Today's early morning highlights from the major news organizations.

KHN: Judge’s Ruling On The CDC Mask Mandate Highlights The Limits Of The Agency’s Power The role that the federal government plays in containing future epidemics will hinge on the outcome of an appeal of this week’s court ruling that overturned the mask mandate for travelers on airlines, trains, and the nation’s mass transit systems. A federal court judge in Florida said the Centers for Disease Control and Prevention had overstepped its authority in requiring masks on public transportation, a mandate that legal experts considered well within the bounds of the agency’s charge to prevent the spread of covid-19 across the nation. (Whitehead and Appleby, 4/21)

KHN: Anti-Vaccine Ideology Gains Ground As Lawmakers Seek To Erode Rules For Kids’ Shots  Not long ago, Kansas showed strong bipartisan support for vaccines as a tool to support a robust public health system. But bills with language expanding religious exemptions for childhood vaccine requirements were passed by the state Senate in March and now face the House when the legislature reconvenes April 25. (West, 4/21)

KHN: Is My Drug Copay Coupon A Form Of Charity — Or A Bribe?  Before my insurer had even preapproved coverage of the new injectable medicine my doctor had prescribed, I got a voicemail from its manufacturer informing me that I might qualify for its copay assistance program. That meant the company would cover at least the lion’s share of my copay, leaving me with a minimal, if any, out-of-pocket contribution. My antennae were up: If a drugmaker is offering copay assistance, you can assume the list price of the drug is high, but I wasn’t sure how high. Did this outwardly kind offer represent, essentially, a kind of bribe? (Rosenthal, 4/21)

NPR: Justice Department To Appeal Recent Mask Ruling  The U.S. Justice Department said it's appealing the ruling by a federal judge that voided the mask mandate for public transportation. DOJ spokesperson Anthony Coley said a notice of appeal had been filed in light of the determination by Centers for Disease Control and Prevention that wearing a mask "remains necessary to protect the public health. "The CDC said it had asked the DOJ to appeal. The public health agency continues to recommend that people wear masks in all indoor public transportation settings and says "wearing masks is most beneficial in crowded or poorly ventilated locations, such as the transportation corridor." (Diaz, 4/20)

NBC News: Justice Department Appeals Ruling Lifting Transit Mask Mandate After CDC Request The Justice Department has not asked the appeals court to block the judge's order that lifted the federal mask mandate on transit systems, meaning passengers will be able to continue traveling maskless while the decision is litigated. (Richards, 4/20)

The Hill: Biden Appeal Of Judge’s Mask Mandate Ruling Risks Backfiring  Legal experts who criticized a judge’s controversial decision this week striking down the federal mask mandate for travel say the Biden administration faces a grave risk if it moves forward with an appeal. These court watchers warned that a conservative-leaning Supreme Court, which has already upended several pandemic-era health measures, could use the Trump-appointed judge’s narrow view of the government’s public health powers to create a far-reaching precedent. (Kruzel and Gangitano, 4/20)

AP: Most People In US Want Masks For Travelers: AP-NORC Poll  A majority of people in the United States continue to support a mask requirement for people traveling on airplanes and other shared transportation, a poll finds. A ruling by a federal judge has put the government’s transportation mask mandate on hold. The poll by The Associated Press-NORC Center for Public Affairs Research finds that despite opposition to that requirement that included verbal abuse and physical violence against flight attendants, 56% of those surveyed favor requiring people on planes, trains and public transportation to wear masks, compared with 24% opposed and 20% who say they are neither in favor nor opposed. (Kolpack, 4/20)

NBC News: Delta To Allow Passengers Banned For 'Mask Non-Compliance' Back On Airplanes Delta Air Lines will begin allowing passengers who were banned from flying for “mask non-compliance” back on its airplanes after a federal judge struck down the Biden administration’s mask mandate for air, rail and other travel, the company said Wednesday.     In a statement, Delta said it will restore flight privileges for customers who demonstrate “an understanding of their expected behavior when flying with us.” (Stelloh and Blackman, 4/20)

CNN: CDC Advisers Mull What's Next For Covid-19 Boosters  Vaccine advisers to the US Centers for Disease Control and Prevention continue to mull over what the future of Covid-19 booster shots might look like – and they acknowledge that entirely different vaccine formulations could be needed. At their meeting Wednesday, the members of the CDC’s Advisory Committee on Immunization Practices discussed their next steps around recommending additional booster doses of Covid-19 vaccines for the general public. (Howard, 4/20)

NBC News: Should People Wait Until The Fall For A Second Booster? CDC Panel Weighs In "My sense is that omicron [and its subvariants] BA.2, 3 and 4 will be major players this fall," Moderna's chief medical officer, Paul Burton, said Tuesday during a meeting of the World Vaccine Congress in Washington, D.C. The company is working on a redesign of its vaccine to specifically target the omicron family of variants. (Edwards, 4/20)

CIDRAP: CDC Advisers Discuss Future Of COVID-19 Booster Shots  ACIP members voiced concerns about booster fatigue, and creating the impression that a vaccination program that required large swathes of the population to get boosted every 4 to 6 months would be viewed as unsuccessful. They also emphases that the primary series of vaccines, the first two doses, remained the most important in terms of preventing deaths. No votes were cast today as ACIP members discussed these questions. (Soucheray, 4/20)

Modern Healthcare: HHS Warns Of 'Exceptionally Aggressive' Ransomware Threat A cybersecurity center at the Health and Human Services Department is warning healthcare and public health organizations to guard against an "exceptionally aggressive" ransomware group that encrypts and steals data from its victims. "Hive is an exceptionally aggressive, financially-motivated ransomware group known to maintain sophisticated capabilities who have historically targeted healthcare organizations frequently," according to an analyst note published this week by the Health Sector Cybersecurity Coordination Center, a center in HHS' Office of Information Security. (Kim Cohen, 4/20)

Modern Healthcare: Feds Release First-Of-Its-Kind Data On Healthcare Consolidation The Health and Human Services Department released its first quarterly tranche of hospital and nursing home merger and acquisition transaction data, which marks a major step forward in the government's effort to track the impact of consolidation across the industry, policy experts said. Hospitals with the lowest profit margins were sold more than twice as often as those with the highest profit margins, according to the analysis of 347 hospital transactions from 2016 to 2021. Long-term care hospitals changed ownership at substantially higher rates than other hospitals and more hospital transactions occurred in the South, where many for-profit chains are based. (Kacik, 4/20)

The Hill: 137 Million In US Live With Unhealthy Levels Of Air Pollution: American Lung Association  More than 40 percent of the U.S. population — or 137 million people — are living in areas with unhealthy levels of particle pollution or ozone, according to the American Lung Association’s newest “State of the Air” report card. That’s 2.1 million people living in counties with unsafe air compared to last year’s report card — and 8.9 million more people impacted by daily spikes in potentially deadly particle pollution, the authors found. (Udasin, 4/21)

ABC News: Almost Half Of Americans Breathing More Unhealthy Air Than Ever Before: Report  Almost half of Americans -- 137 million people -- are experiencing more days of "very unhealthy" and "hazardous" air quality than in the previous two decades combined, according to a report published this week by the American Lung Association. The annual "State of the Air" report looked at Americans' exposure to two types of air pollution: ozone, also known as "smog," and particle pollution, also known as "soot." It found that over 63 million Americans are now impacted by deadly particle pollution, an increase of nearly 9 million people from previous years. (Meltzer, 4/21)

CIDRAP: Air Pollution May Raise Risk Of Positive COVID-19 Test  An observational JAMA Network Open study today involving young adults in Sweden suggests that short-term exposure to even relatively low levels of air pollution is tied to a higher risk of later testing positive for COVID-19, likely by worsening symptoms in those already infected. (Van Beusekom, 4/20)

NPR: Wildfires Are Increasingly Contributing To Unhealthy Air Despite decades of environmental efforts, over 40% of Americans — more than 137 million people — live in cities and states with poor air quality, a new report says. And, in addition to cars and factories, wildfires are increasingly contributing to unhealthy air. For the past 22 years, the American Lung Association has produced its annual State of the Air report, which analyzes the air quality on a local level for communities across the country. This year's study found that more Americans were exposed to unhealthy air, at times deemed hazardous, compared to previous years. (Jones, 4/21)

San Francisco Chronicle: COVID Hospitalizations Fall In California Despite A Rise In Infections The number of Californians hospitalized with COVID-19 has dipped below an average of 1,000 this week — the first time that’s happened since the pandemic’s summer lull last June. Patients hospitalized with coronavirus infections numbered 964 as of Tuesday, according to state data. Hospitalizations are continuing to fall despite a recent statewide rise in cases. The case growth follows months of declines since the peak of the omicron surge in January. California is now averaging about 2,800 confirmed cases per day, up from about 2,300 at the beginning of the month. (Vaziri and Ho, 4/20)

CapRadio: California Will Close Its Central COVID-19 Lab, Cancel $1.7 Billion Contract With PerkinElmer  The Newsom administration has quietly ordered the closure of its central COVID-19 testing laboratory, cutting short a controversial no-bid contract worth up to $1.7 billion with global health care giant PerkinElmer. In a letter obtained by CapRadio, dated March 31, the California Department of Public Health notified the company that it would terminate the contract in 45 days, as allowed under the agreement. The letter thanked PerkinElmer for its partnership and noted the increased availability of antigen testing and expanded commercial testing options as the reasons for terminating the contract. (Rodd, 4/20)

The Hill: Hochul Warns Of COVID Spike In New York, But ‘Not Panicking’  New York Gov. Kathy Hochul (D) on Wednesday said that the state was seeing rising COVID-19 cases but added that there was no reason for New Yorkers to panic. “We’ve had a rising tide of cases. My health department has been embedded in constant communication with our local health departments here,” Hochul said at a press conference. (Beals, 4/20)

CIDRAP: COVID-19 Infection May Offer Similar Immunity As Vaccination In the pre-Omicron variant era, previous symptomatic COVID-19 infection in unvaccinated patients conferred a level of protection against subsequent infections on par with that of mRNA vaccines but longer-lasting, according to a US study of more than 121,000 participants published today in JAMA Network Open. The findings, of course, do not suggest that infection is preferred over vaccination, which is the much safer alternative. (Van Beusekom, 4/20)

Stat: Pfizer Faces Criticism For Arguing That IP For Covid-19 Pill Is A Human Right Numerous advocacy groups and institutional shareholders are chiding Pfizer for arguing that its intellectual property is a human right and would be violated if the Dominican Republican government issues a compulsory license for its Covid-19 pill. Advocates say the company invoked human rights in a recent hearing in which it attempted to convince the Dominican government not to issue such a license for its pill, Paxlovid. A petition to issue a license was filed in December after the country was excluded from a licensing deal to make the medicine available in mostly poor countries. A decision could come by next week. (Silverman, 4/20)

The Washington Post: How To Use Biden's Free Coronavirus Tests For International Travel  When the Biden administration began distributing free coronavirus tests, the special deliveries did not help international travelers fulfill requirements to enter the United States because they did not offer the option to test under virtual supervision or receive a report to show border officials. As is the case with many things during the pandemic, that has changed within a couple of months. Depending on which brand of free test you receive, you may be able to use it on your next international trip, after all. (Compton, 4/20)

The Texas Tribune: Texas Hospitals Prepare To Pick Up The Tab For Uninsured COVID-19 Patients More than $3 billion in federal money has flowed to Texas health care providers in recent months to help pay for COVID-19 treatments, tests and vaccines for patients without health insurance, according to national health officials. Of that, a tiny fraction — some $2.2 million — went to the local independent hospital in rural Titus County for treating patients during wave after overwhelming wave of the devastating virus in an area where 1 in 3 residents are uninsured. (Harper, 4/20)

Houston Chronicle: Texas Got Millions To Boost Pay For Strapped Health Care Attendants. It Left Out The Largest Group Like many states, Texas is struggling to attract and retain home health workers to care for people with intellectual and developmental disabilities, a crisis that has swelled amid the pandemic and after years of low wages. So when state health officials announced last summer that they planned to use federal pandemic money for one-time bonuses, it seemed like relief was on the horizon for a few hundred thousand beleaguered employees. But even that small gesture is now in question, as the Health and Human Services Commission omitted the largest single group of health attendants, who serve about 130,000 low-income Texans. (Blackman, 4/21)

Press Association: Aggressive Prostate Cancer Linked To Five Types Of Bacteria In Study Researchers have identified five types of bacteria that are linked to aggressive prostate cancer. The bacteria was common in urine and tissue samples from men with the condition, a new study found. It is hoped the findings could help pave the way for treatments that could target this bacteria and slow or prevent the development of aggressive disease. Scientists do not yet know how people pick up the bacteria, or whether they are causing the disease. Project lead Professor Colin Cooper from the University of East Anglia's (UEA) Norwich Medical School, said: "We already know of some strong associations between infections and cancer. (Massey, 4/20)

The Boston Globe: Brigham, Children’s Hospital Researchers Find Increased Mutations In Alzheimer’s Patient Brain Cells Alzheimer’s disease patients had a greater number of mutations in their brain cells than people who were normally aging, a new study by researchers at Brigham and Women’s Hospital and Boston Children’s Hospital found. “We know these mutations increase with age. Now we’ve found that with Alzheimer’s disease, there’s even more of them,” said one of the lead authors, Dr. Michael B. Miller of the Department of Pathology at the Brigham. The study was published Wednesday in the journal Nature. Miller said neurons in the brain die in Alzheimer’s disease and the new findings “help us better understand ways in which the cells might be dying.” (Finucane, 4/20)

The Wall Street Journal: Rising Marijuana Use Presents Secondhand Risks  The risks marijuana can pose to people—and even pets—near users is getting more attention from researchers, as consumption rises along with legalization efforts in parts of North America. ... New research examines the possible health effects of wider use. Bong smoke contains tiny pollutants that can linger indoors for up to 12 hours, one study showed. Secondhand marijuana smoke may harm people outdoors or children in adjacent rooms, other research has suggested. And the legalization of marijuana in parts of North America has coincided with an increase of cannabis poisonings in dogs and other pets, a study published on Wednesday in the scientific journal PLOS ONE reported. (Onque, 4/20)

CNN: Copycat Packaging Of Marijuana Edibles Poses Risk To Children, Study Says At first glance, it looks like a single serving bag of Nerds Rope that your child might eat as a treat. But take a closer look. See the word “medicated” and the small white box at the bottom that says 600 milligrams of THC? Those three letters stand for tetrahydrocannabinol, the part of the marijuana plant that makes people high. Eating even a small fraction of that bag would “overwhelm a child,” said Danielle Ompad, associate professor of epidemiology at NYU School of Global Public Health and senior author of a new study investigating copycat packaging in cannabis sales. The study was published Tuesday in the journal Drug and Alcohol Dependence. (LaMotte, 4/19)

CNN: Marijuana Pet Poisonings Are On The Rise, Study Says More pets are being poisoned by marijuana plants and edibles than in the past and some even die, a new study finds. A survey of veterinarians found cases of poisoning occurred most frequently in dogs, but cats, iguanas, ferrets, horses and cockatoos also fell victim to the hallucinogenic effects of marijuana. ... Veterinarians reported a rise in poisoning cases, which could be due to increased access to legal marijuana products in some US states and Canada, which legalized cannabis in 2018. (LaMotte, 4/20)

The New York Times: A Mayor Dispenses Pardons As Alabama Holds Fast To Marijuana Laws  Wearing a bright yellow shirt emblazoned with the words “Legalize Alabama,” the mayor of Birmingham, Ala., said in a video posted on Twitter on Wednesday that he had pardoned anyone in the city who had been convicted of misdemeanor marijuana possession charges in the last eight months of 2021. The announcement from Mayor Randall Woodfin — which fell on April 20, or 4/20, the unofficial holiday for marijuana celebrations — came a year after he pardoned about 15,000 people in the city who had criminal convictions for possession of the drug from 1990 through 2020. (Medina, 4/20)

Politico: Cannabis Sinks Amid Weed Glut, Congress' Inaction The nation’s marijuana industry has boomed during the pandemic. So far, 2022 is looking like a bust. Weed sales hit $27 billion last year, nearly doubling figures from just two years earlier — and revenues are projected to double again over the next six years. Even pot supporters in Congress seemed well-positioned to dismantle decades-old restrictions. (Demko, 4/20)

San Francisco Chronicle: EPA Must Reconsider Approval Of Pet Flea-Collar Pesticide, S.F.-Based Appeals Court Orders A federal appeals court on Wednesday ordered the Environmental Protection Agency to reconsider its approval of a widely used flea-collar pesticide known as TCVP, saying the agency ignored evidence of potential neurological dangers to children. Tetrachlorvinphos, developed from nerve warfare chemicals used in World War II, was approved by the EPA in 2006 to protect dogs and cats from fleas and ticks. It was challenged in 2009 by the Natural Resources Defense Council, which said it posed particular dangers to children who touched their pets and then put their hands in their mouths. The group cited evidence that TCVP can affect youngsters’ neurological development and cause mental, physical and behavioral problems. (Egelko, 4/20)

Fox News: Single Tick Bite Can Cause A Life-Threatening Meat Allergy: Report Have you ever eaten steak at dinnertime and then developed hives at midnight? As tick season kicks into gear, it’s a good idea to know about a potentially life-threatening food allergy called alpha-gal syndrome that may occur after certain tick bites – especially the lone star tick, according to the Centers for Disease Control and Prevention (CDC). "An allergy to ‘alpha-gal’ refers to having a severe and potentially life-threatening allergy to a carbohydrate molecule called galactose-alpha-1,3-galactose that is found in most mammalian or ‘red meat,’" according to the American Academy of Allergy Asthma & Immunology. (Sudhakar, 4/20)

The New York Times: Scientists Find No Benefit To Time-Restricted Eating  The weight-loss idea is quite appealing: Limit your eating to a period of six to eight hours each day, during which you can have whatever you want. Studies in mice seemed to support so-called time-restricted eating, a form of the popular intermittent fasting diet. Small studies of people with obesity suggested it might help shed pounds. But now, a rigorous one-year study in which people followed a low-calorie diet between the hours of 8 a.m. and 4 p.m. or consumed the same number of calories anytime during the day has failed to find an effect. (Kolata, 4/20)

CNN: We Need To Stop Complimenting Weight Loss. Here's What To Say Instead If your friend has recently lost weight, you might want to tell her how great she looks. Maybe you also say that you wish you had her body or self-control or you ask her how she did it. Perhaps you’ve been on the receiving end of such a “compliment” in the past. Such comments are well meaning but can have unintended negative consequences. “In that case, we are unintentionally exacerbating or affirming the thin ideal that our society tends to emphasize and idolize,” said Alvin Tran, an assistant professor of public health at the University of New Haven in Connecticut, who does research on eating disorders and body image. “We need to be very cautious when we do approach conversations around someone’s physical appearance, especially their weight.” (Rogers, 4/20)

The Wall Street Journal: Lucky Charms Sickness Complaints Spread Rapidly, Adding Complexity To Safety Probe  Federal regulators formalized an investigation into the safety of Lucky Charms cereal, adding the probe Wednesday to the agency’s list of ongoing food-safety outbreaks. The Food and Drug Administration said it has received complaints from 231 consumers reporting illnesses after eating Lucky Charms recently, according to the agency’s outbreak investigation website and a person familiar with the matter. The FDA said it has initiated an inspection of the cereal’s production operations. (Gasparro and Walker, 4/20)

The New York Times: Gut Healing Is TikTok’s Latest Trend. Does It Work?  Every few months, like clockwork, hundreds of videos promising tips and tricks to “hack” your gut flood TikTok. In March, influencers pushed shots of aloe vera juice: “My digestive system, like my gut health? Never been better,” one gushed in a video with one million likes while tapping on a purple bottle of the drink. Another, with the username “oliveoilqueen,” advocated drinking extra virgin olive oil every day in a video viewed more than 3.5 million times, claiming that doing so cleared her skin, made her periods less painful and fixed her frequent bloating. Videos tagged with #guttok have garnered nearly 400 million views. They’re crammed with suggestions for cucumber-ginger juices and boiled apples, bone broth in the morning and sludgy sweet potato soups at night. (Blum, 4/20)

ABC News: Baby Born At 23 Weeks Gets Special Surgery To Fix Incomplete Esophagus  A 1-year-old girl is back at home in Nebraska after receiving life-saving treatment in Colorado, including a surgery with magnets that helped connect a large gap in her esophagus. Harper and her fraternal twin sister, Gabriella, were born prematurely on Feb. 22, 2021, at 23 weeks. The newborns were delivered by emergency cesarean section at Box Butte General Hospital in Alliance, Nebraska, and were immediately flown to Rocky Mountain Hospital for Children in Denver, about 250 miles southwest, for treatment. (Yu, 4/21)

The Washington Post: Ohio Doctor William Husel Acquitted Of Killing 14 Patients With Fentanyl In Murder Trial William Husel, an Ohio doctor who was accused of killing 14 patients with what prosecutors described as “wildly excessive” doses of fentanyl between 2015 and 2018, was acquitted on all counts of murder Wednesday, concluding one of the most significant murder cases of its kind against a health-care professional. Husel, a onetime physician of the year trained at the Cleveland Clinic, faced one count of murder for each of the 14 critically ill patients he was accused of killing. The jury deliberated for seven days before finding him not guilty on all 14 counts in what was one of the largest murder trials in Ohio history. (Shammas and Bella, 4/20)

Politico: Florida Releases Guidance Clashing With HHS Advice On Transgender Kids  The Florida Department of Health on Wednesday offered new guidance on transition-related medical care for young people, bucking advice given by the U.S. Department of Health and Human Services Department and medical experts including the American Medical Association. Florida’s health department published a memo claiming that minors should not receive hormone therapies, puberty-blocking drugs or gender reassignment surgery. Instead, Florida’s health agency states that children and adolescents should be provided social support by peers and family and counseling from a licensed provider. The memo serves as guidance and is not a rule or regulation. (Sarkissian, 4/20)

CalMatters: California Bill Would End Coroner Investigations Of Lost Pregnancies A bill that would abolish the requirement that coroners investigate stillbirths passed the Assembly Health Committee on an 11-3 vote late Tuesday, while hundreds of anti-abortion activists protested against the proposed change on the Capitol steps. Under current law, all fetal deaths at or after 20 weeks, with the exception of abortions, are treated as “unattended deaths” in California, requiring a coroner to investigate. In 48 of 58 California counties, the sheriff is also the coroner, which means that law enforcement becomes involved and the person who is pregnant could face potential prosecution. That, say groups representing obstetricians and gynecologists, is dangerous and could make pregnant people less likely to seek medical care. (Duara, 4/20)

CIDRAP: Israel Examining 12 Unexplained Pediatric Hepatitis Cases In the wake of unexplained hepatitis cases reported in young children by a number of countries, Israel's Ministry of Health (MOH) said yesterday on Twitter that a request for information to hospitals has turned up 12 cases in recent months. It said the 12 cases that fit the definition and are under investigation are from two hospitals—Shaare Zedek Medical Center and Schneider Children's Medical Center. (4/20)

Houston Chronicle: Prominent Wuhan Lab Can Ask UTMB To Destroy ‘Secret Files’ And Other Records, Memo States A prominent research lab in China can ask its partner institution in Galveston to destroy records of their joint work, including “secret files, materials and equipment,” according to a memorandum obtained by the nonprofit news organization U.S. Right to Know and shared with the Houston Chronicle. Dr. James Le Duc, the director of the Galveston National Laboratory at the University of Texas Medical Branch, signed the nine-page memorandum of understanding, which lays out the terms of collaborative efforts with the Wuhan Institute of Virology, in 2017. The two research labs, which study some of the most dangerous pathogens in the world, have had a relationship since 2013 and announced a formal cooperative agreement in 2018. (Gill, 4/21)

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