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Doctors in Gaza City faced with dwindling medical supplies performed surgery on hospital floors, often without anesthesia, in a desperate bid to save badly wounded victims of a massive blast that killed civilians sheltering in a nearby hospital amid Israeli bombings and a blockade of the territory. ... “We need equipment, we need medicine, we need beds, we need anesthesia, we need everything,” said hospital director Mohammed Abu Selmia. He warned that fuel for the hospital’s generators would run out within hours, forcing a complete shutdown, unless supplies enter the Gaza Strip. (Jobain, Kullab, Nessman and Lee, 10/18)

"This attack is unprecedented in scale," said Richard Peeperkorn, WHO Representative for the West Bank and Gaza. "We have seen consistent attacks on healthcare in the occupied Palestinian territory." Peeperkorn said there so far have been 51 attacks against healthcare facilities in Gaza, with 15 health workers killed and 27 injured. "The hospital was one of 20 in the north of the Gaza Strip facing evacuation orders from the Israeli military," he said. "The order for evacuation has been impossible to carry out given the current insecurity, critical condition of many patients, and lack of ambulances, staff, health system bed capacity, and alternative shelter for those displaced," he added. (Tetrault-Farber, 10/18)

Leonard Rubinstein, a John Hopkins University public health professor who has studied violence against medical facilities during wartime for 25 years, said the estimated death toll of at least 200 is the highest for a single incident involving a hospital that he is aware of. He added that “the number of attacks or instances of violence on health care facilities in this conflict are very significant.” Doctors Without Borders said on X that it was “horrified." “This is a massacre. It is absolutely unacceptable,” it said in a statement.  (Salam, Dunn and Lubbehusen, 10/17)

The al-Ahli Hospital in Gaza City — where authorities suspect an airstrike killed hundreds of people Tuesday — is owned and operated by a branch of the Anglican Communion, one of the largest Christian groups in the world. The 80-bed hospital normally sees about 3,500 outpatient visits a month, according to the website of the Diocese of Jerusalem, the local branch of the Anglican Communion that runs al-Ahli. It handles about 300 surgeries and roughly 600 radiological visits a month. (Boorstein and Brasch, 10/17)

U.S. President Joe Biden arrived in Israel on Wednesday pledging solidarity in its war against Hamas and backing its account that a blast that killed huge numbers of Palestinians at a Gaza hospital had been caused by militants. ... "But there's a lot of people out there not sure, so we’ve got a lot, we’ve got to overcome a lot of things," Biden added. "The world is looking. Israel has a value set like the United States does, and other democracies, and they are looking to see what we are going to do." (Al-Mughrabi and Holland, 10/18)

World leaders issued statements of condemnation and condolence on Tuesday after an explosion killed hundreds at a hospital in Gaza City, a staggering loss of civilian life in Israel’s 10-day-old war with Hamas that rapidly became enmeshed in competing assertions of blame. Virtually all stressed the horrific nature of the devastation. ... King Abdullah II of Jordan called the explosion “a heinous war crime that cannot be ignored." (Stack, 10/17)

Health insurance premiums jumped this year amid a post-pandemic spike in costs of care, adding to the burden on employers and workers as inflation erodes broader buying power. The average employer-sponsored health insurance premium for US families rose 7% to almost $24,000 this year, according to an annual �鶹Ů�� survey of more than 2,000 US companies, compared with a 1% increase last year. Premiums for individual employer coverage rose at the same rate. (LaPara, 10/18)

Accelerated increases in health-insurance costs are driven by factors including higher labor costs in hospitals and elsewhere across the healthcare system, an uptick in elective care that dipped during the pandemic and demand for new and expensive drugs. Workers tend to enroll for health insurance starting in the fall, so are learning now or will soon find out what their coverage options are for 2024. Executives, meanwhile, are starting to think about coverage for 2025. (Williams-Alavarez, 10/16)

Inflation came for your healthcare this year. Next year is looking to be just as bad. The cost of employer health insurance rose this year at the fastest clip since 2011, according to an annual survey from �鶹Ů��, a healthcare research nonprofit. The 7% jump in the cost of a family plan brought the average tab to nearly $24,000—more than the price for some small cars. Workers’ average payment of $6,575 for those plans was nearly $500 more than last year. (Mathews and Ulick, 10/18)

�鶹Ů�� Health News: Abortion Coverage Is Limited Or Unavailable At A Quarter Of Large Employers, �鶹Ů�� Survey Finds 

About a quarter of large U.S. employers heavily restrict coverage of legal abortions or don’t cover them at all under health plans for their workers, according to the latest employer health benefits survey by �鶹Ů��. The findings demonstrate another realm, beyond state laws, in which access to abortion care varies widely across America since the Supreme Court overturned the constitutional right to abortion last year in Dobbs v. Jackson Women’s Health Organization. (Pradhan, 10/18)

Without patients having access to primary care, minor complaints evolve into chronic illnesses that demand complex long-term treatment plans. Addressing basic patient problems in the emergency room costs up to 12 times what it would in a primary-care office, resulting in billions of additional dollars each year. But even as evidence mounts that access to primary care improves population health, reduces health disparities and saves health-care dollars, the field is attracting fewer and fewer medical students. The remaining small-group medical practices are being replaced by concierge offices with steep annual membership fees. (Sellers, 10/17)

Doctors lowered the incidence of heart disease and strokes among their patients when Medicare rewarded them for focusing on sicker patients, according to research of a pilot program released Tuesday in the Journal of the American Medical Association. The pilot program didn’t increase overall costs at all. (Wilkerson, 10/17)

A group called the Incubate Coalition, comprising the venture capital firms that bankroll most biotech startups, is pressing US lawmakers to extend by four years the time that pills can be on the market before they become subject to price negotiations with Medicare. Such an extension could mean billions of dollars in extra profits to biopharma companies and their investors over time — and billions in additional costs to Medicare and its recipients. (Weisman, 10/17)

After five months of waiting, President Biden's pick for National Institutes of Health director, Monica Bertagnolli, today will get a confirmation hearing before the Senate health committee. And drug development and pricing is likely to loom large. (Sullivan and Bettelheim, 10/18)

The leadership turmoil in the U.S. House of Representatives has clouded the outlook for passing health care legislation this year. However, there’s also a lot of momentum in Congress behind the health policy work that already has been done, so some health care reforms “have a chance of hitching a ride on a big catch-all bill at the end of the year. And legislation that doesn’t cross the finish line this year will carry over to next year.” That was the word from Geoff Manville, partner at Mercer, during a recent webinar that provided an update on health care law and policy. (Rupe, 10/17)

Legislation that addresses potential changes in pharmacy benefit manager (PBM) compensation disclosure requirements, a review of business models and agreements before these disclosures, and changes in the assessment of PBM fees are currently stalled as Congress seeks to elect a new Speaker of the House. ... Currently, there is general bipartisan support for PBM reforms, in both the House and Senate, but there are factors in Congress that are taking priorities. In the Senate, there are 3 committees that have advanced legislation on PBM reforms, with leadership supporting a floor vote before the end of 2023. In the House, a consolidated bill was released in September and although there are plans for a full House vote, they are stalled due to the current issues in Congress. The legislation will be active through the end of 2024. (Gallagher, 10/17)

Pharmacy chain Rite Aid has settled a critical dispute with drug supplier McKesson Corp to ensure that customers' prescriptions will continue to be filled during Rite Aid's bankruptcy, attorneys said on Tuesday. Rite Aid, which filed for Chapter 11 bankruptcy on Sunday night in New Jersey, sued McKesson the following morning, seeking to stop it from terminating a drug supply agreement that accounts for 98% of the pharmacy chain's prescription drug sales. (Knauth, 10/17)

Rite Aid’s plan to close more stores as part of its bankruptcy process could hurt access to medicine and care, particularly in some majority Black and Hispanic neighborhoods and in rural areas, experts say. ... When drugstore chains shutter stores, they often target locations in lower-income, Black and Latino neighborhoods with people covered through government-funded insurance programs like Medicaid, said Dima Qato, a University of Southern California associate professor who studies pharmacy access. (Murphy, 10/17)

The Centers for Disease Control and Prevention published preliminary data Tuesday showing that more than one-third of individuals eligible for a commonly used HIV prevention drug received a prescription, as funding for a critical HIV program grew 16-fold between fiscal years 2019-2023. But the reach of this strategy is highly inconsistent among racial groups. (Raman, 10/17)

Fox Chase Cancer Center is investing in a Minnesota-based start-up that develops drugs to diagnose and treat cancer by injecting patients with radioactive molecules that can target solid tumors with more precision than traditional methods. The investment is part of a $56 million venture capital fundraising round reported Tuesday by Nucleus RadioPharma, a developer of radiopharmaceuticals, as this class of drugs is known. (Gantz, 10/17)

Recent studies have started to illuminate the far-reaching benefits of Ozempic and other medicines in the same class, known as GLP-1 receptor agonists. The drugs appear to have a protective effect on the heart, liver and kidneys in addition to helping people lose weight, which in itself reduces the risk of many ailments. There’s also reason to believe GLP-1s could help combat substance abuse or even Alzheimer’s disease. (Muller, 10/18)

A scientist being sued for defamation by Johnson & Johnson over her research linking the company's talc powder to cancer has said that a recent decision discounting her testimony in a different case does not bolster the company's claims against her, urging a judge to dismiss the lawsuit. Lawyers for Jacqueline Moline, in a filing Monday in New Jersey federal court, said the recent ruling only "shows the system working precisely as it should," with J&J free to challenge the admission of expert testimony in trials, rather than by suing experts. (Pierson, 10/17)

Four regional hospitals are relieving medical debt accrued by hundreds of thousands of Columbus residents, local officials announced yesterday. Medical debt is a leading cause of bankruptcy in America, with major physical and emotional tolls on patients' health. (Buchanan, 10/17)

The city used money from the American Rescue Plan, a $1.9 trillion economic stimulus bill signed into law by President Joe Biden in March 2021. ... Other Ohio cities are taking steps to relieve medical debt for their residents. Toledo — in partnership with Lucas County — is hoping to spend $1.6 million to wipe away an estimated $240 million in medical debt. The city of Akron allocated $500,00 to purchase debts through RIP Medical Debt. RIP then negotiates with hospitals and debt collectors to buy debts at a substantial discount. (Meighan, 10/17)

Several former employees of Saint Luke’s Hospital of Kansas City are alleging the hospital, part of the Saint Luke’s Health System, failed to properly clean and repair operating room instruments, used rusty instruments during operations and failed to address an ongoing problem with cockroaches and other bugs in and around the operating room. (Spoerre, 10/18)

About 350 health care and retail workers associated with Howard Brown Health have voted in favor of a strike, the second of its kind at Howard Brown in less than a year. The strike vote was held Friday among 366 members of Howard Brown Health Workers United. Votes were counted Tuesday morning. (Arougheti, 10/17)

Talks between state officials and Yale New Haven Health over its bid to purchase three ailing Connecticut hospitals have broken down, prompting the state to move ahead on a final decision over whether to approve the acquisition, officials with Connecticut’s Office of Health Strategy said Tuesday. (Carlesso and Altimari, 10/17)

Health insurance startup Alignment Health and Walgreens Boots Alliance have signed an agreement to jointly market Medicare Advantage plans for 2024. The Medicare Advantage insurer and retail giant have agreed to offer $0 premium co-branded plans in some counties in Arizona, California, Florida and Texas, pending regulatory approvals. They said the effort will reach 1.6 million Medicare-eligible enrollees. (Tepper, 10/17)

Despite recent efforts to address the issue, medical-related websites continue to be mined for data including personal medical information, in an apparent violation of patients’ privacy rights, according to a new study. Some of the most common tracking pixels were from Alphabet Inc.’s Google, Microsoft Corp., Meta Platforms Inc. and ByteDance, the parent company of TikTok, according to a report by the cybersecurity company Feroot Security. (Nix, 10/17)

More home healthcare providers are turning to artificial intelligence-powered tools to improve efficiency and close care gaps. An estimated $265 billion in services for Medicare beneficiaries is projected to move into the home over the next few years as more older adults age in place, according to business consulting firm McKinsey and Company. To meet the demand amid a caregiver shortage, home health agencies, hospital-at-home providers and home care companies are starting to rely more heavily on AI technology. (Eastabrook, 10/17)

Dr. AI will see you now. Microsoft Corp. and Mercy, its hospitals, urgent care centers and clinics, are collaborating on the use of artificial intelligence and other digital technology to give doctors, nurses and other health care providers more time with patients. Immediate uses include AI-assisted communication of lab results and other patient information, appointment scheduling and recommendations for patients to pursue, and, for Mercy employees, AI-assisted HR and information on Mercy policies and procedures. (Mize, 10/17)

Twice a week, Boston-area psychiatrist Elissa Ely volunteers at a US anonymous help line for physicians in crisis. The calls she takes are often from people in deep distress — physicians having panic attacks, abusing substances or alcohol, facing divorce or alienation from family and friends. A typical call, she said, could be from “an ER doctor who vomits before she goes in for her shifts; despair and depression; suicidality.” But despite her callers’ high levels of mental distress, they’re often very resistant to her suggestions that they seek mental health care, said Ely. When she suggests doctors consider even just a “tincture” of an antidepressant or anti-anxiety medication, or find a therapist, she inevitably gets the same response, a long pause followed by a question: “Is this call really anonymous?” (Landman, 10/18)

According to a recent study published in the Online Journal of Issues in Nursing, transcendental meditation is/ effective at reducing burnout and enhancing the overall well-being of nurses. The study is a response to increasing levels of burnout within the heath care industry, largely exacerbated by the pandemic. According to another recent study, by market research and consulting company PRC, 15.6% of U.S. nurses surveyed reported feeling burnout. (Boyce, 10/17)

Iowa's top medical officials are exploring changes to its licensing process that advocates say could encourage more doctors to seek treatment for mental health and substance use disorders. The Iowa Board of Medicine is reviewing its licensing applications for physicians, making Iowa one of a nearly dozen states working to determine whether the questions asked may stigmatize those seeking treatment, according to the Dr. Lorna Breen Heroes' Foundation, a group that advocates for greater mental health support for health care workers. (Ramm, 10/18)

A former Cleveland Clinic doctor was jailed Monday after he attempted to plead not guilty by reason of insanity to charges of groping six patients. Omar Massoud was evaluated last week and showed signs of Alzheimer’s and dementia, his attorney, Ian Friedman, said in court Monday. Massoud was the chief of the hepatology department before the charges were levied against him in December. The department treats patients with liver, gallbladder and pancreatic issues. (Shaffer, 10/17)

Insurers and some employers contend the Biden administration's recent proposal to bolster coverage of mental and behavioral care could actually backfire and make it more difficult for patients to access quality care. The health care payers are urging the administration to drop major features of its plan, including a new formula to determine whether insurers are improperly limiting patient access to mental health care. And a leading health insurer trade group called on the administration to scrap the whole thing. (Goldman, 10/18)

Pediatric mental health encounters have generally dropped from the peak levels seen during the COVID-19 pandemic, but the rate of visits among females remains above pre-pandemic levels. An analysis by Epic Research shows girls are more likely to visit emergency departments, outpatient facilities and hospitals for mental health concerns than pediatric males. (Southwick, 10/18)

A hospital in Nebraska that matches teenage suicide survivors with a "caring contact" says the program has seen positive results in preventing young patients from taking their own lives. The first-of-its-kind program provides follow-up care in the form of handwritten, personalized notes from the hospital's social work staff after the teens are discharged. The notes are sent one month, two months, three months, six months, nine months and one year after discharge — and the former patients are able to write notes back as well. (Rousselle, 10/18)

Roland Griffiths, a professor of behavioral science and psychiatry whose pioneering work in the study of psychedelics helped usher in a new era of research into those once banned substances — and reintroduced the mystical into scientific discourse about them — died on Monday at his home in Baltimore. He was 77. The cause was colon cancer, said Claudia Turnbull, a longtime friend. Dr. Griffiths, a distinguished psychopharmacologist and professor at the Johns Hopkins School of Medicine in Baltimore, spent decades studying the mechanisms of dependence on mood-altering drugs. He published scores of papers on opiates and cocaine, on sedatives and alcohol, on nicotine and caffeine. (Green, 10/17)

New clinical-trial data suggest that an antiviral pill called ensitrelvir shortens the duration of two unpleasant symptoms of COVID-19: loss of smell and taste. The medication is among the first to alleviate these effects and, unlike other COVID-19 treatments, is not reserved only for people at high risk of severe illness. (Lenharo, 10/17)

A U.S. House committee is now investigating a COVID-19 policy at University of Maryland, College Park. Starting in September, if a student tests positive, they have to quarantine off campus. For students who live on campus, this means having to either go back to their family's home, or book lodging off campus like a hotel. Its cost falls squarely on the student's shoulders. (Valera, 10/16)

The Baltimore City Health Department will offer new COVID-19 vaccines to children and adults at no cost. The offer extends to adults who are uninsured or underinsured. Now that COVID-19 infections are on the rise, the health department wants to make sure that everyone is staying safe. (Kushner, 10/17)

A study yesterday in JAMA Network Open based on outcomes seen among Singaporean children ages 4 years and younger showed good protection for two doses of monovalent mRNA COVID vaccines during an Omicron surge. The authors said the findings support vaccinating this age-group, despite low incidence of severe disease or hospitalization. (Soucheray, 10/17)

Earlier this week, Chicago-based Pathize Health launched its brand-new app which helps patients living with long Covid to better manage their fatigue by collecting real-time data. This is achieved through connectivity with the Apple Watch enabling patients to develop important insights into key areas such as energy management, activity logging and medication adherence. (Alexiou, 10/18)

�鶹Ů�� Health News: Covid Relief Payments Triggered Feds To Demand Money Back From Social Security Recipients 

As the nation reeled from covid-19, the federal government sent many Americans a financial lifeline. But some recipients say the covid relief payments have triggered financial distress by jeopardizing their Social Security benefits. The government has demanded they repay much larger amounts — thousands of dollars in benefits for the poor and disabled distributed by the Social Security Administration. (Hilzenrath and Fleischer, 10/18)

The bar for taking a sick day is getting lower, and some bosses say that’s a problem. U.S. workers have long viewed an unwillingness to take sick days as a badge of honor. That’s a laurel workers care much less about these days. The number of sick days Americans take annually has soared since the pandemic, employee payroll data show. Covid-19 and a rise in illnesses such as RSV, which can require days away from work, are one reason. Managers and human-resources executives also attribute the jump to a bigger shift in the way many Americans relate to their jobs.  (Chen, 10/17)

Members of the House Democratic Women’s Caucus warned defense committee leaders Tuesday that including provisions that limit abortion access in the fiscal 2024 defense authorization bill would make it impossible for them to support the bill’s final passage. (Coudriet, 10/17)

After hundreds of pages of court filings and more than two hours of legal argument Tuesday, U.S. District Court Judge Daniel D. Domenico arrived at the simplest possible way to tame the sprawling debate around Colorado’s new law banning so-called medication abortion “reversal” treatment and to decide whether the first-of-its-kind law should stand — at least for now. The case, he said, wouldn’t be decided by whose science is most correct. It’s about whose standard is. (Ingold, 10/18)

Democrats' efforts to expand abortion access in Michigan may still be in peril, even after lawmakers dropped a piece of the legislation that was getting pushback within their own party. The Reproductive Health Act would remove many of the restrictions still on the books in Michigan, including a mandatory waiting period and online consent form that has to be signed and printed 24-hours before a patient’s appointment. It also would make it easier for people to pay for abortion care, by allowing private insurers and Medicaid to cover abortions. But on Tuesday, lawmakers cut the Medicaid provision, in order to appease holdouts within the Democratic party. (Wells, 10/17)

The city of San Antonio is facing a lawsuit after budgeting $500,000 to support reproductive health services, including, potentially, transportation and lodging for people seeking abortions outside Texas. A group of anti-abortion organizations filed the lawsuit Tuesday in Bexar County, asking a state district judge to prohibit taxpayer dollars from going to organizations that help Texans travel out of the state for abortion. (Klibanoff, 10/17)

Donald Trump — who has fretted privately that Republicans are “getting killed” electorally on abortion — is now running ads touting his pro-life record in Iowa, the first state to vote in the GOP primary. In the ads, paid for by Trump’s campaign and first reported by Kyle Tharp in his newsletter FWIW, Trump declares himself “THE MOST Pro-Life President in history.” (Stuart and McCann Ramirez, 10/16)

Dr. Colleen McNicholas, the chief medical officer for the St. Louis region’s Planned Parenthood, is among three finalists selected from across the world for the European Union’s top human rights prize. McNicholas, Justyna Wydrzyńska, of Poland, and Morena Herrera, of El Salvador, were jointly nominated as “women fighting for free, safe and legal abortion.” (Munz, 10/17)

Ashley Caswell screamed in pain from inside an Alabama jail, pleading to be taken to a hospital, according to a newly filed lawsuit. The pregnant detainee’s water had broken and she was bleeding, but Caswell was allegedly told to “deal with the pain.” After being in labor for 12 hours, Caswell gave birth to her son in a jail shower on Oct. 16, 2021, her attorneys say. Then, staffers took photos with the baby while Caswell was passed out on the floor, according to a federal civil rights lawsuit filed Friday on behalf of Caswell by the advocacy groups Pregnancy Justice and the Southern Poverty Law Center, as well as the New York City law firm Sullivan & Cromwell. (Paul, 10/17)

�鶹Ů�� Health News: Pregnant And Addicted: Homeless Women See Hope In Street Medicine 

Five days after giving birth, Melissa Crespo was already back on the streets, recovering in a damp, litter-strewn water tunnel, when she got the call from the hospital. Her baby, Kyle, who had been born three months prematurely, was in respiratory failure in the neonatal intensive care unit and fighting for his life. The odds had been against Kyle long before he was born last summer. Crespo, who was abused as a child, was addicted to fentanyl and meth — a daily habit she found impossible to kick while living homeless. Crespo got a ride to the hospital and cradled her baby in her arms as he died. (Hart, 10/18)

Pregnant soldiers based in the U.S. may have easier access to maternity uniforms after a recent expansion of a program offering to lend out the garments for free, according to the Army. The Maternity Uniform Pilot Program now allows soldiers to coordinate directly with program representatives to obtain the free uniforms and other Army maternity attire such as nursing T-shirts, instead of relying only on maternity-wear availability at base exchange stores, the service said in a recent update. Garments are then returned after use. (Baker, 10/17)

�鶹Ů�� Health News: Listen To The Latest '�鶹Ů�� Health News Minute' 

This week on the �鶹Ů�� Health News Minute: Some physicians worry we’re about to see rising numbers of teen pregnancies after decades of progress, and some addiction experts say states are wasting opioid settlement money on ineffective drug prevention programs for young people. (10/17)

Are 3D mammograms better than standard 2D imaging for catching advanced cancers? A clinical trial is recruiting thousands of volunteers — including a large number of Black women who face disparities in breast cancer death rates — to try to find out. People like Carole Stovall, a psychologist in Washington, D.C., have signed up for the study to help answer the question. (Johnson, 10/17)

Can a machine catch a breast cancer tumor better than a human? Radiologists at Lynn Women’s Health & Wellness Institute at Boca Regional Hospital have been working to find that answer. They began adding artificial intelligence technology to existing 3D mammography for breast cancer screening in 2020. With three years of results, they discovered AI can make a significant difference in finding cancer. Both the radiologists at the Institute (part of Baptist Health South Florida) and the machines read thousands of mammogram results each year. In some instances, AI helped catch cancers before they could be detected by the human eye. Since implementing AI, their detection rate has improved 23%. (Krischer Goodman, 10/17)

Oncologists, like Dr. Denise Sanderson of HCA Florida St. Lucie Hospital, said Somers' approach to treatment was non-traditional, but that doesn't diminish what she did to make breast cancer something people aren’t afraid to talk about. "She may have had the same outcome either way, so it was the right outcome for her," Sanderson said. "I think independent of what you might read sometimes about doctors talking about her choices, she really helped women to be able to talk about breast cancer." (Gilmore, 10/17)

This month you’ve probably seen plenty of companies selling pink merch and items with the breast cancer ribbon, since it’s breast cancer awareness month. Many consumers are now asking if companies moving this pink merchandise are actually putting any of that money they’re making toward research, prevention, or supporting those impacted by the disease? ”Anybody can put something in the color pink and people can actually have a pink ribbon on their product and nobody regulates that,” said Better Business Bureau of Southern Colorado CEO Jonathan Liebert. (Nelson, 10/17)

Roughly 35 percent of women of reproductive age in the United States don’t have sufficient amounts of iron in their bodies. And yet the nutritional deficiency, which can affect multiple functions, from immunity to cognition, often goes undiagnosed, said Dr. Malcolm Munro, professor of obstetrics and gynecology at the David Geffen School of Medicine at the University of California, Los Angeles. This oversight is partly because symptoms can be difficult to pin down but also because iron deficiency is rarely recognized as an urgent condition with short- and long-term consequences, he said. (Gupta, 10/17)

Molly Giles was standing in her kitchen one spring night in 2019, musing about whether to do the dishes or leave them until the morning, when a bone in her left leg snapped and she crashed to the ground, breaking her hip. “I passed out, and I’m pretty sure I would have died if my partner hadn’t been there and called 911,” the Northern California novelist recalls. Giles, now 81, had “bones like meringue,” her doctor rather glibly later told her. A scan several years earlier had revealed osteopenia, a precursor to the “silent” disease of bone density loss known as osteoporosis. But neither Giles nor her doctors followed up, and her bones grew increasingly weak until her femur “melted,” as she later described it. (Ellison, 10/17)

People often say “time is money,” but talk to any neurologist and they’ll tell you time is brain. Because when it comes to strokes, every minute counts. “The brain is very sensitive to injury,” said Dr. Eliza Miller, a neurologist at NewYork-Presbyterian/Columbia University Irving Medical Center. The human brain houses 86 billion neurons. For every minute that passes, a person having a stroke loses 1.9 million of them, according to research from the American Heart Association. (Solis-Moreira, 10/17)

The morning of Jan. 10 started as a typical Minnesota winter morning for Hennepin County Commissioner Angela Conley. “I was digging out my driveway,” Conley recalled. Earlier this month, from her office inside the Hennepin County Government Center, Conley recounted how her life changed on that day. It started with an unfamiliar pain between Conley’s shoulder blades. (Moini, 10/18)

A medical waste processing company has pleaded guilty to dozens of environment-related charges and agreed to pay $1.75 million in fines after state prosecutors in Maryland accused a south Baltimore incineration plant owned by the firm of exposing the public to biohazardous material. The waste comes from hospitals, laboratories and other medical settings. It’s supposed to be burned into ash before being transported to landfills, a process that prevents disease transmission, state officials said Tuesday at a news conference announcing the settlement agreement involving the nation’s largest medical waste incinerator. (Skene, 10/17)

The number of bodies found at a rural Colorado funeral home has grown to at least 189, officials said Tuesday, two weeks after they reported that a foul odor had led investigators to the decaying remains of 115 people there. It is unclear if the additional bodies were also decaying. (Carballo, 10/17)

Starting in January, California will accept Medicaid enrollments from all low-income undocumented immigrants who qualify for benefits, and 700,000 people are projected to sign up. California gradually has been opening Medi-Cal, as Medicaid is known in the state, to undocumented immigrants since 2016, starting with low-income children and adults younger than 26 or older than 49, and is poised to lift age restrictions next year. The full expansion will cost an estimated $2.1 billion a year. (Hartnett, 10/17)

Philadelphia joined a growing number of Democratic-led cities calling themselves places of refuge for transgender people when Mayor Jim Kenney signed Tuesday an executive order protecting those who come here for gender-affirming care. ... The newly signed executive order prohibits the city from using any resources to assist states that seek to investigate or punish someone for providing or receiving gender-affirming care in Philadelphia. (Gutman, 10/17)

Republican attorneys general from across the country and major medical organizations are trying to help sway a federal appeals court as it considers Florida restrictions on treatments for transgender people. Briefs filed Friday at the 11th U.S. Circuit Court of Appeals offer clashing views of treatments such as puberty blockers and hormone therapy, particularly for adolescents with gender dysphoria. (Saunders, 10/17)

Jefferson Health is now offering a health program with services tailored for LGBTQ patients who are 55 and older at its clinic for seniors in Center City. The focus represents the first of its kind in the Philadelphia region, where several health systems are investing in the growing field of LGBTQ health. (Gutman, 10/18)

Overdose deaths in San Francisco dropped to 54 in September from a high of 84 in August, a 36% decrease, according to the public health department. ... At the current pace, San Francisco is on track to see more than 800 overdose fatalities this year, topping 2020’s 725. “While we are thankful that those numbers are down compared to last year, that still represents more than two people a day in San Francisco dying largely from fentanyl overdose-related deaths,” Colfax said. (Toledo, 10/17)

Test strips and naloxone are becoming more and more common on college campuses, and at least one health department has recommended they be added to school packing lists. For students who didn't bring their own, many campuses are handing them out at welcome fairs, orientation events or campus health centers. ... "If you are in the position where you have had to give someone naloxone, they've almost died." "Naloxone is what I call an anti-funeral drug," explains Nabarun Dasgupta, a research scientist at UNC-Chapel Hill's school of public health. (Nadworny and Schlemmer, 10/18)

As sexually transmitted infections continue to climb in the United States, a promising tool to combat them is drawing more attention. The Centers for Disease Control and Prevention recently released a draft proposal to recommend the antibiotic doxycycline as a “morning-after” pill to help prevent chlamydia, syphilis and gonorrhea infections among people at especially high risk. (Blum, 10/14)

A randomized clinical trial found that nasal mupirocin is more effective than nasal iodophor for reducing Staphylococcus aureus and methicillin-resistant S aureus (MRSA) in intensive care unit (ICU) patients, researchers reported this week in JAMA. (Dall, 10/13)

The U.S. Food and Drug Administration on Monday approved the expanded use of Merck & Co's blockbuster immunotherapy Keytruda in early-stage patients with non-small cell lung cancer who can get their tumors removed surgically. The U.S. health regulator's approval extends Keytruda's use in combination with chemotherapy as a treatment given before surgery to shrink the size of the tumor in patients. (10/17)

Teplizumab, a humanized monoclonal antibody to CD3 on T cells, is approved by the Food and Drug Administration to delay the onset of clinical type 1 diabetes (stage 3) in patients 8 years of age or older with preclinical (stage 2) disease. Whether treatment with intravenous teplizumab in patients with newly diagnosed type 1 diabetes can prevent disease progression is unknown. (Ramos, M.D., et al, 10/18)

Convenience, past treatment experiences, and health system barriers are among the primary reasons patients said they take nonprescription antibiotics, according to a study presented yesterday at the IDweek 2023 meeting in Boston. In interviews conducted by a team led by researchers from Baylor College of Medicine, nearly all respondents reported taking nonprescription antibiotics to treat viral illnesses such as a cold, flu, or COVID-19, along with other conditions that don't require antibiotics. They said they did so because antibiotics had worked for previous illnesses and over-the-counter medications weren't as effective. (Dall, 10/12)

The U.S. health regulator has approved Hyloris Pharmaceuticals' drug for post-operative pain, the Belgium-based company said on Wednesday, adding that it expects to launch the non-opioid treatment in the United States by early next year. (10/18)

The FDA’s approval of Opill could dramatically improve practical access to family planning. But whether people throughout the country will be able to afford it remains an open question. (Christopher Robertson, J.D., Ph.D., and Anna Braman, B.A., 10/12)

The Food and Drug Administration should halt Cassava Sciences’ ongoing clinical trials in Alzheimer’s disease. That, and other thoughts on the fallout from the City University of New York investigation that raised serious doubts about the science underpinning the company’s experimental drug simufilam. (Adam Feuerstein, 10/17)

The principles underlying the U.S. Supreme Court decision in 303 Creative L.L.C. v. Elenis could have far-reaching implications, possibly affecting our ability to learn about side effects of drugs. (Jerry Avorn, 10/14)

If officials at the Centers for Disease Control and Prevention were hoping that tying an annual Covid booster to the fall flu shot would increase uptake, it isn’t working. (F.D. Flam, 10/18)

With half of Texas school districts lacking mental health services, state lawmakers have opted to anoint chaplains as the solution. In June, Gov. Greg Abbott signed into law SB 763, a bill authorizing public schools to divert money from safety funds to support chaplain employment programs. Each Texas school district has been directed to vote on whether to implement this program. (Sheri Allen and Andy Stoker, 10/18)

The Covid pandemic seemed to worsen teems’ and adolescents’ mental health, according to several recent studies. But now, new research shows a reason for hope: Telehealth seems to be giving many more kids access to support. That’s a win worth celebrating. (Lisa Jarvis, 10/17)

Here are five reforms with bipartisan support that can help reorient SNAP back to its intended purpose of promoting nutrition and improving health. (Leana S. Wen, 10/17)

In the early 2000s, after a mandatory team exam, I learned that I had a rare form of kidney disease, and it took me out of the game. Years later, I learned that disease, known as focal segmental glomerulosclerosis (FSGS), was genetically driven, just like my height. (Alonzo Mourning, 10/18)