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When terrible news breaks, such as Tuesday’s school shooting in Uvalde, Texas, our first instincts might be to shield children from the dangers of the world. But experts say that’s the wrong thing to do. We should expect school-aged children to talk about events in the news — like a mass shooting or a natural disaster — with their peers when they’re out of the house. (Cataudella, 5/24)

The shooting in Texas is forcing parents and schools to once again confront how to talk to kids about violence. Experts have told The Times these are complex and sensitive conversations, but also vital — especially for the children of today, who’ve endured a pandemic. “And now, on top of all those already existing pandemic-related chronic stressors, many children and families may be overwhelmed with the added fear of sending their children to school,” said Katherine Williams, a child and adolescent psychologist and professor of psychiatry at UC San Diego. (Newberry, 5/24)

After the Las Vegas concert shooting in 2017, Jane Ripperger-Suhler, a child psychiatrist at Seton’s Texas Child Study Center, had this advice for parents about how much we should say about a mass shooting, and it’s good advice for what has happened today: We need to be careful about who is watching with TV with us and how we explain it. ... If [children] don’t seem to be able to move on after a few days, are afraid to go to school, are too scared to go to bed, are having physical symptoms of stress or behavior problems, get them help sooner rather than later, Ripperger-Suhler says. Be especially aware if a child has experience a trauma before. Watching this scene on TV will not cause post-traumatic stress disorder, she says, but it can be more traumatic and disturbing to some kids. (Villalpando, 5/24)

Parents in Massachusetts and around the country are facing a tough conversation with their children following Tuesday's deadly school shooting in Texas. The shooting may seem like an unspeakable horror, but mental health experts say it is crucial for parents to talk about it with their kids. "They really need to hear from parents that they are safe and there's lots of ways to tell that to kids," said Dr. Erica Lee, a psychologist at Boston Children's Hospital. Lee said as children are processing the tragedy, parents should use their words to establish a sense of safety. "Letting them know that you're doing everything that you can to protect them; that you would never send them to school if you thought they were going to be unsafe, the school has a good safety plan," Lee said.

In the wake of the deadly mass shooting, many parents are left grappling with how to explain the horrific act of gun violence -- at a setting where most kids spend a majority of their days -- to their children and teens. ... When it comes to children preschool age and below, Dr. Robin Gurwitch, a licensed clinical psychologist and professor at Duke University Medical Center, said that parents should limit their media exposure. "Preschoolers may not understand instant replays," she said. "So that loop of children running out of the school, if they don't know that that's a replay, they think that school has thousands and thousands of students." (Team, 5/24)

Late last year, after four students were killed and others injured in a shooting at Oxford High School in Michigan, Chalkbeat compiled a list of resources for coping with trauma and trying to prevent future tragedies. Among them was a list of common reactions and warning signs to look for in helping a child or student in the aftermath of a school shooting. (5/24)

Two local experts on security in schools shared their perspectives with Pittsburgh’s Action News 4 on the deadly mass shooting in Uvalde, Texas, on Tuesday. ... Before a school or any group of people is a target of violence, retired Secret Service member Jeff James says there are signs. “These things don't just happen. People don't snap,” James said. He said there will be a dive into the suspect’s past and use of social media, but law enforcement can't see everything before someone acts. (Gunderson, 5/24)

Following a mass shooting at an elementary school in Texas that killed at least 19 children and two adults, a large blood bank in San Antonio, Texas, rushed 25 units of donated blood to the small town of Uvalde. Now, South Texas Blood and Tissue is asking the public for more donations. In a statement, the organization said it sent 15 units of low titer O whole blood, which is used in emergency situations because it can be transfused on-site or in an emergency vehicle, to Uvalde via helicopter. After receiving a request for more, they sent an additional 10 units of O negative blood to a hospital in Uvalde late Tuesday afternoon. (O'Kane, 5/24)

Shortly after the nation’s latest mass shooting, which killed at least 18 children at an elementary school in Texas, the California Senate passed a bill Tuesday to allow private citizens to file suit for at least $10,000 — a bounty-hunter provision modeled on a Texas abortion law — against makers or sellers of untraceable ghost guns or illegal assault weapons. “We do have some of the toughest gun laws in the country,” Sen. Anthony Portantino, D-La Cañada Flintridge (Los Angeles County), told his colleagues amid news of the slaughter inside an elementary school in Uvalde, Texas. But public enforcement of those laws has not been enough to protect Californians against the “new wave of weapons,” he said, and private lawsuits would create “an incentive to get these dangerous weapons off the street.” (Egelko, 5/24)

Once again, lawmakers, mental-health professionals, gun-control advocates, the National Rifle Association and people across the land are searching for answers, and debating gun-control laws — or lack thereof — in the United States. “People with mental-health issues are more likely to be victims than perpetrators,” said Chethan Sathya, a pediatric trauma surgeon and director of Northwell Health’s Center for Gun Violence Prevention, headquartered in New Hyde Park, N.Y. “We have to be very careful how we talk about the link between the two,” he said. “When it comes to folks with mental-health issues these public-health strategies are important because they often involve the victims themselves.” (Fottrell, 5/24)

The kids who lived through the start of the school shooting era have grown up. Most of them came of age in the late ’90s and the 2000s, when mass shooters started showing up in schools in Pearl, Mississippi; West Paducah, Kentucky; and Springfield, Oregon (though some survived them even earlier). Now adults in their 30s and 40s, many with children of their own, they are navigating a world in which what happened to them was not an anomaly but the beginning of a recurrent feature of American life. As children, they practiced tornado and fire drills at their schools. Because of what happened to them, their kids have active shooter drills, too. There’s no real guidebook for recovering from what they experienced. What distinguishes the thousands of survivors of the early wave of school mass shootings from those who came after is that they experienced those shootings in a world wholly unprepared to deal with the aftermath. Few got the mental health treatment now considered necessary for survivors of mass violence. As a result, many were left on their own, to process their trauma in the countless years — and school shootings — since. (Cogan, 1/24)

The U.S. Food and Drug Administration is easing regulations to allow infant formula imports from Britain, a move it said on Tuesday would bring around 2 million cans onto empty shelves by June to ease a nationwide shortage. The FDA said it was "exercising enforcement discretion" to allow Britain-based Kendal Nutricare to import certain infant formula products under the Kendamil brand that it has no safety or nutrition concerns over following an evaluation. (Aboulenein and Rajesh, 5/24)

Danone SA [of France] has been doubling shipments to the United States of Neocate formula for infants allergic to cow's milk while Enfamil maker Reckitt is also working to boost supplies amid a nationwide shortage, company executives said on Wednesday. ... Danone - the world's second-biggest baby formula maker after Nestle but a relatively small player in the United States with less than 5% of market share - is stepping up supply of Neocate. ... The French company declined to say how many cans or tonnes of product it is exporting. (Naidu, 5/25)

Abbott Laboratories will release about 300,000 cans of a specialty infant formula for children in urgent medical need, while U.S. health regulators cleared the import of about 2 million cans of formula from the U.K. to try to mitigate a shortage. Abbott, of Abbott Park, Ill., said Tuesday it is releasing limited quantities of EleCare, an amino acid-based powder for infants with severe food allergies or gastrointestinal disorders. (Loftus, 5/24)

Abbott Laboratories plans to restart production of infant formula at its Michigan facility June 4, and it will begin releasing specialty formula EleCare in the next several days, the company said Tuesday. The announcement comes amid a nationwide shortage of infant formula caused by supply chain issues and exacerbated by a recall of formulas made at Abbott’s Sturgis, Mich., facility. Abbott recalled a number of infant formulas produced at that facility in February as the U.S. Food and Drug Administration announced that it was investigating complaints of Cronobacter sakazakii infections among four babies who reportedly consumed formula made there. All four were hospitalized, and Cronobacter may have contributed to two babies’ deaths, according to the FDA. (Schencker, 5/24)

The Federal Trade Commission (FTC) announced an inquiry Tuesday into the infant formula shortage and said it will assess the impact of mergers and acquisitions in the market. The agency said it will investigate bots reselling formula at “exorbitant prices” and seek public comment on the factors that “contributed to the shortage or hampered our ability to respond to it.” (Schonfeld, 5/24)

Federal plans to inspect a baby formula factory linked to the nationwide shortage were slowed by COVID-19, scheduling conflicts and other logistical problems, according to prepared testimony from the head of the Food and Drug Administration. FDA Commissioner Robert Califf is set to answer questions Wednesday from House lawmakers probing the events leading to the formula shortage, which has forced the U.S. to begin airlifting products from Europe while many parents still hunt for scarce supplies. (Perrone, 5/25)

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has warned that stigmatising language used in the coverage on the monkeypox virus could jeopardise public health, citing some portrayals of Africans and LGBTI people that “reinforce homophobic and racist stereotypes and exacerbate stigma." UNAIDS said “a significant proportion” of recent monkeypox cases have been identified among gay, bisexual and other men who have sex with men. But transmission is most likely via close physical contact with a monkeypox sufferer and could affect anyone, it added, saying some portrayals of Africans and LGBTI people “reinforce homophobic and racist stereotypes and exacerbate stigma." (5/23)

David Heymann, a leading advisor to WHO, said the recent cases appear to have gotten into the population through sexual contact. He told the Associated Press earlier this week that the leading theory to explain the recent spread was sexual transmission at raves held in Spain and Belgium. That has led to some reporting that monkeypox can only be passed through sexual contact. On Fox News, Jesse Waters called monkeypox a "sexually transmitted disease" that is "primarily passed through homosexual sex." But an expert on sexually transmitted diseases at WHO has emphasized that monkeypox is "not a gay disease" and that anyone can contract it through close contact. (Rahman, 5/24)

California’s first suspected case of monkeypox has been publicly reported in Sacramento County. The person, who recently traveled to Europe, is isolating at home and isn’t in contact with other people, health officials said Tuesday. During a briefing Tuesday morning, Sacramento County Public Health Officer Dr. Olivia Kasirye said she was unable to provide the suspected patient’s gender or age but confirmed the person is a county resident. (Money and Lin II, 5/24)

The outbreak of monkeypox cases outside of Africa can be contained, the World Health Organization said on Tuesday, as more governments said they would launch limited vaccinations to combat rising infections of the virus. The moves came as authorities investigated 237 suspected and confirmed cases of the virus in 19 countries since early May. That number is expected to increase, WHO officials have said, but most of the infections so far have not been severe. (Rigby and Roy, 5/24)

A veterinarian who contracted monkeypox during a U.S. outbreak in 2003 described the "scary" ordeal of becoming suddenly ill before authorities knew what was happening. Dr. Kurt Zaeske, who is now retired in Wisconsin, said he developed flu-like symptoms and lesions after coming into contact with a monkeypox-infected prairie dog through a client. Neither knew what had made the animal sick. (Silva, 5/24)

Karen DeSalvo’s latest challenge came in the nanometer-sized envelope of a virus: monkeypox. Since becoming Google’s first chief health officer in 2019, DeSalvo has overseen many disparate programs, ranging from AI-enabled diagnostics to patient records. But increasingly, as the tech giant has rethought some of its biggest aims in health, losing a longtime executive and dissolving its dedicated health-focused division, her focus has shifted to consumers. (Mast, 5/24)

The Centers for Disease Control and Prevention wants to calm public anxiety over how the monkeypox virus is transmitted, emphasizing that it doesn’t spread that easily through the air because it requires close contact with an infected person. Monkeypox is primarily spread through sustained physical contact such as skin-to-skin touch with someone who has an active rash, CDC officials said this week. The virus can also spread through contact with materials that have the virus on it like shared bedding and clothing. But it can spread through respiratory droplets as well, although not nearly as easily as Covid-19, they said. (Kimball, 5/24)

At least one antiviral medicine shows promise against monkeypox and should be investigated further, scientists said as the outbreak widens. The finding is based on a single case that occurred in the UK before the current flare-up. The study, which calls for more research on a drug called tecovirimat, was published in The Lancet Infectious Diseases journal. The study focused on seven cases of transmission outside of Africa, where the virus is considered endemic in a dozen countries. It suggests SIGA Technologies Inc.’s tecovirimat may be able to shorten symptoms and the amount of time people are contagious. The scientists said more work is needed to reach any conclusions but their study found little evidence that another drug, brincidofovir, was beneficial. (Paton, 5/24)

Germany's health minister said Tuesday the country has ordered 40,000 smallpox vaccine doses as a precaution after Germany and other countries reported multiple monkeypox infections, Reuters reports. Cases of monkeypox, a disease rarely seen outside of western and central African countries, have been recently reported in multiple European countries. The World Health Organization's (WHO) European chief said last week that those outbreaks could spread in the summer as people gather for parties and festivals. (Knutson, 5/24)

In a part of Nigeria that has dealt with monkeypox outbreaks for years, one doctor saw the photos circulating in Western media this week and chuckled. “Those are the very severe cases,” said Oyewale Tomori, a virologist in the nation’s southwest. “Like, ‘Ahh! This is monkeypox!’ ” ... What bothers infectious-disease experts across the continent is the double standard that has emerged since monkeypox grabbed the world’s attention: Few seemed to care, or even notice, until people in the West started getting sick. (Paquette and Ombuor, 5/24)

CDC officials have expressed concern that the extraordinary disruptions the country’s Covid response have caused to HIV-related services have inflicted collateral damage that could take years to undo. It even remains possible that, after decades of hard-fought declines, the national HIV transmission rate has crept up again. “We definitely had a hit from Covid-19,” said Dr. Demetre Daskalakis, the director of the CDC’s Division of HIV/AIDS Prevention. He called 2020 “a lost year” for the HIV fight, even amid the launch of a federal plan called Ending the HIV Epidemic in the U.S., or EHE. “We don’t really know where HIV transmission is going to land, but it’s something that we obviously are concerned about,” he added. (Ryan, 5/24)

The COVID-19 pandemic severely hampered HIV testing in the U.S., leading to a significant drop-off in the number of diagnosed infections from 2019 to 2020, according to a new Centers for Disease Control and Prevention (CDC) report. The agency’s annual HIV Surveillance Report found infections decreased 17 percent in 2020, from 36,940 to 30,635. But rather than good news, the numbers likely show an underdiagnosis because of a decrease in testing. It’s possible the number of infections is actually increasing. (Weixel, 5/24)

Despite the amazing scientific advances in HIV care that have taken place since the epidemic began 40 years ago, many people in racially and sexually minoritized communities still fall through the cracks. Some can’t afford care, and others can’t access it because of job or family demands, lack of transportation or documentation, or other barriers. Many face stigma and discrimination from medical providers themselves. I was determined to do everything I could to change the narrative of Nicole’s health-care experiences that day. (Malebranche, 6/1)

Kristine Gebbie, a health policy expert who served as the nation’s first AIDS czar in the early 1990s, died on May 17 in Adelaide, Australia. She was 78. The cause was cancer, her daughter Eileen Gebbie said.After serving as the chief health officer for the states of Oregon and Washington and as a member of two national panels, formed by President Ronald Reagan, seeking to cope with the emergent AIDS epidemic, Dr. Gebbie, a nurse, was recruited by President Bill Clinton in June 1993 to fulfill his campaign promise that he would make the disease a public health priority. (Roberts, 5/23)

Dozens of Democrat lawmakers are demanding that Google stop unnecessarily collecting and retaining users' location data out of concern that "far-right extremists" could use the data to go after those who've had abortions. "Google's current practice of collecting and retaining extensive records of cell phone location data will allow it to become a tool for far-right extremists looking to crack down on people seeking reproductive health care," the lawmakers said in a letter addressed to Google's CEO Sundar Pichai. (Soon, 5/25)

In their letter, the Democrats, who were led by Sen. Ron Wyden from Oregon, asks Google to stop collecting and keeping records of their customers’ every movement. Law enforcement officials routinely obtain court orders forcing Google to turn over its customers’ location information, the letter notes. This includes “geofence” orders, which are requests for Google to provide data about everyone who was near a specific location at a specific time. (Ortutay, 5/24)

Nine-term Rep. Henry Cuellar of Laredo was battling for survival Tuesday night in a fierce South Texas congressional race that drew huge attention as a bellwether for the nation’s mood on reproductive rights. Cuellar, a rare anti-abortion Democrat, faced Jessica Cisneros, an immigration lawyer who nearly ousted him two years ago .Just after midnight, with a lead of 177 votes out of 45,211, Cuellar – who won his 2002 race by just 58 votes, after two recounts – declared victory, though Cisneros did not concede. “The votes are in, the margin will hold. We have won by 177 votes,” he tweeted .With the Supreme Court poised to overturn Roe vs. Wade, the 28th District became a battleground between the party’s establishment and insurgent progressive wings. (Gillman, 5/24)

Florida Republican leaders are signaling they’re open to a complete ban on abortions next year if the Supreme Court overturns the landmark 1973 Roe v. Wade decision. Incoming state Senate and House leaders this week told POLITICO they aren’t immediately ready to pursue a strict ban on abortions but will follow the will of the GOP-led Legislature, which already voted to ban abortions after 15 weeks of pregnancy. That ban is the strictest in state history. (Sarkissian, 5/24)

Workers at the four Planned Parenthood clinics in Massachusetts are organizing a union, an effort that has taken on new urgency as the fate of Roe v. Wade hangs in the balance. If the Supreme Court overturns the decision, as expected, clearing the way for at least 26 states to ban or severely limit abortion, workers in locations where the procedure will remain legal, such as Massachusetts, are anticipating an influx of patients from other states. This added workload will increase pressure on already understaffed clinics with underpaid staff, employees say. Being part of a union will help support existing workers and bring in new ones, they note — and would benefit patients, too. (Johnston, 5/24)

KHN: As ‘Trigger Law’ Looms, New Clinic Preps To Provide Abortions In Conservative Bastion

A modest, tan building sandwiched between a gas station and a small apartment house near this Western city’s downtown has become an unexpected focal point of America’s abortion debate, just weeks before Wyoming could outlaw the procedure. Inside, a nonprofit is renovating the space into a clinic that, beginning in June, would be the only one in Wyoming to provide procedural abortions. The Casper clinic also would become the closest option for people in what the nonprofit’s founders describe as an “abortion desert,” extending into western Nebraska and South Dakota. (Zionts, 5/25)

There are questions about whether the FDA’s regulation of medication abortion trumps state abortions laws, potentially expanding medication abortion access even in states that attempt to ban all abortion. The U.S. Constitution provides that federal law preempts state law. The United States, the drug’s manufacturer, or a provider could bring a lawsuit arguing that a state cannot regulate medication abortion more harshly than the FDA, a federal entity. It’s clear that states cannot regulate drugs less harshly than the FDA. But whether the FDA’s regulation is just the nationwide floor or is also the nationwide ceiling is a complex question that might be different for different products. If it’s both, then states would not be able to ban an FDA-approved drug, especially one as closely regulated as mifepristone. (Rebouche, Cohen and Donley, 5/24)

Another form of the Omicron subvariant BA.2 has become the dominant version among new U.S. coronavirus cases, according to federal estimates on Tuesday, a development that experts had forecast over the last few weeks. There was no indication yet that the new subvariant, known as BA.2.12.1, causes more severe disease than earlier forms did. BA.2.12.1 made up about 58 percent of all new U.S. cases, according to estimates by the Centers for Disease Control and Prevention for the week ending May 21. (Hassan, 5/25)

The parent of these subvariants, omicron, provides some important lessons about what to expect with BA.2.12.1, BA.4, and BA.5. Omicron stands out from past Covid-19 variants because it has so many changes, close to 50 mutations compared to the original SARS-CoV-2 virus. Many are in the virus’s spike protein, enhancing how it breaks into human cells and making it harder for the immune system to target. So protection conferred by the previous versions of SARS-CoV-2 doesn’t translate as well to omicron and its subvariants. Omicron also appears to replicate much faster in the upper airways, making it easier to breathe out virus particles and spread them to others. Health officials warned in January that omicron would “find just about everybody.” (Irfan, 5/24)

Oregon is reporting some of the highest numbers of new COVID-19 cases since the pandemic started more than two years ago. The Oregon Health Authority reported nearly 12,000 new cases last week and the state is averaging 1,685 new cases a day, The Oregonian/OregonLive reported Tuesday. (5/24)

Coronavirus cases in the Bay Area’s spring surge have surpassed the peaks of the devastating winter wave of early 2021, but high levels of vaccination and immunity in the community are keeping hospitalizations at more manageable levels so far, and deaths remain notably low throughout the region. Statewide, coronavirus cases continue to rise sharply, with the Bay Area reporting overall higher levels than the rest of California. Officials said the current surge shows no signs of waning: The Bay Area is reporting about 53 new cases per 100,000 residents as of Tuesday, up from 18 per 100,000 a month ago and 42 last week. (Vaziri, 5/24)

COVID-19 case rates and hospitalizations are again rising, and hospital officials here on Tuesday urged residents to reconsider wearing masks indoors. The St. Louis Metropolitan Pandemic Task Force reported that the seven-day average of new COVID-19 admissions to area hospitals had doubled, to 32 on Monday, up from a low of 16 last month, and doctors expect rates to continue to rise. “We haven’t seen signs of that breaking,” said BJC Healthcare Chief Clinical Officer Dr. Clay Dunagan, who co-leads the task force. “So we expect that to continue to rise.” (Merrilees, 5/24)

The University of Hawaii said Tuesday it will require masks indoors across its 10-campus system amid a spike in COVID-19 cases in the islands. The new rule takes effect Wednesday. Those working alone or who are separated by more than 6 feet from others will be exempt. (5/24)

A West Virginia man pleaded guilty Monday to sending emails that threatened Dr. Anthony Fauci and former National Institutes of Health Director Dr. Francis Collins, federal prosecutors in Maryland said. Thomas Patrick Connally Jr., 56, most recently of Snowshoe, West Virginia, pleaded guilty to making threats against a federal official, U.S. Attorney for the District of Maryland Erek L. Barron announced in a news release. Connally also admitted threatening former Pennsylvania Health Secretary Dr. Rachel Levine, a Massachusetts public health official and a religious leader in New Jersey. (5/24)

For nearly two years, as the Covid pandemic disrupted life around the globe, other infectious diseases were in retreat. Now, as the world rapidly dismantles the measures put in place to slow spread of Covid, the viral and bacterial nuisances that were on hiatus are returning — and behaving in unexpected ways. Consider what we’ve been seeing of late. The past two winters were among the mildest influenza seasons on record, but flu hospitalizations have picked up in the last few weeks — in May! Adenovirus type 41, previously thought to cause fairly innocuous bouts of gastrointestinal illness, may be triggering severe hepatitis in healthy young children. (Branswell, 5/25)

One in five adult Covid survivors under the age of 65 in the United States has experienced at least one health condition that could be considered long Covid, according to a large new study by the Centers for Disease Control and Prevention. Among patients 65 and older, the number is even higher: one in four. (Belluck, 5/24)

Results from a new survey of more than 100,000 COVID-19 survivors released Tuesday by the personal genetics company 23andMe offer further evidence of a biological cause for the persistent, sometimes debilitating syndrome known as long COVID. Although 23andMe is best known for analyzing customers’ DNA samples, the new study did not look at DNA. Rather, it collected thousands of survey responses from among the company’s genetic testing customers that shine light on who is most at risk for post-COVID problems. The results underscore what earlier, smaller studies have found, researchers said, and even contain new clues about what may be causing the confounding symptoms, which range from body aches to brain fog to chronic fatigue. (Asimov, 5/24)

Doctors combed through the volunteers' medical records looking for anything that might predispose them to the lingering health problems that later would be called long COVID, symptoms like fatigue, headaches, and shortness of breath. The researchers also put the subjects through more than 130 tests for any signs their vital organs were damaged, that the virus was still hiding in their bodies, or their immune systems were malfunctioning. On Tuesday, the scientists released the first results from the study, which is ongoing. The study, published in the Annals of Internal Medicine, compared 189 patients diagnosed with COVID-19 to 120 similar patients who did not get sick. The results are both disappointing and provocative. (Stein, 5/24)

Some people disabled by long COVID-19 are struggling in the workplace, with employers refusing to make accommodations for the new condition, disability activists told a House committee on Tuesday. During a hearing for the House Financial Services Subcommittee on Diversity and Inclusion, witnesses detailed the challenges that disabled people continue to face in accessing financial services, equitable housing and work opportunities. (Choi, 5/24)

Leah Stagnone used to hold records as a distance runner at Campbell High School in Litchfield. The 26-year-old still tries to pass by when she can, on neighborhood walks with her family dog, Theo. But a few months ago, she got a harsh reminder that she needs to move at a much slower pace than she used to. “I got a little too confident,” Stagnone said, “and I ended up in bed for three days.” Stagnone often feels like she’s sick with the flu. Her head will ache with unrelenting pressure. It can be hard to think straight. Too much physical exertion, including walking, can cause her symptoms to flare up. (Fam, 5/24)

Federal health regulators on Tuesday issued a warning that COVID-19 patients who have taken the antiviral treatment Paxlovid may experience a rebound and test positive again two to eight days after initial recovery. The warning comes more than a month after droves of patients began swapping accounts on social media of COVID rebounds after taking Paxlovid. The alert from the Centers for Disease Control and Prevention said it continues to recommend Paxlovid for patients at high risk for serious complications from infection. It also said that people with a recurrence of COVID-19 symptoms, or a new positive test after having tested negative, should isolate again for at least five days. It added that people should wear a mask for a total of 10 days after rebound symptoms start. (Lazar, 5/24)

The advisory affirmed a trend many patients and doctors have been discussing for at least a month. A case study posted online in late April sequenced virus samples from a 71-year-old man who saw his illness rebound after finishing Paxlovid. The study, which is under review by a medical journal, found no indication that the man had developed resistance to the drug; instead, the authors suggested that symptoms may recur “before natural immunity is sufficient to fully clear” the virus. More recently, three prominent doctors have documented so-called Paxlovid rebounds within their own households on Twitter. (Bendix, 5/24)

A study from Israel published today in BMJ shows that the effectiveness of a fourth dose of Pfizer-BioNTech's mRNA COVID vaccine waned faster than a third dose in adults ages 60 and older. ... To gauge breakthrough infections, the authors performed a matched analysis that compared positive cases to controls by week since vaccination. The added relative vaccine effectiveness of a fourth dose against infection quickly decreased over time, peaking during the third week at 65.1% (95% confidence interval [CI], 63.0% to 67.1%) and falling to 22.0% (95% CI, 4.9% to 36.1%) by the end of the 10 week follow-up period, the authors said. (5/24)

A UK study suggests that COVID-19 vaccination offers protection against infection, hospitalization, and death for most cancer patients but is less effective and wanes faster than in the general population. In the study, published yesterday in The Lancet Oncology, a team led by University of Oxford researchers mined public data on English adults with and without cancer who had received two doses of a COVID-19 vaccine from Dec 8, 2020, to Oct 15, 2021, a period during which the Delta variant became dominant. (5/24)

There are thousands of children across Maryland who not only haven’t been vaccinated against COVID-19, but also lack protection from influenza and the kinds of diseases that routine shots long ago made scarce, such as measles and chickenpox. It’s a worrisome trend for public health experts, who see a surging number of children infected with the coronavirus and fear another outbreak in particular may be on the horizon — measles. (Cohn, 5/25)

Billions of people around the world have now been dosed at least once, twice, or thrice; the shots have saved hundreds of thousands, if not millions, of lives, in the United States alone—and they probably could have saved hundreds of thousands more, had more people rolled up their sleeves. “We’re so much better off than where we were in 2020, when nobody had any immunity,” says Donna Farber, an immunologist at Columbia University. It feels, in some ways, like gazing down the side of a mountain we’ve been trekking up for a good 30 months: A nice, stubborn buffer of elevation now lies between us and the bottom, the sea-level status of no protection at all. The body’s defenses against severe disease are immunological bedrock—once cemented, they’re quite difficult to erode. Even as the fast-mutating virus pushes down from above, our footing has, for more than a year now, felt solid, and the ground beneath us unlikely to give. (Wu, 5/23)

At first, Michelle Rogers thought the Craigslist ad she’d stumbled upon was a scam. It sounded like something out of a science fiction film: Researchers were offering thousands of dollars to volunteers who were willing to give themselves the flu. However strange it sounded, the experiment was the real thing. Vaccine researchers at the University of Maryland School of Medicine were testing just how much exposure to a current strain of influenza would cause infection as a way to prepare for future testing of antiviral drugs and vaccines. (Condon, 5/24)

The No Surprises Act shielded private health insurance enrollees from an estimated 2 million surprise bills during the first two months of the year, according to a report health insurance industry groups released Tuesday. AHIP and the Blue Cross Blue Shield Association surveyed more than 80 commercial health insurance companies, 31 of which responded. Those insurers represent 115 million commercial health plan members. These companies reported receiving 600,000 claims covered by the surprise billing law in January and February. Based on claims experiences from prior years and factoring in processing delays this year, the insurance groups estimate that the true amount of such bills at 2 million. (Berryman, 5/24)

A self-insured pharmacy sued Advocate Aurora Health on Tuesday for allegedly using all-or-nothing contracts to force Wisconsin employers to pay inflated prices rather than steer patients to lower-cost hospitals outside the health system. Advocate Aurora allegedly charges more than its competitors for routine services like a colonoscopy with a biopsy, which costs $10,700 at Advocate Aurora compared to $4,700 at Froedtert & the Medical College of Wisconsin, according to the lawsuit filed Tuesday in a Wisconsin federal court by Uriel Pharmacy, which offers a self-funded health plan for its employees in East Troy, Wisconsin. The not-for-profit health system operates 27 hospitals in Wisconsin and Illinois. (Kacik, 5/24)

Health insurance companies haven't adequately implemented changes to the prior authorization process that insurers and providers devised in 2018, according to survey results the American Medical Association published Tuesday. Four years ago, the AMA, AHIP, the Blue Cross Blue Shield Association and other healthcare groups agreed to encourage reviews of medical services and drugs subject to prior authorization, better communication about prior authorization processes, exemptions for some physicians and services, policies to promote continuity of care, and the adoption of electronic prior authorization systems. But the AMA now says insurers haven't upheld their end of the bargain. (Goldman, 5/24)

Patient data might be the biggest business you’ve never heard of. As a STAT investigation published Monday revealed, data brokers are quietly trafficking in Americans’ health information — often without their knowledge or consent, and beyond the reach of federal health privacy laws. This market in medical records has become highly lucrative  — $13.5 billion annually —  thanks to advances in artificial intelligence that enable the slicing, dicing, and cross-referencing of that data in powerful new ways. (Molteni, 5/24)

Something as simple as getting a Covid-19 test can be complicated for Joshua Miele, a principal accessibility researcher at Amazon. Miele is blind. When he got his rapid test results at the STAT Health Tech Summit in San Francisco on Tuesday morning, the clinician handed a sheet of paper with his result not to Miele, but to a sighted STAT reporter standing beside him. That is just one example of the erasure people with disabilities face when seeking health care, especially when that care is unrelated to disability, he later told the audience at the Commonwealth Club. (Cueto, 5/24)

Johns Hopkins All Children’s Hospital in St. Petersburg is now a Level 1 Children’s Surgery Center. The designation means the hospital is among the top institutions in the country for pediatric surgery. The American College of Surgeons has awarded the status to only two other hospitals in Florida and fewer than 50 around the nation. For All Children’s, it comes just a few years after regulators demanded changes at the hospital because of a spike in the mortality rate among pediatric heart surgery patients. (Ochoa, 5/24)

The National Football League on Tuesday unveiled a partnership with historically Black colleges and universities to give 16 medical students an opportunity to practice sports medicine in the league. Starting next football season, the NFL Diversity in Sports Medicine Pipeline Initiative will give HBCU students a one-month clinical rotation at one of eight NFL teams: the Atlanta Falcons, Cincinnati Bengals, Los Angeles Chargers, Los Angeles Rams, New York Giants, San Francisco 49ers, Tennessee Titans and Washington Commanders. (Abrams, 5/24)

A survey of college athletes by the NCAA suggests that rates of mental exhaustion, anxiety and depression remain as much as twice as high as pre-pandemic levels, but feelings of hopelessness have improved. The results of the study, a follow-up to two conducted in the fall of 2020, were released Tuesday. The data is based on input from more than 9,800 respondents and shows that mental health concerns remain sharply elevated. (5/24)

Irfan Akbani was worried about one of his newly pledged fraternity brothers at St. Louis University this spring. The student seemed “off” — not like his usual self. Akbani, a junior, didn’t think the younger student would confide in him, but he wanted someone to check in with him. Akbani approached the newly appointed mental health chair in his frat. “There’s something going on,” he said. His fraternity brother promised to look into it. (Sultan, 5/23)

Oklahoma's state health department has shut down a medical marijuana testing lab after state regulators found more than 140 samples containing yeast, mold, salmonella and E. coli the lab allegedly reported as passing. The order immediately suspended the medical marijuana business license for Scale Laboratories in Oklahoma City. Scale is the trade name for Shiv Krupa LLC. On Friday, the Oklahoma Medical Marijuana Authority issued a recall for 99 products related to the lab’s alleged rules violations. (Denwalt, 5/24)

A recent viral TikTok food hack has been dubbed unsafe by the U.S. Food and Drug Administration. Videos of halved avocados submerged in bowls or containers of water have bubbled up on TikTok and other social media platforms over the past few months. ... But an FDA official told "Good Morning America" the agency "does not recommend this practice." "The main concern is with the possibility that any residual human pathogens (i.e. Listeria monocytogenes, Salmonella spp., etc.) that may be residing on the avocado surface may potentially multiply during the storage when submerged in water," the official said in a statement to "GMA." (McCarthy, 5/24)

Knowing your "ABCs" may save your life." The Real Housewives of Orange County" star Tamra Judge recently took to Instagram to remind her followers about the dangers of melanoma. "May is melanoma awareness month. Please Go get a full body skin check, it could save your life.  #melanomasurvivor," she posted several days ago. The 54-year-old was diagnosed with the skin cancer in 2017 after first noticing a mole that summer on a very sensitive area -- the buttock, but it was later diagnosed as melanoma after a massage therapist encouraged her to make sure it was not serious, according to Self, a wellness and health content platform. (Sudhakar, 5/24)

Recent Consumer Reports tests of more than 100 food packaging products from U.S. restaurants and supermarkets found dangerous PFAS chemicals in many of the products, including paper bags for french fries, wrappers for hamburgers, molded fiber salad bowls and single-use paper plates. Previous CR tests found PFAS — per- and polyfluoroalkyl substances — in drinking water and bottled water. (Loria, 5/23)

Montana Gov. Greg Gianforte’s administration says transgender people can not change their birth certificates even if they undergo gender-confirmation surgery, in defiance of a court order that temporarily blocked the Republican state’s bid to restrict transgender rights. The state health department said in an emergency rule that it would no longer record the category of “gender” on people’s birth certificates, replacing that category with a listing for “sex” — either male or female — that can be changed only in rare circumstances. (Brown, 5/24)

Just minutes after the Indiana General Assembly overrode Gov. Eric Holcomb’s veto of the state’s ban on transgender girls playing girls school sports, the first lawsuit against the measure was filed. The American Civil Liberties Union of Indiana is suing the Indianapolis Public Schools district on behalf of a 10-year-old transgender girl who will no longer be able to play softball on her school’s all-girls’ softball team. The child and her family were identified only by initials in the lawsuit. (Herron, 5/24)

Delaware Gov. John Carney on Tuesday vetoed a bill to legalize possession of up to one ounce of marijuana by adults for recreational use, drawing the wrath of fellow Democrats who have fought for years to make weed legal. In vetoing the measure, Carney reiterated his previously expressed concerns about legalizing recreational pot — concerns that did not dissuade fellow Democrats from pushing the legislation through the General Assembly. (Chase, 5/24)

Iowans won't have to pay state taxes on the bonuses that Iowa Gov. Kim Reynolds awarded to teachers, correctional officers, police officers and child care workers under a bill headed to her desk.  The same bill also eliminates sales tax on feminine hygiene products and the tax on child and adult diapers. The wide-ranging tax legislation won unanimous support in both the House and Senate on Monday. Lawmakers passed the bill Monday evening amid a flurry of other legislation as they drew closer to the end of the session. (Richardson, 5/24)

The Department of Justice has opened an investigation into how Kentucky cares for mentally ill adults in the Louisville area. The probe will look into potential violations of the Americans with Disabilities Act. Investigators are looking at whether the state subjects adults with serious mental illness “to unnecessary institutionalization and serious risk of institutionalization in psychiatric hospitals,” according to a media release from the Justice Department. (5/24)

Sen. Bill Cassidy, R-La., is under fire for comments he made about the state of Black maternal health in an interview with Politico last week. Cassidy said that while Black people make up a third of the state’s population and experience higher rates of pregnancy-related deaths, “if you correct our population for race, we’re not as much of an outlier as it’d otherwise appear.” (Bellamy-Walker, 5/23)

The University of California system agreed Tuesday to settle lawsuits brought by hundreds of alleged victims of a former UCLA gynecologist, bringing total litigation payouts to nearly $700 million, the largest ever related to sexual abuse involving a public university. The latest $374.4 million in settlements covers 312 former patients who sued alleging they were abused by Dr. James Heaps under the guise of medical examinations between 1983 and 2018. (Winton, 5/24)

KHN: The Blackfeet Nation’s Plight Underscores The Fentanyl Crisis On Reservations 

As the pandemic was setting in during summer 2020, Justin Lee Littledog called his mom to tell her he was moving from Texas back home to the Blackfeet Indian Reservation in Montana with his girlfriend, stepson, and son. They moved in with his mom, Marla Ollinger, on a 300-acre ranch on the rolling prairie outside Browning and had what Ollinger remembers as the best summer of her life. “That was the first time I’ve gotten to meet Arlin, my first grandson,” Ollinger said. Another grandson was soon born, and Littledog found maintenance work at the casino in Browning to support his growing family. (Bolton, 5/25)

Mayor Michelle Wu announced an expanded effort Tuesday to address the humanitarian crisis in the area known as Mass. and Cass with an 11-point focus on housing, health care, and public safety programs, amid concerns that crime and vagrancy have persisted and will grow worse as summer approaches and more people tend to stay on the streets. Called the “Warm Weather Program,” the plan involves directing more health care workers and police officers to the intersection of Massachusetts Avenue and Melnea Cass Boulevard, guiding people to support services and housing options, and arresting those engaging in drug dealing, prostitution, and violent crime. Tent encampments will be taken down the moment they go up. City public works crews will increasingly clean streets and sidewalks, and paint new crosswalks. (Valencia and Fatima, 5/24)

A day after a news report captured Los Angeles Homeless Services Authority workers throwing away food meant for unhoused people, L.A. City Atty. Mike Feuer sent a letter to the agency demanding answers. The report, aired by KCBS-TV Channel 2 on Monday, showed LAHSA workers throwing cases of food into a dumpster. The news station said it had followed homeless services workers for months and used hidden cameras. Many were seen at the end of their work days folding empty boxes after presumably handing out the meals, according to KCBS. (Yee, 5/24)

Pfizer Inc. plans to sell its entire portfolio of brand-name drugs at cost in as many as 45 lower-income countries, one of the most comprehensive and ambitious drug-access programs ever announced by a large pharmaceutical manufacturer. The initiative will start in five African countries with 23 drugs for cancer, rare illnesses, inflammatory conditions and infectious diseases. It will eventually include all of the New York-based company’s future therapies or vaccines. The drugs will be sold at the cost of manufacturing, Pfizer said, typically a fraction of their price in U.S. or European markets. The company also plans to invest in local health systems to improve diagnostic capabilities, get the drugs approved and make sure doctors know how to administer them. (Armstrong, 5/25)

The gold rush for drugmakers making Covid-19 vaccines and treatments might be over, as demand plateaus, supplies turn ample and the pandemic evolves. Merck & Co. and Johnson & Johnson are among the companies cutting sales expectations for pandemic products this year as they assess the outlook. Analysts, meantime, are lowering sales estimates for Covid-19 drugs such as Pfizer Inc.’s antiviral Paxlovid, citing softening demand and few new supply deals. (Hopkins, 5/24)

WHO Director-General Tedros Adhanom Ghebreyesus was reappointed to a second five-year term on Tuesday by the U.N. health agency’s member countries. No other candidate challenged Tedros for the post amid the ongoing difficulties of responding to the devastating coronavirus pandemic. (Cheng, 5/24)

Following detections of avian flu in foxes in Canada and the United States, veterinary officials in Alberta have detected the virus in skunks found dead, according to CTV News. The detections in wild mammals are notable, raising concerns about the zoonotic potential of the circulating virus. (4/24)

CVS Health Corp. will stop filling prescriptions for controlled substances ordered by clinicians working for telehealth startups Cerebral Inc. and Done Health starting Thursday, a move that will impact thousands of patients. Cerebral disclosed the change in a statement to The Wall Street Journal. The pharmacy plans to block Done prescriptions for controlled substances as well, according to a person familiar with the matter. (Winkler, 5/25)

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin are widely used to treat pain and inflammation. But even at similar doses, different NSAIDs can have unexpected and unexplained effects on many diseases, including heart disease and cancer. (Yale University, 5/23)

On April 30, 2022, communities across the country demonstrated their support for DEA’s annual National Prescription Drug Take Back Day by dropping off more than 720,000 pounds of unneeded medications at 5,144 collection sites. Since 2010, DEA, along with its law enforcement partners, has collected nearly 16 million pounds of unneeded prescription medications. (5/23)

A systematic review and meta-analysis of clinical trials of antibiotic treatment for children with community-acquired pneumonia provides further support for shorter treatment duration, Finnish researchers reported yesterday in Clinical Infectious Diseases. (5/18)

A new study by researchers in the United Kingdom indicates that antibiotics given to pregnant women prior to a caesarean birth do not increase the risk of asthma, eczema, or other allergic conditions in children. The findings of the longitudinal study, published yesterday in the BMJ, provide support for a policy instituted in 2011 by the UK's National Institute for Health and Care Excellence (NICE) that recommended prophylactic antibiotics before incision in women undergoing caesarean section, who are more susceptible to postpartum infections. (Dall, 5/19)

The G7 Health Ministers late last week highlighted the "silent pandemic" of AMR as one of their primary health priorities. In a communique issued after their May 19-20 meeting in Berlin, the health ministers of the G7 countries (Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States) called AMR an "urgent public health and socio-economic problem" that will affect the entire globe but have a significant impact on low- and middle-income countries. Acknowledging AMR as a shared responsibility, they committed to "taking further urgent and tangible action" to address the issue. (5/23)

The World Health Organization (WHO) last week published its strategic priorities for tackling antimicrobial resistance (AMR). The document lays out four strategic priority areas that incorporate what the WHO says are the essential components of the AMR response at global, regional, and country levels. It also lists the key achievements and the next steps that need to be taken in those four areas. (5/23)

Dietary supplements are often sold alongside over-the-counter medications, but the regulatory frameworks for these products differ substantially. Unlike over-the-counter and prescription drugs, supplements aren’t vetted by the Food and Drug Administration (FDA) before being introduced, and their advertising is often deceptive. (Pieter A. Cohen, M.D., Jerry Avorn, M.D., and Aaron S. Kesselheim, M.D., J.D., M.P.H., 5/18)

The pharmaceutical market has become complex and dysfunctional. In the absence of federal action on the costs of prescription drugs, state legislatures continue to debate and enact policies that help policymakers understand the market problems. More recently, states have begun to take action to manage the costs of drug products through creation of prescription drug affordability boards. (Jane Horvath, 5/18)

Here in Ohio, we have seen a terrifying rise in the prevalence and use of counterfeit prescription pills being sold on the street and online. These imitation pills can look exactly like prescription drugs, but they often contain fentanyl. And there is no way to tell whether a pill purchased on the street or on the internet is safe. (Rob Portman, 5/23)

Rates of drug-overdose deaths, which had already been rising for more than two decades, have increased dramatically during the Covid-19 pandemic. Between May 2020 and April 2021, more than 100,000 people died of overdoses in the United States, a 28.5% increase from the previous year and a higher number than in any other year. The epidemic of illness and death due to substance use has also caused tremendous economic, mental, and emotional harm. Without dramatic changes in federal policy approaches to substance use, harm reduction, substance use disorder treatment, and widening social inequities, rates of drug-related deaths will most likely continue to increase. (Aneeqah H. Naeem, B.A., Corey S. Davis, J.D., M.S.P.H., and Elizabeth A. Samuels, M.D., M.P.H., M.H.S., 5/21)

The World Health Organization has revealed that there are now 131 confirmed cases of monkeypox, and a further 106 suspected cases, in 19 countries. Experts describe the event as “random” but “containable” and was likely sparked initially by sexual activity at recent raves in Spain and Belgium. Nevertheless, with the world still reeling from the effects of the Covid pandemic, the rise of a different disease is putting many people on edge. (Sam Fazeli, 5/24)

You might call it a disastrous “October surprise” for Democrats in this year’s crucial midterm campaign — except it wouldn’t be a surprise at all, and it is completely avoidable. The governing party’s inability thus far to reach some kind of agreement on a scaled-back version of President Biden’s Build Back Better legislation is raising a real possibility that millions of middle-class Americans will see their health insurance costs go up by hundreds of dollars per month next year. And if it happens, they will hear the news about it just weeks before Election Day. (Karen Tumulty, 5/24)

The mind reels, words falter, anger rises, and nothing is done. Nothing. Nothing. American children are dead, and still nothing. This time, it’s Texas — an elementary school. Kids. At least 19 children dead, not counting the killer. Two adults as well. Ten days ago it was a grocery store in Buffalo, New York. Before that, a church. At other times, a concert, a nightclub, a shopping mall, a movie theater, a high school, a workplace, a military base, a baseball diamond, a home. Still, nothing. “What are we doing? Why are we here?” Connecticut Sen. Chris Murphy asked Tuesday evening. “This only happens in this country and nowhere else. Nowhere else do little kids go to school thinking that they might be shot that day.” To which we must answer Sen. Murphy, in words appalling and shameful: We are doing nothing. (5/24)

Even in the best of times, nursing is a terrible job. We get pooped on. Yelled at. We care for a lot of people who are having the worst day of their lives. Unsurprisingly, they’re not always particularly nice or grateful, no matter how kind and gentle we try to be. We cause pain in the name of healing, sticking needles and tubes in places nature never intended, and we spend a surprising amount of time extracting, collecting, measuring, and transporting bodily fluids. (Clara Yim Bolduc, 5/25)

Traumatic brain injury, long linked to military service and sports, has another more insidious source: domestic violence, also known as intimate partner violence. In fact, the number of people who sustain traumatic brain injuries during domestic violence episodes may outstrip their combined incidence in athletes and military personnel. Unfortunately, this connection isn’t often discussed. (Cecille Joan Avila, 5/25)

The pandemic has been furnishing new and distressing episodes almost weekly for more than two years now. But what is in retrospect perhaps the most concerning, for me, came in May 2021, when the International Monetary Fund calculated that the full cost of vaccinating the large majority of the world’s vulnerable people would be $50 billion — just 1 percent of the money spent by Congress on pandemic relief and only about half of the money the United States has spent on fighting AIDS abroad. The I.M.F. called this “A Proposal to End the Covid-19 Pandemic” and meant it. The organization suggested the global payback for that $50 billion program, by 2025, would be $9 trillion — nearly a 200-fold return — in just four years. The humanitarian gains of a global vaccination effort would have been incalculable and still are. The diplomatic gains, as well. (David Wallace-Wells, 5/24)

It was probably inevitable that the baby formula shortage would devolve into a noxious quarrel between the breastfeeding and formula-feeding camps. Within days of the now weeks-long crisis finally hitting the mainstream news cycle, social-media feeds were filling up with all kinds of thoughtless commentary. Some iteration of, “Can’t find formula? Try breastfeeding,” was a common refrain. As was: “How about trusting women to do what’s best for them and their babies.” (Cynthia M. Allen, 5/24)

A dear friend reached out a few weeks ago. They asked, “What’s the plan for the Bad Day in June?” Meaning, the day we expect Roe v. Wade to be overturned and a massive rollback of civil and human rights to ensue. We discussed coping strategies: stocking up on comfort foods and favorite beers, hand-selecting the people we’d want to be with — the colleagues we felt closest to, the ones we loved the most, the ones who were going to quietly pass the tissues when we couldn’t hold back the tears. (Morgan Nuzzo, 5/20)

Now that the Oklahoma State Legislature has voted to ban abortion from the moment of conception, I have a few questions for Justice Samuel Alito and any others who would join him in overturning Roe v. Wade: What is your reaction to the news from Oklahoma? The State Legislature gave final approval last Thursday to a bill that would prohibit nearly all abortions, starting at fertilization. It now awaits the signature of the governor, who has pledged to make Oklahoma “the most pro-life state in the country.” (Linda Greenhouse, 5/24)

Last week, Gov. Jared Polis appeared on Colorado Matters with host Ryan Warner. The opening question was as straightforward as it gets: “Do you support removing the ban on state funding for abortion?” For pro-choice supporters — which Polis claims to be — the answer should have been a simple “yes.” But Polis refused to answer the question directly. Instead, after multiple follow-ups, the governor ultimately resorted to a condescending dismissal of Warner’s question as “hypothetical” and falsely likened abortion to a “nose job.” (Trish Zornio, 5/23)