthma patients who hadn't had COVID. (Wappes, 2/15)

Editorials And Opinions

Viewpoints: Synthetic rFC Urgently Needs Approval For Pharmaceutical Testing; US Is Failing Its Children

Editorial writers discuss these public health issues.

Anyone who gets a flu or Covid shot, childhood immunization, heart stent or hip replacement — and that’s almost everyone — is protected from exposure to potentially lethal contaminants known as endotoxins by a test that uses what might seem like an odd ingredient: the blue blood of the horseshoe crab. (Deborah Cramer, 2/16)

This week, the Centers for Disease Control and Prevention released data from the first Youth Risk Behavior Survey collected across the United States since the start of the coronavirus pandemic. It is devastating. (Kate Woodsome, 2/15)

Exposure to gun violence at any point during childhood is an adverse childhood experience, and extensive research on exposure to these experiences shows links to dozens of negative outcomes in a person’s life. (Sonali Rajan, Charles Branas and Mark S. Kaplan, 2/16)

The ability to listen to others in an emotionally validating way is largely an innate talent, not something that’s easily learned. So one way to expand the pool of potential mental health providers is to recruit people based on their talent for empathetic engagement rather than formal degrees and certifications. (Mini Kahlon, 2/15)

A physician's instincts that something wasn't right gave the Henrikson family of St. Paul an early heads-up that Vivian, their newborn, was born infected with a serious and surprisingly widespread pathogen known as cytomegalovirus (CMV). (2/15)

The fact is, no one—including doctors (especially doctors, dear God, these doctors)—knows the right things to say to those of us who have long COVID, because no one seems to be thinking about this wretched condition in the right way. (Jennifer Senior, 2/15)

Matt Fitzgerald used to bike up and down 3,500 feet through the Santa Ana Mountains on three-hour rides just for fun. Now, nine months after being infected with SARS-CoV-2, the virus that causes Covid-19, he can’t muster walking on flat surfaces for 20 minutes without days of exhaustion. (E. Wesley Ely, 2/16)

It’s anti-transgender week in the Kansas Legislature. Lawmakers are holding hearings on three bills aimed at ostracizing the state’s transgender residents. (2/15)

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