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The vaccines made by Pfizer-BioNTech and Moderna set off a persistent immune reaction in the body that may protect against the coronavirus for years, scientists reported on Monday. The findings add to growing evidence that most people immunized with the mRNA vaccines may not need boosters, so long as the virus and its variants do not evolve much beyond their current forms — which is not guaranteed. People who recovered from Covid-19 before being vaccinated may not need boosters even if the virus does make a significant transformation. (6/28)

As COVID-19 vaccines were first being approved for emergency use in the United Kingdom, the UK Joint Committee on Vaccination and Immunisation decided to extend the interval before the second dose from 4 to 12 weeks to maximize the amount of people who could be vaccinated. This week, two Lancet Infectious Diseases studies estimated vaccine effectiveness (VE) for the elderly after receiving just one dose. (McLernon, 6/25)

Dr. Robert Montgomery had several reasons for getting a COVID-19 vaccine as soon as he could. As a transplant surgeon at a busy New York hospital, his patients were among the most vulnerable to the disease. The pandemic has exacted a terrible toll on transplant recipients. About 20% of those infected died – almost 2,000 in New York City alone last year compared to just one or two transplant patient deaths in a typical flu season, Montgomery said.He also is a transplant patient himself. The heart beating inside his 61-year-old chest is not the one he was born with. (Weintraub, 6/27)

Gus Perna, the four-star Army general responsible for coordinating the U.S. coronavirus vaccine response, is set to retire this summer, according to four current and former Health and Human Services officials. A number of Perna’s top deputies have also left the initiative in recent weeks, including Doug Meyer, the operation’s former chief of operations, Marion Whicker, the former deputy chief of supply, production and distribution, and Eric Shirley, the operation’s former chief of staff, according to STAT’s review of the officials’ LinkedIn profiles. (Florko, 6/25)

One of the unexpected ripple effects of the global pandemic is how it catalyzed medical breakthroughs. Most prominently, the same technology used in SARS-CoV-2 vaccines has the potential to improve treatments for diseases like cancer and HIV. Earlier this June, President Biden's medical adviser Dr. Anthony Fauci noted that the extraordinary success of the messenger ribonucleic acid (mRNA) COVID-19 vaccines had given new hope to HIV vaccinologists. In fact, researchers across multiple disciplines have renewed enthusiasm based on the techniques advanced during the pandemic. Such a vaccine would be an astonishing achievement in vaccinating against a retrovirus, HIV, that has eluded scientists for decades. (Malik, 6/27)

KHN: Children And Covid: Journalists Explore Grief And Vaccine Side Effects 

KHN senior correspondent JoNel Aleccia discussed grief among the estimated 46,000 children in the U.S. who lost a parent to covid-19 on NBC News NOW on Tuesday. ... KHN senior correspondent Sarah Varney discussed one family’s reckoning with racism after a police shooting on NPR/WBUR’s “Here & Now” on Monday. ... California Healthline editor Arthur Allen discussed children and the covid vaccine on KGO-810’s “The Chip Franklin Show” on Monday. (6/26)

Calls are rising from some experts for the Food and Drug Administration (FDA) to move faster to fully approve the COVID-19 vaccines, in what could be a key step to address vaccine hesitancy. As the vaccination rate lags, with the country on pace to miss President Biden’s goal of vaccinating 70 percent of adults by July 4, polling indicates full approval could help convince some of the remaining unvaccinated people to get the shots.  (Sullivan, 6/27)

Arkansas Governor Asa Hutchinson said Sunday he believes final, non-emergency use approval from the Food and Drug Administration (FDA) of coronavirus vaccines would help combat hesitancy among Arkansas residents to get their shots. "Whenever they see emergency use authorization, then they say, well, they haven't made a final approval, they haven't got all the research completed that is needed on there. They want to do more study. And so it was approved as emergency use," Hutchinson, a Republican, said in an interview on "Face the Nation." "And so for that reason, you can't mandate it. We don't mandate it in Arkansas. We have to rely upon the education." (Quinn, 6/27)

In reality, vaccines that have been given an EUA have gone through a rigorous examination by the FDA that is very similar to its full approval process. In the case of the authorized COVID-19 vaccines, the FDA evaluated data from clinical trials that included tens of thousands of study participants, as well as the companies’ manufacturing plans to ensure the quality and consistency of the vaccines. An EUA is only given after the FDA’s Vaccines and Related Biological Products Advisory Committee—15 scientists with expertise in immunology, epidemiology, vaccine safety, and more—determines the “known and potential benefits outweigh the known and potential risks of the vaccine,” according to the FDA. (Kramer, 6/11)

Teenagers keep all sorts of secrets from their parents. Drinking. Sex. Lousy grades. But the secret that Elizabeth, 17, a rising high-school senior, keeps from hers is new to the buffet of adolescent misdeeds. She doesn’t want her parents to know that she is vaccinated against Covid-19. Her divorced parents have equal say over her health care. Although her mother strongly favors the vaccine, her father angrily opposes it and has threatened to sue her mother if Elizabeth gets the shot. Elizabeth is keeping her secret not only from her father, but also her mother, so her mom can have plausible deniability. (Hoffman, 6/26)

Thrown off-stride to reach its COVID-19 vaccination goal, the Biden administration is sending A-list officials across the country, devising ads for niche markets and enlisting community organizers to persuade unvaccinated people to get a shot. The strategy has the trappings of a political campaign, complete with data crunching to identify groups that can be won over. But the message is about public health, not ideology. The focus is a group health officials term the “movable middle” — some 55 million unvaccinated adults seen as persuadable, many of them under 30. (Alonso-Zaldivar, 6/27)

Arkansas Gov. Asa Hutchinson said Sunday that hospitalizations are up among those who are unvaccinated and that vaccinations have slowed, a worrying trend among several states across the country. Hutchinson said on CBS News’ “Face the Nation” that “people started feeling comfortable” after vaccines were first doled out. “People saw the cases of hospitalizations go down. And so, the urgency of getting the vaccine slowed down,” he said. (Bice, 6/27)

Sisolak announced a state raffle on June 17 in which vaccinated residents could win a total of $5 million in prizes, including college tuition and a $1 million grand prize. The rewards were intended to boost the state’s declining numbers of new vaccinations. Brian Labus, an assistant professor of epidemiology and biostasticis at UNLV’s School of Public Health, said the offer didn’t immediately result in big gains. “There wasn’t a giant spike in people vaccinated the next day,” he said when asked to review vaccination data from the Centers for Disease Control and Prevention. Through Friday, the seven-day daily average of first doses administered also appeared to continue its downward trend. (Hynes, 6/27)

Vaccines are working against Covid-19, including the highly contagious delta variant — but the challenge is in getting enough people inoculated, according to a professor of preventive medicine at the Vanderbilt University School of Medicine. “Leaving it in the refrigerator doesn’t help, that won’t prevent disease. You have got to move that vaccine into arms,” William Schaffner said on CNBC’s “Squawk Box Asia” on Monday. (Choudhury, 6/28)

Speaking in sign language, Jacqueline Augustine said her right arm hurt after she received her first dose of the coronavirus vaccine on Saturday. Augustine received the shot at a small pop-up clinic inside the Deaf Counseling Advocacy and Referral Agency in San Leandro. The clinic was designed to attract people from the deaf and hearing-impaired community as well as anyone else in the area who still needs a vaccination. “My family was so worried about me,” said Augustine, who was going to get a shot in March but developed a skin infection that kept her housebound for months. “My family was encouraging me. My doctor was, too. He said it’s time.” (Cabanatuan, 6/26)

Black people in the city of Philadelphia, the nation's largest predominantly Black county, are lagging far behind white people when it comes to COVID-19 vaccinations, the Washington Post reports. It's a reflection of larger racial disparities in vaccination rates across the United States. "Coronavirus immunizations are the latest iteration of the pandemic’s unequal burden," the Post writes. (Chen, 6/27)

Troves of misinformation, language barriers and fears around immigration enforcement are hampering efforts to vaccinate Hispanic communities against Covid-19, challenging the Biden administration’s push to crush the coronavirus as a dangerous new variant quickly spreads. Much of the nationwide attention on the slowing vaccination campaign has focused on hard-line resisters, predominately in Republican-led states in the South and Mountain West. But Hispanic communities, even as they’re among the most eager to receive the shots, are still facing barriers to vaccination that could leave them vulnerable to the virus this summer, according to interviews with nearly two dozen people working on vaccination efforts, including state officials and community groups. (Roubein and Goldberg, 6/27)

As the highly contagious delta variant of the coronavirus gained traction around the world, the World Health Organization urged vaccinated people to continue to wear masks and social distance, according to reports. "Vaccine alone won’t stop community transmission," Dr. Mariangela Simao, WHO’s assistant director-general for access to medicines and health products, said during a briefing in Geneva, according to CNBC. "People need to continue to use masks consistently, be in ventilated spaces, hand hygiene ... the physical distance, avoid crowding. This still continues to be extremely important, even if you’re vaccinated when you have a community transmission ongoing." (Stimson, 6/27)

The World Health Organization on Friday urged fully vaccinated people to continue to wear masks, social distance and practice other Covid-19 pandemic safety measures as the highly contagious delta variant spreads rapidly across the globe. “People cannot feel safe just because they had the two doses. They still need to protect themselves,” Dr. Mariangela Simao, WHO assistant director-general for access to medicines and health products, said during a news briefing from the agency’s Geneva headquarters. (Lovelace Jr., 6/25)

A bipartisan group of senators has asked the Centers for Disease Control and Prevention (CDC) and Transportation Security Administration (TSA) when they will update their mask guidance for travelers. In a letter, Sens. Brian Schatz (D-Hawaii), Roger Wicker (R-Miss.), Amy Klobuchar (D-Minn.), Susan Collins (R-Maine), and Jerry Moran (R-Kan.) requested information about the agency’s process for updating the mask guidelines for vaccinated people, adding that they want answers by July 12. (Oshin, 6/27)

Three House Republicans each must pay $500 fines imposed by the sergeant-at-arms for being warned and then failing to wear a mask on the House floor. Reps. Brian Mast of Florida, Beth Van Duyne of Texas and Mariannette Miller-Meeks of Iowa were all fined, according to an announcement released on Friday by the House Ethics Committee. (Marquette, 6/25)

For more than a year now, Katie Burke’s work life has been a month-to-month series of twists and shimmies. A co-owner of the Zumba studio Triangle Dance 4 Life, Burke has had to make more than a few pivots in how she taught her dance classes since coronavirus took over. The initial change came all at once. Gov. Roy Cooper’s stay-at-home orders shuttered gyms almost right away in spring 2020. Later, in the summer, as North Carolinians came to terms with capacity restrictions at stores, takeout-only restaurants and the mask mandate, hundreds of gym owners across the state had to find a way to stay afloat and comply with a seemingly endless stream of statewide orders. (Engel-Smith, 6/28)

Infectious disease experts are weighing the need for booster shots of the Pfizer/BioNTech or Moderna mRNA-based vaccines for Americans who received Johnson & Johnson's (JNJ.N) one-dose vaccine due to the increasing prevalence of the more contagious Delta coronavirus variant. A few say they have already done so themselves, even without published data on whether combining two different vaccines is safe and effective or backing from U.S. health regulators. Canada and some European countries are already allowing people to get two different COVID-19 shots. (Erman, 6/27)

The Delta coronavirus variant is now the third-most common in California, new data show, underscoring the danger of the highly contagious strain to people who have not been vaccinated against COVID-19. The variant makes up 14.5% of California coronavirus cases analyzed so far in June, up from 4.7% in May, when it was the fourth-most identified variant in California, according to data released by the California Department of Public Health. (Lin II, Money and Wigglesworth, 6/27)

The Delta variant, a strain of Covid-19 believed to be more transmissible and dangerous than others, is likely to break out in some US communities, a health expert told CBS's Face the Nation. "It's not going to be as pervasive," Dr. Scott Gottlieb, former commissioner of the US Food and Drug Administration, told the station Sunday. "It's going to hyper-regionalized. There's certain pockets of the country where you're going to have very dense outbreaks." Those pockets will be ones with low vaccination rates and low rates of prior infection, Gottlieb said, like in many rural and southern communities. (Holcombe, 6/28)

Based on a recent government projection, the Delta variant of the Covid-19 virus could become the dominant type of this coronavirus in the U.S. within a month, making it one of most aggressive variants to take hold in the country. Delta is the latest in a series of variants that have spread throughout the U.S. Like all viruses, coronaviruses mutate as they reproduce. Some of these genetic changes make them better at infecting human cells or evading our immune defenses. As newer, better-adapted variants emerge, they push aside earlier versions of the virus. Here is a look at how this process has played out across the U.S. since the start of the pandemic. (Ulick, 6/27)

Since the start of the coronavirus pandemic, the U.S. has been keeping a close eye on the U.K. From its initial response to Covid-19 (questioned by many), to its much-praised immunization program and world-class research, all have helped inform how the U.S. — which faced its first major Covid outbreak after Britain — has reacted. (Ellyatt, 6/28)

The “delta variant” has come to dominate headlines, having been discovered in India where it provoked an extreme surge in Covid-19 cases before spreading around the world. But now a mutation of that variant has emerged, called “delta plus,” which is starting to worry global experts. (Ellyatt, 6/24)

COVID-19 survivors who lost their sense of taste and smell may have to wait up to a year to fully recover, a new study found. Researchers followed 97 COVID-19 patients who lost their sense of taste and smell for an entire year and asked them to complete a survey every four months, according to the study published Thursday in JAMA Network Open.Out of 97 patients, 51 of them also were asked to undergo objective testing to corroborate the self-reported surveys. At eight months, 49 out of the 51 patients had fully recovered their sense of taste and smell. (Rodriguez and Rice, 6/25)

KHN: Covid’s Lingering Effects Can Put The Brakes On Elective Surgeries 

The week before Brian Colvin was scheduled for shoulder surgery in November, he tested positive for covid-19. What he thought at first was a head cold had morphed into shortness of breath and chest congestion coupled with profound fatigue and loss of balance. Now, seven months have passed and Colvin, 44, is still waiting to feel well enough for surgery. His surgeon is concerned about risking anesthesia with his ongoing respiratory problems, while Colvin worries he’ll lose his balance and fall on his shoulder before it heals. (Andrews, 6/28)

In the final days of the Trump administration, the Justice Department issued a memo saying inmates whose sentences lasted beyond the “pandemic emergency period” would have to go back to prison. But some lawmakers and criminal justice advocates are urging President Biden to revoke the rule, use his executive power to keep them on home confinement or commute their sentences entirely, arguing that the pandemic offers a glimpse into a different type of punitive system in America, one that relies far less on incarceration. (Kanno-Youngs and Turcotte, 6/27)

When 76 veterans died last spring of COVID-19 in the Holyoke Soldiers’ Home, the need to get to the bottom of what happened and why, and who was to blame, could hardly have been more clear. So when Governor Charlie Baker tapped a private attorney to conduct an independent investigation, it seemed like the moment for one of those no-stone-unturned independent probes that have made history here. But a Boston Globe Spotlight Team review of Baker’s arrangement with former prosecutor Mark Pearlstein — including communications between the governor’s office and Pearlstein — raises troubling new questions about whether the investigation was truly independent. The legal contract between the Office of the Governor and Pearlstein’s law firm created an explicit attorney-client relationship, which could be used to keep their communications and other materials private and suggested Pearlstein was working for Baker, not the public. (Estes and Ostriker, 6/26)

A vaccinated person was among the eight deaths caused by COVID-19 reported Sunday by the Utah Department of Health. Of those deaths, seven occurred prior to May 27, and none of the people was hospitalized. This, despite the number of people hospitalized with COVID-19 rising to 215 on Sunday, a 14-person jump over Saturday and the highest number of hospitalizations since early March. One of the eight was a “breakthrough case,” which is defined by the UDOH as “someone who has a positive test [more than] 14 days after they have completed the full series of an approved COVID-19 vaccine.” Four fully vaccinated Utahns have now died of COVID-19. (Jag, 6/27)

A fragile bipartisan infrastructure deal appeared to be moving forward once again on Sunday, as moderate Republicans said they had been reassured that President Biden would not hold it hostage while Democrats simultaneously work on a larger, partisan economic package. After 48 hours of chaos, the statements by leading Republicans prompted a sigh of relief for the White House, where Mr. Biden and top aides had worked through the weekend to keep the eight-year, $1.2 trillion investment to rebuild the nation’s infrastructure from falling apart. G.O.P. negotiators even suggested that they could now begin drafting the bill and said they believed it would win enough Republican votes to pass the Senate next month. (Fandos, 6/27)

When Morgan Champion brought her 74-year-old father home to live with her, she had little time to prepare. It was early May when she and her sister had found him emaciated and sitting in a soiled diaper at his memory care facility in Tallahassee, Florida, after the pandemic lockdown finally lifted.“We really felt like dad was in danger,” Champion said. The family needed to get him out as quickly as possible. ... “I want him to have the dignity of being taken care of well,” Champion, 34, said. “It’s definitely been a struggle.” (Khimm, 6/26)

Thousands of Texans have banded together and hired an attorney to file suit to block Gov. Greg Abbott from ending emergency federal unemployment benefits before the programs expire in September. The plaintiffs, two groups that organized over Facebook with more than 30,000 people, argue that the decision to end the benefits early exceeded the governor’s authority, according to the lawsuit, filed this week in state district court in Austin. The benefits, aimed at providing relief to workers during the pandemic, are scheduled to expire Saturday under Abbott’s order. (Carballo, 6/25)

While California lawmakers automatically sent checks to 1.2 million people who receive SSI, the 1.2 million Californians on SSDI only qualify if they had income from work in 2020. But that’s rare — research shows that fewer than one in five SSDI recipients work during a typical year, often because they are limited by their disabilities or risk losing their benefits if they work too much. Disability advocates say it’s the latest example of the state abandoning some of its most vulnerable residents during the pandemic, after having directed medical health providers to ration COVID-19 care to elderly and less healthy people last spring and deprioritize people with disabilities for vaccines earlier this year — both policies that were reversed after considerable outcry. (Botts, 6/26)

The number of unemployment-benefit recipients is falling at a faster rate in Missouri and 21 other states canceling enhanced and extended payments this month, suggesting that ending the aid could push more people to take jobs. Federal pandemic aid bills boosted unemployment payments by $300 a person each week and extended those payments for as long as 18 months, well longer than the typical 26 weeks or less. The benefits are set to expire in early September, but states can opt out before then. (Morath and Barrett, 6/27)

By lunchtime, the representatives from the recruiting agency Express Employment Professionals decided to pack up and leave the job fair in the St. Louis suburb of Maryland Heights. Hardly anyone had shown up. “We were hoping we would see prepandemic levels,” said Courtney Boyle, general manager of Express. After all, Missouri had just cut off federal unemployment benefits. (cohen, 6/27)

The new face of hunger in the Washington region is a Hispanic man or woman who struggles to feed their household despite working, according to a new report from the Capital Area Food Bank. The 2021 “Hunger Report” comes a year after the organization released a July 2020 report warning that the coronavirus pandemic could greatly grow the number of food-insecure people in the area. (Swenson, 6/27)

Housing has emerged as one of the most unequal and consequential parts of the economic recovery from the coronavirus pandemic. Low interest rates, cheap mortgages and bidding wars are fueling a housing boom for wealthier Americans and making homeownership out of reach for many first-time buyers. Meanwhile, housing is a top expense and worry for millions of renters and unemployed workers, and advocates fear a wave of homelessness once the CDC’s final moratorium lifts July 31. (Siegel, 6/27)

Facing a looming deadline, legislative budget officials said late Friday they had reached a framework for the state budget with Gov. Gavin Newsom, hashing out agreements on homelessness funding, health coverage for undocumented seniors and other lingering policy differences. But the officials, who declined to speak on the record, said some key details remained unsettled, even as the Legislature prepares to pass the $262.2 billion spending plan on Monday, three days before the start of the new fiscal year. (Koseff, 6/26)

A 118-page plan to help end homelessness released by the Oklahoma City Mayor's Task Force on Homelessness looks to tackle problems service providers admit are complex. Dan Straughan, executive director of the Homeless Alliance, said one way the plan does this is looking at root causes. "Until you address the issues that contribute to poverty, you're not going to be able to effectively address the issues that contribute to homelessness," Straughan said. (Williams, 6/28)

Senate Democrats are calling on federal authorities to take action on aggressive medical debt collection, citing reports about hospitals suing patients over unpaid bills. In a letter to the the Consumer Financial Proection Bureau (CFPB), Democratic Sens. Chris Murphy (Conn.) and Chris Van Hollen (Md.) recommended a series of actions to protect consumers' credit scores, provide patients with more information about financial assistance and coverage options, and give them more time to dispute or resolve debts before they are sent to collections. (Hellman, 6/25)

A national charity will for the first time buy medical debt, totaling $278 million, directly from hospitals, a push to speed financial relief to patients, many of whom shouldn’t have been billed at all under the hospitals’ financial-aid policies. RIP Medical Debt, which uses donations to wipe out unpaid medical bills, has reached a deal with nonprofit Ballad Health, a dominant hospital system in Tennessee and Virginia, to buy debt owed by 82,000 low-income patients. Many likely qualified for free care under Ballad’s policy but didn’t get it, executives at Ballad involved in the agreement said. The patients lacked applications, they said. (Evans and Mathews, 6/15)

Credit monitoring site Credit Karma said its members' medical debt grew by 6.5 percent from May 2020 to March 2021, Newsweek reported June 14.Credit Karma said medical debt grew by $2.8 billion among its members, and the number of people facing past-due medical bills rose by 9 percent. (6/14)

A third of working Americans have medical debt. And about half of that group has defaulted on medical loans. Even for the insured, deductibles and out-of-pocket expenses are going up—while hospitals are inflating bills in a price war with insurance companies. And when people can’t pay, many hospitals sue or send bills to debt collectors. It’s the terrible reality of America’s healthcare, and a new series of data visualizations by Axios, spotted by FlowingData, takes you right inside of it. Built from an analysis of the top 100 hospitals in the United States by Johns Hopkins University, Axios’s charts let you easily sort through the data by tapping on a few tabs to spot some of the worst predatory billing behaviors. “We wanted to make this data feel personal and understandable,” Michelle McGhee, a visual journalist at Axios, wrote in an email to Fast Company. (Wilson, 6/28)

Medical debt in the US is higher than ever before. Although Americans generally didn’t have to pay for Covid-19 testing and treatment, other medical expenses didn’t stop during the pandemic, and the high rates of unemployment meant many lost employer-sponsored health insurance, too. According to the most recent estimate, from 2018, there is $81 billion of outstanding medical debt in the US, based on sample credit data from the Consumer Financial Bureau Protection. This value is likely higher after the pandemic, although it’s hard to give an accurate estimate. (Merelli, 6/24)

Northwell Health is creating an independent medical debt ombudsman, the New Hyde Park, N.Y.-based health system said June 15.Northwell said it is the only hospital or health system in the U.S. to have such a role. The medical debt ombudsman will act as an independent reviewer to help patients pay their medical debt and avoid legal action by educating them about the health system's financial assistance options. (Adams, 6/16)

If innovation is the mother of necessity, the market for disrupting the pharmacy industry could be limitless. Attention to the cost of prescription drugs intensified this month when the Food and Drug Administration approved the Alzheimer's disease drug Aduhelm, which manufacturer Biogen has priced at $56,000. But for policymakers, payers and patients, high drug prices are nothing new. Nearly 90% of consumers believe the federal government should negotiate directly with the drugmakers to drive down prices, according to a June poll by the Kaiser Family Foundation. Respondents across the political spectrum agreed that lowering prescription costs should be a key priority for President Joe Biden's administration. (Tepper, 6/25)

A Texas state court jury on Thursday awarded two emergency department staffing companies more than $19 million in damages from Molina Healthcare of Texas due to underpaid claims. ACS Primary Care Physicians Southwest PA and Emergency Services of Texas will receive $1.5 million in actual damages and $17.5 million in punitive damages. The Houston jury found Molina Healthcare "engaged in unfair or deceptive practices" in paying emergency department claims. The staffing companies' attorney, John Zavitsanos, said this was the first lawsuit that evaluated how ACA plans would have to reimburse for ED claims. ACS and Emergency Services first sued Molina in 2017. (Devereaux, 6/25)

KHN: A Hospital Charged $722.50 To Push Medicine Through An IV. Twice. 

Claire Lang-Ree was in a lab coat taking a college chemistry class remotely in the kitchen of her Colorado Springs, Colorado, home when a profound pain twisted into her lower abdomen. She called her mom, Jen Lang-Ree, a nurse practitioner who worried it was appendicitis and found a nearby hospital in the family’s health insurance network. After a long wait in the emergency room of Penrose Hospital, Claire received morphine and an anti-nausea medication delivered through an IV. She also underwent a CT scan of the abdomen and a series of tests. (Bichell, 6/28)

KHN: Doctors’ Lobby Scores ‘Major Victory’ On Bill To Hold Physicians Accountable

The board that licenses and disciplines doctors in California is failing to hold bad actors accountable, endangering patients in the process. That’s the verdict of state lawmakers and patient advocates who have been working for years to reform the Medical Board of California. But an attempt this year to give the board more money and power to investigate complaints of fraud, gross negligence, sexual misconduct and other misbehavior is under attack from one of the most politically potent forces in California’s Capitol: doctors themselves. And so far, it seems, the doctors are winning. (Young, 6/28)

The Centers for Medicare and Medicaid Services pulled the plug on Arizona's and Indiana's plans to require some Medicaid beneficiaries to work, attend job training or participate in other activities to keep their health coverage, according to letters the federal agency sent the two states Friday. The waivers President Donald Trump's administration approved were unlikely to promote the objectives of Medicaid, which federal courts have ruled is to provide health insurance, CMS Administrator Chiquita Brooks-LaSure wrote in the letters. The pandemic also presents challenges to the Medicaid population that make work requirements especially burdensome, she wrote. At this time, beneficiaries may lack access to economic opportunities, transportation and affordable childcare as the public health emergency gradually winds down. Imposing a work requirement under these circumstances could lead to unfair benefit losses, she wrote. (Brady, 6/25)

Georgia will delay the rollout of its limited Medicaid expansion, originally planned for July 1, until at least August 1, according to a letter the state Department of Community Health sent to Washington dated Thursday. The delay comes after the plan has come under scrutiny by the Biden Administration because of the state’s requirements that beneficiaries either work or attend school or engage in other qualifying activities. In several other states, the administration has already revoked Medicaid work requirements, citing the pandemic and economic environment and saying such rules present barriers to those lacking access to transportation or child care, among other issues. (Hart, 6/26)

CMS can't ensure that hospitals are prepared for emerging infectious disease threats like COVID-19, according to a federal watchdog report released Monday. Although the agency announced in February 2019 that hospitals had to plan for potential outbreaks, CMS can't confirm that all hospitals have updated their emergency preparedness plans during the pandemic because it only inspects them every three to five years, HHS' Office of Inspector General said in its report. That's mainly because CMS can't require accrediting organizations, which inspect about 90% of Medicare and Medicaid-approved hospitals, to carry out more frequent quality and safety surveys or targeted infection control inspections. (Brady, 6/28)

The Food and Drug Administration’s decision to grant wide-ranging approval to the controversial, pricey new Alzheimer’s drug Aduhelm will have an eye-popping impact on Medicare finances. The question is exactly how big the impact will be. Estimates of how many seniors on Medicare will actually take Aduhelm, which has a list price of $56,000, vary wildly. Some experts have guessed at relatively low patient interest, around 500,000 people. Biogen, the company behind the drug, has put its target population far higher, around 1 million to 2 million people. (Cohrs and Parker, 6/28)

Missouri senators passed a bill to renew a key tax for Medicaid funding early Saturday after hours of debate over coverage of family planning services. The GOP-led Senate voted 28-5 to send the bill to the House. Senators were able to advance the bill after some Republicans joined with Democrats to vote down a proposal that sought to cut off any government money for Planned Parenthood. (6/26)

California will soon pay the health care bills for low-income people 50 and older who are living in the country illegally, part of an expansion of Medicaid that aims to inch the nation’s most populous state toward Democrats’ goal of making sure everyone has health insurance. The new coverage will eventually cost taxpayers about $1.3 billion per year, money that’s part of the new state operating budget that Gov. Gavin Newsom and state legislative leaders unveiled Friday night. The budget is scheduled for a vote in the state Legislature on Monday, with Newsom likely signing it into law before the state’s fiscal year begins Thursday. (Beam, 6/26)

Johnson & Johnson has agreed to pay $230 million to New York state to settle claims that the pharmaceutical giant helped fuel the opioid crisis, Attorney General Letitia James said on Saturday. The drugmaker also agreed to permanently end the manufacturing and distribution of opioids across New York and the rest of the nation, James said in a statement announcing the settlement. The company "helped fuel this fire, but today they're committing to leaving the opioid business—not only in New York, but across the entire country," she said. (6/26)

On the eve of a widely anticipated trial, Johnson & Johnson (JNJ) agreed on Saturday to pay $230 million to the state of New York to settle a lawsuit alleging that the company helped fuel the devastating opioid crisis. The deal comes as negotiations intensify with the health care giant and three of the nation’s largest pharmaceutical wholesalers to complete a sweeping $26 billion settlement of thousands of other lawsuits. The settlement includes an additional $33 million in attorney fees and costs, as well as a commitment from J&J to halt opioid sales, a step the company said it has already taken (you can read the settlement here). (Silverman, 6/26)

Opioid deaths spiked in Connecticut during the pandemic and continue to increase in 2021, fueled by continued disruptions to recovery programs and a deadly, fentanyl-laced drug supply. The synthetic opioid fentanyl, which is 80 to 100 times more powerful than morphine, was found in 4 percent of accidental intoxication deaths in the state in 2012 but showed up in the vast majority of fatal overdoses last year, the Hartford Courant reported. (6/27)

Despite a new law making it harder to operate the life-saving operations, the Cabell-Huntington Health Department will continue to offer syringe exchange services. The Cabell Board of Health voted unanimously Wednesday to continue operating the program at the behest of health officer and CEO Dr. Michael Kilkenny. Kilkenny said with the help of grants the department already has for the program, they will be able to operate under the law and still rebound from the pandemic-driven increase in overdoses. (Stuck, 6/27)

Tyler Cordeiro slept on a couch outside his mother’s Bucks County home, suffering from opioid withdrawal. His sister took a photo of his mother, Susan Ousterman, on the other section of the L-shaped sofa, resting with him, the two lying nearly head-to-head. Those days in September 2020 were exhausting and desperate for the family. The 24-year-old Cordeiro struggled with addiction for several years, and he had recently lost access to Medicaid insurance coverage. Ousterman and her daughter, Mary Cordeiro, called every 800-number and helpline they could find to help pay for addiction treatment. (Mahon, 6/28)

The thin young man quietly took in the room as he waited for the free supplies meant to help him avoid dying: sterile water and cookers to dissolve illicit drugs; clean syringes; alcohol wipes to prevent infection; and naloxone, a medicine that can reverse overdoses. A sign on the wall — “We stand for loving drug users just the way they are” — felt like an embrace. It was the first day the drop-in center in a residential neighborhood here had opened its doors since the coronavirus forced them shut in the spring of 2020. “I’m so glad you all are open again,” the man, whose first name is Jordan, told a volunteer who handed him a full paper bag while heavy metal music riffed over a speaker in the background. He asked for extra naloxone for friends in his rural county, an hour away, where he said it had been scarce throughout the pandemic. (Goodnough, 6/27)

The top House Democrats on two powerful committees on Friday announced an investigation into the approval and pricing of Biogen’s controversial Alzheimer’s drug, Aduhelm. Both Biogen and the Food and Drug Administration will be under the microscope, House Committee on Oversight and Reform Chair Carolyn Maloney (D-N.Y.) and Energy and Commerce Chair Frank Pallone (D-N.J.) said. (Cohrs, 6/25)

Advocates of lowering prescription drug prices are beginning to use an expensive new Alzheimer's drug to make the case for reform, but actually addressing the therapy's price raises complicated policy challenges. Democrats may be positioning themselves to push policy measures that assign value to drugs and then price them accordingly. If successful, that could be a huge blow to the pharmaceutical industry. (Owens, 6/28)

The FDA’s approval of a new Alzheimer’s treatment — the first one in almost two decades — should have been a cause for celebration. Instead, it has become a scientific and financial mess. Experts from all corners of the health care world fear the FDA’s decision will undermine medical standards, explode the federal budget and fill millions of desperate people with false hope. (Baker and Herman, 6/28)

In a major milestone for the still-young field of genome editing, Intellia Therapeutics said Saturday that the first six patients to receive a CRISPR-based treatment for a genetic nerve disorder have safely had the DNA inside their liver cells edited. Preliminary results from the study — the first to show that CRISPR-based gene editing can be delivered systemically and performed in vivo, or inside the body  — found that the treatment reduced levels of a disease-causing protein by an average of 87% in the higher dose cohort with only mild side effects. The encouraging interim Phase 1 results, presented at a conference on Saturday, were published simultaneously in the New England Journal of Medicine. (Molteni, 6/26)

The U.S. Chamber of Commerce and other national groups say an environmental protection lawsuit filed in New Mexico could strain medical supplies across the state and country. Their warnings focus on a 41-page complaint filed by New Mexico Attorney General Hector Balderas seeking damages and other relief against a Santa Teresa plant that sterilizes medical equipment. The industry groups say any disruption to the facility’s work could affect medical procedures across New Mexico and the United States. (McKay, 6/25)

When buying a dietary supplement, you probably assume that what’s on the label is what’s in the pill. But this assumption doesn’t always hold up, says Pieter Cohen, a physician at Cambridge Health Alliance. In March, Cohen published his 14th paper concerning dietary supplements that contained either prohibited or unlisted ingredients. This time, he and his colleagues analyzed 17 brands of sports and weight-loss supplements sold in the United States, and they detected nine prohibited stimulants in them. Almost half of the brands tested included more than one prohibited stimulant. (Aschwanden, 6/26)

Even before the pandemic drove an extreme shift toward telemedicine, diabetes care was leading the march toward digital care. A crop of health care companies including Onduo, One Drop, Lark Health, Omada, Livongo, and Virta Health have built businesses on the idea that virtual coaching and remote monitoring can help people with diabetes keep their glucose levels in healthier ranges. Next year, estimates suggest the market for digital diabetes care will exceed $700 million. (Palmer, 6/28)

The makers of ketamine, a drug planned for the execution of convicted killer Zane Floyd, have demanded that Nevada prison officials return the supply before the lethal injection scheduled for next month. A lawyer for Hikma Pharmaceuticals wrote in a cease-and-desist letter to Attorney General Aaron Ford on Thursday that the Nevada Department of Corrections obtained 50 vials of ketamine illegally. “NDOC’s purchase and intended use of Hikma’s products for capital punishment is in violation of state and federal law, in knowing violation of Hikma’s property and proprietary interests in its products, and these actions will cause significant damage to Hikma’s business reputation and the interests of its investors,” Hikma’s lawyer, Josh Reid, wrote in the nine-page letter obtained by the Review-Journal. (Ferrara, 6/25)

Nearly a quarter of public health workers said they felt bullied, threatened or harassed because of their work since the pandemic began, new CDC data shows. The data corroborates the anecdotal evidence of how politically charged public responses and work burnout wreaked havoc on the mental health of public health workers this past year, causing some to even resign. (Fernandez, 6/28)

Even before the pandemic, a scarcity of nurses was an ongoing concern in Arizona especially in more rural areas. An Arizona State University nursing program, set to debut at the school’s Lake Havasu City campus this fall, aims to put a dent in that shortage. ASU Havasu, which is still a young campus at 9 years old, got approval in April from the Arizona Board of Nursing to offer a 12-month bachelor of science degree in nursing. The program is expected to draw more than 30 new students, the Today’s News-Herald reported. (6/27)

The city of San Diego sued three health insurers on Friday, alleging Kaiser Permanente, HealthNet and Molina Healthcare all advertised false networks of providers in an attempt to get consumers to sign up for their plans. The three insurers together enrolled more than 3.3 million California residents in 2019, and "are among the worst actors in California when it comes to the inaccuracy of their provider networks," according to the three separate suits, all filed in San Diego Superior Court. (Tepper, 6/25)

Bright Health raised $924 million on a valuation of approximately $12 billion during its initial public offering on Thursday, with the Minneapolis-based insurtech booking the largest IPO among the health insurance startups that went public this year. The company's shares failed to reach their estimated price of $18 during the IPO, meaning its valuation fell about $2 billion short of what investors expected. Bright Health is the last of the insurtechs expected to make an IPO this year, with Alignment Healthcare, Oscar Health and Clover Health all going public earlier in 2021. (Tepper, 6/25)

UF Health announced Friday that it has restored the electronic medical records for its hospitals and clinics in The Villages and Leesburg following a cybersecurity event. UF Health's investigation of the cyberattack is ongoing. The hospital system still is not describing the nature of the cyberattack, which was detected on the night of May 31. (Byrnes, 6/26)

A developer has won approval for a nine-story office building in downtown Malden that would add to a cluster of projects seeking to attract life-sciences companies to the city center. The Malden City Council on June 22 signed off on the planned project by Quaker Lane Capital at 11 Dartmouth Street, where the developer says it intends to create space for retail, with offices above “targeted at innovation-driven tenants, including public and private sector organizations as well as entrepreneurial and research and development focused firms.” The 160,000-square-foot project comes as developers throughout the region are investing heavily in lab space, betting that life sciences will be a key to the future of the Boston’s economy. In Malden, additional office space is coming online to support companies working on research and development. (Rosen, 6/27)

Jeff Tangney launched his first health-tech start-up, Epocrates, in the middle of the dot-com bubble. While the company survived the crash and eventually went public, the endgame was a disappointing acquisition for less than $300 million. By the time Tangney started his next venture, Doximity, in 2010, he’d learned a few things: Don’t raise too much money. Don’t burn too much cash. Fix a real problem for doctors. (Levy, 6/27)

June might be Pride month, but the work to ensure better access to healthcare for the LGBTQ community happens all year round. Health networks including NYC Health + Hospitals and Stony Brook Medicine have built clinics and care centers in areas of need. Earlier this month, the city public health system opened a gender-affirming integrated services practice in the South Bronx—its first such facility in the borough. Similarly, the Long Island health network brought LGBT-specialized care to the East End with a new, 2,000-square-foot, $750,000 health center. Robert Chaloner, chief administrative officer at Stony Brook Southampton Hospital, says he hopes the center will inspire other facilities to spring up in the future. (Sim, 6/25)

Receiving a cancer diagnosis can be scary and life-altering. It takes strength to navigate the world following a diagnosis, so any additional barriers to this process can be tough, such as for transgender patients. Although the world of medicine largely remains a cisgendered world, the landscape is changing to include more research, advocacy and education about transgender patients. (Okolo, 6/27)

Many elder LGBTQ Americans, already disproportionately isolated before the pandemic, faced greater loneliness in quarantine as they lost access to resources and community, two older LGBTQ Americans told Axios. Data is lacking on how LGBTQ Americans have been affected by the coronavirus — especially older populations, who battle a myriad of complications as a high-risk and under-resourced group. (Rummier, 6/26)

It's been a long circuitous journey to restarting cruise travel in the United States. But more than 15 months after the pandemic halted the industry, the first big cruise ship has sail out of a US port on Saturday. Celebrity Edge left from Port Everglades in Fort Lauderdale just after 6 p.m. on a seven-night voyage with ports of call in Mexico and the Bahamas. The ship is sailing at 40% capacity as Celebrity -- and the industry -- sets off toward a US recovery. (Hunger, 6/26)

Two young unvaccinated passengers on a Royal Caribbean International cruise out of the Bahamas tested positive for the coronavirus, the cruise line said. The passengers, who were younger than 16 and traveling in the same group, left Adventure of the Seas before the end of the cruise on Thursday in Freeport with their companions. They returned home to Florida on a private flight arranged by the cruise company, CEO Michael Bayley said in a Facebook post. (Sampson, 6/25)

Next Sunday marks the Fourth of July, President Joe Biden's target date of getting 70% of adult Americans at least partially vaccinated for COVID-19. But the White House last week said that wasn't predicted to happen. Getting at least one shot into the arms of 70% of all American adults will take a few more weeks, said Jeff Zients, the White House coronavirus response coordinator. But with Transportation Security Association screening numbers trending upward, including its highest recorded number since March 7, 2020 reported Friday, neither the faulty prediction nor variants is not predicted to deter holiday revelry.  The spread of the delta variant of COVID-19 into the U.S. is becoming a concern for medical experts because of pockets of people in the nation who have yet to receive the vaccine. (Aspegren and Vargas, 6/28)

Health officials in New Jersey confirmed the state’s first mosquito-borne disease of the year after a man in his sixties from Sussex County tested positive for Jamestown Canyon virus. The unnamed patient experienced onset of fever and neurological symptoms in May, the state health department announced this week. The patient had not traveled, and was released from the hospital to a long-term rehabilitation center last week, a spokesperson for the health department told Fox News. The case marks the state's second such reported infection; the first case occurred in 2015 in Sussex County. (Rivas, 6/26)

A US Salmonella outbreak linked to backyard poultry has grown by 311 cases, to 474 illnesses, and the CDC has reported the first outbreak death, according to a CDC update yesterday. Three more states are affected (46 total) and a new serotype has been added (Salmonella Mbandaka) since the CDC's first notice of the outbreak on May 20. An Indiana patient has died. ... Of 271 people interviewed, 209 (77%) reported contact with backyard poultry before getting sick. (6/25)

Three years ago, Laura Gaither and her family spent their summer vacation in Panama City Beach. One afternoon, while rinsing sand off her feet, the 35-year-old Alabama resident felt something biting her legs and noticed tiny black bugs on her skin. Gaither brushed them away, and later, when she described the bites to local residents, they told her that she had likely been bitten by sand flies. Three of Gaither's five kids had been bitten, too, but she didn't worry. The marks on their legs and arms looked like ant or mosquito bites, which can cause burning and itching, but usually subside within a week. (Petroni, 6/25)

Laura Baker, a retired special education teacher from Santa Barbara, California, was 18 months into a brain cancer diagnosis when she typed out a distressing Facebook post in the fall of 2019.“I am currently having some concerning symptoms and nobody seems to know what to do,” Baker, then 57, wrote. What Baker really needed, she said, was a CT scan of her head. Her local hospital had a working CT scanner, but it wasn’t available to her. The reason: her size. (Schapiro, 6/27)

The week after Rebecca Grant took away her kids’ video games for a month, after a year of relaxed pandemic rules, her 10-year-old son was livid. He gave her the silent treatment, mostly ignoring her except to spit out a hurtful “I don’t love you” one night at bedtime. The ban wasn’t an easy decision for Grant. The 46-year-old mom of two from Fremont, Calif., did hours of research and read multiple books from parenting experts. She joined Facebook groups for families in similar situations and closely watched her children’s behavior, which had been worrisome for a while. Still, she was caught off guard by the reaction. (Kelly, 6/26)

She's an energetic and fun-loving 6-year-old, but beneath Violet Jackson's vibrant smile, she's battling B-cell acute lymphoblastic leukemia. She was diagnosed just last month. Violet is undergoing treatment at Omaha's Children's Hospital, where she's received pints of blood and platelets. "I was thankful the blood was available for Violet when she needed it," said Violet's mother, Wendy Jackson. "And I wanted to pay that gift forward, so I scheduled my blood donation." Then, big sister Eden got really inspired. (Preston, 6/27)

Though they’ve existed for more than a decade, weighted Hula-Hoops have emerged as a social media favorite during the pandemic, enticing fitness enthusiasts looking for new, affordable and convenient ways to work out at home with the promise of childlike fun (some gyms and studios are adding in-person classes as clients return). Videos tagged “weighted hula hoop” have generated more than 176 million views on TikTok, and some popular hoops have reportedly been selling out online. (Haupt, 6/23)

Louisiana's health insurer for state workers, teachers and retirees will soon cover weight loss surgery for people who are obese, under a bill signed into law by Gov. John Bel Edwards. Sen. Regina Barrow, a Baton Rouge Democrat, had previously tried to get the Office of Group Benefits to cover gastric bypass surgery and other types of weight loss surgeries, to lessen the health conditions associated with obesity. But lawmakers had raised concern about the costs. Barrow made some adjustments to the legislation and won unanimous support from the House and Senate in the recently ended legislative session. The governor agreed to the idea and signed the bill, which will take effect Aug. 1. (6/26)

To mark National HIV Testing Day, South Carolina health officials are offering free testing for HIV and sexually transmitted diseases later this week. The free testing is Tuesday at several local health departments across the state, the Department of Health and Environmental Control said in a statement. (6/27)

The federal government has given Maine a $7 million boost to help prepare for another public health crisis. Republican Sen. Susan Collins and independent Sen. Angus King said the Maine Department of Health and Human Services has received the money from the U.S. Centers for Disease Control and Prevention. About $1.8 million of the money is for preventing and controlling emerging diseases and the rest is for preparing and responding to public health emergencies. (6/27)

Lawmakers reached a bipartisan agreement Sunday afternoon on a revised $8.5 billion two-year state budget that will provide $300 COVID-19 relief payments to most Maine workers. The budget bill negotiated by the Legislature’s budget committee will likely go before both chambers on Wednesday. A deal was largely in place over the past week, but the budget panel formally reached an agreement over the weekend after weeks of negotiations. (Piper, 6/27)

West Virginia Chief Justice Evan Jenkins has suspended many of the court health protocols that arose last year from the coronavirus pandemic. Jenkins’ administrative order contained some exceptions. Courts should continue using remote technology when possible for hearings and proceedings, Jenkins’ order said. They should also continue avoiding the use of call dockets to cut back on extended waiting periods in lobbies, common areas and court rooms, he wrote. (6/28)

More than $30 million of federal funding could be directed toward expanding child care capacity in Montana under recommendations approved by a state health advisory commission. The commission approved up to $31 million for the state health department to administer grants to expand child care in the state, the Montana State News Bureau reported Thursday. The commission, which is made up of three members of the executive branch and seven lawmakers, is tasked with directing coronavirus relief dollars. (6/27)

Des Moines area families whose children are going through mental health crises will soon have more options when seeking help. Starting July 1, young residents of Polk County will be offered new, short-term mental health crisis services either in their homes or at a residential program. The new crisis services are meant to be an alternative to sending children to a psychiatric hospital unit, said Liz Cox, executive director of Polk County Health Services. Until now, she said, many children with relatively mild issues, such as anxiety or low-level depression, have been served well with occasional counseling. Children in critical situations, such as actively attempting suicide, could be taken to a hospital. But there have been few intermediate alternatives. (Leys, 6/27)

Britain’s health secretary has resigned after a tabloid splashed photos and videos of him kissing an aide in his office — breaking the same coronavirus social distancing rules he imposed on the nation. While Matt Hancock was swiftly replaced, the scandal was another blow to Prime Minister Boris Johnson and his Conservative government, which has repeatedly come under criticism for incompetence and hypocrisy in its handling of the pandemic over the past year. (Hui, 6/28)

Sajid Javid’s return to Boris Johnson’s top team as health secretary seals a speedy comeback for one of the political heavyweights of the Conservative Party, a one-time managing director at Deutsche Bank AG who is expected to push for a timely end to Britain’s coronavirus restrictions. Replacing Matt Hancock following his dramatic resignation over the weekend, Javid is more likely to support easing coronavirus rules than his predecessor, according to former Javid aide Salma Shah, speaking on BBC TV on Sunday. (Mayes, 6/28)

The pharmaceutical industry has developed a “hidden web of policy influence” over members of the U.K. parliament through payments that run the risk of creating of “institutional corruption,” according to a new analysis. Specifically, researchers focused on All-Party Parliamentary Groups, which are informal clusters of lawmakers that focus on particular issues and seek to influence government through meetings and reports (read more here). However, APPGs do not receive government funding, so the findings raise questions about the extent to which these groups act independently. (Silverman, 6/25)

A new study projects more than 2 million adults in England likely experienced persistent symptoms in the months following COVID-19 infection, or so-called long COVID. Researchers affiliated with Imperial College London released findings Thursday, stemming from over half a million people in England who participated in several rounds of the Real-Time Assessment of Community Transmission-2 (REACT-2) study, which invited random samples of adults to take surveys from September to February. "Long COVID, describing the long-term sequelae after SARS-CoV-2 infection, remains a poorly defined syndrome. There is uncertainty about its predisposing factors and the extent of the resultant public health burden, with estimates of prevalence and duration varying widely," authors prefaced. (Rivas, 6/26)

The Toronto Raptors were the only team in the National Basketball Association not to play in its home arena this season due to Covid-19 restrictions. On Sunday, they handed over the venue to health authorities to smash Canada’s record for most vaccinations at a single site in a day. The clinic at the Scotiabank Arena administered 26,771 doses of Pfizer Inc. and Moderna Inc. vaccines, according to a statement on Twitter from the facility’s owner, Maple Leaf Sports & Entertainment Ltd. (Decloet, 6/27)

In yet another twist in a complicated tale, Health Canada has reinstated approval of a rare disease drug after the manufacturer of a rival medicine claimed the regulator had originally issued an “incorrect and unreasonable” endorsement. The move came after Canada’s Federal Court earlier this month quashed the approval for Ruzurgi, which is used to treat people with a rare neuromuscular disorder called Lambert-Eaton myasthenic syndrome, or LEMS. The medicine is marketed by Jacobus Pharmaceuticals, a small, family run company, although a competitor, Catalyst Pharmaceuticals (CPRX), has sought to push back the approval until 2028. (Silverman, 6/26)

Australian authorities announced a two-week lockdown in the city of Sydney and surrounding areas as the Delta coronavirus variant continues to rapidly spread. This is the first full lockdown for Sydney since the beginning of the pandemic in 2020. It takes effect from Saturday at 6 p.m. local time until at least midnight on Friday, July 2. (Gonzalez, 6/26)

Battling a fast-increasing surge of COVID-19 cases, South Africa has reintroduced tough restrictions including a ban on alcohol sales and an extended nightly curfew. The delta variant, first discovered in India, appears to be driving South Africa’s new increase, President Cyril Ramaphosa said Sunday night, announcing the return to strict measures. South Africa recorded more than 15,000 new cases Sunday, including 122 deaths, bringing its total fatalities to near 60,000. (Magome and Meldrum, 6/27)

New coronavirus infections in the United Arab Emirates are mostly from more infectious variants leading to an increase in the number of virus-linked deaths, a federal authority has said. The Gulf Arab state, with a population of about 9 million, has had one of the world's fastest vaccination campaigns. (6/28)

India has officially recorded more than 390,000 coronavirus deaths, but families who have lost loved ones, health experts and statisticians say that vastly undercounts the true toll. ... India’s undercount has also left a huge gap in the world’s understanding of the impact of the Delta variant, which health experts believe helped drive one of the world’s worst Covid-19 surges in April and May. India was the first to detect the highly infectious variant, which has hopscotched around the world. It is fueling a surge in the U.K., and is expected to become the dominant variant in the U.S. (Li, Bhattacharya and Agarwal, 6/27)

At least 10 of the 26 doctors in Indonesia who died from Covid-19 this month had received both doses of the vaccine developed by Sinovac Biotech Ltd., a medical association said, raising questions about the Chinese-made shot that is being used in many parts of the developing world. (Emont, 6/27)

Authorities in Mallorca are investigating a coronavirus outbreak involving more than 600 students celebrating the end of term in the Spanish island, just as it prepares for British tourists to return following the easing of travel curbs. Students visiting from the mainland went to a music concert at a bullring in the capital, Palma, as well as parties on boats and in hotels, and officials said on Saturday they wanted to find out if venues had adhered to virus-control measures. ... At least 1,000 students have had to go into isolation. (6/26)

In August 2020, Russia became the first country in the world to register a Covid-19 vaccine. President Vladimir Putin announced the news on national television and said one of his daughters had already been vaccinated. At the time, Russia was set to race ahead of other countries in its efforts to vaccinate its population. Instead, 10 months after Sputnik V’s approval, Russia's vaccination rate is one of the lowest in countries where vaccines are widely available. (Chistikova and Elbaum, 6/27)

It took just a few hours for fraudsters to act after Moscow's mayor announced this month that coronavirus vaccinations were compulsory for most of the city's service sector employees. Accounts advertising the availability of fake coronavirus vaccination certificates suddenly appeared as social media followers of Russians who identified as working in restaurants or bars. A new black market was born with a deep potential clientele: the many Russians still hesitant to be vaccinated even amid a surge in coronavirus cases. (Khurshudyan, 6/27)

Huons Global Co Ltd said on Monday its South Korean consortium plans to begin production of a single-dose Sputnik Light COVID-19 vaccine from as early as September. The plan followed a request by the Russian Direct Investment Fund (RDIF), which markets the vaccine, and production would take place along with Sputnik V vaccines the consortium also intended to make for the sovereign wealth fund, Huons said. (Cha, 6/27)

Over the past few months, thousands of people in India who survived Covid-19 returned to hospitals with a rare and life-threatening infection called mucormycosis, or black fungus. But the medicine used to treat the infection is in short supply and priced out of reach for many people, according to dozens of advocacy groups that are urging the manufacturer to quickly widen access. (Silverman, 6/25)

The vaccine advisory group to the Centers for Disease Control and Prevention (CDC) yesterday unanimously voted to recommend Sanofi's dengue vaccine (Dengvaxia) for children ages 9 to 16 years who live in areas such as Puerto Rico where the disease is endemic. The vaccine is given in three doses and requires a test to confirm that a child has had a previous dengue infection. Vaccination in someone who has never been exposed to dengue before can lead to a more severe future infection through a phenomenon called antibody-dependent enhancement. (6/25)

President Joe Biden recently pledged to donate 500 million COVID-19 vaccine doses to developing countries over the coming year. The European Union also promised 100 million doses. The announcement is welcomed news. The fight against COVID-19 is a tale of two worlds. In the United States, case counts have plummeted to the lowest level since March 2020, thanks to plentiful vaccines. Well over half the population has now received at least one vaccine dose. (Democratic former Vermont Gov. Howard Dean, 6/25)

From the start of the COVID-19 pandemic, Americans have been yearning for the bygone life they once took for granted. But many of those most impatient to return to normal have been the least willing to help us get there. First, some people refused to wear masks. Now, some — often the same ones — balk at getting vaccinated. This resistance is behind a lawsuit filed by eight students against Indiana University, which is requiring all students, faculty and staff at all campuses to be inoculated against the virus for the fall semester. The school says exceptions will be “extremely limited,” covering only those with religious objections or certain medical conditions. (Steve Chapman, 6/27)

"China lied and Americans died." With those words, Elise Stefanik, the number three Republican in the House of Representatives, showed her party's plan to put the origins of the pandemic at the center of next year's midterm elections. Republicans are calling on Democratic Speaker of the House Nancy Pelosi to hold hearings on whether the virus was naturally transmitted from animals to humans or leaked out of a lab in Wuhan in China. They want to paint Democrats as defending the ruling Chinese Communist Party by not being more active in punishing Beijing for the virus. (Stephen Collinson, 6/27)

Early in this century, post-SARS, and in a period when China started allowing more students and scientists to study abroad, collaboration and exchange between American and Chinese scientists blossomed. Many of China’s top scientists today were educated in the West. These include George Gao, the head of China’s Center for Disease Control and Prevention, who trained and taught at Oxford and Harvard; and Shi Zhengli, who directs the Center for Emerging Infectious Diseases at the Wuhan Institute of Virology and received her PhD in France. (Elizabeth Rosenthal, 6/27)

Ravaged by Covid-19, India is desperately trying to contain a pandemic that has infected nearly 30 million people and claimed — officially — nearly 400,000 lives. Others put the toll closer to 4 million deaths. Medical teams, traumatized by their experiences, recently called it a “a war zone.” In April, doctors and other clinicians working in a hospital in Gurgaon were attacked by family members after patients died of Covid-19, likely from lack of oxygen. A few weeks afterward, they hid in the canteen to avoid a repeat assault. (Lipi Roy, Reshma Gupta and Bhavna Lall, 6/26)

As someone who has tested positive for Covid-19 in both Britain and Hong Kong, I've experienced the worst of both worlds. In one, I fell victim to the complete failure to check the disease's spread, and in the other I got caught up in a zealous system intended to completely eradicate Covid-19. (Pauline Lockwood, 6/27)

Among the unseen victims of COVID-19’s ravages are the legions of foster children for whom basic services and support were for months suspended. Financial, emotional, educational, social and even some basic housing issues were pushed aside; the foster care system itself was overwhelmed by virus-related court closures and delays. Mental health care, so critical for young foster children, was confined often to calls or Zoom meetings. Uncertainty about the future, always a reality in the system, became the coin of the realm. Chicago saw a 33 percent increase in the number of children entering foster care. States like California, Kansas and Florida meanwhile, noted decreases in reports of child abuse—a chilling reminder of what can happen when watchful eyes no longer are present. A CDC report also noted fewer child abuse-related emergency department visits during the pandemic. “It’s not that it is happening less,” says Moisés Barón, CEO of the San Diego Center for Children. “It’s just that there are fewer mandated reporters interacting with the youth.” (Carolyn Barber, 6/27)

As mask mandates end and workplaces and schools reopen, viruses long held in check by precautions against COVID-19 are making comebacks. And they’ll be infecting a population in which relatively few people have picked up any immunity to them since the pandemic began. Are we headed for a year of nonstop sniffles and coughs and even worse? Not necessarily. Researchers studying how COVID-19 and the common cold interact with the body’s immune system suggest that as we return to a semblance of normalcy, an underappreciated phenomenon called viral interference may help put some limits on the next cold and flu season. (Veronique Greenwood, 6/25)

"I'm sorry I'm late Dr. Tummala," a patient tells me at the start of a recent clinic appointment. Smiling with what I hope is a look of understanding, I brush off her apology. I have come to know this patient over many years and am well aware that she is apologizing for something that is not her fault. Using a walker for support, she takes three different modes of public transportation and braves the elements -- whether it's rain, snow or sweltering heat -- to get to her clinic visits. (Neelu Tummala, 6/27)

Max Nisen: In November, a prestigious FDA advisory committee you sit on overwhelmingly voted that there wasn’t convincing evidence that Biogen Inc.’s Alzheimer’s drug aducanumab helps patients. The FDA approved it anyway earlier this month, and you resigned in protest. Most people don’t know what these advisory committees do. What purpose do they serve, and how did you end up on one?  (Max Nisen, 6/26)

Look no further than the coronavirus pandemic to see an immediate and high-profile example of the evolutionary battle between microbes and humans and the antimicrobial resistance it breeds. Even as medicines and vaccines are developed to defeat Covid-19, new viral variants that resist treatment are evolving and spreading. (Sevahn Vorperian and Stephen Quake, 6/25)

Pride Month is being marked by some lawmakers in Kentucky with a renewed push to ban “conversion therapy — the discredited practice of trying to change someone’s sexual orientation or gender identity. If successful, the bill, which aims to prohibit mental health professionals in the state from “engaging in sexual orientation and gender identity change efforts” with minors, would make Kentucky the 21st state in the U.S. to put in place such a prohibition. As experts in mental health counseling, we welcome these moves. But we remain concerned that at present many LGBTQ youth live in states that have no ban in place protecting them from conversion therapy — a practice that the scientific community has long since shunned. (Donna Sheperis and Carl Sheperis, 6/25)

To the medical school graduating class of 2021: As I write this, I imagine a younger version of myself sitting next to you, not knowing, like you, what will come next. I worried, during that anxious period between graduation and the start of residency, whether I was up to the physical and mental tasks of being a physician: the long hours and the intellectual requirements of practicing medicine. What I learned was that the most important challenges would be emotional, ethical, and philosophical, tests of the spirit and soul rather than of the body and mind. (David Weill, 6/27)

The greatest threat to our health is not heart disease, nor is it cancer (the most common causes of death for women), but the insidious effects of women's declining mental health. I make this claim not simply because women continue to be diagnosed with anxiety and depression at more than double the rate of men; nor do I assert this because providers are much more likely to write-off a female patient suffering from pain and mental illness than a male patient—though both these facts are true. I make this assertion because research has shown time and time again that how we perceive stress and internalize it in our bodies has a lasting impact on our physical health. And yet, our health care system has not responded to this evolving research and nuanced understanding of the way psycho-social stress implicates long-term health outcomes. (Felicity Yost, 6/25)