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The blood thinner Eliquis and popular diabetes treatments including Jardiance are among the first drugs that will be targeted for price negotiations in an effort to cut Medicare costs. President Joe Biden’s administration on Tuesday released a list of 10 drugs for which the federal government will take a first-ever step: negotiating drug prices directly with the manufacturer. (Murphy, Seitz and Megerian, 8/29)

The drugs include Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and insulins that go by names including Fiasp and NovoLog. The new prices will be announced on Sept. 1, 2024 and will go into effect on Jan. 1, 2026. The drugs were chosen from a list of 50 drugs that cost Medicare’s pharmacy drug benefit the most money. (Cohrs, 8/29)

The drugs listed Tuesday are among the top 50 with the highest spending for Medicare Part D, which covers prescription medications that seniors fill at retail pharmacies. The 10 medicines accounted for $50.5 billion, or about 20%, of total Part D prescription drug costs from June 1, 2022, to May 31, 2023, according to the Centers for Medicare and Medicaid Services, or CMS.  (Constantino, 8/29)

When could Medicare patients who take one of the 10 drugs pay less? Jan. 1, 2026. However, several factors could complicate that timeline. This includes the outcomes of several lawsuits challenging the constitutionality of the law and the outcomes of the 2024 presidential elections. If the law goes forward as prescribed, then the final negotiated price for the products won’t be reached until Sept. 1, 2024. (King and Lim, 8/28)

In the year since the passage of Democrats' drug pricing law, pharmaceutical companies and venture capitalists have shifted their priorities and placed less emphasis on developing synthetic drugs that will be subject to price negotiations faster than biologics. Pharmaceutical interests say it's proof that Democrats' signature health policy achievement is driving investment away from some mainstays of modern medicine. (Reed, 8/29)

Texans struggling with skyrocketing medication costs could see relief under a new program that allows distributors to import cheaper drugs from Canada. House Bill 25 creates the “Wholesale Prescription Drug Importation Program.” The state’s Health and Human Services Commission would contract with Canadian drug wholesalers and suppliers to bring safe, eligible prescription drugs to Texas consumers at prices far cheaper than U.S. wholesalers. (Harper, 8/29)

Millions of people are being pushed off state Medicaid rolls as the U.S. dismantles one of the last major Covid-era safety nets, and congressional Democrats and health advocates want the Biden administration to do more to ensure people are protected. Nationwide, nearly 5.5 million people have been purged from state Medicaid rolls across 45 states and the District of Columbia, according to health policy research group �鶹Ů��.  (Weixel, 8/28)

For months, Evangelina Hernandez watched helplessly as her autistic twin sons regressed – their screaming, biting and scratching worsening. The Wichita, Kansas, resident couldn’t afford the $3,000 monthly tab for their 10 prescriptions or their doctor visits without Medicaid. The toddlers, along with three of their sisters, lost their health insurance in May, swept up in the state’s eligibility review of all its Medicaid enrollees. Hernandez said she only received the renewal packet a day before it was due and mailed it back right away. She also called KanCare, the state’s Medicaid program, and filled out another application over the phone, certain that the kids remained eligible. (Luhby, 8/26)

Schools across the country are missing out on millions of dollars from an unlikely federal source — Medicaid — because of longstanding bureaucratic hurdles that the Biden administration is now trying to address. (Harris, 8/29)

With the state budget’s passage now two months late, North Carolina Gov. Roy Cooper’s administration announced Monday that it can’t start the implementation of Medicaid expansion to hundreds of thousands of low-income adults in the early fall as it had wanted. State Health and Human Services Secretary Kody Kinsley said that expansion won’t begin on Oct. 1, which in July he unveiled as the start date — provided that a budget law was enacted by Sept. 1. (Robertson, 8/28)

Physicians who take Medicaid will start to see payment increases for certain office visits. Children’s wellness visits are one of the fields affected. “This last legislative session, there were some payment increases for Medicaid services, specifically payment for office visits to children including well-child visits,” said Dr. Zeke Silva, President of the Bexar County Medical Society. Doctors will also see payment increases for certain women’s health visits. (8/27)

Ohioans United for Reproductive Rights announced Monday afternoon that it plans to file a lawsuit Monday asking the Ohio Supreme Court either to order the ballot board to use the full text of the amendment on ballots this November, or to “correct blatant inaccuracies.” “The summary that was adopted by the Ballot Board is intentionally misleading and fails to meet the standards required by Ohio law,” said OURR’s Lauren Blauvelt in a statement announcing the move. (Tebben, 8/28)

Gov. Gretchen Whitmer on Wednesday is expected to endorse legislative measures seeking to undo current Michigan regulations on abortion, including the elimination of waiting periods ahead of an abortion, proposed moves that drew quick opposition from a key anti-abortion group. Michigan's 24-hour waiting period, part of the state's informed consent law, requires a woman to attest she has reviewed various educational materials and fetal development illustrations at least 24 hours before having an abortion. Whitmer and abortion rights advocates on Monday called it "medically unnecessary" and one of several areas considered to inhibit access to abortion. (LeBlanc, 8/28)

A Texas law about to take effect on Friday carves out exceptions to the state’s abortion ban. In June, the Republican governor, Greg Abbott, quietly signed HB 3058, allowing doctors to provide abortion care when a patient’s water breaks too early for the fetus to survive, or when a patient is suffering from an ectopic pregnancy. (Sasani, 8/28)

“Only one candidate stopped abortion in Kentucky: Daniel Cameron,” boasts a September 2022 ad from his campaign for governor. For the current attorney general and now Republican gubernatorial nominee, it’s a central issue in his run. It is for abortion rights advocates, too. (Panetta, 8/28)

Colorado is a leading provider nationwide of abortions through telehealth clinics — a status that is only expected to increase in future years. The future of telehealth abortions is at risk after a recent federal appeals court ruling limiting access to the abortion pill mifepristone, which may pave the way for a Supreme Court showdown. (Frank, 8/28)

�鶹Ů�� Health News: Californians Headed To HBCUs In The South Prepare For College Under Abortion Bans 

When I’laysia Vital got accepted to Texas Southern University, a historically Black university in Houston, she immediately began daydreaming about the sense of freedom that would come with living on her own, and the sense of belonging she would feel studying in a thriving Black community. Then, a nurse at her high school’s health clinic in Oakland, California, explained the legal landscape of her new four-year home in Texas — where abortion is now fully banned. (Dembosky, 8/29)

It was previously reported that Mr. Palmeter was held for involuntary psychiatric evaluation in 2017, when he was 15, and that a year earlier the police received a domestic violence call involving him and his brother. On Monday, those police reports were released. (Betts andM anna, 8/28)

Saturday’s racially motivated attack at a Dollar General store in a Black neighborhood in Jacksonville — by a young White gunman armed with a assault-style rifle emblazoned with swastikas — has provoked fear and unease among African Americans here, but also a swell of anger. “The rhetoric we’ve seen from this governor and state leadership — folks are angry,” said Michael Sampson of the Jacksonville Community Action Committee. ... “It’s been a war on us and a war on our community.” (Shammas, 8/28)

A racist attack that killed three Black people at a Dollar General store in Jacksonville, Florida, on Saturday resurfaced anguish and frustration among residents of Buffalo, New York, whose community was also altered after a gunman opened fire at a Tops supermarket in May 2022. The shooter in Jacksonville, a 21-year-old white man, “hated Black people” and left behind a vitriolic white supremacist document, Jacksonville Sheriff T.K. Waters said. In Buffalo, the 18-year-old gunman responsible for killing 10 Black people orchestrated the attack “for the future of the White race,” according to a federal criminal complaint. (Bellamy and Ede-Osifo, 8/29)

Gun control opponents have typically framed the gun violence epidemic in the US as a symptom of a broader mental health crisis. But every country has people with mental health issues and extremists; those problems aren’t unique. What is unique is the US’s expansive view of civilian gun ownership, ingrained in politics, in culture, and in the law since the nation’s founding, and a national political process that has so far proved incapable of changing that norm. “America is unique in that guns have always been present, there is wide civilian ownership, and the government hasn’t claimed more of a monopoly on them,” said David Yamane, a professor at Wake Forest University who studies American gun culture. (Narea, Zhou and Millhiser, 8/27)

An assailant fatally shot a faculty member in a laboratory at the University of North Carolina at Chapel Hill on Monday, forcing the campus into lockdown for several hours as students barricaded themselves in classrooms, dorms and bathrooms, the authorities said. ... Chief James and Kevin M. Guskiewicz, chancellor of the University of North Carolina at Chapel Hill, did not name the faculty member who was killed, saying that relatives were still being notified. (Levenson and Holpuch, 8/28)

Two people died and five were injured Sunday after an early morning shooting at a restaurant in Louisville, Kentucky in what police said appears to have started between restaurant-goers and people on the street. 9Johnson, 8/28)

The uproar came when Speaker Cameron Sexton and chamber leaders decided that Mr. Jones, for the second time in the day, had breached the rules of the House by speaking out of turn. This time, Mr. Jones had suggested, during a debate about increasing the number of police officers in schools, that the state’s resources should be focused instead on mental health professionals and teacher pay — comments Mr. Sexton said were off-topic. ... In March, an assailant opened fire at the Covenant School, a Christian school in Nashville, killing three 9-year-olds and three adults. Many of the school’s grieving parents have spent the summer quietly lobbying lawmakers for modest gun reform and a direct response to their school’s suffering. (Cochrane, 8/28)

In Maryland, Charles County is the first school district in the state to use AI to detect guns and potential threats. Charles County Public Schools has seen an increase in weapons found over the past two school years, jumping 25% from 70 to 88. "We have to prepare for everything. We have to be right all the time," said Jason Stoddard, the director of school safety and security for the county. (Wilkins, Yarborough and Jones, 8/28)

Along with the physical and emotional effects, survivors of firearm injury carry a “distressingly high” risk of being shot again, Dr. Kristen Mueller, an associate professor of emergency medicine at Washington University School of Medicine in St. Louis, and others wrote in the new study. About 1 of every 14 gunshot victims will be harmed by a firearm again within a year, according to the new research. Within five years, that risk rises to about 1 in 8, and it jumps to about 1 in 6 after eight years. “That is pretty comparable to your risk of a second heart attack or a second stroke,” said Mueller, the lead author of the new study. (Christensen, 8/28)

There have been more than 470 mass shootings across the US so far this year, according to the Gun Violence Archive, which defines a mass shooting as an incident in which four or more people are injured or killed. Their figures include shootings that happen in homes and in public places. For each of the last three years there have been more than 600 mass shootings - almost two a day on average. (8/28)

Vaccine skepticism has spread to our pets. More than half of US dog owners expressed concerns about vaccinating their dogs, including against rabies, according to a new study published Saturday in the journal Vaccine. The study comes as anti-vaccine sentiments among humans have exploded in the wake of the Covid-19 pandemic. (Brown, 8/28)

Covid-19 was never just another cold. We knew it was going to stick around and keep changing to try to get the upper hand on our immune systems. But we’ve changed, too. Our B cells and T cells, keepers of our immune memories, aren’t as blind to this virus as they were when we first encountered the novel coronavirus in 2020. The US Centers for Disease Control and Prevention has screened blood samples and estimates that 97% of people in the US have some immunity to Covid-19 through vaccination, infection or both. (Goodman, 8/28)

Ohio, which had a preliminary positive from wastewater, now has a BA.2.86-positive human sample, which was collected on July 29. Marc Johnson, PhD, a molecular virologist at the University of Missouri School of Medicine, said the patient sample was collected from the same general area as Ohio's wastewater sample and that the Ohio sample matches a sublineage that includes earlier Danish and UK samples, which differs from an earlier Michigan sample that was related to the lineage that includes Israel's sample. The different lineages hint at three separate introductions into the United States, he said. (Schnirring, 8/28)

Infection with the SARS-CoV-2 Omicron variant is less likely to lead to long COVID than previous variants, and prior infection—but not monovalent (one-strain) vaccination—helps protect against persistent symptoms, suggests a study published late last week in the International Journal of Infectious Diseases. (Van Beusekom, 8/28)

A group of researchers at the Ohio State University who first reported detection of SARS-CoV-2 in white-tailed deer (WTD) in December 2021 published a study today based on ongoing surveillance that shows more than 30 human-to-animal spillover events and fast virus evolution in a relatively small sample size of deer in northeastern Ohio. The findings, published in Nature Communications, raise questions for scientists who are trying to see how and if SARS-CoV-2 will become established in animal reservoirs. And, when established, how the virus in animals might ricochet back to reinfect humans. (Soucheray, 8/28)

Hospitalized US patients who had a type of heart attack called non–ST segment elevation myocardial infarction (NSTEMI) were at a 51% higher risk of death by 30 days and 32% higher risk of release to non-home settings amid COVID-19 patient surges than before, a University of Rochester–led research team reports. (Van Beusekom, 8/28)

Walmart Inc., Walgreens Boots Alliance Inc. and CVS Health Corp. are rolling out new care options normally only available at doctor’s offices. Testing and treatment services for strep throat, flu and Covid-19 are now available from Walmart pharmacists in 12 states, the company said in a statement Tuesday. Walgreens will soon have a similar offering across 13 states. And CVS pharmacists will evaluate symptoms and prescribe flu antiviral medicine and cough suppressants in 10 states, although they won’t offer tests. (Rutherford and Case, 8/29)

Many respiratory viruses circulate year-round in the United States, and more activity is typically seen during fall and winter. The public is likely to be exposed to coronavirus, flu, and RSV in the coming months. Here’s what people should know about these viruses and the available vaccines. (Li, 8/28)

A federal jury in San Francisco has found a Michigan man guilty of failing to deliver almost $3.5 million worth of N95 masks to thousands of customers as the COVID-19 pandemic began. Online court records show the jury found Rodney Lewis Stevenson II of Muskegon guilty of wire and mail fraud as well as money laundering Thursday. (8/28)

Pfizer said on Monday it expects to restart production at its North Carolina plant by the beginning of the fourth quarter of 2023 as it seeks to repair tornado damage to one of the world's largest sterile injectable drug facilities. The facility was struck by a tornado on July 19, and Pfizer had earlier said some drugs, including painkiller fentanyl, could see a supply disruption. Pfizer has since placed limits on how much supply of those drugs its customers can buy. (8/28)

Back-to-school season is sparking renewed concern about the long-running shortage of Adderall and other medicines prescribed for ADHD. It's hard to predict how long drug shortages may last due to limited transparency in the supply chain, but experts note that prescriptions for Adderall historically pick up as students head back to the classroom. (Millman, 8/28)

When US Food and Drug Administration (FDA) inspectors visited Integra LifeSciences' drug manufacturing facility in Boston in March through May, the company's collagen-based Durepair product failed bacterial endotoxin testing. The FDA issued a warning letter to the company on July 17 for that and other violations of good manufacturing practices (GMP) tied to its wound care, soft-tissue repair, and reconstructive surgery products. Durepair is a nonsynthetic dura mater substitute used in neurosurgery. As a result, the company recalled the Durepair products and issued a statement saying it wouldn't distribute them again until it can conform to quality system regulations, hopefully by the end of the year. (Van Beusekom, 8/28)

In response to growing complaints, the U.S. Food and Drug Administration has postponed its plans to enforce a law designed to thwart counterfeit or diverted medicines passing through the pharmaceutical supply chain. The law was supposed to be fully enforced in late November, but the agency now says it will not take action until November 2024. (Silverman, 8/28)

Insulet filed a lawsuit this month against its rival EOFlow, accusing it of stealing trade secrets in a case that could shake up the diabetes technology market and throw a wrench in Medtronic’s planned $738 million acquisition of EOFlow. (Lawrence, 8/29)

After 100 years of relatively quiet existence as a maker of diabetes drugs, the Danish firm Novo Nordisk has suddenly grown so big that the company is reshaping the Danish economy. The reason: Ozempic and Wegovy, two weight loss drugs made by Novo Nordisk that have been proclaimed as revolutionary in the field of obesity. (Nelson, 8/28)

�鶹Ů�� Health News: Epidemic: Speedboat Epidemiology

Shahidul Haq Khan, a Bangladeshi health worker, and Tim Miner, an American with the World Health Organization, worked together on a smallpox eradication team in Bangladesh in the early 1970s. The team was based on a hospital ship and traveled by speedboat to track down cases of smallpox from Barishal to Faridpur to Patuakhali. Every person who agreed to get the smallpox vaccination was a potential outbreak averted, so the team was determined to vaccinate as many people as possible. ... Episode 4 of “Eradicating Smallpox” explores what it took to bring care directly to people where they were. (8/29)

Hospital systems are returning to their roots as they look to cut costs and simplify operations. Over the past two decades, many health systems have acquired long-term care, rehabilitation, home health, nursing home and hospice businesses, seeking to keep patients within their system. Owning these services allowed providers to generate extra revenue while closely overseeing care transitions and quality. (Kacik, 8/28)

Oregon’s third-largest city is about to lose its only hospital, illustrating the fallout of pressured health-care systems across the country. Operator PeaceHealth announced last week its plan to shutter University District hospital because of underutilization. The hospital in Eugene, which is home to the University of Oregon, loses an average of $2 million a month, PeaceHealth, a nonprofit Catholic health system, said in a press release. The departure will leave roughly 23,000 college students without an emergency room in town. (Coleman-Lochner, 8/28)

Cigna will halt health insurance exchange sales in Kansas and Missouri while expanding its presence in North Carolina for the 2024 plan year, the company announced Monday. The insurer will participate in the health insurance exchange marketplace in 350 counties across 14 states for next year, including 15 additional counties in North Carolina, a net decrease of 13 counties compared with this year. Cigna previously outlined plans to sell exchange policies in 20 states by 2025. (Tepper, 8/28)

Bon Secours Mercy Health sued Anthem Blue Cross Blue Shield on Monday, alleging that the insurer owes the health system nearly $100 million in unpaid, reduced and denied claims for patient care provided in Virginia. ... Cincinnati-based Bon Secours Mercy filed the suit in the Circuit Court of Henrico County. It seeks the damages of at least $93 million and an injunction that would stop “Anthem’s slow pay and systemic, unfair claims practices,” according to the suit. (Kacik, 8/28)

Healthcare providers and researchers have combed through clinical guidelines and decision-support tools to uncover debunked racial biases that contribute to inequity and disparities in care. Expunging those problematic elements from electronic health records systems, however, has proven to be vexing. The task is technically simple. Health systems such as Chicago-based CommonSpirit Health and Philadelphia-based Penn Medicine are slowly working with EHR vendors, medical societies and other healthcare organizations to identify and fix the problem. (Hartnett, 8/28)

Providence Health & Services is still working to recover from last year's multibillion-dollar losses. The Renton, Washington-based system on Monday reported a net loss of $232 million in the first half of 2023, compared with a loss of $5.24 billion in the year-ago period. Providence did not report the size of its second-quarter net loss but a spokesperson said it totaled $115 million. The system reported a net loss of $117 million in the first quarter. (Hudson, 8/28)

Johns Hopkins Bloomberg School of Public Health plans to expand into a new building to accommodate its growth. Construction is slated to start early next year on a 250,000-square-foot, seven-story building on existing Johns Hopkins property at the corner of McElderry and Washington streets, next to Bloomberg School’s main building at 615 N. Wolfe Street, Johns Hopkins said in a news release. (Roberts, 8/28)

Amid the pandemic and a behavioral workforce shortage, the growing need for adolescent mental healthcare has created opportunities for telemedicine startups to provide specialized services to children and teens. But in an unstable funding environment for telemedicine, emerging companies in the New York City area say they’ve had to develop solutions that address the complexity of the youth mental health crisis—such as combining virtual care with in-person models and creating a supply of clinicians to mitigate the behavioral health workforce shortage. (D'Ambrosio, 8/28)

�鶹Ů�� Health News: She Paid Her Husband’s Hospital Bill. A Year After His Death, They Wanted More Money

Last summer, Eloise Reynolds paid the bill for her husband’s final stay in the hospital. In February 2022, doctors said that Kent, her husband of 33 years, was too weak for the routine chemotherapy that had kept his colon cancer at bay since 2018. He was admitted to Barnes-Jewish Hospital in St. Louis, not far from their home in Olivette, Missouri. Doctors discovered a partial blockage of his bowel, Reynolds said, but she remained hopeful that his treatment would soon resume. (Liss, 8/29)

Michigan Gov. Gretchen Whitmer will call on state lawmakers this week to pass legislation proactively protecting key provisions in the Affordable Care Act, including no-cost preventive services, as the nation’s health law continues to face legal challenges in federal court. Whitmer, who is in her second term and working for the first time with a Legislature under complete Democratic control, will call for a plan to codify the Affordable Care Act during a speech Wednesday where she will outline her legislative priorities for the second half of the year. (Cappelletti, 8/28)

California’s attorney general, Rob Bonta, filed a lawsuit against a Southern California school district on Monday, asking a judge to halt a new requirement that parents be notified when their child changes pronouns or gender identity. The Chino Valley Unified School District in San Bernardino County recently began requiring that parents be notified when their child asks to use a name or pronoun that does not align with the child’s birth certificate, or seeks to use a bathroom assigned to a different gender. Mr. Bonta is seeking not only to stop that policy, but also taking aim at three other districts in California that are trying to follow suit. (Hubler, 8/28)

Civil rights advocates are suing Indiana’s Department of Corrections over the state’s law prohibiting gender-affirming surgery for inmates. The American Civil Liberties Union filed the lawsuit against the department in federal court in Evansville on Monday. ... Republican Gov. Eric Holcomb also signed a bill in April prohibiting minors from accessing gender-affirming care such as transgender surgeries or medication. The ACLU has filed a federal lawsuit challenging that law, as well. (8/28)

Two new laws restricting the access of transgender youth in Missouri to gender-affirming health care and school sports took effect Monday. One law bans minors from beginning puberty blockers and hormones and outlaws gender-affirming surgeries for youths. The other law requires student athletes from kindergarten through college to play on sports teams that align with their sex as assigned at birth. (Ballentine, 8/28)

Gov. Jim Justice announced the appointment Monday of five people to the board of a private foundation that will distribute most of West Virginia’s $1 billion-plus in opioid lawsuit settlements. (8/28)

The vast majority of young adults and single adults experiencing homelessness in the District remained unhoused last year despite an infusion of vouchers meant to address a problem that is surging in the region, according to data publicly shared earlier this month by D.C. officials. The stark breakdown in services that target some of D.C.’s most vulnerable populations, including young adults under the age of 25 and members of the LGBTQ+ community, points to a deep disparity that government officials had not previously revealed in such detail. (Lang and Moyer, 8/28)

Louisiana's measles vaccination coverage has dipped below the threshold generally accepted to prevent community transmission. "Measles is one of the most infectious diseases known to mankind," Louisiana state health officer and medical doctor Joseph Kanter tells Axios, but outbreaks are "entirely preventable" through vaccination. (Brasted, 8/28)

Arkansas, like much of the country, continues to grapple with a surge in syphilis cases. Syphilis can cause serious health problems — like blindness, hearing loss or dementia — if left untreated, according to the CDC. (Golden, 8/28)

Three additional conditions have been approved for the Minnesota Department of Health's Newborn Screening Program. On Monday, MDH announced the addition of these conditions will boost protections for newborn infants in Minnesota. The conditions are rare, but can be serious if not detected and treated early. (8/28)

Ted Doolittle, the state’s health care advocate, is leaving his job to take a position as a federal immigration judge. His last day is Thursday. Doolittle was selected by then-Gov. Dannel P. Malloy in January 2017 to head the Office of the Health Care Advocate. He started work with the state a month later. (Carlesso, 8/28)

Anne Arundel County Public Schools filed a lawsuit against social media companies Meta, Google, ByteDance, and Snap Inc. for their roles in the youth mental health crisis. The district alleges that its social media platforms increase the mental health crisis for its 85,000 students and place an increasingly large burden on the school system to provide essential mental health resources. (8/28)

IV drips are not a new concept — as a medical procedure — but more and more, people are turning to them as a non-medical preventive measure against dehydration, electrolyte deficiency and hangovers. One of the places where you'll find people suffering from all three of these issues is at an outdoor music festival. In fact, some artists are now including access to IV infusions in their contract riders, as was the case in 2022 with headliner Nathaniel Rateliff. (Pope, 8/28)

The findings, published last week on Environmental Science & Technology, a peer-reviewed journal, showed that different racial and socioeconomic groups are likely exposed to varying sources of the harmful substances, known as PFAS. The family of thousands of synthetic chemicals are used in a vast array of consumer products, from rugs to straws, due to their resistance to stains, grease and water. The report highlighted a longstanding need for more research around the effect of PFAS on people of Asian descent, said Shelley Liu, lead study author. (Yam, 8/28)

Sustained exposure to wildfire smoke is taking a toll on human health in California, where residents of one county are losing an average of two years off their lives due to the air they breathe, a new report has found. Twenty of the nation’s top 30 most polluted counties in 2021 were located in California, according to new data released by the Air Quality Life Index (AQLI) of the University of Chicago’s Energy Policy Institute. (Udasin, 8/29)

Workers across California are grappling with yet another climate change-induced threat: a rapidly spreading fungus that can land its unsuspecting victims with prolonged flu-like symptoms, or far worse. The culprit is a soil-dwelling organism called coccidioides, which is now spreading the disease coccidioidomycosis — known as “Valley fever” — farther and farther north of its Southwest origins. Rather than spreading from person to person, Valley fever results from the direct inhalation of fungal spores — spores climate change is now allowing to flourish in new places. (Udasin, 8/28)

Some passengers say their dogs have been rejected for simple paperwork mistakes. The required forms also have been difficult to fill out, blind travelers say, because they are often not compatible with the screen reader technology people use to convert text to speech. In interviews, blind people told The Washington Post that the regulations are so difficult to navigate that they are now hesitant to fly or are anxious about the experience. Various organizations for the blind are calling for the forms to be changed or eliminated. (Morris, 8/28)

Each year, more than 470,000 people in the United States are infected with Lyme disease, and the National Institutes of Health estimates that between 10 percent and 20 percent will go on to battle lingering symptoms, now officially referred to as Post-treatment Lyme Disease Syndrome. The experiences shared by the Pinckneys and many other chronic Lyme patients sound remarkably similar to those now battling long COVID.“Long COVID and chronic Lyme share so many features that it’s uncanny,” said Michal Caspi Tal, principal scientist in biological engineering at the Massachusetts Institute of Technology. Tal is leading one of the two Massachusetts teams awarded federal grants, and the Pinckneys have enrolled in her study. (Lazar, 8/29)

Ask Alexa or Siri about the weather. But if you want to save someone’s life? Call 911 for that. Voice assistants often fall flat when asked how to perform CPR, according to a study published Monday. Researchers asked voice assistants eight questions that a bystander might pose in a cardiac arrest emergency. In response, the voice assistants said: “Hmm, I don’t know that one" and “Sorry, I don’t understand.” (Johnson, 8/28)

After Cody Bohanan, 24, was locked up on a charge related to possession of drug paraphernalia in 2021, he told the staff at Butler County Jail in Ohio that he was withdrawing from opioids. His cellmates saw him vomiting blood. They implored guards to intervene. (Maia Szalavitz, 8/29)

Emotional abuse is underrecognized as abuse even though psychological violence — more than physical violence or sexual violence — is the strongest predictor of post-traumatic stress disorder in abused women and often precedes physical abuse. (So'Phelia Morrow, 8/28)

To fully appreciate the transformative potential of artificial intelligence in health care, one must think globally. When applied to people in extreme poverty, its impact could be as great as the discovery of penicillin. (Leana S. Wen, 8/29)

In my career as a physician, I've seen medical services and procedures, including many routine ones, shift from offices to hospital outpatient settings. This migration of services has also come with higher costs for patients. And at a time when Americans are struggling to make ends meet and even forgoing care because they simply can't afford to see a doctor, these extraneous and medically unnecessary additional fees are another barrier to care that puts people's health at risk. (Raina Young, 8/28)

Climate change is an existential problem for human health. As climate change intensifies, the frequency and severity of extreme weather events such as heatwaves, cold fronts, and floods will increase. Undoubtedly, this will result in devastating effects for human health and wellbeing, contributing to increased susceptibility to infectious diseases, an already growing mental health crisis, and, most directly, heat-related mortality. (Arya Rao and Shira Hornstein, 8/29)

Telehealth use expanded greatly with the start of the COVID-19 pandemic in 2020. Until now, however, little has been known about the results for patients who used telehealth during the pandemic as compared to those who received medical services without telehealth. A new study by FAIR Health sheds light on this issue in Connecticut, with particular attention to differences in treatment in areas with greater minority populations. (Robin Gelburd, 8/29)

Advance directives were born in the Senate. Now they can help preserve the dignity of its aging members. In Cruzan v. Director, Missouri Department of Health, the parents of Nancy Cruzan, a young woman who had been left in a permanent vegetative state after a car accident, wanted the right to remove her life support. In 1990, the Supreme Court ruled in favor of her parents, affirming the constitutional right to refuse life-sustaining treatment. (Joseph J. Fins, 8/29)

The case of Lucy Letby, a serial killer masquerading as a nice neonatal nurse at Countess of Chester Hospital in Northern England, is so horrific as to beggar belief. On Aug. 18, the 33-year-old Letby was convicted of murdering seven babies and attempting to murder six others between June 2015 and June 2016. Over the past few days, the British media has also reported on other mysterious infant deaths when Letby was present, suggesting that the total number of murders from a woman who has become known as the worst serial killer of children in British history was not fully accounted for in a country already wracked with anguish. (8/29)