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The U.S. government will allot nearly 85% less Johnson & Johnson COVID-19 vaccines to states next week, data from Centers for Disease Control and Prevention (CDC) showed. Only 785,500 J&J doses will be allocated, compared to 4.95 million doses this week. The U.S. Department of Health and Human Services (HHS) and J&J did not immediately respond to requests, made outside regular hours, for comment on the drop in numbers. (4/8)

California is expecting about 90% fewer Johnson & Johnson vaccine doses next week, marking a significant decrease in the total number of doses that will lead to fewer first-time appointments, even as the state expands eligibility to any resident over age 16 on April 15. State health officials anticipate that allocations of all COVID-19 vaccines will drop by 367,000 doses next week to about 2 million total, down from about 2.4 million doses received this week, said California Department of Public Health spokesperson Darrel Ng said Wednesday night. Doses are expecting to drop again to about 1.9 million the week after next. (Kelliher, 4/7)

All people who live and work inside Pennsylvania’s prisons will soon be offered the single-dose Johnson & Johnson vaccine, ending a long wait exacerbated by a lack of transparency about coronavirus infections. At least 11 of the state’s 23 prisons have started to receive the vaccine, with thousands of inmates and corrections staff expected to be offered a shot in coming weeks, according to corrections officials and incarcerated people. (Darius Jaafari, 4/8)

In updates on the Maryland plant that manufactures Johnson & Johnson vaccines —

A top federal pandemic official warned last June that Emergent BioSolutions, the government contractor that last month threw out millions of doses of Covid-19 vaccines because of contamination, lacked enough trained staff and had a record of problems with quality control. A copy of the official’s assessment, obtained by The New York Times, cited “key risks” in relying on Emergent to handle the production of vaccines developed by both Johnson & Johnson and AstraZeneca at Emergent’s Bayview plant in Baltimore. (Stolberg, LaFraniere and Hamby, 4/7)

The U.S. reached a milestone in its vaccination efforts on Wednesday, with new data showing that close to 25 percent of adults in the country have been fully vaccinated. The data from the Centers for Disease Control and Prevention also show that 40 percent of adults and 75 percent of seniors have received at least one dose. (Ramos, 4/7)

The list of universities requiring vaccinations to return to campus in the fall is growing longer by the day. With the mandates, universities are going where most corporations have not. The political and legal blowback is already taking shape. (Brown and Fernandez, 4/7)

Nearly 90% of college students say they probably or absolutely will get vaccinated, according to a Generation Lab poll exclusive to Axios. College students have contributed to the nationwide spread of the virus, and their vaccination is necessary in bringing the pandemic under control before variants spread any further. (Fernandez, 4/8)

Useful Covid-19 information isn’t reaching the Instagram generation. There’s almost no messaging specifically tailored to them from federal or state public health officials. There’s hardly anything official on Tik Tok. And even the limited efforts to reach them where they are — like Instagram’s links to its “Covid-19 information center”— aren’t working. (Florko, 4/8)

More than 450 PCOM Georgia medical, pharmacy and physician assistant students are working to meet the need for COVID vaccinators in Georgia. During a four-day period in March, the PCOM Georgia student vaccinators worked in shifts to administer 1,200 doses of the vaccine to Newton County School System teachers at the Porter Performing Arts Center in Covington. Local pharmacist Jeff Reagan called the students “professional” and “a great help” in the effort. (4/7)

It was a move that put other vaccine selfies to shame. In a March meet against Minnesota, University of Illinois gymnast Evan Manivong sprinted toward the vault, launched into the air, spun and stuck the landing, nailing his routine and tying his career-high. As his teammates cheered, Manivong clapped and celebrated and then whipped out a coronavirus vaccination card that was tucked in his leotard and flashed it for the cameras. (Kornfield, 4/6)

In vaccine news from Florida —

Gov. Ron DeSantis refused to send COVID-19 vaccines to state prisoners for several months, but state officials announced Tuesday that about 30,000 doses have been earmarked for the Florida Department of Corrections. Florida Division of Emergency Management Director Jared Moskowitz told the Miami Herald the state is sending doses within the next week. (4/7)

An executive order signed by Gov. Ron DeSantis on Friday that prohibits businesses from requiring customers to provide vaccination documents could effectively keep Florida's cruise industry from reopening. DeSantis signed the order banning businesses from requiring vaccination "passports" — documents that prove a person has been vaccinated. (4/7)

And allergic reactions are looked at more closely —

The anecdotal reports are true: people who get the Moderna COVID-19 vaccine say they have more side effects than people who get the Pfizer / BioNTech shots, according to new data published this week in JAMA. The study analyzed reports collected through a Centers for Disease Control and Prevention program called v-safe. It’s a text message-based program designed to track side effects in vaccine recipients. For the first week after each vaccine dose, people who enroll are prompted to fill out a daily survey about any symptoms, like fatigue or arm pain. (Wetsman, 4/7)

The National Institutes of Health (NIH) has launched a clinical trial to better understand allergic reactions related to the Moderna and Pfizer- BioNTech COVID-19 vaccines. The trial, which will involve 3,400 adults, 60% of whom have a history of severe allergic reactions or a diagnosis of mast cell disorder, will also consider the biological mechanism behind the reactions to see if a genetic pattern or other factors can better predict who is at risk of a reaction. The participants will be split into two groups and be unaware as to if they are receiving a vaccine or placebo until after the second dose is administered and the observation period has concluded. (Hein, 4/7)

Hospitals are seeing more and more younger adults in their 30s and 40s admitted with severe cases of Covid-19, Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said Wednesday. “Data suggests this is all happening as we are seeing increasing prevalence of variants, with 52 jurisdictions now reporting cases of variants of concern,” Walensky said at a press briefing on the pandemic. (Mendez, 4/7)

The number of new Covid-19 cases has plateaued at a "disturbingly high level," and the US is at risk from a new surge, Dr. Anthony Fauci warned on Wednesday. Although off the highs of earlier this year, there were still more than 61,000 new cases reported on Wednesday, according to data from Johns Hopkins University. And the lack of continued significant decreases in infections is a concern, the director of the National Institute of Allergy and Infectious Diseases told CNN's Anderson Cooper, particularly given the spread of variants. (Holcombe, 4/8)

In updates on the surge in Michigan and the Midwest —

As states lift restrictions and worrisome coronavirus variants spread, scientists and federal health officials have been warning that a new wave of cases could arise in the United States even as the nation’s vaccination campaign gathers speed. The seeds of such a surge may now be sprouting in the Upper Midwest and the Northeast. Michigan is already in tough shape. New cases and hospitalizations there have more than doubled in the last two weeks. The six metro areas in the United States with the greatest number of new cases relative to their population are all in Michigan. (Ngo and Stolberg, 4/8)

Michigan hospitals are responding to a third surge of COVID-19 patients since the pandemic began early last year that has been highlighted by a larger percentage of admissions of younger patients under 65 who are mostly unvaccinated. Hospital admissions are up 51% since the end of March — increasing for all age groups and all regions — but are highest for those 50-59 years old. The numbers of COVID-19 patients in intensive care units also have increased 43%, the state Department of Health and Human Services said in its March 30 report. (Greene, 4/7)

Amid Michigan’s worst-in-the-nation coronavirus surge, scientists and public health officials are urging the Biden administration to flood the state with additional vaccine doses. So far, though, their plea has fallen on deaf ears. Instead, the federal government is sticking to a vaccine-allocation strategy that largely awards doses to states and territories based on their population. As a result, most jurisdictions are still receiving similar per-capita vaccine supplies, regardless of how many people there are getting sick — or how many excess vaccine doses they have. (Facher, 4/8)

The global scramble to produce enough Covid-19 vaccine for 7 billion people is about to get even tougher, as drugmakers and countries ready a second round of shots to combat the growing threat of virus variants. Finding vaccines that can ward off more contagious or virulent strains is only half the battle. The United States has virtually no capacity to manufacture revised vaccines or booster shots alongside the original versions, according to a half-dozen vaccine experts and Biden administration health officials. Setting up additional facilities could take months or even years. (Owermohle, 4/7)

The B.1.1.7 coronavirus variant that originated in the United Kingdom is now the most common strain in the U.S., Centers for Disease Control and Prevention (CDC) director Rochelle Walensky said Wednesday at a White House briefing. Studies have shown the B.1.1.7 variant is more contagious than the original strain and is associated with a higher risk of death. (Chen, 4/7)

The spread of the U.K. variant, which scientists have found to be more contagious, adds to growing concerns that the country may be on the cusp of another surge. Both case numbers and hospitalizations are increasing, even as the U.S. is vaccinating an average of nearly 3 million people each day. Walensky reported that some of the recent clusters of cases have been linked to day care centers and youth sports, adding that the uptick in infections seem to be driven by young people. (Chow, 4/7)

In related news about the variants —

The Florida Department of Health reported 5,556 people tested positive for the coronavirus since Monday's report, bringing the total number of cases statewide to 2,090,862. Tuesday's report showed an increase of 2,076 in daily positive cases from Monday, when 3,480 cases were reported. (Lisciandrello, 4/7)

As the California coronavirus variant continues to spread across the Golden State and beyond, new research suggests that several vaccines should continue to provide an effective defense against it. The findings, published Wednesday in the New England Journal of Medicine, offer good reason for Californians to keep rolling up their sleeves as the vaccination campaign picks up steam across the state. “We’re not expecting this variant to be a problem for the vaccines — so that’s really good news,” said study leader David Montefiori, a virologist at Duke University. (Khan, 4/7)

West Virginia health officials on Wednesday warned that the United Kingdom variant of COVID-19 will make a significant impact in the state if young people do not get vaccinated at a higher rate. ... In West Virginia, the U.K. variant has been found in 19 counties, totaling 142 cases, state health officer Dr. Ayne Amjad said. The number has nearly tripled from just seven days ago, when 53 cases of the U.K. variant had been identified. The Kanawha-Charleston Health Department detected the first case of the U.K. variant in Kanawha County on Wednesday, breaking the mold of where most prior cases had been found. Infections have mostly been in border counties, Amjad said, with Berkeley, Monongalia and Ohio counties reporting the most variant cases. (Severino, 4/7)

Georgia Gov. Brian Kemp (R) announced on Wednesday that all remaining COVID-19 restrictions in the state will be lifted starting Thursday. “We know hard-working Georgians cannot endure another year like that last. That is why beginning tomorrow we are loosening the remaining restrictions on our economy here in Georgia,” Kemp said in a video statement Wednesday. (Lonas, 4/7)

North Dakota’s Republican-led Senate endorsed a measure Wednesday that would prohibit the state from mandating face coverings. Senators approved the bill 30-17, but amended it to give local governments, schools and employers the option of requiring masks. (4/7)

If you don't want a COVID-19 shot, several Republican lawmakers want to make sure you don't face any penalties because of that decision. House Bill 248, introduced Wednesday, would allow Ohioans to decline a COVID-19 shot – or any other vaccine – because of religious reasons, medical reasons or natural immunity. The proposal would prevent anyone who chooses not to be vaccinated from facing discrimination, being denied services or forced to follow a requirement that they wear masks or other penalties financial or social from businesses, schools or government. (Balmert, 4/7)

Although a new Utah law means mask mandates will end statewide this weekend, Salt Lake City Mayor Erin Mendenhall said nothing will change in the capital. HB294, which lifts mask requirements Saturday, allows counties to extend their own local mandates. The Salt Lake County Council opted Wednesday not to do so. But Mendenhall said the law does not apply to her own local authority and emergency powers. She issued a proclamation extending the current mask mandate, in line with her numerous other declared local emergencies since March 2020 that are related to the pandemic. “This proclamation does not conflict with state’s so-called COVID ‘endgame’ bill,” Mendenhall said at a news conference. “As a city, we will be guided by public health data. Protecting the health of our residents will always be my highest priority.” (Larsen, 4/7)

A day after saying Pasco County Schools would not follow the county's lead by removing a requirement to wear masks, Superintendent Kurt Browning reversed track Tuesday and said masks in schools may soon be voluntary. Browning told the school board at a meeting that once Gov. Ron DeSantis' order declaring a state of emergency over the COVID-19 pandemic expires, mask wearing will be optional. (Schreiner, 4/7)

News that California will finally emerge from nearly all pandemic restrictions on June 15 included one glaring exception: The face coverings that have hidden our grins and grimaces for the better part of a year are not going away. Given a chance to provide a glimmer of hope for ending California’s mask mandate, Gov. Gavin Newsom and the state’s health secretary, Dr. Mark Ghaly, firmly decided not to go there, saying there was no end date goal just yet. (Vaziri, 4/7)

Returning to a maskless Disney World may not yet be on the horizon, but new changes make taking off your mask easier for guests. Starting Thursday, visitors at Walt Disney World Resort are permitted to remove their mask to take outdoor photos, though it comes with a few rules. (4/7)

Also —

Oregon said Tuesday it won’t approve widely adopted technology that would allow smartphone users to be notified if they are potentially exposed to COVID-19, saying the health authority has “all available resources” assigned to vaccine management. The announcement ended suspense over a project first announced six months ago but repeatedly delayed, with limited explanation. Oregon is one of just four states along or west of the Continental Divide that hasn’t adopted the technology. (Theen, 4/6)

The Biden administration has rescinded permissions for Michigan and Wisconsin to require Medicaid beneficiaries to either work or attend school or job training in order to enroll in the public health program for lower-income Americans. The administration’s actions follow recissions of similar requirements in Arkansas and New Hampshire. (Ollove, 4/7)

After refusing to set money aside in next year’s budget to pay for a voter-approved expansion of Medicaid, Republicans in the Missouri House took steps Tuesday to distribute the unspent cash on other items. From directing $18 million to school transportation costs to sending an additional $88 million to nursing homes, the House Budget Committee reviewed how it will spend the $1 billion that Republican Gov. Mike Parson had earmarked for the expansion of the health insurance program for the poor. (Erickson, 4/7)

Republican Texas House Speaker Dade Phelan threw his weight Wednesday behind a bill that would extend Medicaid coverage to mothers for a year postpartum as part of a broad package of proposals meant to increase access to affordable health care in Texas. The number of reported maternal deaths has increased nationwide in recent decades, and Texas data shows Black women in the state die disproportionately while pregnant or after delivery, from causes like infections, heart problems and mental disorders. (Najmabadi, 4/7)

Come July 1, North Carolina’s Medicaid program is being placed into the hands of commercial insurers, and this time, state officials say, the transition is all but guaranteed. The move will change Medicaid, the largest public insurer in the state, into something that looks and acts more like private health insurance. (Engel-Smith, 4/8)

In Medicare news —

CMS wants to boost Medicare payments for inpatient rehabilitation facilities by 2.2% and inpatient psychiatric facilities by 2.3% next year, the agency said Wednesday. According to CMS, the changes would increase federal spending on inpatient rehab by $160 million compared to 2021. Likewise, federal spending on inpatient psychiatric facilities would go up by about $90 million. Regulators plan to require inpatient rehabilitation and psychiatric facilities to report COVID-19 vaccine coverage among their healthcare personnel. (Brady, 4/7)

Early data indicate President Biden faces an even worse opioid abuse epidemic than former president Donald Trump. Biden's administration has signaled some initial indications of how it intends to approach the problem of drug abuse — a crisis that will get renewed attention as the threat of the coronavirus recedes. Overdose deaths in the United States last year may have topped 90,000.Final data won’t be available until near the end of this year. But an analysis of preliminary data by the Commonwealth Fund found that shortly after the pandemic started, monthly overdose deaths spiked 50 percent to more than 9,000 deaths in May. (Cunningham and Ellerbeck, 4/7)

In Rhode Island, doctors set up a hotline to get people started on buprenorphine, commonly known as Suboxone. Those involved in the hotline believe it has saved lives. Without it, the deadliest year on record for opioid overdoses might have been even worse, they say. But that hotline’s future is in doubt. It only exists because the federal government waived regulations requiring doctors to see patients in-person first in response to the COVID-19 pandemic. And a bill in the U.S. Senate — introduced by senators including Rhode Island’s Sheldon Whitehouse — would put the hotline out of business once the state of emergency is over, the people who set it up say. (Amaral, 4/7)

A federal judge has given a green light to lawyers representing children with birth defects — allegedly due to exposure to opioids in utero — to question Purdue Pharma over efforts to provide documents concerning any links to its addictive painkiller and birth defects. The decision is a modest, but potentially significant victory in a long-running battle to connect OxyContin with neonatal abstinence syndrome, or NAS, a group of conditions caused when a baby withdraws from certain drugs while exposed in the womb. NAS is most often caused by opioid use during pregnancy. (Silverman, 4/7)

CVS Health Corp., Walgreens Boots Alliance and other pharmacy chains face mounting pressure to settle thousands of government lawsuits over their role in the U.S. opioid epidemic, after a federal judge warned the companies they risk financial peril. As drug makers and distributors work to resolve similar complaints, mediation has failed with pharmacies, which are accused of ignoring red flags about suspicious painkiller prescriptions. The first trials are set to start this year, and a judge on Wednesday may expand the number of early cases going before juries to help gauge the potential cost of settling all the cases. (Feeley, 4/7)

In news about fentanyl —

Georgia officials are warning that some people may be overdosing on fentanyl pills that were falsely sold to them as Xanax or Percocet. The suspected overdoses began in January and have continued through March. Of 137 suspected incidents reported to hospital emergency rooms statewide, 99 have come from Augusta or neighboring Columbia County, and another 26 have been in the broader 13-county health district that includes Augusta. (4/7)

As overdose deaths rise, a growing number of Maine police departments are beginning to distribute fentanyl testing kits to those who may come in contact with the potent synthetic opioid. The Bath and Brunswick police departments are the latest Maine law enforcement agencies to join the Police Assisted Addiction and Recovery Initiative’s One2One program, which supplies departments with fentanyl testing kits as an engagement and harm reduction tool for people at risk of an overdose. The kits will allow an individual to test substances for the presence of fentanyl and will also include information about treatment and recovery options. (Abbate, 4/8)

While providers expected insurers to relax prior authorization policies during the pandemic, 70% of surveyed physicians reported the changes were brief, if made at all, and did not relieve some of their burdens. Slow prior authorization protocols contributed to care delivery delays and poor treatment outcomes for some patients during the surge in COVID-19 cases last winter, according to American Medical Association survey. (Gellman, 4/7)

Most US patients saw an increase in days of supply (DOS) for medication for chronic conditions during the pandemic, but prescription data still showed an increased likelihood of drug discontinuation, according to a study published last week in PLOS One. The researchers chose an example drug with available generics from six therapeutics classes less likely to be affected by the COVID-19 pandemic: hormonal contraception, immunosuppression, serotonin regulation, and drugs to address attention deficit hyperactivity disorder (ADHD) and psychoses. They determined that patients had discontinued a drug if the DOS were not sufficient to cover a given month. (McLernon, 4/7)

An international study that identified a dramatic increase in out-of-hospital cardiac arrests (OHCAs) preceding and paralleling the COVID-19 pandemic suggests that OHCA is yet another example of the virus's myriad multisystemic effects and a signal of upcoming community surges. In the observational study, published today in the Lancet's EClinicalMedicine, emergency services medical directors in 50 large cities in the United States, Italy, the United Kingdom, France, Australia, and New Zealand reported tallies of monthly OCHAs among adults in their respective jurisdictions from January to June 2020 and compared them with numbers from the same periods in 2018 and 2019. (Van Beusekom, 4/7)

Hospitals nationwide are making progress in meeting national standards in caring for women who are giving birth, though there's been less progress in lowering C-Section rates, according to quality and safety not-for-profit Leapfrog Group. A little over half of 2,200 surveyed hospitals voluntarily reported that less than 23.9% of their first-time pregnant women gave birth via C-section, a change that's been slowly decreasing over the past five years. (Gillespie, 4/8)

ProMedica has launched an initiative addressing the health impact of unsafe housing conditions, one of the first health systems to do so. The Toledo, Ohio-based health system announced Wednesday it was entering into a multi-year, multi-city partnership to reduce the health hazard caused by substandard housing conditions with the Green & Healthy Homes Initiative, a Baltimore-based, not-for-profit organization that provides support services and technical assistance to create healthy housing environments. (Ross Johnson, 4/7)

In news about health care personnel —

The president of Massachusetts General Hospital, Dr. Peter L. Slavin, plans to step down after 18 years leading the powerful and prestigious institution, amid a broad restructuring at its parent company. Slavin announced the move in an e-mail to staff Wednesday morning. He plans to stay at MGH — which has consistently ranked among the top hospitals in the country — until his successor arrives, after a search process that could take months. (Priyanka Dayal McCluskey, 4/7)

KHN and The Guardian: 12 Months Of Trauma: More Than 3,600 US Health Workers Died In Covid’s First Year
More than 3,600 U.S. health care workers perished in the first year of the pandemic, according to “Lost on the Frontline,” a 12-month investigation by The Guardian and KHN to track such deaths. Lost on the Frontline is the most complete accounting of U.S. health care worker deaths. The federal government has not comprehensively tracked this data. But calls are mounting for the Biden administration to undertake a count as the KHN/Guardian project comes to a close today. (Spencer and Jewett, 4/8)

KHN and The Guardian: Calls Mount For Biden To Track US Health Care Worker Deaths From Covid 
Calls are mounting for the Biden administration to set up a national tracking system of covid-19 deaths among front-line health care workers to honor the thousands of nurses, doctors and support staffers who have died and ensure that future generations are not forced to make the same ultimate — and, in many cases, needless — sacrifice. Health policy experts and union leaders are pressing the White House to move quickly to fill the gaping hole left by the Trump administration through its failure to create an accurate count of covid deaths among front-line workers. The absence of reliable federal data exacerbated critical problems such as shortages of personal protective equipment that left many workers exposed, with fatal results. (Pilkington, 4/8)

Researchers found that when male and female patients expressed the same amount of pain, observers viewed female patients' pain as less intense and more likely to benefit from psychotherapy versus medication as compared to men's pain, exposing a significant patient gender bias that could lead to disparities in treatments. (4/6)

After an unprecedented push to test and track COVID-19, public health workers are grappling with a worrisome side effect: a collapse in screening for sexually transmitted diseases that have been on the rise for years. Testing for diseases like chlamydia and gonorrhea plummeted in many parts of the U.S. last year as COVID-19 sapped away resources and staff. Health officials say this testing gap left them unable to track or control outbreaks of the diseases, which were already at record levels before the pandemic. (Perrone, 4/7)

While suicidal thoughts and self-harm have been well documented in teenagers, mental health experts say too little attention has been paid to young children, despite growing evidence that more elementary and middle school students are in crisis. ... In interviews, more than a dozen mental health professionals, including school counselors, social workers, psychiatrists and suicidologists, said they are seeing more children as young as kindergarten who are in dire need of support. (Kingkade and Chuck, 4/8)

Jack Hanna, celebrity zookeeper and wildlife conservationist, has been diagnosed with dementia, his family said Wednesday. The former director of the Columbus Zoo and Aquarium will be retiring from public life.  Hanna's three daughters — Kathaleen, Suzanne and Julie — announced their 74-year-old father's diagnosis in a letter posted on social media. Doctors believe his condition, which progressed much faster than anticipated, to be Alzheimer's. (Goel, 4/7)

In public health news about the coronavirus —

Millions of counterfeit masks have been seized by Customers and Border Protection (CBP) officials since the start of the pandemic. But the last few months have seen an "exponential increase" in counterfeit mask seizures, a CBP official told CNN. Since the start of the pandemic, CBP has seized more than 34 million counterfeit masks, most of them modeled to resemble N95 or KN95 masks. Around 20 million of those masks were caught in 2021, said John Leonard, acting executive assistant commissioner of the agency's Office of Trade. (Andrew, 4/8)

Ryan Riley is a British chef who has spent the past several months concocting an array of science-based recipes to help people like Dixon enjoy food even though their sense of smell and taste is compromised. He co-wrote the cookbook “Taste & Flavour,” which has recipes that elevate flavor combinations, textures and other sensory elements that might stimulate a long-hauler’s dulled senses. (Page, 4/7)

As millions of Americans spend hours at a time in videoconferences — and then hop in their car — many are struggling to maintain their concentration, making experts fear this zoning out due to cognitive overload could be contributing to a surge in roadway deaths. “After you get into your car, you may be operating on autopilot,” Joan Claybrook, a former head of the National Highway Traffic Safety Administration, said. “I think computer use, in general, can overload you." (Eisenstein, 4/7)

At this point of the pandemic, the idea of visiting extended family again may be a bright spot after a dark year. Some people have been vaccinated against coronavirus, but the risks associated with spending time around others outside of your household haven't been fully eradicated. "The tough part is that right now, I think that we all still need to be vigilant in everything we do, whether we're vaccinated or not," said Dr. Ada Stewart, a family physician with Cooperative Health in Columbia, South Carolina, and the president of the American Academy of Family Physicians. (Rogers, 4/7)

Following a three-year probe, Merck (MRK) reached a deal with Austrian regulators to end a “predatory” pricing strategy for a brain cancer treatment, the latest instance in which European authorities have scrutinized the pharmaceutical industry over anticompetitive practices. The focus of the investigation was Temodal, which is used to treat such brain tumors as glioblastoma, the most frequent type of brain tumor in adults. Approximately 350 people develop this malady in Austria each year, but the Federal Competition Authority determined the company was making it difficult for lower-cost generic versions to reach the market. (Silverman, 4/7)

Researchers are reporting some progress in their search for drugs that tamp down the overwhelming immune reaction that can kill a patient with COVID-19. These reactions are triggered by coronavirus infections and can veer out of control in some people. It's this reaction, rather than the virus itself, that is the real peril for people seriously ill with COVID-19. Doctors last year recognized that a cheap and readily available steroid drug called dexamethasone can often rein in this overreaction, which is a form of inflammation. In fact, it's the only COVID-19 drug so far that clearly saves lives. (Harris, 4/7)

Just a few years ago, the idea of at-home testing was practically antithetical to Caesar Djavaherian’s mission. The clinician and founder was laser-focused on serving people in person with his network of urgent care clinics. Fast forward to the spring of 2020, and his company — fresh off the heels of a merger with Carbon Health — was dashing to offer one of the first at-home test kits for Covid-19. (Brodwin, 4/8)

In research and biotech news —

Weeks after it was scrubbed from the Journal of the American Medical Association's website, a disastrous podcast — whose host, a white editor and physician, questioned whether racism even exists in medicine — is surfacing complaints that JAMA and other elite medical journals have routinely excluded, minimized, and mishandled issues of race. Recent examples include research blaming higher death rates from COVID-19 in African Americans on a single gene in their nasal passages; a letter claiming structural racism doesn’t play a role in pulse oximeters working less well on patients with dark skin because machines can't exhibit bias; and an article claiming that students of programs designed to increase diversity in medicine won’t make good doctors. (Lee McFarling, 4/7)

Clinical trials have a dirty little secret. For all the careful work that goes into randomizing and blinding participants just so, the criteria that determine who can enter a trial can be unexpectedly arbitrary. Patients can be nixed because of age, lab values, medication history, and a laundry list of other factors that may not always be necessary. (Palmer, 4/7)

A new list of the top 100 private AI companies shows that health is driving investment in the industry. COVID-19 has shown the power and potential of AI applications for health, and the growth of the field will continue long after the pandemic has finally ended. (Walsh, 4/7)

When Nancy Hopkins joined the faculty of the Massachusetts Institute of Technology nearly 50 years ago, she didn’t think that her gender would have any impact on her career. “I was a person who thought that there really were no issues left for women to worry about in academia, once they were able to get jobs,” she said. But when she saw male colleagues receiving better treatment and more opportunities, she began to understand that a “strange undervaluation of women” was shaping her career and the careers of her female colleagues. (Sohn, 4/7)

The Virginia Legislature voted Wednesday to accelerate its timeline for marijuana legalization to July 1 instead of January 2024. Personal possession and home cultivation would be legal starting in July. Marijuana sales still wouldn’t start until 2024, giving the government time to set up a cannabis regulatory agency to oversee the new industry. (Zhang, 4/7)

The Texas House Committee on Public Health passed a bill Wednesday that would include more patients in the Texas Compassionate Use Program (TCUP) for medical marijuana. House Bill 1535, authored by Fort Worth Republican Rep. Stephanie Klick, would grow the Texas Compassionate Use Program by including patients with any type of cancer, not just terminal, PTSD in veterans and chronic pain that would otherwise be treated with an opioid. (Briseno, 4/7)

House Republicans on Tuesday endorsed all three GOP-sponsored marijuana implementation bills, meeting the party leadership's expectations to propel each proposal to the Senate. After a rapid-fire round of amendments during the chamber's third floor session of the day, House bills 701, 707 and 670 still require third readings in the House on Wednesday before they will be passed over to the Senate. Thursday's transmittal deadline has kicked the process into high gear, which stirred some concern among several lawmakers that committees did not have time to properly vet the proposals and introduced some uncertainty as to the fate of each bill before the House floor vote on Tuesday. (Larson, 4/6)

A medical marijuana bill on Wednesday cleared its first major hurdle in the Alabama House of Representatives. The House Judiciary Committee approved the bill after lengthy debate and multiple amendment attempts. The bill now goes to the Health Committee after House leaders decided the controversial bill must go through two committees before going to a floor vote. A version of the proposal has already passed the state Senate. (Chandler, 4/7)

Venushki “Venus” Hemachandra has made it her mission to diversify the often white and male dominated medical marijuana industry. The founder and owner of Herbiculture, a 4,000-square-foot dispensary housed in a business park in Burtonsville, Montgomery County, says she’s used to surprising people by going against age, gender and ethnicity expectations. Already licensed as a dispenser, the Randallstown resident, 31, last year became one of the few women in Maryland also licensed as a grower and processor. She’s now poised to open just such a facility in Baltimore. (Williams IV, 4/8)

The acceptance of legal weed by governors and state lawmakers in 2021 — without the explicit blessing of voters — marks a turning point. Until this year, only two states had legalized recreational marijuana programs through the legislature: Illinois in 2019 and Vermont in 2020. “The sky hasn't fallen in those states that have legalized,” said Karen O’Keefe, director of state policies for legalization advocacy organization Marijuana Policy Project. “It doesn't hurt that these laws generate a lot of economic growth in the way of new jobs, new small businesses and hundreds of millions of dollars in tax revenue that states could really use as they recover from Covid.” (Zhang, 4/7)

One day will likely cost some Wisconsin residents one month’s worth of food aid. Last week’s Wisconsin Supreme Court ruling striking down Gov. Tony Evers’ COVID-19 emergency order means that next month the state will begin losing more than $50 million per month in emergency supplemental FoodShare benefits, the state Department of Health Services confirmed Wednesday. (4/7)

In mental health news from Iowa and Georgia —

The Iowa Senate has passed a sweeping tax proposal that would revise Iowa's mental health funding system, phase out property tax replacement payments to local governments and ensure Iowans see a series of income tax cuts begin in 2023. The bill, Senate File 587, also includes a handful of changes affecting school funding and various state tax credit programs. It passed Tuesday evening on a 30-17 party-line vote. (Richardson, 4/7)

Students at six Atlanta schools will have more access to mental health services because of a $1.95 million grant recently awarded to the district. Atlanta Public Schools secured the five-year grant from School-Based Healthcare Solutions Network. The district will use the money to make licensed mental health providers available at six campuses starting next school year. (McCray, 4/8)

In abortion news from Idaho and Florida —

A panel of Idaho lawmakers advanced two bills targeting abortion Wednesday. The first bill attempts to dissuade women from having abortions if the fetus is diagnosed with Down syndrome. The other bill would eliminate government funding from health care providers, schools or other entities if they provide abortions, refer someone to an abortion provider or even contract with someone affiliated with an abortion provider for non-abortion services. (Boone, 4/7)

Physicians who terminate pregnancies solely because women don’t want children with disabilities could face felony charges under a bill moving through the Florida House. Members of the House Health & Human Services Committee voted 12-8 on Tuesday to advance the controversial bill (HB 1221), which would apply to physicians who know or should know abortions they perform were requested solely because of prenatal diagnoses, tests or screenings that indicated fetuses would have disabilities. (Sexton, 4/7)

In other state news —

Leaders in the Texas House on Wednesday unveiled a suite of health care initiatives aimed at boosting access for new moms, children, Texans in rural areas and those who depend on costly prescription drugs. The bills, many of which have bipartisan backing, are among what was suggested to be the first wave of measures the lower chamber hopes to pass this session amid the coronavirus pandemic. Texas has long had some of the worst health outcomes in the country, as well as the highest uninsured rate. (Blackman, 4/7)

A Navy medic who shot and wounded two U.S. sailors before he was killed by police on a nearby Army base was a laboratory technician assigned to a Naval medical research center on the base, according to his service record and a military official. Fantahun Girma Woldesenbet, 38, and the two men he shot Tuesday at a government-leased military warehouse were all assigned to Fort Detrick in Frederick, authorities have said. (Burns and Kunzelman, 4/7)

A suspect was found after an hours-long search following a South Carolina shooting Wednesday evening that left five people dead, including two children and a prominent doctor, authorities said. ... The York County coroner's office said Dr. Robert Lesslie, 70, and his wife, Barbara Lesslie, 69, were pronounced dead at the scene along with grandchildren Adah Lesslie, 9, and Noah Lesslie, 5. A fifth victim, James Lewis, 38, from Gaston, was found dead outside. ... Dr. Robert Lesslie has been practicing in Rock Hill since 1981, according to the Riverview website. He received his degree at the Medical University of South Carolina and has worked in the surrounding Rock Hill area and Charlotte, North Carolina. (4/8)

KHN: ‘Go Ahead And Vote Me Out’: What Other Places Can Learn From Santa Rosa’s Tent City 
They knew the neighborhood would revolt. It was early May, and officials in this Northern California city known for its farm-to-table dining culture and pumped-up housing prices were frantically debating how to keep covid-19 from infiltrating the homeless camps proliferating in the region’s celebrated parks and trails. For years, the number of people living homeless in Santa Rosa and the verdant hills and valleys of broader Sonoma County had crept downward — and then surged, exacerbated by three punishing wildfire seasons that destroyed thousands of homes in four years. (Hart, 4/8)

Britain said on Wednesday that it would curb the use of AstraZeneca’s vaccine in adults under 30 because of the risk of rare blood clots, a blow to the efforts of scores of countries reliant on the vaccine to stamp out the coronavirus pandemic amid a global surge in cases. Adding to the unease, the European Medicines Agency outlined a “possible link” between the vaccine and rare clots, even as it said that Covid-19 remained the far greater threat, leaving decisions about how to use the vaccine in the hands of the 27 member states of the European Union. (Mueller, 4/7)

AstraZeneca's coronavirus vaccine took yet another public relations hit yesterday, when the European Medicines Agency announced that the shot has a "possible" link to rare blood clots, and they should be listed as a "very rare" side effect of the vaccine. Even before the link was announced, the U.S. didn't need the AstraZeneca vaccine, based on its existing supply of other shots. But what the Food and Drug Administration decides to do about the vaccine — if the company seeks U.S. authorization — will likely have global ramifications. (Owens, 4/8)

Coronavirus vaccine maker CureVac has said it hopes its Covid shot will receive European approval in the second quarter. CureVac’s CEO Franz-Werner Haas told CNBC Thursday that the vaccine maker was close to finalizing the recruitment for the vaccine’s Phase 3 clinical trial. Approval could come not long after, he said, given the urgent need for additional effective coronavirus vaccines and the expedited regulatory approval process. (Ellyatt, 4/8)

New Zealand has announced a temporary entry ban on all travelers from India, including NZ citizens, after a spike in COVID-19 cases at the border from the South Asian nation — which set another pandemic record on Thursday. NZ Prime Minister Jacinda Ardern announced at a briefing the 17-day suspension after 17 of the 23 new coronavirus infections confirmed Thursday in returned travelers in managed hotel quarantine were from India. (Falconer, 4/8)

In news about polio —

Afghanistan is trying to inoculate millions of children against polio after pandemic lockdowns stalled the effort to eradicate the crippling disease. But the recent killing of three vaccinators points to the dangers facing the campaign as turmoil grows in the country. The three women were gunned down in two separate attacks on March 30 as they carried out door-to-door vaccinations in the eastern city of Jalalabad. (Faiez, 4/8)

An analysis of US mortality data shows all-cause mortality rose 23% in 2020, researchers reported today in JAMA. To assess excess deaths during the pandemic, researchers from Virginia Commonwealth University School of Medicine examined provisional data from the National Center for Health Statistics and the US Census on observed deaths from COVID-19 and non-COVID causes in 49 states and the District of Columbia from Mar 1, 2020, through Jan 2, 2021. They then compared the numbers to a model that used US mortality data from 2014 through 2019 to predict expected deaths in 2020. They also looked at regional death patterns. (4/2)

Hospitalized patients with COVID-19 pneumonia who were discharged with home oxygen equipment after being clinically stable had an 8.5% readmission rate, which led to a 1.3% rate of in-hospital deaths, according to a study yesterday in JAMA Network Open. None died in ambulatory care. The researchers followed up with 621 clinically stable adults discharged with home oxygen from Mar 20 to Aug 19, 2020, for a median of 26 days. All patients had been hospitalized in California for COVID-19 pneumonia and had received a median of 2.0 liters of oxygen per minute while in the hospital. Upon discharge, they received home oxygen equipment, educational resources, and at least one follow-up phone call within 12 to 18 hours. (4/2)

The COVID-19 B117 strain, which was first identified in the United Kingdom, has similar aerosol stability compared with three other COVID strains, so transmissibility differences are most likely due to other factors, according to a study last week in The Journal of Infectious Diseases. The researchers looked at an isolate of B117 as well as three other COVID-19 strains (hCoV-19/France/IDF0372/2020, hCoV-19/USA/NY-PV08449, and hCoV-19/USA/WA-1/2020), testing the effects of light, humidity, and temperature on aerosols from a simulated respiratory tract lining fluid (sRTLF) in a rotating drum chamber. (4/5)

Thirty-day incidence of venous thromboembolism (VTE) [or blood clots in deep veins] does not appear to have a greater association with outpatients infected with COVID-19 compared with non-infected adults, according to a research letter today in JAMA Internal Medicine. The researchers looked at 220,588 adults tested for COVID-19 from Feb 25 to Aug 31, 2020, in the Kaiser Permanente Northern California health plan. After excluding patients who were asymptomatic at the time of testing or who had previously received anticoagulants, 26,104 (11.8%) were included in the positive COVID subgroup. (4/5)

The COVID-19 pandemic was associated with a marked decrease in pediatric ED visits across a broad range of conditions; however, the proportional decline of poisoning and mental health visits was less pronounced. The impact of decreased visits on patient outcomes warrants further research. (DeLaroche et al, 4/1)

As schools reopen nationwide, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in youth settings remains a concern. Here, we describe transmission of SARS-CoV-2 among >6800 youth and staff at YMCA of the Triangle day camps in North Carolina (March to August 2020). (D'Agostino et al, 4/1)

In late June 2020, a large outbreak of coronavirus disease 2019 (COVID-19) occurred at a sleep-away youth camp in Georgia, affecting primarily persons ≤21 years. We conducted a retrospective cohort study among campers and staff (attendees) to determine the extent of the outbreak and assess factors contributing to transmission. (Szablewski et al, 4/1)

Also —

In previous studies, researchers have reported that youth with a lifetime history of prescription opioid misuse (POM) are at an increased risk for suicidal ideation, planning, and attempts. In this study, we investigate whether the association between youth POM and suicide outcomes differs by recency of POM (ie, none, past, or current misuse). METHODS: In this report, we use data from the 2019 Youth Risk Behavior Survey to examine associations between recency of POM (current POM, past POM, and no POM) and suicide risk behaviors among US high school students. (Wilkins et al, 4/1)

A worldwide analysis of hospital antibiotic prescribing patterns found considerable differences between countries and regions in proportional use of Access, Watch, and Reserve (AWaRe) antibiotics, researchers reported today in the Journal of Antimicrobial Chemotherapy. Using data collected in 2015, 2017, and 2018 by the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance (Global-PPS), researchers from the University of Antwerp analyzed hospital antibiotic use at 664 hospital in 69 countries. They categorized inpatient antibiotic consumption using the AWaRe classification system, introduced by the World Health Organization (WHO) in 2017 to provide an indirect indication of the appropriateness of antibiotic use at national and global levels, then calculated proportional Access, Watch, and Reserve use by region and country. The final dataset included 80,671 patients who received at least one systemic antibiotic. (4/5)

A comparison of dental antibiotic prescribing rates found that US dentists prescribe antibiotics much more frequently than those in England, Australia, and Canada, researchers reported today in Infection Control & Hospital Epidemiology. The population-level analysis of dental antibiotic prescribing looked at pharmacy-dispensed systemic antibiotic prescriptions by dentists in the United States, England, Australia, and British Columbia in 2017. The three outcomes analyzed for each country were the rate of antibiotic prescribing per 1,000 population, the relative proportions of each antibiotic class, and the prescribing rate per 1,000 population of each antibiotic type. (4/5)

On the surface, Parkinson's disease and melanoma do not appear to have much in common. However, for nearly 50 years, doctors have recognized that Parkinson's disease patients are more likely to develop melanoma than the general population. Now, scientists report a molecular link between the two diseases in the form of protein aggregates known as amyloids. The researchers will present their results today at the spring meeting of the American Chemical Society (ACS). (4/7)

Though many people initially believed a vaccine was the magic bullet that would save us from a devastating pandemic and return our lives to normalcy, we now find ourselves contemplating simultaneously how to ethically allocate a limited number of vaccine doses to the many people who want them and how to increase vaccine uptake among those who don’t. ... Vaccine confidence seems to be rising, but recent polling suggests that about 31% of Americans wish to take a wait-and-see approach, and about 20% remain quite reluctant. The behavioral obstacles to widespread vaccination are thus as important to understand as the scientific and logistic hurdles. (Dr. Lisa Rosenbaum, 4/8)

As the U.S. and U.K. vaccinate their populations much faster than initially anticipated, two disparate concepts have been swirling online in English-language vaccine discourse: the moral need for global vaccine equity and the consumer-driven desire for vaccine passports. I am a much bigger fan of creating global vaccine equity—by breaking intellectual property patents if necessary—to suppress the level of SARS-CoV-2, the virus that causes COVID-19, in as many humans as possible as quickly as possible across borders than I am a fan of creating vaccine passports that only allow those with the privilege of getting a vaccine to cross borders. Borders in some countries are currently being used to determine who does and doesn’t get a vaccine. It would be even more unethical to use those borders to bar the movement of people who have been denied vaccination. (Steven W. Thrasher, 4/7)

The United States is doing better than most nations in delivering vaccines. About 168 million doses have been administered and more than 63 million Americans are fully vaccinated. That’s great news, but before we raise our aching vaccinated arms in triumph, we must realize that none of us will be safe unless we help protect the rest of the world. “It’s in the interest of everybody to make sure that as soon as possible and in a fair way, everybody gets vaccinated everywhere and that vaccines are considered to be a truly global public good,” said United Nations Secretary-General António Guterres. (4/8)

We need to stop using the phrase “vaccine passport.” The term is inflammatory and divisive, and runs the real risk of triggering a lasting backlash against vaccinations. It’s also inaccurate. A passport is generally understood as a government-issued document that provides proof of the carrier’s identity and citizenship. Israel’s “Green Pass” is a version of a vaccine passport; it is required for entry into gyms, theaters and other designated areas, and forgery of a pass is a crime. While it has some fans, almost no one is proposing this kind of national ID for coronavirus vaccination in the United States. (Leana S. Wen, 4/7)

From Michigan to Massachusetts, COVID-19 cases and hospitalizations are on the rise again. Deaths will soon follow. We have a way to respond and save lives: vaccinations, which prevent infection and have also shown they are effective in preventing transmission. There will be enough vaccines by summer to vaccinate every American, including children as young as 12. But summer is not here yet. And the recent spoilage of 15 million doses of Johnson & Johnson’s one-dose vaccine means we will need 30 million more doses of two-shot vaccines soon, to make up for the loss. (Govind Persad, William F. Parker and Ezekiel J. Emanuel, 4/7)

In 2000, the small farming town of Walkerton, Ontario, suddenly became known to scientists around the world. During the second week of May that year, the town, about 115 miles northwest of Toronto, got more than five inches of rain. Bacteria from manure on a farm was carried by runoff to a nearby well. Public utilities operators failed to appropriately monitor the water supply or to quickly advise the town how to ward off contamination, a government inquiry later concluded. Without that information, Walkerton residents continued to drink the water, and more than 2,300 people became sick. Twenty-four children experienced severe kidney damage that occurred after the gastrointestinal symptoms subsided. Seven people died. (Roxanne Khamsi, 4/6)

As people around the world have spent the past year trying to dodge a deadly virus, everyone has learned more about masks, social distancing and washing hands than anyone thought possible. Many folks have pivoted their workout routines to at-home renditions and tried to eat more vegetables because we're fighting coronavirus and trying to feel better at the same time. (Many have also eaten more junk because -- comfort food comforts us in a pandemic.) On yet another World Health Day during a pandemic, it's worth noting on April 7 what we've learned over the past year about our health and well-being. (Allison Hope, 4/7)

The images of a police officer in Miami-Dade County taking a 7-year-old boy — in handcuffs — for a psychiatric exam after he hit a teacher sparked outrage in 2018. That’s not what the Florida Mental Health Act of 1971, known as the “Baker Act,” was intended to do. It allows law enforcement, courts or health professionals to commit a person, with or without their consent, for psychiatric evaluation if they present a danger of bodily harm to themselves or others or are likely to suffer neglect because of mental illness. (4/7)

We’re more than a year into the pandemic and COVID-19 has impacted nearly every facet of San Diegans’ lives. As our communities combat SARS-CoV-2 transmission across the city, we are simultaneously, and quite literally, in the fight of our lives against sexually transmitted diseases (STDs) and HIV in the region. For the last five years, STDs have been on the rise in San Diego. So much so that in 2018, a study by AIDSVu found that residents of the San Diego metropolitan area were diagnosed with chlamydia at a rate of 656.5 per 100,000 people — bestowing America’s Finest City with the No. 1 chlamydia rate among major cities in the American West. (Susan Little, 4/7)

In Philadelphia today, your zip code determines your life expectancy. Neighborhoods just one mile apart can see average life expectancies that differ by 20 years. And this was before COVID-19 killed over 3,000 Philadelphians, the vast majority of whom are Black and brown people. There are a multitude of factors that play into community health: social and economic conditions, the environment, the accessibility of healthy products, like fresh and nutritious food, behavioral choices, and the healthcare system. Nearly all of these factors are impacted by systemic racism. For generations, policies and programs influenced by systems ingrained with racial bias and outright discrimination have created the situation we find ourselves in today. Black and brown people are more likely to live in poverty, are more likely to have chronic health conditions, and are more likely to live near toxic pollution, all leading to lower lifespans. (Katherine Gilmore Richardson, 4/7)

More than a year into the COVID-19 pandemic, our country is still grappling with numerous crises. With the vaccine rollout underway, conversations are starting to shift from management to recovery. Nowhere is this truer than in the health and housing sectors, where a vaccine won't magically fix one's ability to pay for long-term health issues or rent. Given the breadth of the recovery, policymakers must be strategic, but also identify opportunities to promote long-term stability. That begins with treating housing instability, including homelessness, as a public health crisis. As policymakers and professionals in the health and housing sectors embark on a post-pandemic recovery process, they must work together to deliver solutions that simultaneously promote a person's health and housing stability. This will help speed up the recovery by allowing experts to share resources, align efforts and more purposefully address systemic root causes of illness and housing instability. (Erin Kelly, 4/8)

Business as usual has not been the mantra for companies developing Covid-19 vaccines and drugs. Instead, biopharma companies and their partners pursued various transformational approaches to get vaccines and treatments to market at unprecedented speeds. These included adaptive trials, master protocols, real-world evidence, and other approaches powered by advanced statistical techniques, data science, and analytics using curated datasets. (Andrew Bolt and Sonal Shah, 4/8)

If you’re thinking about the COVID pandemic as an assault against physical health alone, you’ve got it all wrong. The statistics on illness and death are staggering—but there’s been an equally staggering toll exacted on our mental health. Nearly one third of Americans are experiencing symptoms of clinical depression or anxiety, and the Well Being Trust estimates we will suffer up to 150,000 additional deaths tied to the social isolation and economic stressors associated with COVID-19. In nonpandemic times, making choices that benefit both physical health and mental health was relatively straightforward, for these choices were often one and the same. Doing good for your body has tangible benefits for your mood and psychological well-being. For example, exercise significantly reduces anxiety and depression—at rates comparable to pharmacotherapy. Likewise, healthy sleep habits that foster physical homeostasis and more efficient immune system functioning also significantly reduce our risk for depression, anxiety and bipolar illness. (June Gruber and Jessica L. Borelli, 4/7)