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Monkeypox can spread before symptoms appear, British researchers said on Wednesday, providing the first evidence indicating the virus can be transmitted this way. It was previously thought that monkeypox was almost entirely spread by people who were already sick, although pre-symptomatic transmission had not been ruled out and some routine screening had picked up cases without symptoms. (Rigby, 11/3)

Researchers looked at the time it took from when first symptoms occurred in the first patient to when symptoms developed in a second patient, and also looked at the incubation period - the time from exposure to the virus to the onset of symptoms. The findings showed four days was the maximum time that transmission was detected before symptoms appeared. (Osborne, 11/2)

The study examined more than 2,700 people with monkeypox in the U.K. from May 6 to Aug. 1. The researchers were able to link 13 of those cases to the people they infected. Ten pairs showed evidence of pre-symptomatic transmission, meaning the first patient spread the virus to the second before the first felt sick or had developed lesions. (Bendix, 11/2)

The Department of Health and Human Services (HHS) on Wednesday renewed the national public health emergency for the monkeypox outbreak, with officials stating that the virus is still very present in the U.S. even as cases continue to drop. HHS Secretary Xavier Becerra cited the “continued consequences of an outbreak of monkeypox cases across multiple states” as well as a “consultation with public health officials” for his decision to renew the public health emergency. (Choi, 11/2)

A new study published in eClinicalMedicine analyzed 19 studies on monkeypox, which included 7,553 reported cases, among which there were 555 hospitalizations. The meta-analysis suggests monkeypox patients have a 14.1% hospitalization rate. (11/2)

As respiratory illnesses spread rapidly among children across the country, an increased demand for amoxicillin is causing a shortage of the commonly prescribed antibiotic. Parents filling their kids’ prescriptions may have to try a few pharmacies or end up with a different strength or form than originally prescribed, but amoxicillin in some form is generally still available, pharmacists said. The supply of the liquid version is most strained, along with some chewable tablets. (McDaniel, 11/2)

One of the most commonly used antibiotics in the country, amoxicillin, is in short supply, federal health officials say. The notice from the Food and Drug Administration about an oral solution of the drug comes as pharmacy owners report diminished inventory of the medication, which is prescribed to treat bacterial infections, including pneumonia and bronchitis. (Stelloh and Chow, 11/3)

A 6-year-old Macomb County boy has died from respiratory syncytial virus, better known as RSV, Oakland County's chief medical examiner said Wednesday, amid a surge of infections among Michigan children that has pediatric hospitals across the state at or near capacity. (Jordan Shamus, 11/2)

The number of positive flu tests and hospitalizations in the United States is the highest in more than a decade, indicating this influenza season may be the most severe in years. (Kekatos, 11/3)

The federal government is officially reducing Medicare payments to physicians next year by 4.5%, but doctors and their lobbyists are ready to blitz Congress over the next two months to convince lawmakers that those cuts should be averted — again. (Herman, 11/2)

Medicare will increase payments for discounted drugs provided to safety-net hospitals next year under a policy the Biden administration finalized Tuesday that will affect how the program reimburses other facilities. (Goldman, 11/2)

Some House Republicans aren't waiting for the election to think about overhauling Medicare. But it's hard to tell if there are specifics behind the talking point. (Sullivan and Knight, 11/3)

Hospitals that decide to convert to a new type of rural provider won’t have to report quality metrics next year, but they also won’t qualify for a popular drug discount program — a likely dealbreaker for some. (Bannow, 11/2)

The Biden administration needs to crack down on deceptive Medicare Advantage marketing, Democratic staff for the Senate Finance Committee wrote in a report released Thursday. (Goldman, 11/3)

Companies selling private Medicare plans to older adults have posed as the Internal Revenue Service and other government agencies, misled customers about the size of their networks and preyed on vulnerable people with dementia and cognitive impairment, according to a new investigation of deceptive marketing practices in the industry released Thursday by the Senate Finance Committee. Many individuals say they were enrolled in plans without realizing it. (Abelson and Sanger-Katz, 11/3)

The number of abortions performed monthly in Texas declined from a few thousand to less than 10 after the state implemented a near-total ban on the procedure this summer, new data shows. Texas, already operating under significant abortion restrictions, accounted for more than half of the national decline in abortions after the U.S. Supreme Court overturned Roe v. Wade. (Klibanoff, 11/2)

Protesters opposed to the Supreme Court’s decision overturning abortion rights briefly interrupted arguments at the court Wednesday and urged women to vote in next week’s elections. It was the first courtroom disruption since the court’s decision in June that stripped away women’s constitutional protections for abortion after nearly a half-century under Roe v. Wade. (11/2)

The law, introduced by City Atty. Mike Feuer, allows the city to fine a pregnancy center up to $10,000 if it is caught falsely advertising the services it provides, such as prenatal care, abortions or emergency contraceptives. Individuals who are misled by these centers can sue and seek damages under the new law, which takes effect immediately via an urgency clause. (Valdez, 11/2)

A mobile healthcare unit hopes to open in Casper by the end of the year. The unit will be operated by Wellspring Health Access -- the same organization that was planning to open a healthcare facility that would provide abortion services. But someone set the clinic on fire back in May before it could open. (Kudelska, 11/2)

Just after news leaked in May that the Supreme Court planned to overturn Roe v. Wade, Liz Lebrón and her colleagues noticed something unusual: a spike in false and misleading information on abortion being shared in Spanish on social media. (Godoy, 11/3)

Voters in California, Kentucky, Michigan, Montana and Vermont are weighing in on abortion ballot measures — a total that, when combined with this summer’s vote in Kansas, sets a record for the most abortion initiatives in a single election year. (Luthra, 11/2)

A single dose of a synthetic version of the mind-altering component of magic mushrooms, psilocybin, improved depression in people with a treatment-resistant form of the disease, a new study found. The randomized, double-blind clinical trial, which authors called “the largest of its kind,” compared results of a 25-milligram dose to a 10-milligram and 1-milligram dose of a synthetic psilocybin, COMP360, that was administered in the presence of trained therapists. (LaMotte, 11/2)

Researchers tested the chemical in 233 adults in the U.S., Europe and Canada. Each swallowed capsules containing one of three doses of psilocybin during a 6-to 8-hour session. Two mental health specialists guided them through hallucinatory experiences. (Tanner, 11/2)

Once administered, patients entered a sort of "waking dream-like" state that lasted between four to six hours. People came in the morning, had their psychedelic experience and left that afternoon or evening at their baseline state, said James Rucker, consultant psychiatrist and senior clinical lecturer at King’s College London, who was involved in the study. (Grover, 11/2)

The hype around psychedelic therapy has been put to the test, with the publication Wednesday of the largest-ever study of psilocybin to treat depression. The Phase 2 trial found that the drug was effective — it reduced or eliminated symptoms in the short term in more than one-third of patients who took the highest dose — but not as dazzlingly powerful as earlier smaller studies had suggested. (Goldhill, 11/2)

Since the late ’90s, Kathy Wallace has been battling major depression with a series of drugs — first Prozac, then three others, and back again to Prozac. But in the last six months, nothing seemed to be helping. So her psychiatrist recommended something new: Spravato, a nasal spray approved in 2019 that delivers a drug similar to the hallucinogen ketamine. (Palmer, 11/3)

A blockbuster weight-loss medicine led to dramatic effects for adolescents diagnosed with obesity, a result that will likely widen the use of an in-demand drug — and fan a debate over whether someone’s body weight should be treated as a disease. (Garde, 11/2)

Results of a clinical trial released in the New England Journal of Medicine on Wednesday found that adolescents who got a weekly injection of a drug that reduces appetite lost an average of 14.7% of their starting bodyweight, while those who got a placebo and counseling on diet and exercise gained 2.7% of their initial weight. The trial included 201 young people ages 12 to 17 at three medical centers around the country and in Europe and Mexico. (Carroll, 11/2)

The first highly effective weight-loss drug has been in short supply since it was approved last year. But Novo Nordisk told investors Wednesday that its drug Wegovy—whose users average a loss of 16% of their weight—will be broadly available toward the end of the year. (Alpert, 11/3)

Health and dieting trends on TikTok glorify weight loss and may contribute to disordered eating behaviors and body dissatisfaction, particularly in adolescent and young users, according to a University of Vermont study published Tuesday in the journal PLOS One. (11/2)

Providers of methadone for addiction treatment have a message for advocates seeking a giant expansion in access: Be careful what you wish for. (Facher, 11/3)

CVS Health Corp. and Walgreens Boots Alliance Inc. have agreed to pay more than $10 billion in a landmark settlement to resolve opioid-crisis lawsuits brought by states, cities and other governments. The two largest U.S. drugstore chains said they reached a framework to settle the collection of lawsuits brought by governments and Native American tribes blaming pharmacies for helping fuel the nation’s opioid epidemic. (Terlep, 11/2)

Texas has joined a multibillion-dollar, multistate opioid settlement with CVS Pharmacy — the latest development in numerous lawsuits regarding the roles of manufacturers, distributors and consultants in the opioid crisis. (Nguyen, 11/2)

Cincinnati Children's Hospital announced a new clinic dedicated to treating opioid addiction on Wednesday. The program provides office-based outpatient medication treatment for young people between the ages of 16 to 21. The new addition will be one of the only outpatient clinics offering medication treatment to people under 18 years old in the region. (Cockrell, 11/2)

For much of his 30-plus-year career, Dr. Russell Suda, an OB/GYN and Cabarrus Health Alliance’s medical director since 2004, didn’t care to treat patients with substance use disorder. Suda said treatment required too much of one individual and one specialty. But as more pregnant women presented with substance use disorder in his community, he realized he needed to step up and care for them. (Crumpler, 11/3)

In his new autobiography, Matthew Perry reveals that his colon burst as a result of his addiction to opioid painkillers. The 53-year-old actor, who played Chandler Bing in Friends, was in a coma for two weeks following the incident and had to wear a colostomy bag for nine months. ... Opioids reduce gut activity, which is why they are sometimes used to treat diarrhea. And people who take them often suffer from constipation. Over time, the body develops tolerance to many of the effects of opioids, but constipation tends not to improve – in fact, it can become more severe. (Poole, 11/3)

Nov. 1 marked the first day of the Affordable Care Act (ACA) open enrollment and the beginning of the largest nonunion strike since the beginning of 2021. (Fierce Healthcare Editor's Note: This story has been updated with a statement from Maximus and new information about the number of workers who went on strike.) (Burky, 11/2)

KHN: Haven’t Seen Your Doctor In A Few Years? You May Need To Find A New One

When Claudia Siegel got a stomach bug earlier this year, she reached out to her primary care doctor to prescribe something to relieve her diarrhea. The Philadelphia resident was surprised when she received an online message informing her that because she hadn’t visited her doctor in more than three years, she was no longer a patient. And since he wasn’t accepting new patients, she would have to find a new primary care physician. (Andrews, 11/3)

For startups and investors aiming to bring health technology to underserved populations, evidence of impact should be everything: It’s what shows employers and payers a new offering is worth paying for, and what can help convince patients to give it a try. (Ravindranath, 11/3)

The annual price of a newly-launched cancer drug in the United States averaged $283,000 last year, a 53% increase from 2017, according to a new report from U.S. Democratic Representative Katie Porter, a consumer bankruptcy law professor running for re-election in California. (Beasley, 11/2)

Seven drugmakers pledged to work together to reduce carbon emissions in supply chains, health-care delivery and clinical trials, saying a joint effort will enable the industry to achieve more than individual companies could alone. (Kresge, 11/3)

Swiss drugs regulator Swissmedic said on Wednesday it is examining potential risks in connection with bubbles that appeared in vials of COVID-19 vaccine boosters retooled to target the Omicron variant of the coronavirus. (11/2)

Air bubbles in a syringe are typically problematic due to their impact on accuracy of vaccine dose (i.e., large air bubbles reduce the volume of vaccine in syringe, thus creating risk for underdosing). While small air bubbles can be ignored, large air bubbles can lead to underdosing and should be addressed. (February 2021)

Americans who received an mRNA COVID-19 vaccine after SARS-CoV-2 infection are more likely to experience severe systemic adverse events (AEs) than their never-infected counterparts, according to a study published yesterday in Vaccine. (11/2)

This summer, when the shocking news emerged that there was a case of polio in New York, the US Centers for Disease Control and Prevention immediately turned to Shoshana Bernstein. The agency urgently needed to increase polio vaccination rates in Rockland County, New York. And while Bernstein is neither a doctor nor a public health official, she is exactly what the CDC was looking for: a local vaccine educator who’s part of the Orthodox Jewish community, one of several groups that has a low vaccination rate. (Cohen and Lape, 11/2)

US teens who could correctly answer survey questions about COVID-19 reported lower stress, anxiety, and depression as well as less loneliness and fear of missing out, according to a study today in Journal of Child and Family Studies. (11/2)

There is no question these variants are increasing at a rapid rate. BQ.1.1, for example, currently accounts for 7,000 cases per day and appears to be doubling every nine days, says Trevor Bedford, a virologist at the Fred Hutchinson Cancer Center who models COVID evolution. It is outpacing BA.5—the current leading variant in the U.S. That’s because every person sick with BQ.1.1 is infecting an average of 1.4 other people, while those sick with BA.5 are averaging an infection of less than one other person. (11/1)

Wastewater data shows that COVID-19 transmission levels are higher than official case counts indicate in Santa Clara County, health officials told the board of supervisors Tuesday. “It looks to the casual observer that we’re in pretty good shape because we’re between waves and it’s gone lower,” said Dr. Sara Cody, the county health officer, but added that data from the sewer sheds covering 75% of the population showed substantially higher virus levels in circulation. (Vaziri, Buchmann and Asimov, 11/2)

The state-run veterans home at Union Grove was cited for six violations in its latest yearly inspection − including several repeats of recurring issues − adding to a laundry list of violations leveled against the facility in the last five years. (Volpenhein, 11/2)

Columbus officials shared statistics Tuesday on what they say has been success so far with programs that reduce the number of instances when armed police officers respond to 911 calls by directing people in a mental- or substance abuse-crisis to resources. (Behrens, 11/2)

For the past five years, Orange County has ranked as one of the states highest case totals for new HIV infections. But last year, the Florida Department of Health saw a slight slowdown in transmission rate around the county, reporting a 5% decrease in the relative change of diagnoses made. The stat change is welcome news to the state, which has an aggressive goal to reduce HIV cases by 75% by 2025 and 90% by 2030 via diagnosis treatment, and education plans, said Kara Williams, a Central Florida HIV program manager for the health department. (Pedersen, 11/2)

As officials tested coastal waters, concerned that bacteria levels had exceeded state standards, the county Department of Public Health advised people to avoid swimming or any contact with the water, due to the risk of illness. (Valdez, 11/2)

KHN: California’s Proposed Flavored Tobacco Ban Gives Hookah A Pass 

In 2019, local business owners began gathering regularly at Arnie Abramyan’s hookah lounge on the outskirts of Los Angeles to fight a proposed statewide prohibition on the sale of flavored tobacco. From the heavily Armenian neighborhood of Tujunga in the foothills of the San Gabriel Mountains, Abramyan and other hookah shop and cafe owners began spreading the word that the ban, prompted by a burgeoning epidemic of e-cigarette use among teens, could put them out of business and extinguish a beloved social ritual that many feel is part of their heritage. (Scheier, 11/3)

KHN: Colorado Voters To Decide Whether All Schoolkids Get A Free Lunch 

During most of the pandemic, in every public school cafeteria throughout the country, every kid could get a free lunch, not just those from the poorest homes. Everyone. The program that fed 50.6 million U.S. students expired in September, but some states are figuring out ways to extend it. California and Maine have both passed legislation to fund universal free lunch. In Colorado, a coalition of parents, teachers, and anti-hunger advocates are pushing to make permanent universal free school lunches, and lawmakers in the Democratic-controlled legislature put it on the ballot. (Daley and Winfrey, 11/3)

In this well powered approach, we did not find convincing evidence for a genetic overlap between Alzheimer's disease and type 2 diabetes. (John Hardy, Bart de Strooper and Valentina Escott-Price, 11/1)

COVID-era emergency department patients who had follow-up appointments via telehealth more often returned to the ED or were hospitalized than those who followed up with doctors in person, according to a new retrospective study. Published in JAMA Network Open, the investigation measured 30-day return visits or hospital admissions following nearly 13,000 patients’ ED visits at an integrated academic health system in Los Angeles. (Muoio, 10/27)

Physicists have identified a natural delivery system which can safely carry potent antibiotics throughout the body to selectively attack and kill bacteria by using red blood cells as a vehicle. (McMaster University, 10/31)

Giving Duroc boars taxifolin, an antioxidant and anti-tumor drug, has been found to increase their sperm quality. (Thomson, 10/27)

The Covid pandemic still isn’t over, but it has gone remarkably flat. (David Wallace Wells, 11/2)

When the first round of Covid shots became available, income disparities in vaccination rates quickly reared their heads. (Bryce Covert, 11/2)

Three respiratory viruses — covid, flu and respiratory syncytial virus (RSV) — are all expected to surge this fall and winter, once again straining hospitals. (Leana S. Wen, 11/2)

Life expectancy is down across the United States for the second year in a row — from an average of 77 years in 2020 to 76.1 years in 2021 — with much of the drop attributed to the COVID-19 pandemic. (11/3)

The Inflation Reduction Act, recently signed into law by President Biden, will allow Medicare to negotiate drug prices for the first time. (Isabel R. Ostrer, MD and Cary P. Gross, M, 10/31)

Voting is essential to engaging with democracy and our health. Tuesday’s midterms will determine the future of our health policy. (Zoe Siegel, 11/1)

In early 2020, I wrote about the struggles of the “sandwich generation,” demographers’ label for those who are caring for children and aging relatives at the same time. (Jessica Grose, 11/2)

The first major Ebola outbreak in Uganda happened when I was a medical student at Makerere University in Kampala. A professor of virology explained to us the dangers of filoviruses, the virus family Ebola belongs to, and why they should be avoided at all costs. (Henry Kyobe Bosa, 11/3)