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In the hours after the COVID-19 vaccine was formally approved for use in younger children Tuesday, social media pages lit up with eager parents seeking appointments for their grade-schoolers. So on Wednesday morning, it didn’t take long for some parents in the Boise region to figure out that a couple of health care providers were already accepting appointments. “My kids are scheduled for Walgreens on Saturday,” one parent wrote on a Facebook page for local parents of school children. (Boone, 11/3)

Nine-year-old Parson Harrington had to isolate more than most during this pandemic -- and the lung transplant recipient hopes the Covid-19 vaccine she received in Houston on Wednesday is her ticket to relief and freedom. Parson is one of numerous children ages 5-11 who lined up for a dose around the country on the first full day that kids in this age group were eligible in the US after the CDC gave its endorsement Tuesday. (Hanna, 11/4)

At a Decatur, Georgia, pediatrician’s office, 10-year-old Mackenzie Olson took off her black leather jacket and rolled up her sleeve as her mother looked on. “I see my friends but not the way I want to. I want to hug them, play games with them that we don’t normally get to,” and have a pillow fight with her best friend, Mackenzie said after getting her shot at the Children’s Medical Group site. With the federal government promising enough vaccine to protect the nation’s 28 million kids in this age group, pediatricians’ offices and hospitals began inoculating children. Schools, pharmacies and other locations plan to follow suit in the days ahead. (Tanner, 11/3)

Young children began receiving COVID-19 vaccines Wednesday in what was a moment of joy not only for their parents but the kids themselves. The Western States Scientific Safety Review Workgroup, a group of immunization and public health scientists from California, Nevada, Oregon, and Washington, concluded that the Pfizer-BioNTech vaccine is safe and effective for children aged 5 to 11 on Wednesday. The workgroup's decision reinforces the FDA's authorization of the vaccine for 5- to 11-year-olds, and officially allowed California to start vaccinating young children. “This expanded eligibility for lifesaving vaccines moves us closer to ending the pandemic, which has taken a heavy toll on the well-being of our kids," California Gov. Gavin Newsom said in a statement. (Schnell, 11/4)

Hoping to encourage a strong rollout for COVID-19 vaccinations for 5- to 11-year-olds, Wednesday’s West Virginia COVID-19 briefing telecast featured Dr. Jessica McColley, of Cabin Creek Health Center, giving a shot to her 7-year-old son. The federal Centers for Disease Control and Prevention on Tuesday gave authorization for pediatric doses of the Pfizer vaccine, and James Hoyer, state interagency task force director, said Monday the government had secured 50,000 doses for distribution as soon as the CDC approval was finalized. (Kabler, 11/3)

Children’s Hospital of Philadelphia announced Wednesday that it will open 10 vaccine clinics in Pennsylvania and New Jersey, a day after the government gave final clearance to Pfizer’s two-dose COVID-19 vaccine for children ages 5 to 11. The CDC estimates there are 28 million children in the United States in that age group, and Philadelphia health officials say there’s no time to lose in this critical step toward a return to normalcy. Yet smaller patients require a different approach that has an already-strained health care workforce scrambling. Young children will receive a smaller dose with smaller needles and, in many cases, will have appointments at clinics and offices dedicated to pediatric care — separate from the clinics many health systems are already running for adults and children age 12 and older. (Gantz, 11/3)

The country's largest pharmacies, Walgreens and CVS, are already accepting online appointments for children 5 to 11 to get the COVID-19 vaccine following the CDC's sign-off Tuesday night of the Pfizer-BioNTech vaccine for the age group. Walgreens will begin administering the pediatric doses at thousands of stores nationwide starting Saturday. The first vaccine shipments are scheduled to arrive at some Walgreens locations this week, the company said Wednesday. CVS will begin administering the vaccine this weekend, spokesperson Joe Goode told USA TODAY. (Ortiz, Miller and Fernando, 11/3)

Families are getting an early gift this holiday season: the chance to protect their children between the ages of 5 and 11 against Covid-19 through vaccination. For many, the winter holidays mean gathering with family and friends from near and far to share meals and quality time, situations that can quickly lead to the spread of Covid-19 -- especially for those who are unvaccinated. (Holcombe, 11/3)

President Biden on Wednesday urged millions of parents to get their young children vaccinated against the coronavirus, touting the government’s authorization of inoculations for children between 5 and 11 as a major milestone in the nation’s effort to end the pandemic. Mr. Biden’s comments came a day after the Centers for Disease Control and Prevention endorsed the Pfizer-BioNTech coronavirus vaccine for children. The decision was in sync with the Food and Drug Administration, which on Friday authorized emergency use of pediatric doses for the roughly 29 million children in that age group. (Kanno-Youngs and Weiland, 11/4)

Maine Center for Disease Control and Prevention Director Nirav Shah made an impassioned plea to parents on Wednesday that they get their young children vaccinated, saying it would provide a return to normalcy and protect their children from a devastating virus. His message, which was directed at the parents of 5- to 11-year-olds, comes one day after the U.S. Centers for Disease Control and Prevention signed off on giving the vaccine to that age group. Preparations are already being made to begin giving the shots at pharmacies, schools, clinics and doctors’ offices, with appointments becoming available in the coming days. (Marino Jr., 11/4)

Dr. Jerome Adams, who served as U.S. surgeon general under former President Trump, said Wednesday that he will be getting his 11-year-old daughter vaccinated against COVID-19 as the benefits clearly outweigh the risks. "It's really just about doing everything we can to protect our children and give them the best possible chance of growing up healthy and strong," Adams told Fox News. Health officials gave final approval to Pfizer's COVID-19 shot for children ages 5 to 11 on Tuesday, opening up 28 million more Americans to the vaccine. (Best, 11/3)

It's true that most children infected with the virus have only mild symptoms and that children rarely die from the disease. But scientists and health officials recommending the shot emphasize that vaccination could prevent many infections, as well as disruptions to schooling, hospitalizations and rare but severe complications of the disease. (Simmons-Duffin, 11/3)

"If they're going to turn 12 soon, best to just go ahead and get started with that lower dose now and if they turn 12 in between the doses they'll have an option to either stick with the lower dose or go on to the higher dose. The good thing is the kids had fantastic immune responses with that lower dose. So parents don't need to worry that the lower dose won't be effective enough," said Kaiser Permanente pediatrician Dr. Nicole Makram. (Gonzales, 11/3)

The Centers for Disease Control and Prevention has approved the use of COVID vaccines in children ages 5 to 11. But a Kaiser Family Foundation survey found only 27% of parents plan to opt for the shot. One third plan to wait. Another 30% say they won't vaccinate their kids. William Brangham reports with Dr. Yvonne Maldonado, chair of the American Academy of Pediatrics' infectious diseases committee. (11/2)

Dr. Lloyd Fisher, a Worcester pediatrician and president of the Massachusetts chapter of the American Academy of Pediatrics, said about 30 percent of the parents calling his office are already seeking the kids’ shots, and another 30 percent are “extremely resistant.” The rest, about 40 percent, aren’t sure. “Those are the ones we focus on,” Fisher said. ”They probably want to give their child the shot, but they want to be reassured they are doing the right thing.” Historically, Massachusetts has one of the highest rates in the country for established childhood vaccines, from polio to pertussis. And CDC data show it also has one of the highest rates for COVID vaccinations among people 12 and older, trailing only Vermont and Connecticut. (Lazar, 11/3)

The United States had the second-steepest decline in life expectancy among high-income countries last year during the pandemic, according to a study of death data spanning several continents. The only country studied that saw a starker overall trend was Russia. The study, published Wednesday in The BMJ (formerly the British Medical Journal), assessed premature death in 37 countries, comparing observed life expectancy in 2020 with what would have been expected for the year based on historical trends from 2005-2019. Life expectancy dropped in 31 of these countries during the pandemic.  (Bush, 11/3)

More than 28 million extra years of human life were lost in 2020, a year marked by the global spread of the coronavirus, according to a study released Wednesday that further underscored the immense human toll that the pandemic has wrought. The international study, published in the BMJ journal, examined changes to life expectancy in 37 upper-middle to high-income countries where researchers said reliable data was available. The study, led by an Oxford University public health researcher, also considered years of life lost, a metric that measures the degree of premature mortality among the dead, by comparing the ages of the deceased to their life expectancies. (Jeong, 11/4)

Uncle Tyrone went first. On his way to the hospital in South Florida, he implored his niece Lisa Wilson: “I want the vaccine.”“You can’t get it now,” Wilson told Tuyrono “Tyrone” Moreland, who was 48. He never made it home, dying Aug. 22. Wilson’s grandmother, Lillie Mae Dukes Moreland, who raised Lisa and nine of her own children, was next. She’d decided against the vaccine. It was too new, she thought. Plus, some members of the family had counseled her against getting the shot. At 89, they said, she was too old. In late August, she came down with covid-19, was taken to the hospital the day after Tyrone’s funeral and died less than 24 hours later. The next day, Aug. 31, one of Wilson’s cousins died of covid complications. A few days later, another cousin, and then a third. And on Sept. 14, yet a fourth of Lisa’s cousins succumbed. (Fisher, Rozsa and Ruble, 11/3)

COVID-19 cases rising again in Iowa as the state's death toll from the disease surpassed 7,000, according to new data the Iowa Department of Public Health released Wednesday. The state reported 104 additional COVID-19 deaths on Wednesday, of which some occurred as far back as August. That brings Iowa's total number of COVID-19 deaths to 7,069. Put another way, since March 2020, COVID-19 has killed one out of every 451 Iowans. (Webber, 11/3)

The number of hospitalized COVID-19 patients in Wyoming has fallen steadily over the last two weeks, but officials say the virus is still very present in the state, and remains a threat. At the same time, virus deaths continue to surge, with the state reporting 69 on Tuesday — the highest single-day announcement this year. A Wyoming Department of Health spokesperson declined to predict what the hospitalization numbers may look like going forward, but said the state “remains vulnerable” to the virus with the more aggressive delta variant still spreading and the state’s low vaccination rate. (Hughes, 11/3)

KHN: Patients Went Into The Hospital For Care. After Testing Positive There For Covid, Some Never Came Out

They went into hospitals with heart attacks, kidney failure or in a psychiatric crisis. They left with covid-19 — if they left at all. More than 10,000 patients were diagnosed with covid in a U.S. hospital last year after they were admitted for something else, according to federal and state records analyzed exclusively for KHN. The number is certainly an undercount, since it includes mostly patients 65 and older, plus California and Florida patients of all ages. Yet in the scheme of things that can go wrong in a hospital, it is catastrophic: About 21% of the patients who contracted covid in the hospital from April to September last year died, the data shows. In contrast, nearly 8% of other Medicare patients died in the hospital at the time. (Jewett, 11/4)

Los Angeles Mayor Eric Garcetti tested positive for COVID-19 Wednesday while attending the U.N. climate conference in Glasgow, Scotland, an event that has drawn world leaders and tens of thousands of other people from around the world. His office announced a positive test result in a tweet, adding only: “He is feeling good and isolating in his hotel room. He is fully vaccinated.” (Knickmeyer and Borenstein, 11/3)

Green Bay Packers quarterback Aaron Rodgers, the reigning NFL MVP, has tested positive for the coronavirus, according to multiple media reports. Packers head coach Matt LaFleur told reporters Wednesday that a different quarterback, Jordan Love, would start next weekend against the Kansas City Chiefs and that Rodgers was "in the COVID-19 protocols." LaFleur would not explicitly confirm whether Rodgers tested positive and also would not comment on whether Rodgers is vaccinated. NPR reached out to the team for comment and was directed to LaFleur's media appearance earlier in the day. According to ESPN, "The NFL has considered Rodgers as unvaccinated since the start of the season." NFL.com also reports that the Packers quarterback has not been vaccinated against COVID-19. (Kennedy, 11/3)

COVID-19 didn't appear to spread efficiently within and among teams competing in the fall 2020 Southeastern Conference (SEC) college football season, finds an observational study published late last week in JAMA Network Open. The study, led by a Texas A&M University researcher, analyzed close contacts (within 6 feet) among opposing players during official games and COVID-19 athlete testing data from Sep 26 to Dec 19, 2020. (Van Beusekom, 11/3)

Early research suggests that SARS-CoV-2 can enter the brain easily through a person's nose, infiltrating brain cells where it lurks unchecked, possibly leading to lasting neurological symptoms, such as trouble with thinking and memory. Two new studies — from the California National Primate Research Center and the Rotman Research Institute in Toronto — suggest that the virus directly infects neurons in the brain, potentially offering clues as to why some people suffer from a range of symptoms long after their initial Covid infection. (Edwards, 11/4)

An inner ear infection may be a significant cause of COVID-19-associated problems with hearing and balance, according to researchers. In a new study published last month in the journal Nature Communications Medicine, the U.S.-based study authors wrote that they examined human inner ear tissue, human inner ear in vitro cellular models and mouse inner ear tissue to reach their conclusions. Observing 10 COVID-19 patients with ear-related symptoms like hearing loss, vestibular dysfunction and tinnitus, the researchers said they had found a pattern of inner ear infection consistent with symptoms after developing some of the first human cellular models of infectious inner ear disease. (Musto, 11/3)

The coronavirus appears to have infected many of Iowa’s deer, posing risks the virus could mutate in the animals and then re-enter the human population in an altered version, a new study says. “Our results suggest that deer have the potential to emerge as a major reservoir host” for the coronavirus, the study says. The paper, which has not yet been published in a peer-reviewed journal, has been posted online. The findings were verified on Tuesday by federal scientists at the National Veterinary Services Laboratories, according to a spokesperson who spoke to the New York Times. (May Sahouri, Leys and Eller, 11/3)

The Louisiana State University veterinary school’s diagnostic lab is providing free COVID-19 testing for dogs and cats in Louisiana through the end of the year, the school said Wednesday. The U.S. Centers for Disease Control and Prevention is paying for the tests, and the Louisiana Office of Public Health is also a partner in the program, a news release said. (11/3)

Troops who refuse the coronavirus vaccine won’t see any extra protections or leniency in how their dismissals are handled, Defense and Veterans Affairs officials confirmed Wednesday. Instead, decisions on whether to give those individuals other-than-honorable discharges — potentially blocking them from a host of veterans benefits — will be left to local commanders, and their cases won’t receive any preferential evaluations for veterans’ benefits eligibility, despite recent lobbying from Republicans lawmakers for a less punishing approach. (Shane III, 11/3)

At least 7,599 airmen and members of the Space Force haven’t received a Covid-19 vaccine, either refusing to do so or seeking exemptions from military requirements, the Air Force said Wednesday, in a first set of challenges to a departmentwide mandate that troops be vaccinated to serve. Of that number, the Air Force has approved medical or administrative exemptions for 1,866 Air Force and Space Force members, meaning they don’t have to receive a vaccine, the Air Force said. (Youssef, 11/3)

Nearly all active-duty members of the Air Force and Space Force complied with the mandate to be fully vaccinated against the coronavirus by Nov. 2, but almost 8,500 troops did not — and are now in danger of being kicked out of the military. Another 1,800 or so secured exemptions from the requirement, a spokesperson said Wednesday. In total, 10,352 active-duty airmen and guardians remain unprotected. (Cohen, 11/3)

Oklahoma’s governor has asked the U.S. Secretary of Defense to suspend COVID-19 vaccine mandates for Oklahoma National Guard troops after 10% of the state’s personnel said they either have not or do not plan to get vaccinated. In his letter to Lloyd Austin, Gov. Kevin Stitt wrote that about 800 Oklahoma National Guard personnel haven’t or won’t get vaccinated despite a Department of Defense requirement that all military troops be vaccinated or face dismissal. (Stecklein, 11/3)

Eric Adams, who was just elected as mayor of New York, is jumping right into the hot-button topic of coronavirus vaccine mandates — saying he plans to review the requirements now in place for municipal workers, which have been unpopular among some unions representing the city’s firefighters and police officials. Adams, a Democrat and a former police captain, said, “The mask mandates we should keep in place … We need to revisit how we are going to address the vaccine mandates.” (Jeong and Suliman, 11/4)

For weeks, Los Angeles County Sheriff Alex Villanueva has blasted the county’s vaccine mandate for employees, saying he won’t force his deputies to get inoculated. It’s a decidedly different stance from the one taken by Michel Moore, chief of the Los Angeles Police Department, who has agreed to enforce the vaccination rules city officials put in place. And it shows in their vaccination figures. About 53% of 16,070 Sheriff’s Department employees, both sworn and civilian, have had at least one dose of a vaccine, compared with 74% of 12,143 LAPD employees, according to figures released by each agency. (Tchekmedyian, Rector and Winton, 11/3)

Polk County Administrator John Norris acknowledges erupting this week at Sheriff Kevin Schneider over the sheriff’s refusal to begin testing unvaccinated employees in his office for COVID-19. The county's top public safety official has resisted, Norris said, even though other county department heads have been doing so for more than a month, as required under a policy the county supervisors approved Sept. 14. Norris said he confronted Schneider over the issue after a supervisors' meeting Tuesday. He said he told the sheriff it could become a budget issue if he isn't willing to enforce a public safety policy aimed at protecting county employees, jail inmates and the public at large. (Rood, 11/3)

Six teachers who refused to wear masks have been fired from Oklahoma City Public Schools. The district Board of Education voted to terminate their employment after hearing testimony and asking questions during a hearing Wednesday evening. The board voted unanimously after hearing hours of testimony. The six board members present deliberated for almost two hours in executive session. (Martinez-Keel, 11/3)

Ford Motor Co. became the first of the Detroit Three automakers to comply with a federal order on COVID-19 vaccines, announcing that it will require salaried workers get the shots by early December. The company notified employees Tuesday that most of the 32,000 white-collar employees in the U.S. will be affected. (Wall Howard, 11/3)

San Francisco will soon require children as young as 5 to show proof of Covid-19 vaccination to enter certain indoor public spaces like restaurants, entertainment venues and sporting events, public health officials said this week. The local mandate already requires children and adults over the age of 12 to show proof that they are vaccinated before entering those places. Now, city health officials are planning to extend the health order to children ages 5 to 11, the group newly eligible for the shot. (Colliver, 11/3)

A new sense of political urgency swept over restive Democrats from the White House to Capitol Hill on Wednesday, as they raced to resolve the final issues stalling President Biden’s roughly $3 trillion economic agenda in the aftermath of a stinging election defeat in Virginia. With a loss in the state’s gubernatorial race — along with a slim win for the Democratic incumbent in New Jersey — party lawmakers found themselves anxious, exasperated and newly ready to try to advance two spending initiatives that have been bogged down in Congress for months. (Romm, DeBonis and Sotomayor, 11/3)

Smarting from an off-year electoral rebuke, congressional Democrats pushed forward on Wednesday toward House votes as soon as Thursday on nearly $3 trillion worth of social policy, infrastructure and climate change programs — but with a deep new worry: Would a legislative victory help or hurt their bruised political standing? The day after a defeat in the Virginia governor’s race and an unexpectedly close race in the Democratic stronghold of New Jersey, the Democrats in Congress toiled to keep recriminations to a minimum. But centrists grumbled that the party’s left flank had held back final passage of what they considered the most popular part of the agenda, a bipartisan $1 trillion infrastructure bill, while liberals blamed poor campaigns and ineffectual candidates. (Weisman and Cochrane, 11/3)

House Democrats on Wednesday unleashed legislation that would enact President Joe Biden’s expansive social spending vision after months of negotiating, seeking support from the entire caucus by Thursday. Answering major questions about what can ultimately win support from the party’s warring factions, the new package includes compromises on issues like lowering prescription drug costs and the federal write-off for state and local taxes. Democratic leaders are hoping to enact at least $1.75 trillion in promises before Thanksgiving. But not everyone is happy, and untold political landmines await in the Senate. (Emma, Scholtes, Miranda Ollstein and Becker, 11/3)

Democrats are touting a historic deal that would for the first time cap seniors’ out-of-pocket drug costs and empower Medicare to negotiate some prices with drugmakers, arguing it sets a precedent after decades of failures to curb spending that has frustrated consumers. But patient advocates and industry analysts are raising questions about the compromise, which significantly pares back proposals that House Speaker Nancy Pelosi (D-Calif.) and Sen. Bernie Sanders (I-Vt.) had pushed for months and offers a reprieve to a deep-pocketed drug industry. (Diamond, Goldstein and Roubein, 11/3)

KHN: Uninsured In South Would Win Big In Democrats’ Plan, But Hospitals Fear Funding Loss 

At least 2.2 million low-income adults — nearly all in Texas and the Southeast — would be eligible for government-funded health insurance under the Democrats’ $1.75 trillion social spending and climate change plan. That’s the number of people who are eligible for Medicaid under the Affordable Care Act but have been left uninsured because they live in one of the dozen states that have not expanded coverage under the 2010 law. They are in the coverage gap — with incomes too high to qualify for Medicaid, but below the $12,880 annual federal income minimum for an individual to qualify for subsidized coverage in the insurance marketplaces created by the ACA. (Galewtiz and Miller, 11/4)

House Democrats released an updated version of the party’s social spending and climate package, adding back a paid-leave program that had previously fallen out of the bill and including a measure sharply raising the $10,000 cap on the state and local tax deduction. The House bill, which top Democrats want to bring up to a vote in the chamber soon, is the latest proposal in the monthslong negotiations among Democrats over President Biden’s agenda. But it is set to face changes in the Senate, where Sen. Joe Manchin (D., W.Va.) has objected to the inclusion of a paid-leave benefit. (Duehren, Andrews and Rubin, 11/3)

Paid family and medical leave is back in Democrats' sweeping domestic policy bill. In a letter to colleagues Wednesday, House Speaker Nancy Pelosi, D-Calif., wrote that the inclusion of paid leave is at the urging of members of the House Democratic caucus. It also comes the morning after Republicans performed strongly in Tuesday's elections, including among suburban voters and women in places like Virginia. Pelosi said she expects the changes to the legislation to be debated in the House Rules Committee Wednesday, potentially setting up a vote later this week. (Kim, 11/3)

When Sen. Shelley Moore Capito’s phone rang with a call from an unlisted number, she assumed it was just her fellow senator from West Virginia, Joe Manchin III (D). It was not. Meghan, Duchess of Sussex, had personally dialed the Republican senator’s phone to talk about paid family leave, a program for working families that is at risk of being cut out of President Biden’s final social spending package as Democrats scramble to make it more palatable for their moderate colleagues. Sen. Susan Collins (R-Maine) also got a ring from the wife of Prince Harry, Duke of Sussex, to discuss paid family leave. “I was happy to talk with her,” Collins told Politico. “But I’m more interested in what the people of Maine are telling me about it.” (Alfaro, 11/3)

Over 200,000 Oklahomans have now enrolled in SoonerCare through Medicaid expansion, the Oklahoma Health Care Authority announced Wednesday. Of those, more than 118,000 are new applicants, while the rest were transitioned into SoonerCare from a more limited benefits program, or people who had older applications reprocessed. Another 80,000 people still may be eligible for benefits through Medicaid expansion, the Health Care Authority said. (Branham, 11/3)

A slim majority of Republican voters in North Carolina favor expanding Medicaid in the state, but the support grows to about three of every four when they learn more about who benefits from the taxpayer-funded health insurance program, according to a new poll. Advocacy group NC Child commissioned the poll, which will be released Wednesday, to demonstrate widespread support for expanding health coverage to tens of thousands of low-income working adults in North Carolina. (Burns, 11/3)

House Democrats are taking a new approach to convince recalcitrant conservative states to expand Medicaid to low-income adults: threatening funding cuts to hospitals. Under an updated version of the domestic policy package that the House may consider as soon as this week, hospitals in states that don't expand Medicaid could face a 12.5% cut in funding meant to help hospitals that serve large numbers of Medicaid patients. These so-called disproportionate share hospital payments are intended to keep safety net facilities financially stable by offsetting Medicaid's low payment rates and helping cover uncompensated care costs. (Hellmann, 11/2)

Open enrollment season is underway. With millions of employees reevaluating their job or considering a change, employer-sponsored benefits are an even greater consideration heading into 2022. About 157 million Americans rely on employer-sponsored health insurance coverage and yet, before the Covid-19 pandemic, many people spent very little time reviewing their workplace health-care plan during the open enrollment period. (Dickler, 11/2)

Workers are often told to get a job with good benefits, but they rarely think about why. At many companies each fall, employees receive a thick booklet in the mail, or their inboxes, listing myriad options for financial, health, and other benefits. Many skip over the more complicated ones in favor of simple, quick choices. Going quickly, however, is a mistake. Choosing the right benefits during open-enrollment season can help save money and build wealth. It can also give individuals and families broader support with their health. The importance of benefits like medical coverage is particularly crucial as the pandemic continues. (McCorvey, 11/3)

Covid-19 cut into third-quarter results at MetLife Inc. MET 2.50% as deaths linked to the Delta variant increased for people in their working years. It was one of the costliest quarters since the pandemic began for the insurer’s big business of providing employer-sponsored life insurance. The high level of death-benefit payout was more than offset by unusually strong investment gains from the small slice of the insurer’s investment portfolio held in private-equity funds. The New York company more than doubled its net income and posted a 31% increase in its adjusted earnings. (Scism, 11/3)

KHN: New Health Plans Offer Twists On Existing Options, With A Dose Of ‘Buyer Beware’ 

Trendy-looking websites promise convenience and freedom from networks, at far less than the cost of traditional health insurance. “Welcome to insurance that’s finally fair,” says one, in bold lettering. “Take care of your health with one easy app,” says another. It’s all part of shopping for health coverage in 2021. (Appleby, 11/4)

Britain on Thursday approved the antiviral drug molnupiravir for treating the coronavirus, making it the first pill to be endorsed for Covid patients. The country’s regulatory body said that the antiviral pill, originally designed to fight the flu, was “safe and effective” in reducing the risk of hospitalization and death for those at increased risk of severe symptoms, according to a statement. The decision was made after a “rigorous review” of its “safety, quality and effectiveness,” according to the statement from the regulatory body, the Medicines and Healthcare Products Regulatory Agency. (Khan, 11/4)

Regulators in Britain granted approval to the experimental drug molnupiravir from U.S. pharmaceutical giant Merck on Thursday, marking the first authorization from a public health body for an oral antiviral treatment for covid-19 in adults. Experts say that if widely authorized, the medicine could have huge potential to help fight the coronavirus pandemic: Pills are easier to take, manufacture and store, making them particularly useful in lower- to middle-income countries with weaker infrastructure and limited vaccine supplies. (Francis and Parker, 11/4)

It is the world's first oral antiviral to be authorized anywhere for the treatment of Covid-19. The drug comes in capsule form and will be known as Lagevrio. The companies have sought US Food and Drug Administration emergency use authorization for the drug, and the FDA said it will convene its Antimicrobial Drugs Advisory Committee on November 30 to discuss molnupiravir's ability to treat mild-to-moderate Covid-19 in adults who are at high risk for severe disease, including hospitalization or death. (Gumbrecht, 11/4)

Coronavirus infections in England reached their highest level yet in October, based on a large study published before what may prove to be a difficult winter. While hospitalizations and deaths remained low, the React-1 study led by Imperial College London recorded the highest prevalence of cases since the research began in May 2020. Covid infections among study participants increased to 1.72%, or one in 58 people, more than double the level in the previous month’s report. The study arrives as the U.K. is stepping up efforts to tackle respiratory illnesses. Last month, the country started its largest ever flu shot drive to address concern over a spike in Covid cases coinciding with a resurgent flu. On Monday, National Health Service walk-in centers began offering Covid booster jabs without an appointment. (Leon, 11/4)

Germany’s disease control agency on Thursday reported the highest number of new coronavirus infections since the outbreak of the pandemic. The Robert Koch Institute, or RKI, said 33,949 new cases had been registered in the last 24 hours, up from 28,037 daily cases a week ago. The previous record was 33,777 new cases on Dec. 18, 2020. (Grieshaber, 11/4)

Chinese authorities are ring-fencing Beijing against growing Covid-19 outbreaks now permeating more than half the nation’s provinces, seeking to protect the capital as it gears up to host top political leaders next week and the Winter Olympics in less than 100 days. The country’s state-owned rail operator said on Wednesday they suspended ticket sales for trains departing from 123 stations in 23 locations that reported coronavirus infections. Previously, Beijing’s municipal government all but barred people visiting the city from areas reporting Covid cases. (11/4)

Puerto Rico’s governor said Wednesday that officials will start vaccinating children ages 5 to 11 this week against COVID-19, and that getting the vaccine will be required to attend school in person with few exceptions. Health Secretary Carlos Mellado said he anticipates that some 227,000 children will be vaccinated, with a goal to inoculate 95% of that population. (11/3)

The World Health Organization granted emergency authorization to a Covid-19 vaccine co-developed by India’s medical-research agency and local manufacturer Bharat Biotech International Ltd., ending a months-long wait that added to controversy around the homegrown shot. The WHO approved the vaccine’s use in people aged 18 and older on a two-dose schedule with four weeks between shots, according to a statement on Wednesday. Covaxin joins a range of WHO emergency-cleared shots from AstraZeneca Plc, China’s Sinopharm Group Co. and Sinovac Biotech Ltd., Pfizer Inc. and BioNTech SE , Johnson & Johnson and Moderna Inc. (Kay, 11/3)

A government advisory committee on Wednesday recommended that all U.S. adults younger than 60 be vaccinated against hepatitis B, because progress against the liver-damaging disease has stalled. The decision means that tens of millions of U.S. adults — mostly between the ages of 30 and 59 — would be advised to get shots. Hepatitis B vaccinations became standard for children in 1991, meaning most adults younger that 30 already are protected. (Stobbe, 11/3)

Defective proteins clump into toxic plaques and tangles. Plaques of amyloid and tau tangles kill neurons, causing Alzheimer’s disease. So goes the central dogma that has ruled neuroscience since the early ’90s. But in the last few years, as researchers have amassed large databases of brain scans and collections of donated tissue, it’s become apparent how frequently the conventional wisdom fails. By one recent estimate, about 30% of older adults have brains loaded with enough amyloid or tau to meet the criteria for an Alzheimer’s diagnosis, but no outward symptoms of dementia. (Molteni, 11/3)

Federal agencies widened recalls and warnings to doctors Wednesday about aromatherapy sprays that have been linked to fatal cases of a rare tropical disease.The US Centers for Disease Control and Prevention said doctors should be on the lookout for symptoms of melioidosis -- a difficult-to-diagnose infection caused by the bacteria Burkholderia pseudomallei -- and should ask patients about whether they've used certain sprays. And people who have bought sprays containing "gemstones" should not throw them out but should pack them carefully and send them in for refunds, the CDC and the Consumer Product Safety Commission said. (Fox, 11/3)

We are not trying to food shame you, but you might want to put down the Tastykake chocolatey cream-filled cupcake. The Food and Drug Administration published a notice from the company, recalling some of the its multi-pack cupcakes sold at stores in Delaware, Maryland, New Jersey, New York, Pennsylvania, Virginia, Washington, D.C., and West Virginia. Flowers Foods, the maker of Tastykake goods, said the treats could have tiny fragments of metal mesh wire in them. (Romo, 11/3)

Cars already know how to park themselves, warn drowsy drivers, steer back into the right lanes and propose map routes to destinations. The cars Mazda has in the works for next year in Japan know when drivers have a stroke or heart attack. By 2025, the cars will even know when drivers are about to have a sudden health problem and warn them, according to the Japanese automaker. What’s involved are data from cameras inside the car, without resorting to laser sensors or other more obtrusive technology. And it’s going to be offered in affordable models, not just luxury vehicles. (Kageyama, 11/4)

Aspiring nurses are lining up even as the coronavirus pandemic has taken a toll on medical staff. Enrollment in nursing programs across the U.S. increased nearly 6% in 2020 from the year before, according to the American Association of Colleges of Nursing. Nursing school applications at Temple University in Pennsylvania increased about 15% this fall, according to assistant dean Michael Usino. In 2019, almost 7,500 people applied for about 110 spots. Usino said he initially expected the pandemic to reduce interest in nursing. (Lenghi, 11/3)

Nurses at Tacoma’s St. Joseph Medical Center, part of Virginia Mason Franciscan Health, took to the picket lines Wednesday after failing to make progress in bargaining talks after 10 sessions in two months. The nurses seek improved staffing levels, higher pay and safer conditions to and from parking lots, among other issues. (Cockrell, 11/3)

Hundreds of nurses, pharmacists and supporters flooded a stretch of Michigan Avenue between Sparrow Hospital and its attached administrative building. They marched in a loop as cars passed, honking in support, and chanted: "Sparrow, Sparrow, you can't hide, we can see your greedy side." A union representing Sparrow’s caregivers, a category of workers that includes nurses and pharmacists, staged the informational picket Wednesday decrying the hospital’s proposed contract as essentially amounting to a pay reduction while patient numbers rise. (Aguiar, 11/3)

Mississippi health care providers say they may have to close floors and reduce patient beds after losing hundreds of nurses due to the recent expiration of a federal contract put in place to help the state battle the coronavirus pandemic. During the last wave of COVID-19, 900 nurses were deployed to hospitals across the state under a 60-day contract funded by the federal government. That contract expired Nov. 1 and the number of virus cases has subsided since the summer peak. (11/3)

Hundreds of traveling nurses who have spent the past three months caring for Hawaii’s COVID patients will return to the mainland next week. That means many local hospitals will again be left short-staffed. It’s a problem that’s plagued Hawaii long before the pandemic. And in search of a solution, some facilities have managed to get those nurses to give up life on the road. (Blair, 11/3)

Since early 2020, when the pandemic exploded around the world, Massachusetts has seen nearly 19,000 COVID deaths and more than 840,000 cases. If a line graph of hospital admissions over the past 20 months looks like a series of peaks and valleys, the initial surge was Mount Everest for the state’s medical facilities, with patient loads and death rates that have not been matched since. To understand how the crisis has felt for frontline workers caring for the sick and dying, the Gazette reached out to 14 nurses at four Harvard-affiliated hospitals, many of whom work in intensive-care units. When the pandemic began, some had just started their careers, while others had been on the job for years. They risked their lives to stand by their patients, and their stories are marked by hope, heartbreak, and resilience. (Walsh, 11/2)

The American Psychological Association is seeking to make amends for past wrongs. The APA, an organization that has been around since the late 1800s, issued a lengthy statement on Friday apologizing not only for the APA's role in perpetuating systemic racism, but for the role psychology, as a field of study, has also played in systemically harming people of color for decades. The organization's Council of Representatives unanimously voted to adopt a resolution that, among other things, apologizes for engaging in "racism, racial discrimination, and denigration" of communities of color; as a result, they failed in their mission to better the lives of others, they admitted. (Pruitt-Young, 11/3)

The 170-year-old Bronzeville institution treated the neediest and was rescued from closure for $1. Here’s why hospitals like it are on life support. (Schorsch, 10/25)

A charitable trust donated $11.3 million to 10 Nevada hospitals to expand diagnostic and radiologic equipment in rural areas of the state, officials announced. The Helmsley Charitable Trust, a national philanthropic organization largely focused on health initiatives and grants, awarded the grants to Nevada hospitals as part of its rural health care program. Walter Panzirer, a trustee, said the trust sought out Nevada to add to the program because many rural health care systems are sandwiched between large expanses of federal land, meaning patient transports by land can take four hours. (Ross, 11/3)

When Mark Wahlberg helped ring in the grand opening of Walmart’s second health clinic in Calhoun, Ga., alongside a raucous crowd of customers in January 2020, the world was a very different place. It was a celebrated moment at an exciting time in Walmart’s push to open a string of new clinics scattered across America. The plan to build out its health care footprint seemed to have a shot at success: What busy parent wouldn’t jump at the chance to tackle the grocery list and their child’s earache in a single trip? The pandemic that soon followed has blurred the prospect of that success. (Brodwin, 11/4)

Aaron Beck liked to tell a story about how he came to reject psychoanalysis and revolutionize how talk therapy for mental disorders was conducted in the United States and much of the world. Like other psychiatrists in the mid-20th century, Dr. Beck was trained in Freudian concepts, including the idea that depression was the result of anger turned inward. In what would become a lifelong pattern, he decided in the late 1950s to test that idea more scientifically. He found little evidence that his patients were angry inside, but they did suffer from negative, irrational thinking about themselves. (Burling, 11/3)

Detroit has joined the growing number of cities and states that have decriminalized entheogenic plants and fungi, more colloquially known as “magic mushrooms” and psychedelics. Voters, including the city’s incumbent mayor who won a re-election, passed Proposal E on Tuesday night to decriminalize entheogenic plants and fungi. Just more than 61 percent of voters supported the measure, with nearly 39 percent of voters opposing it, according to the City of Detroit’s unofficial election results Wednesday. (Kai-Hwa Wang, 11/3)

Progressive lawmakers and civil rights groups want more states to follow Oregon’s recent example and drop criminal penalties for carrying small amounts of heroin, cocaine or other drugs, and to spend more money on addiction recovery services. They say substance use disorder should be treated as a disease, rather than as a crime. Democratic lawmakers in Maine, Massachusetts, Rhode Island and Vermont all proposed decriminalization bills this year. Advocacy groups hope to get a decriminalization measure on the ballot in Washington in 2022 and in California in 2024, said Matt Sutton, director of public relations for the Drug Policy Alliance, a New York-based nonprofit. The Drug Policy Alliance helped fund the ballot initiative that resulted in Oregon’s new law, which took effect in February. (Quinton, 11/3)

The investigative news site ProPublica this week released a new mapping tool that offers a concrete look at the persistent, daily cancer risks that residents in parts of this region may have long felt they faced. The reporters explain how their work is especially important because it shows on a granular level what is known as the "cumulative" effects of pollution from all industrial facilities in an area, rather than a single facility on its own. The journalists spent two years analyzing an enormous amount of emissions data from a five-year span. ProPublica calls the final product "the most detailed map of cancer-causing industrial air pollution ever published." It's not meant to be a definitive indicator for any single case of cancer, they explain, but rather a resource for people to understand better the risks of where they live. (Foxhall, 11/3)

The Los Angeles County Board of Supervisors declared a persistent “rotten-eggs” smell coming from a nearby river a local emergency. The decision will expand resources to address the levels of hydrogen sulfide gas emanating from the Dominguez Channel that has caused the foul odor for at least four weeks. The county deployed a multi-agency response team to clean up the channel and bring “much-needed relief to affected communities.” The board said the odor remains at levels that aren’t expected to pose long-term health problems and that no imminent danger exists. So far, the odor has led to short-term adverse health symptoms that include headaches, nausea and throat irritation. (Saraiva, 11/3)

President Biden on Wednesday said migrants separated from family members at the border would not receive hundreds of thousands of dollars for the damage inflicted by the Trump-era policy, rejecting an option for monetary compensation that had been floated in negotiations with lawyers representing the families. (Kanno-Youngs, 11/3)

In a Wednesday status conference to schedule his license appeal hearings, Dean’s attorney said he expects that information gathering process before going to trial will take 12 months. And an attorney representing LDH, Jay O’Brien, said he also expects a year to 18 months of evidence-gathering. Dean’s nursing homes will remain closed in the meantime. They will not reopen until he goes to trial in the case and a three-judge panel from the state’s Division of Administrative Law issues a judgment, said Dean’s attorney, John McLindon. No trial date has been set yet. McLindon is also requesting that the Division of Administrative Law rule on whether Dean can have his licenses back before they take up his Medicaid provider agreements. (Gallo, 11/3)

On the fourth Saturday of every month, antiabortion protesters gather outside the Planned Parenthood in Waco, Tex., the only clinic that performs abortions for almost 100 miles in any direction. Each one picks out the sign they’ll stand beside for the next two hours, selecting their favorite antiabortion message from a truck emblazoned with the largest sign of all: “Texas is Pro-Life.” The truck’s billboard has new significance now, two months after Texas banned nearly all abortions, said John Pisciotta, director of the antiabortion group Pro-Life Waco. Even if the U.S. Supreme Court ultimately blocks Senate Bill 8, the law will have sent an important message to the world, he said: Abortion is not welcome in Texas. (Kitchener and Wax-Thibodeaux, 11/3)

SARS-CoV-2-associated deaths among persons 21 years of age occurred predominantly among Black (non-Hispanic) and Hispanic persons, male patients, and older adolescents. The most commonly reported underlying conditions were obesity, asthma, and developmental disorders. Decedents with coronavirus disease 2019 were more likely than those with MIS-C to have underlying medical conditions. (McCormick et al, 11/1)

We found a clear association between COVID-19 vaccination and specific immunoglobulin concentrations in HM. This effect was more pronounced when lactation periods exceeded 23 months. The influence of the lactation period on immunoglobulins was specific and independent of other variables. (Ramirez et al, 11/1)

Cancer patients who received systemic treatment like chemotherapy or radiation in the 3 months before testing positive for COVID-19 were at increased risk of death, admission to an intensive care unit (ICU), and hospitalization, according to a study yesterday in JAMA Oncology. Researchers from the University of Texas MD Anderson Cancer Center analyzed the clinical outcomes in the electronic health records of 507,307 US adults with and without a diagnosis of cancer who tested positive for COVID-19 from Jan 1 to Dec 31, 2020. (10/29)

Among children with community-acquired pneumonia (CAP) who were discharged from the hospital within 48 hours but required further outpatient treatment, a lower dose of oral amoxicillin was non-inferior to a higher dose, and a 3-day duration was non-inferior to 7 days, according to the results of a randomized clinical trial published today in JAMA. (11/2)

In 2008, over-the-counter cough and cold medications (CCMs) underwent labeling changes in response to safety concerns, including fatalities, reported in children exposed to CCMs. ... Pediatric fatalities associated with CCMs occurred primarily in young children after deliberate medication administration with nontherapeutic intent by a caregiver. (Halmo, 11/1)

Findings of this case series cohort study indicate a slightly increased risk of Guillain-Barré syndrome during the 42 days following RZV vaccination in the Medicare population, with approximately 3 excess Guillain-Barré syndrome cases per million vaccinations. Clinicians and patients should be aware of this risk, while considering the benefit of decreasing the risk of herpes zoster and its complications through an efficacious vaccine, as risk-benefit balance remains in favor of vaccination. (Goud, 11/1)

Nurses and our health care teams have brought this nation through the worst devastation to our health in over 100 years. We have witnessed more than 720,000 deaths in the United States as a result of COVID-19. And it’s not over. COVID continues to ravage many of our communities, taking the lives of potentially anyone, including younger, healthier adults and hundreds of children. (Beth Wathen and Amanda Bettencourt, 11/3)

Americans should be asking ourselves what else needs to happen before we can declare an end to the crisis phase of the pandemic. Although the coronavirus’s course remains unpredictable—and bad surprises are still possible—the Delta-variant surge that started in early July ushered in what may have been the final major wave of disease in the United States. The 1918 influenza pandemic ended only when enough Americans obtained immunity through infection to bring the pathogen under control. The U.S. may soon reach a similar point of controlling the coronavirus as well, both because of widespread vaccination and because of the immunity generated by the sheer volume of Delta infections. (Monica Gandhi, 11/3)

The text from our pediatrician’s office popped up on my phone a few weeks ago. “We are getting ready to order the COVID-19 vaccines for the age group of 5-11. Would you like to give your child the vaccine? Please respond 1 YES or 2 NO.” I immediately texted back “YES.” Like millions of other parents and caregivers, and alongside our public health and health care colleagues (I am a public health professor; my husband is a primary care physician), we have been anxiously awaiting the availability of this vaccine for months. (Monica L. Wang, 11/4)

On Tuesday, the Centers for Disease Control and Prevention recommended that all children 5 to 11 receive the low-dose COVID-19 vaccine made by Pfizer-BioNTech, clearing the way for shots to begin this week. Yet a recent Kaiser Family Foundation study indicates that one-third of parents plan to take a wait-and-see approach for their children. As a mom of two elementary school-aged boys, I know every parent’s priority is keeping their children healthy and safe. And, as a physician, I understand why some parents have concerns about a new vaccine. I’ve spent time carefully reviewing the data and talking with my children and their father about the vaccine. And I want to share the facts that helped us make our decision to vaccinate our boys as soon as possible. (Mona Gahunia, 11/3)

Florida had a terrible summer in its fight against COVID-19. The state set several grim records, including recording nearly as many deaths from June to the end of September as in all of 2020, when vaccines weren't available. The change in seasons, however, has delivered a brighter outlook. No one should be bellowing "The pandemic is over!" COVID and its variants will likely be with us for a long time. But there are positive signs that the state is regaining its footing after the summer's staggering blow. (11/2)

For most of us, local public health officers in Maryland have always presented as a knowledgeable and caring presence in their communities. Who reminds people to get their flu shots? Who gently recommends annual checkups and blood pressure screening, or weight loss and smoking cessation programs? That would be the individuals running the county health departments. They fight addiction, heart disease, cancer and other killers with a fervor, but they also spearhead basic outreach campaigns that seek to bring preventive medicine to families who may lack traditional health resources. They’re hardly controversial. That is until they became the targets of antagonism, conspiracy theories, ridicule and worse. (11/2)

A long time ago, soon after I arrived in the Soviet Union as a young wire service reporter and became acutely aware that I was being followed, my eye began to twitch. It became hard to work, so I flew to Paris to have it checked out. By the time I landed the twitching had stopped, and the doctor who checked it out found nothing wrong. (Serge Schmemann, 11/3)

It started in November of 2016, with a young U.S. undercover agent in Havana hearing a piercing noise, then realizing that his ears wouldn’t stop ringing and that he’d lost some of his hearing. He told colleagues who remembered hearing weird noises, too. Soon, more than a dozen American diplomats and intelligence agents were reporting distressing symptoms — difficulty concentrating, headaches, insomnia, dizziness. Some heard weird noises, some didn’t. (Faye Flam, 11/3)

Staffing issues continue to challenge all healthcare sectors, especially demand for nurses, as the COVID-19 pandemic has led to burnout and is driving more workers into early retirement. From a provider perspective, what do you think should be some top priorities for strengthening the healthcare workforce? (Dr. David Gifford and Darryl Robinson, 11/2)

Tennessee’s CHOICES program was designed by TennCare over a decade years ago to rebalance long-term care delivery in our state to offer services and help eligible seniors (age 65 and older) and adults (age 21 and older) with a physical disability remain in their own homes as they age, rather than moving into a nursing home. (Thom Mills, 11/3)

The drug overdose crisis continues to worsen in the United States. While COVID-19 fatalities have eclipsed U.S. drug overdose deaths, there were more than 93,000 of the latter in 2020 — an increase of more than 20,000 from the previous year, according to the Centers for Disease Control and Prevention. Journalist and author Sam Quinones has documented this scourge for years and famously wrote "Dreamland" about the opioid crisis in 2015. (David Plazas, 11/3)

After Donald Trump took office in 2017, there was a surge of interest among the intellectual left in “1984,” George Orwell’s classic novel about statist repression. So it’s ironic that, in this first year of the Biden administration, those same leftists are set on coopting the language in a distinctly Orwellian way. Sign up.The latest entry in this category comes from the American Medical Association and the Association of American Medical Colleges, which last week issued a manifesto titled “Advancing Health Equity: A Guide to Language, Narrative and Concepts.” (Matt Bai, 11/3)