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Results from a U.S. trial of AstraZeneca’s COVID-19 vaccine may have included “outdated information” and that could mean the company provided an incomplete view of efficacy data, American federal health officials said early Tuesday. A spokesman from the drug company said Tuesday it was “looking into it.” (3/23)

In a statement issued soon after midnight Tuesday morning, the National Institute of Allergy and Infectious Diseases said it had been informed about the data questions by the data and safety monitoring board auditing the trial. DSMBs consist of independent medical experts who provide an extra screen of data produced from clinical trials. "We urge the company to work with the DSMB to review the efficacy data and ensure the most accurate, up-to-date efficacy data be made public as quickly as possible,” NIAID said.

It's unclear what, if any, impact this development could have on a possible future rollout of an AstraZeneca vaccine in the U.S. It's also still unknown what this news could mean for the vaccine's alleged efficacy. The pharmaceutical company had just released preliminary results from its late-stage COVID-19 vaccine trial earlier on Monday. Those results showed two doses of the vaccine administered four weeks apart had an efficacy of 79% at preventing symptoms of COVID-19 and an efficacy of 100% at preventing severe illness and hospitalization. (Diaz, 3/23)

Coupled with earlier missteps in reporting data and a recent blood clot scare, experts said the new stumble could cause lasting harm to the shot that is key to global efforts to stop the pandemic and erode vaccine confidence more broadly. “I doubt it was (U.S. officials’) intention to deliberately undermine trust in the AstraZeneca vaccine,” said Dr. Paul Hunter, a professor of medicine at the University of East Anglia. “But this will likely cause more vaccine hesitancy.” (Cheng, 3/23)

Public health experts are divided over whether the U.S. should add AstraZeneca's coronavirus vaccine to its arsenal, or let the rest of the world have it. By the time the AstraZeneca vaccine is authorized for distribution, the U.S. may already have more than enough supply. Meanwhile, most of the world is still waiting for shots. (Owens, 3/23)

Long-awaited data from the Oxford/AstraZeneca U.S. trial suggests the vaccine is safe, 79% effective at preventing symptomatic COVID-19, and fully effective at preventing hospitalizations and deaths. The suspension of the vaccine in at least 13 countries due to blood-clotting concerns has severely damaged the shot’s reputation in Europe, with majorities in France (61%), Germany (55%) and elsewhere now deeming it unsafe, according to a YouGov poll. (Lawler, 3/22)

More than 200,000 Americans flocked to the Affordable Care Act’s online marketplace to sign up for health insurance during the first two weeks of an open enrollment period created by President Biden — a sign that those who lost insurance during the pandemic remain in desperate need of coverage. At the same time, a provision in the president’s $1.9 trillion stimulus law to make Medicaid expansion more fiscally appealing has prompted deeply conservative Alabama and Wyoming to consider expanding the government health program to residents who are too rich to qualify now but too poor to afford private health plans. (Gay Stolberg, 3/23)

From February 15 to 28, 206,236 Americans chose to enroll in new plan selections. The jump in prospective beneficiaries is further represented by a total of more than 3.1 million online HealthCare.gov users recorded during this timeframe. Some of the states that saw a high volume of enrollments in new plan selection include Texas, Tennessee, North Carolina, Iowa, Florida, and Georgia, although sharp increases were reported across each of the 36 states that use HealthCare.gov as a platform for the 2021 coverage year. This is part of a broader pattern than has continued since 2019. (Kelley, 3/22)

President Joe Biden is wasting no time establishing his vision for the Affordable Care Act and reversing many Trump-era measures aimed at weakening it. In his first two months in office, Biden has taken several steps to bolster the landmark health reform law, which marks its 11th anniversary on Tuesday, and to embed it even more firmly in the nation's health care system. (Luhby, 3/22)

President Joe Biden will showcase health insurance cost cuts in a speech in Ohio Tuesday during what may be the best time for Democrats to talk up the Affordable Care Act since it became law. Biden’s COVID-19 relief bill pumps up “Obamacare” premium subsidies to address longstanding problems of affordability, particularly for people with solid middle-class incomes. More taxpayer assistance means, in effect, that consumers who buy their own policies through HealthCare.gov will pay hundreds of dollars less out of their own pockets. (Jaffe and Alonso-Zaldivar, 3/23)

The affordable care act, the health-care law also known as Obamacare, turns 11 years old this week. Somehow, the program has not merely survived the GOP’s decade-long assault. It’s actually getting stronger, thanks to some major upgrades tucked in the COVID-19 relief package that President Joe Biden signed into law earlier this month. ... And although the measures are temporary, Biden and his Democratic Party allies have pledged to pass more legislation making the changes permanent. The expansion measures are a remarkable achievement, all the more so because Obamacare’s very survival seemed so improbable just a few years ago, when Donald Trump won the presidency. Wiping the law off the books had become the Republicans’ defining cause, and Trump had pledged to make repeal his first priority. (Cohn, 3/22)

The U.S. Department of Agriculture announced Monday a 15% increase in Supplemental Nutrition Assistance Program (SNAP) benefits through September, providing about $3.5 billion of assistance to people affected by food insecurity. The pandemic has spurred an uptick in food stamp spending. As part of the $1.9 trillion COVID-19 relief package, the increase in benefits will provide about $28 more per person per month or more than $100 more per month for a household of four. (Chen, 3/23)

Vice President Kamala Harris urged the public to receive vaccinations during a visit on Monday to Florida, a Republican-led state that has largely remained open for business despite concerns that doing so may prolong the pandemic. Ms. Harris, who in the past week has traveled the country to promote the particulars of the Biden administration’s $1.9 trillion coronavirus relief package, said she did not have a specific message from the administration to a state where a prominent coronavirus variant has spread, even as officials have aggressively courted tourists for an unmasked spring break season that has spiraled out of control. (Rogers, 3/22)

The failure of a federal $15 minimum wage to protect its place in the Biden stimulus package will not be the only headwind for low-wage workers as advanced economies like the U.S. emerge from the Covid recession. More than 100 million low-wage workers globally will need to find a different occupation by 2030, according to a recent McKinsey & Company forecast, with the situation worse in the largest economies, and signalling a labor market shift that would replace decades during which job losses have been concentrated in the middle-income positions. (Rosenbaum, 3/22)

Former President Donald Trump says he didn’t heed the advice of Dr. Anthony Fauci in his response to the coronavirus pandemic, which has left more than 500,000 Americans dead and nearly 30 million infected, including Trump himself. "I listened to him, but I didn't do what he said," Trump told Fox News personality Lisa Boothe on the premiere episode of her podcast, which went live Monday. Boothe asked Trump if he regretted "elevating" Fauci — the nation's leading infectious disease expert, who rose to fame as a member of Trump's coronavirus task force — because of his refusal to back the former president's dubious claims about the virus. (Stableford, 3/22)

Former President Trump, in an interview released Monday, labeled the nation's top infectious diseases expert, Anthony Fauci, “a promoter more than anything” after the two sometimes clashed on the nation's response to the COVID-19 pandemic. “I thought rather than firing him, you know, I listened to him, but I didn't do what he said because, frankly, his record is not a good record,” Trump told the podcast “The Truth with Lisa Boothe." (Coleman, 3/22)

Dr. Anthony Fauci is getting the children’s book treatment. The nation’s top infectious disease expert — who became a household name during the COVID-19 pandemic — will be featured in a new book about his life called, “Doctor Fauci: How a Boy from Brooklyn Became America’s Doctor.” (Brown, 3/22)

Anthony Fauci, the top U.S. expert on infectious diseases, said the data on the Sputnik V Covid-19 vaccine developed in Russia leads him to believe that it’s “quite effective.” “I’ve taken a look at some of the reports. It looks pretty good,” Fauci, director of National Institute of Allergy and Infectious Diseases, said Monday during the Hugh Hewitt radio show. (Jacobs and Klimasinska, 3/22)

The pharmaceutical industry is preparing to take a hit in Democrats’ next major legislative package — and the long-untouchable powerhouse is racing to contain the damage. Democratic lawmakers are weighing whether to include drug pricing measures that could extract tens of billions of dollars from the industry, or potentially more, to help pay for a massive infrastructure bill they could try to pass along party lines this summer. (Luthi and Owermohle, 3/23)

KHN: Democrats Eye Medicare Negotiations To Lower Drug Prices

Democrats, newly in control of Congress and the White House, are united behind an idea that Republican lawmakers and major drugmakers fiercely oppose: empowering the Department of Health and Human Services to negotiate the prices of brand-name drugs covered by Medicare. But they do not have enough votes without Republican support in the Senate for the legislation they hope will lower the price consumers pay for prescription drugs. That raises the possibility that Democrats will use a legislative tactic called reconciliation, as they did to pass President Joe Biden’s covid relief package, or even eliminate the Senate filibuster to keep their promise to voters. (Huetteman, 3/23)

In a move directed at the owners of Purdue Pharma, a pair of Democratic lawmakers has introduced a bill that would prevent people who have not filed for bankruptcy from being released from lawsuits brought by local communities or the U.S. government. The legislation follows controversy over the bankruptcy plan filed last week by the drug maker. If the plan is approved by a federal bankruptcy court, some members of the Sackler family, who own Purdue, would receive immunity from the nearly 3,000 lawsuits filed by states, counties, cities and tribes seeking compensation for the costs of the opioid crisis. (Silverman, 3/22)

Earlier this week, Purdue Pharma filed a bankruptcy plan that would have some members of the Sackler family, which owns the drug company, relinquish control and pay nearly $4.3 billion to reimburse states, cities, and tribes for the costs associated with the long-running opioid crisis in the U.S. The plan is designed to end nearly 3,000 lawsuits that blamed Purdue for helping to spark a wave of prescription abuse, addictions, and deaths over the past two decades. (Silverman, 3/19)

New cases of Covid-19 are once again on the rise across more than half of the United States as officials race to vaccinate additional people before highly contagious variants become prevalent in the country. As of Sunday, the seven-day average of new cases rose by 5% or more in 27 states, according to a CNBC analysis of data compiled by Johns Hopkins University. Across the U.S., the nation logged an average of 54,308 new cases per day over the past week — a 1% rise from the prior week after months of rapidly declining case numbers, according to the data. (Feuer, 3/22)

"We just do not want have a rapid uptick in cases; we are behind the 8 ball when that happens," said Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky, MD, MPH, today during a White House briefing, as she urged Americans to remain vigilant against COVID-19 and avoid unnecessary travel in the coming weeks. The message came after a weekend of spring break revelry resulted in officials in Miami Beach declaring a state of emergency in response to a surge of maskless visitors, NPR reports. The city's mayor suspended outdoor dining after 7 pm and banned strolling on Ocean Drive after 8 pm. (Soucheray, 3/22)

Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), said Monday she's concerned the U.S. could experience "another avoidable surge" in coronavirus infections due to new variants, if people don't follow mitigation measures like mask-wearing and social distancing. A growing number of states have moved to reopen despite the spread of new variants. States are increasingly attributing their coronavirus cases to variants, Walensky noted. (Chen, 3/22)

And high levels of infection now could also mean problems for vaccines later on, one expert told CNN on Monday. "Not only does uncontrolled spread cause avoidable illness, hospitalization and death, but it increases the risk that an even more dangerous variant may emerge that could make the vaccine less effective," said Dr. Tom Frieden, the former CDC director. (Maxouris, 3/23)

Variant coronavirus strains first identified in California in the latter half of 2020 have now surfaced in North Dakota, where state officials also have confirmed more cases of the variant first detected in the United Kingdom last fall. There are two cases of each of the two new California strains in North Dakota -- four total cases -- along with seven confirmed cases of the U.K. strain, Kirby Kruger, disease control director for the Health Department, told the Tribune on Wednesday. All 11 people have recovered, he said. Their names and cities of residence haven't been released due to medical privacy reasons. (Nicholson, 3/17)

As more U.S. residents receive their COVID-19 vaccinations, testing for the virus has plummeted, dropping by a third in two months. This is a positive development wrapped in a potentially worrisome one, public health experts say. They say the decline reflects diminishing COVID-19 caseloads and suggests fewer Americans are fearful that they have contracted or been exposed to the virus. That relief leaves people less inclined to get tested. (Ollove, 3/22)

DoorDash has launched a new initiative to provide same-day on-demand delivery of FDA authorized COVID-19 test collection kits, it announced in a statement Monday. The initiative could go a long way in helping make at-home COVID-19 testing more accessible, as many Americans prepare to reenter workplaces and schools. (Saric, 3/22)

Don't even think about heading to Denton's Legends Diner if you're not planning to wear a mask. The fee is $50 if "we have to explain why a mask is mandatory," Legends Diner owner Wayne LaCombe told Chron. Posted right outside LaCombe's restaurant is a bright pink sign with the rules: "Our new surcharge: $50 if I have to explain why masks are mandatory; $75 if I have to hear why you disagree." (Medley, 3/19)

Regeneron Pharmaceuticals Inc. said it would apply for U.S. authorization for a lower dose of its Covid-19 antibody cocktail, after data from a final-stage trial showed early use of the drug reduced hospitalizations and deaths by 70%. The Food and Drug Administration in November cleared Regeneron’s therapy for emergency use. The treatment is part of a class of therapies that were widely hailed for their effectiveness, though the drugs have been slow to be widely adopted because they are difficult to administer. (Langreth, 3/23)

New late-stage trial data show Regeneron and Roche’s antibody cocktail against Covid-19 cut hospitalization or death by 70% versus a placebo in non-hospitalized patients, the Swiss drugmaker said on Tuesday. The shot, consisting of casirivimab and imdevimab antibodies developed by Regeneron with financial help from the U.S. government, also met all key secondary endpoints in the phase III trial with 4,567 participants, including reducing symptom duration to 10 days from 14, Roche said. (3/23)

Among subjects in a late-stage trial receiving a lower dose of the antibody drug, 1% were hospitalized or died, compared with 3.2% of patients receiving placebos, Regeneron said Tuesday. Study subjects getting a higher dose had a similar risk reduction, the company said. (Walker, 3/23)

Biden administration officials are increasingly concerned Johnson & Johnson may not deliver the 20 million doses of coronavirus vaccine it promised would be available by the end of this month, according to three senior administration officials. The full tranche of vaccine Johnson & Johnson committed in February to delivering may not be ready to ship until the second or third week of April, the officials said, potentially complicating preparations for states expecting millions of J&J shots. (Banco, Owermohle and Roubein, 3/22)

The Biden administration is enlisting the help of groups including the Christian Broadcasting Network Inc. and Nascar to encourage more people to get the Covid-19 vaccine, particularly members of communities that have been the most skeptical. The administration aims to use such organizations to help persuade conservatives, one of the demographic groups that polls show have significant reluctance to get the coronavirus vaccine. The Ad Council, a nonprofit that produces public-service announcements, and the Covid Collaborative, a coalition of leaders in education, health and economics, announced a campaign Tuesday that will run during time donated by media across TV and digital media platforms. (Armour and Siddiqui, 3/23)

More producers of COVID-19 vaccines should follow AstraZeneca’s lead and license technology to other manufacturers, the World Health Organization’s head said on Monday, as he described continuing vaccine inequity as “grotesque”. AstraZeneca’s shot, which new U.S. data on Monday showed was safe and effective despite some countries suspending inoculations over health concerns, is being produced in various locations including South Korea’s SKBioScience and the Serum Institute of India. (Nebehey and Miller, 3/23)

Pfizer will develop new shots using the technology, called mRNA, to target other viruses and pathogens beyond the coronavirus, Chief Executive Albert Bourla said in an interview. He said the company’s scientists and engineers gained a decade’s worth of experience in the past year working on the Covid-19 vaccine with Germany’s BioNTech SE, BNTX -0.55% and is ready to pursue mRNA on its own. “There is a technology that has proven dramatic impact and dramatic potential,” Mr. Bourla said. “We are the best positioned company right now to take it to the next step because of our size and our expertise.” (Hopkins, 3/23)

The coronavirus outbreak made household names of companies like Moderna Inc. and BioNTech SE, whose shots offered hope for ending the pandemic. Now a new wave of vaccines is on the horizon that may get the world over the finish line of inoculation. Protecting 7.7 billion people is a herculean task. There are more than 250 vaccine candidates in the wings to take on the challenge, including 82 in human studies. In addition to sheer numbers, they offer unique benefits compared to the dozen now available. (Pernice, 3/23)

Governors in multiple states announced plans Monday to open coronavirus vaccine access to all residents over the age of 16. States opening access included West Virginia, Tennessee and Arizona. Ohio, meanwhile, said vaccine providers who are unable to fill appointment slots this week can book anyone 16 or older. The timeline and details vary by state. West Virginia Gov. Jim Justice (R) said residents over 16 are eligible to be vaccinated immediately, although seniors will still receive preference. (Shammas, 3/23)

The North Dakota Department of Health has announced that the state's full general public over the age of 16 will be eligible to receive the COVID-19 vaccine as soon as Monday, March 29. Some vaccine providers, including public health units in Burleigh and Morton counties, have already opened up eligibility to the general public, but other providers are still focusing on Phase 1C, which includes essential workers and adults with underlying conditions. (Turley, 3/19)

For a rollout large enough to combat the novel coronavirus pandemic, you need volunteers. A lot of them. Getting shots into millions of arms requires boots on the ground, and to vaccinate a majority of North Carolina’s population – who reside in a nation already experiencing a shortage of health care workers – the state has/providers have turned to members of the public who are willing to lend a helping hand. (Critchfield, 3/22)

Orange County lowered the eligibility age to receive the COVID-19 vaccine to 10 years lower than the state requirement on Monday morning and filled 7,000 appointments in 13 minutes before closing registration. Reservations were required for the county-run drive-thru site at the Orange County Convention Center, the first location in Florida to open vaccine eligibility to residents 40 and older. (Aboraya, 3/22)

KHN: ‘An Arm And A Leg’: In Vaccinating Philadelphia, A Mix Of The Good, The Bad And The Ugly

In Philadelphia, the good, the bad and the ugly have all been on vivid display in the covid vaccine rollout. The Bad comes with a giant serving of gall: For a while, the city put its mass-vaccination program in the hands of Andrei Doroshin, a 22-year-old with no experience in health care but what, from all reports, seemed a healthy interest in making money. It did not go well. In this episode, we get a deep dive from public-radio reporter Nina Feldman, who uncovered the debacle. (Weissmann, 3/23)

An Arizona man was arrested Monday after he allegedly held at gunpoint a caravan of National Guardsmen transporting COVID-19 vaccines to Matador, Texas, according to police. Larry Harris, 66, of Willcox, is accused of following and making several attempts to run the vans off a roadway earlier on Monday, authorities said. He allegedly claimed to be a detective and ordered the unarmed Guardsmen out of their vehicles at gunpoint, according to reports.  (Aaro, 3/23)

Gov. Ron DeSantis has emphatically resisted placing restrictions on businesses during the COVID-19 pandemic. But DeSantis suggested this past week he may go after companies if they require customers to show proof they are vaccinated, saying “it’s more than just a private decision.” The governor was referring to what have been called "COVID-19 passports," a phenomenon gathering momentum abroad. (Sexton, 3/22)

Getting a COVID-19 vaccine has been difficult for many in Florida. But the visually impaired have several additional hurdles that sighted people don’t. Maggie Saldana of Naples is legally blind. She calls the process to get a vaccine appointment online “long and hopeless.” “Because I am legally blind, the computer is not my friend,” Saldana said. (WGCU, 3/22)

Karen Meadows’ plans on Wednesday did not involve leaving her house, and they certainly did not involve a Covid-19 vaccination. Wired to an oxygen tank and largely homebound with chronic obstructive pulmonary disease, it’s a challenge for Meadows to make it up her driveway. The voyage to her county’s mass vaccination site, at a basketball arena 10 miles to the east, is all but impossible. (Facher, 3/23)

Asian people across the country and in Texas have already experienced an increase in racist attacks since the beginning of the coronavirus pandemic and now, many are finding themselves left out as the vaccine rollout trundles forward. From refugee communities across the state to older people living in low-income housing, many face language barriers, technological difficulties and lack of access to transportation, leaving community organizations to ensure their most vulnerable groups do not fall through the cracks. (Bohra, 3/22)

KHN: ‘Press 1 For English’: Vaccination Sign-Ups Prove Daunting For Speakers Of Other Languages 

In late February, a week after Virginia launched a centralized website and call center for covid-19 vaccine preregistration, Zowee Aquino alerted the state to a glitch that could prove fatal for non-English speakers trying to secure a shot. Callers who requested an interpreter on its new 1-877-VAX-IN-VA hotline would be put on hold briefly and then patched through. Then the line would automatically hang up on them. (Pradhan, 3/23)

Atlanta and Fulton County school districts are dangling a host of incentives — from tropical vacations to relaxed dress codes — to entice employees to get vaccinated at special events this week. Fulton County Schools started mass vaccinations Monday at Mercedes-Benz Stadium. Atlanta Public Schools will begin Wednesday. ... APS will raffle off a host of prizes provided by businesses. There’s a chance to win resort stays in Antigua, the Grenadines, St. Lucia, Barbados and Panama. There’s also gift cards to Amazon, Jiffy Lube and Delta Air Lines. Fulton calls its big push “Project Vaccinate 2021.” (McCray, 3/22)

With each shot in the arm, more and more Americans are letting down their guard — seeing family and friends outside the home again, venturing out to eat or relaxing social distancing precautions, according to the latest installment of the Axios/Ipsos Coronavirus Index. Nine in 10 respondents said they know someone who's already been vaccinated, and 36% said they've been vaccinated themselves. Meanwhile, the share who know someone who died from COVID-19 has leveled off at around one in three, after climbing through 2020. (Talev, 3/23)

Fully vaccinated people should feel free to visit their unvaccinated family and friends without restrictions, but visits should be limited to one unvaccinated household at a time, Centers for Disease Control and Prevention officials said Monday. And sorry, but even fully vaccinated grandparents should not be bringing their grandkids to church or otherwise exposing them to crowds, CDC officials said during a web briefing. (Rios, 3/22)

Reaching that 70% threshold statewide or even citywide isn't a guarantee against future outbreaks. If vaccination rates lag in some areas, the virus could continue to circulate and mutate, generating new variants impervious to vaccines and making the entire region vulnerable again. With a mutating virus, it becomes "much harder to get to herd immunity, and it requires a different public health response than what we typically think of for measles or some other childhood vaccine-preventable diseases," says Dr. Marielle Fricchione, a medical director at the Chicago Department of Public Health. (Goldberg, 3/22)

Top executives at large health care companies have been registering more money during the 2020 pandemic year than before, new company filings show. The coronavirus upended how and when people sought care, but it didn't change the stock-heavy nature of how the industry's power brokers get paid. (Herman, 3/22)

Health insurer Humana Inc. is looking for a new chief financial officer following the resignation of Brian Kane, who will step down on June 1. Mr. Kane is leaving to pursue other career goals, the Louisville, Ky.-based company said on Monday, without providing additional details. Mr. Kane will serve as an adviser through the end of the year, the company said. He has been Humana’s CFO since 2014. Humana has begun searching for a new finance chief, the company said. (Broughton and Dabaie, 3/22)

KHN: Under New Cost-Cutting Medicare Rule, Same Surgery, Same Place, Different Bill

A cost-saving change in Medicare launched in the final days of the Trump administration will cut payments to hospitals for some surgical procedures while potentially raising costs and confusion for patients. For years, the Centers for Medicare & Medicaid Services classified 1,740 surgeries and other services so risky for older adults that Medicare would pay for them only when they were admitted to the hospital as inpatients. Under the new rule, the agency is beginning to phase out that requirement and, on Jan. 1, 266 shoulder, spine and other musculoskeletal surgeries were crossed off what’s called the “inpatient-only list.” By the end of 2023, the list — which includes a variety of complicated procedures including brain and heart operations — is scheduled to be gone. (Jaffe, 3/23)

A state lawmaker who is also a surgeon has twice tuned into Maryland General Assembly committee meetings from an operating room during a legislative session in which many hearings and votes have been held online because of the coronavirus pandemic. When Del. Terri Hill’s Zoom account was logged into a March 12 meeting of the House of Delegates Health and Government Operations Committee for about an hour, it showed multiple gowned and masked figures moving about, with sets of operating room lights visible on the screen. (Wood, 3/23)

American adults gained half a pound on average for every 10 days spent under stay-at-home orders, a new study finds. In a study posted online by the JAMA Network health journal, researchers from University of California San Francisco (UCSF) found that participants under stay-at-home orders gained on average 0.59 pounds every 10 days spent under lockdown — a finding that could indicate as many as 20 pounds gained over the course of 2020 and early 2021 for some newly-remote workers. (Bowden, 3/22)

In the first, a large single-center observational study published late last week in JAMA Network Open, University of Chicago researchers retrospectively assessed electronic health records of patients who had a vitamin D test in the year before testing for COVID-19 from Mar 3 to Apr 10, 2020. Those checked or treated for low vitamin D levels in the 2 weeks before coronavirus testing were excluded. Of the 4,638 patients, the risk of a positive coronavirus test result in Black patients was 2.64 times greater if they had a vitamin D level of 30 to 39.9 nanograms per milliliter (ng/mL) than if they had concentrations of at least 40 ng/mL. And the odds of infection dropped by 5% for every 1 ng/mL increase in patients with a vitamin D level of at least 30 ng/mL, the concentration generally considered sufficient. Similar associations were not found for White patients. (Van Beusekom, 3/22)

The pandemic normalized working from home, and that could open doors for America’s workers with disabilities. All sorts of hurdles — like getting to work if you’re in a wheelchair or adjusting to office environments if you’re a person with autism — are eliminated by remote work. This new future could be a more inclusive one for all Americans. (Pandey, 3/23)

“I stopped going places, even to my mom’s house or to dinner with friends, because anything from food to candles smelled so terrible,” Ms. LaLiberte, 35, said. “My relationships are strained.” She is dealing with parosmia, a distortion of smell such that previously enjoyable aromas — like that of fresh coffee or a romantic partner — may become unpleasant and even intolerable. Along with anosmia, or diminished sense of smell, it is a symptom that has lingered with some people who have recovered from Covid-19. (Krueger, 3/22)

It doesn’t have a formal name or a definition. No one can predict who will develop it, but whether you call it long Covid or post-acute Covid-19 or just identify yourself as a long-hauler, the constellation of prolonged symptoms after Covid-19 infection has become all too familiar. (Cooney, 3/23)

Airlines and other tourism-related businesses are pushing the White House to draw up a plan in the next five weeks to boost international travel and eliminate restrictions that were imposed early in the pandemic. More than two dozen groups made their request in a letter to the White House on Monday. They want people who have been vaccinated against COVID-19 to be exempt from testing requirements before entering the United States. They also want the U.S. Centers for Disease Control and Prevention to say that vaccinated people can travel safely. (Koenig, 3/23)

Eating breakfast earlier in the day — specifically, starting before 8:30 a.m. — appears to lower the risk for developing Type 2 diabetes, according to a report presented recently at the Endocrine Society’s annual meeting. Looking at eight years of national data on 10,575 adults, researchers found that people who began eating earlier than 8:30 a.m. tended to have lower blood sugar levels and less insulin resistance than people whose daily food intake started later. (Searing, 3/22)

Wildfire smoke was associated with a far greater number of pediatric respiratory care visits than other sources of airborne fine particles, according to a new study, even when wildfires were less severe. The study, published Tuesday in Pediatrics, examined more than 170,000 emergency and urgent care visits for respiratory concerns from 2011 to 2017 in the Rady Children’s Hospital Network, which cares for around 90% of hospitalized children in San Diego County. (Sohn, 3/23)

Last spring, an analysis based on the National Survey of Drug Use and Health found that marijuana use in the prior year among people over 65 had jumped 75 percent from 2015 to 2018, from 2.4 percent of that group to 4.2 percent. By 2019, use had reached 5 percent. “I would expect it to continue to increase sharply,” said Dr. Benjamin H. Han, the lead author of the analysis. The data showed use rising particularly among women and among people with higher education and income. A team using a different national data set documented a similar trend last fall. From 2016 to 2018, the proportion of men ages 65 to 69 who reported using marijuana or hashish within the past month had climbed to 8.2 percent from 4.3 percent. Among women, it grew to 3.8 percent from 2.1 percent. (Span, 3/20)

Arkansas Gov. Asa Hutchinson on Sunday admitted that the near-total abortion ban he signed into law earlier this month is unconstitutional, but said the bill was designed to “directly challenge” the landmark Roe v. Wade Supreme Court decision that protects a woman’s right to choose to have an abortion. “It is not constitutional under Supreme Court cases right now,” Hutchinson told CNN's Dana Bash of the Arkansas law, before saying he thinks there’s a “very narrow chance” the Supreme Court will ultimately hear the case. (Ponciano, 3/21)

Republican Arkansas Gov. Asa Hutchinson said over the weekend that he signed a sweeping anti-abortion bill into law earlier this month with the sole purpose of setting into motion a review of the landmark Roe v. Wade case. During an interview with CNN's State of the Union, Hutchinson confirmed that the "whole design of the law" was to overturn the Supreme Court’s current case law. "And so I signed it because it is a direct challenge to Roe vs. Wade. That was the intent of it," Hutchinson said. "I think there's a very narrow chance that the Supreme Court will accept that case, but we will see. (De Lea, 3/22)

Arkansas lawmakers on Monday voted to require a woman undergoing an abortion to first view an ultrasound, the latest restriction to advance in a state that has already enacted an outright abortion ban. The majority-Republican House voted 74-14 for the requirement and sent it to GOP Gov. Asa Hutchinson. The state Senate approved the measure earlier this month. Similar requirements are in place in Louisiana, Tennessee, Texas and Wisconsin. (3/22)

Conservative Supreme Court justices have demonstrated a desire to reverse prior decisions on abortion rights. The question, with Chief Justice John Roberts no longer the undisputed swing vote on abortion, is when and how far at least five justices will go to overturn rulings that support a constitutional right to end a pregnancy. The aims of individual justices, based on their recent writings, range from reversing Roe v. Wade to forbidding clinics from challenging restrictions on behalf of women to relaxing the standard that states must meet to limit women's access to the procedure. (Biskupic, 3/19)

The battle over abortion rights has a dramatic new front: the fight over whether the Biden administration will make pills available online. Even as they keep a sharp eye on the increasingly conservative Supreme Court, activists, lawmakers and medical groups are pushing Biden’s FDA to lift restrictions on a 20-year-old drug for terminating early pregnancies. Such a decision would dramatically remake the abortion landscape by making the pills available online and by mail even if the Supreme Court overturns or cuts back Roe vs. Wade. (Miranda Ollstein and Tahir, 3/20)

When Polish doctors told Paulina, 29, that her unborn child had no kidneys and would die upon birth, she knew she couldn’t go through with the pregnancy. ... [But] Polish law now considers only incest, rape or a threat to a mother’s life and health as valid grounds to terminate a pregnancy. ... Two weeks after Paulina learned of her baby’s condition, abortion rights activists helped her to find a psychiatrist prepared to state that she needed to have an abortion on mental health grounds, and her abortion went ahead. This makes her one of perhaps only around a dozen women who has managed to get an abortion on such grounds since the ruling came into effect, abortion support groups told Reuters. (Plucinska and Stezycki, 3/20)

Manuela, a mother of two in rural El Salvador, couldn't even walk to the hospital. In February 2008, her relatives had to wrap her in a hammock and transport her as best they could to the health center two hours away, after a pregnant Manuela suffered severe pelvic pain, started hemorrhaging, expelled her fetus and passed out. A day later, still bleeding, she was interrogated by a doctor at the hospital who came to the conclusion that Manuela did not have an obstetric emergency, but instead had an abortion. Manuela, who had a visible mass on her neck, was shackled for days, then arrested and charged with aggravated homicide, accused of killing her fetus. The masses in her body turned out to be cancer, but she did not get timely and appropriate chemotherapy in jail where she was serving a 30-year sentence. She died in April 2010.Manuela's story, described in detail in a report from the Center for Reproductive Rights, was argued last week at the Inter-American Court of Human Rights. (Linares and Nunez, 3/17)

New York City high schools reopened on Monday for the first time since November, the last group of schools in the nation’s largest system to welcome back students after a shutdown driven by high coronavirus infection rates. The vast majority of students — some 70 percent — will continue to learn entirely from home for now because they chose to sign up for all-remote classes. (Durkin, 3/22)

There is no plan to reduce social distancing between student desks in classrooms to three feet in Orange County Public Schools, despite a change in federal guidelines to to reduce the distance from six feet. On Friday, the Centers for Disease Control and Prevention updated its guidance for schools and recommended that, with universal masking, students should maintain a distance of at least 3 feet in classroom settings. (Prieur, 3/22)

KHN: Indiana School Goes Extra Mile To Help Vulnerable Kids Weather Pandemic

After covid-19 forced Olivia Goulding’s Indiana middle school to switch back to remote learning late last year, the math teacher lost contact with many of her students. So she and some colleagues came up with a plan: visiting them under the guise of dropping off Christmas gifts. One day in December, they set out with cards and candy canes and dropped by the homes of every eighth grader at Sarah Scott Middle School in Terre Haute, a city of more than 60,000 near the Illinois border where both Indiana State University and the federal death row are located. They saw firsthand how these kids, many living in poverty and dysfunctional families, were coping with the pandemic’s disruptions to their academic and social routines. (Bruce, 3/23)

When the Boston Red Sox invite a limited number of fans back to Fenway Park on April 1 for the first home game of the season, one thing will be missing: the pushcarts that sell peanuts, hot dogs, and sausages on the street. Fenway Park street vendors received an e-mail on Friday from the permitting office of the Boston Public Works Department, informing them they can’t reopen until at least June. “The city has decided that they will place vending at Fenway Park on hold for the next two months due to COVID concerns,” said the e-mail, which was shared with the Globe. “The city will revisit that decision in June and decide at that time the safety of opening Fenway vending activities with COVID guidelines for customer distancing.” (Gardizy, 3/22)

On a winding, country road, just past the Sykesville Freedom District Fire Department, a billboard bearing the phrase “Addiction is a disease. Recovery is possible.” gives passersby a glimpse of an ongoing crisis that has plagued Carroll County for years. With a silhouette of a young family looking far off into a body of water, the sign is one of six in the county that provides the most recent count of overdoses and lives lost. The numbers on the sign from January and February represent the second-highest two-month period of overdose deaths the county has seen in five years. (Askari, 3/22)

It’s common for law enforcement officers to respond to people in mental health crises. Desperate family members often call 911 if they believe a loved one is at risk of harming themselves. If a patient expresses suicidal intent, health professionals will sometimes call for the police assistance. And in North Carolina, sheriffs’ deputies are responsible for transporting psychiatric patients — often in shackles — when they need to go from one hospital to another for forced treatment. (Knopf, 3/23)

A top expert at the World Health Organization (WHO) on Monday said that COVID-19 deaths are seeing a “slight increase” for the first time in six weeks, a trend that she called a “worrying sign.” “I do want to mention that it had been about six weeks where we were seeing decreases in deaths,” Maria Van Kerkhove, technical lead on COVID-19 at the United Nations health agency, told reporters. “And in the last week, we’ve started to see a slight increase in deaths across the world, and this is to be expected if we are to see increasing cases. But this is also a worrying sign.” (Schnell, 3/22)

Sinovac said its COVID-19 vaccine is safe in children ages 3-17, based on preliminary data, and it has submitted the data to Chinese drug regulators. More than 70 million shots of Sinovac’s vaccine have been given worldwide, including in China. China has approved its use in adults but it has not yet been used in children, because their immune systems may respond differently to the vaccine. Early and mid-stage clinical trials with over 550 subjects showed the vaccine would induce an immune response, Gang Zeng, the medical director at Sinovac, said at a news conference. (Wu, 3/23)

The COVAX vaccine-sharing scheme will set aside 5% of the vaccine doses it procures for a “buffer” to be used in humanitarian settings or released in the case of severe outbreaks, the GAVI vaccine alliance said on Tuesday. That amounts to up to 100 million vaccine doses by the end of 2021, it said. COVAX is the programme backed by the World Health Organization and GAVI vaccine alliance to provide vaccines for poor and middle-income countries. So far, 31 million doses have been delivered to 57 economies, although the rates trail behind wealthier countries, revealing inequity that WHO Director-General Tedros Adhanom Ghebreyesus described this week as “grotesque”. (Farge, 3/23)

The nurse lay in bed this month, coughing, wheezing and dizzy with fever. It was three months after rich countries began vaccinating health workers, but Kenyans like the nurse, Stella Githaiga, had been left behind: Employed in the country’s largest public hospital, she caught the coronavirus on an outreach trip to remote communities in February, she believes, sidelining her even as Kenya struggles with a vicious third surge of infections. Ms. Githaiga and her colleagues are victims of one of the most galling inequities in a pandemic that has exposed so many: Across the global south, health workers are being sickened and killed by a virus from which doctors and nurses in many rich countries are now largely protected. (Latif Dahir and Mueller, 3/22)

We've heard it many times over the past few months: vaccines won't end the pandemic, vaccinations will. One way to increase vaccinations is for employers to require them in the workplace. But employers should not rush to do this. Although vaccine mandates are likely legal, other tools are probably better. (Dorit Reiss, 3/22)

When I arrived for work at the health center on a chilly recent Monday morning, I didn’t know I’d end my day on Sheila Holloway’s cozy sofa watching Meghan, Oprah, and Harry. For Ms. Sheila, a mother and family caregiver, getting to our health center with one child was a challenge. A debilitating chronic condition made that commute difficult. For Ms. Sheila and her two adult children with developmental disabilities, a family vaccination trip was nearly impossible. To Pennsylvania health-care providers like me, the increased availability of COVID-19 vaccinations has meant more opportunities to make house calls to patients like Ms. Sheila and her children. The 15-minute post vaccination observation window allowed me to learn more about this loving family, share a few laughs in their living room — and even briefly catch up on the former royals. (Tarik S. Khan, 3/22)

COVID-19 vaccines are finally helping us see light at the end of this long, dark tunnel. Unfortunately, early reporting suggested that the most-recent vaccine entrant — from Johnson & Johnson — doesn’t live up to the standard set by the first two, from Pfizer and Moderna. Some speculated that it would be “dumped” on populations as a second-rate alternative. To the contrary, the J&J vaccine very effectively prevents severe disease and death — and should be celebrated as another tool speeding protection for all of us. (H. Westley Clark, Margaret McLean and Craig Stephens, 3/20)

The most important thing to know about AstraZeneca’s Covid-19 vaccine is that it’s safe and it works — in spite of the missteps that have marred nearly every stage of its rollout. New data shared Monday shows the vaccine was 79 percent effective in preventing symptomatic infections in a trial of over 32,000 people, and the company says it will prepare to apply for emergency authorization from the Food and Drug Administration in the coming weeks. (Dr. Keren Landman, 3/23)

Ultimately it will be up to Loretto Hospital’s board of directors to decide how to handle alleged violations of vaccine protocol involving the hospital’s top executives. They’re now caught in a controversy first exposed by Block Club Chicago over how they distributed coveted COVID-19 vaccinations. This was, ahem, not about vaccine shortages or long lines. First, the executives offered vaccines to hotel staff at Trump Tower, where hospital Chief Operating Officer Dr. Anosh Ahmed lives. Oh, a few residents might have been inoculated as well. And maybe Eric Trump. But who’s counting, right? A shot in the arm is a shot in the arm. (3/22)

The Centers for Disease Control and Prevention on Friday changed its guidelines for physical distancing in elementary schools from six to three feet. This was the right decision, but not because the shorter distance is suddenly more safe. As I’ve argued before, we as a society will never agree on the level of virus transmission deemed safe. Rather, we should focus on whether an activity must occur, then work backward to reduce risk. If full-time, in-person schooling is essential, as President Biden and many public health experts have said, then many schools wouldn’t have space to accommodate six feet of distancing. The question isn’t whether to do away with the six-foot rule, but how to work around it. What more must be done to replace a previously crucial layer of protection? (Leana S. Wen, 3/22)

Adecade ago, a team of researchers showed clearly that a new treatment for advanced lung cancer significantly improved patients’ quality of life, reduced symptoms of depression, lowered the likelihood of being admitted to the hospital for a complication of their disease, and improved survival. Subsequent research has found similar beneficial effects in other cancers and diseases. Flash forward to today: Two-thirds of patients living with a serious illness who could benefit from this therapy don’t get it, and the majority of cancer physicians do not prescribe it despite endorsements from the American Cancer Society and the American Society of Clinical Oncology. (R. Sean Morrison and Mireille Jacobson, 3/23)

“Estrogen deficiency” is a common phrase. It is often used to describe people who are one year or more beyond their last period. However, estrogen deficiency has been diagnosed in 13- or 14-years-olds who have just experienced their first period. Or in a thin or stressed university student whose menstruation suddenly stopped. It could also be found in a teenager who is eventually diagnosed as having polycystic ovary syndrome (PCOS) after persistent adolescent acne, unwanted facial hair and irregular periods. Finally, someone with estrogen deficiency might be having irregular or skipped periods as a perimenopausal 35-plus-year-old. Odd, isn’t it, that so many people lack estrogen? (Jerilyn C. Prior, 3/24)

In a country growing rapidly older, New England has the potential to become a kind of living laboratory for all things related to aging. Several of the nation’s oldest states and communities are here, and it is in our regional DNA to innovate. We are also home to many professionals who can establish New England as a global Longevity Hub — academics, biomedical researchers, financial service providers, technology designers, venture capitalists, housing developers, and experienced government and private sector leaders with a vision of what is possible. Many have not focused their attention on aging yet but, given the potential in this area, they should. (3/22)

It’s always around this time of day in the pandemic that I feel my anxiety rising. It’s not worry, it’s not “bad thoughts” it’s a physical, visceral reaction to the never ending loop that has become life — all of the demands, none of the traditional coping strategies, and an intense feeling of isolation. It’s in this anxiety that I have gone back to a behavior that I long ago recovered from. It was buried somewhere deep, locked away and waiting for a trying situation to return and comfort me, and then slowly chip away at my happiness and relationships. I feel like an absolute failure being back in this place. Addiction is often referred to as a “disease of isolation,” and that’s precisely how I’ve been feeling: completely alone. (Vanessa Dueck, 3/22)