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U.S. health officials are giving $350 million to researchers in four states hit hardest by the deadly opioid epidemic. The study announced Thursday aims to cut overdose deaths by 40% over three years in local communities grappling with misuse of the addictive drugs. Researchers will study evidence-based techniques for fighting addiction and overdose, such as medication-based treatments like methadone and criminal justice reforms. (Perrone, 4/18)

The National Institutes of Health will award grants to research sites in Kentucky, Massachusetts, New York and Ohio, NIH Director Dr. Francis Collins said at a news conference to unveil the plan. They will go to the University of Kentucky, Boston Medical Center, Columbia University and Ohio State University. Prescription opioid pain treatments and drugs like heroin and the more potent fentanyl were responsible for 47,600 U.S. deaths in 2017, according to government figures, with only a small decline last year, according to provisional data. (Mishra and Mathias, 4/18)

The $353 million effort will test the idea that the best approaches to combat the drug crisis are well known but poorly implemented and coordinated. It will employ a comprehensive strategy in each community that encourages the involvement of doctors, treatment providers, law enforcement, courts, churches and even housing providers — an approach that has worked in a few places. Critics have long complained, for example, that even the small portion of substance abusers who are able to find treatment often are abandoned when they seek jobs, housing or continued counseling and social support. Those problems are among the many factors that lead to repeated relapses. (Bernstein, 4/18)

An NIH spokeswoman said the ambitious 40% goal was based on experiences from adding evidence-based steps into communities. The federal government estimates the number of U.S. deaths by opioid overdose reached 47,000 cases in 2017, and the new initiative is part of a broad, concerted effort to combat the scourge. The Food and Drug Administration recently announced new dosage forms, limited-quantity packaging and new research requirements on companies that make painkillers. (Burton, 4/18)

"Each site is partnering with at least 15 communities to measure the impact of integrating evidence-based prevention, treatment and recovery interventions across primary care, behavioral health, justice and other settings in highly affected parts of the country," according to an NIH release on the project. (King, 4/18)

Boston Medical Center has received an $89 million federal grant to participate in a nationwide research study addressing the opioid crisis, with an ambitious goal of curbing opioid deaths in a broad swath of Massachusetts by 40 percent in the next three years. The grant from the National Institute on Drug Abuse, part of the National Institutes of Health, spans four states and totals more than $350 million. (Kempe, 4/18)

Senator Mitch McConnell, long one of the tobacco industry’s loyal allies, said on Thursday that he would sponsor legislation to raise the minimum age to 21 for the purchase of tobacco and e-cigarettes. Mr. McConnell, the Republican Senate majority leader whose home state, Kentucky, is the nation’s second-largest tobacco producer, said he was motivated by the increasing rate of vaping among teenagers and young adults. Public health agencies have cracked down on e-cigarette companies and distributors in an effort to curb access to the products. (Kaplan, 4/18)

Senate Majority Leader Mitch McConnell plans to introduce legislation raising the minimum age to purchase tobacco products to 21 from 18, a move that public-health advocates and tobacco companies hope would curb the use of e-cigarettes among youths. More than a dozen states have passed or enacted laws raising the minimum age to 21 and others are considering doing so. Sen. McConnell’s announcement Thursday follows the introduction earlier this month of similar bills in the House. (Maloney, 4/18)

“For some time, I’ve been hearing from the parents who are seeing an unprecedented spike in vaping among their teenage children. In addition, we all know people who started smoking at a young age and who struggled to quit as adults. Unfortunately it’s reaching epidemic levels around the country," McConnell said in a statement. He added that his bill would have exemptions for individuals who serve in the military. (Carney, 4/18)

As presidential hopeful Sen. Bernie Sanders (I-Vt.) grabs headlines with his plan for “Medicare for All” and targets doing away with private health insurance, equity analysts have been working overtime to tell investors what companies have the most to lose. Health insurers and now hospitals have led the sector-wide plunge even as policy analyst like Veda’s Spencer Perlman argue that Medicare for All has a slim shot at becoming law. With the plan moving 10 percent of GDP to public control from private hands, “it is unprecedented in scale and scope – nothing of this magnitude has ever been attempted, let alone succeeded,” Perlman argues. (Flanagan, 4/18)

The drubbing in the health-care sector spread to pharmaceutical companies this week, with investors bloodied by a rout that left stocks trading near their lows of the year. About $150 billion of market value was erased from companies in the S&P 500 Health Care Index in the four days through Thursday, when markets closed for the holiday weekend. The 4.4 percent decline left the gauge trading around lowest level since Jan. 3. (Darie, 4/18)

Global private equity-backed healthcare deals rose almost 50% to $63.1 billion 2018, the highest level since 2006, according to a new report. The provider sector continued to be the most active, with global transaction value surging to $35 billion across 159 deals, compared with $18.9 billion across 139 deals in 2017, Bain & Co.'s 2019 private equity and corporate M&A report found. (Kacik, 4/18)

New York City health officials issued summonses to parents of three children Thursday for failing to have their children vaccinated against measles, a violation of the city’s emergency order mandating immunizations to control a surging outbreak. The adults face civil penalties of $1,000 if an officer upholds the summons at a hearing. Health officials identified three children who were exposed to the severe respiratory virus but were not yet vaccinated by April 12, in violation of the order. (Sun, 4/18)

The city last week issued a vaccine mandate that applies to certain ZIP Codes in the Williamsburg section of Brooklyn, where the outbreak began last fall in the ultra-Orthodox Jewish community. Since that order was issued on April 9, disease detectives for the city have been tracking people who have come in contact with people known to have measles. In that investigation, the city identified three children who were exposed to measles, but remained unvaccinated as of April 12. The city didn’t say if the three children developed measles. The parents for those three children were issued the summons, which carries a $1,000 fine. (West, 4/18)

The Washington state Senate narrowly passed a measure late Wednesday that would make it harder for parents to opt out of vaccinating their children against measles in response to the state’s worst outbreak in more than two decades. The bill, which would eliminate personal or philosophical exemptions from the measles, mumps and rubella (MMR) vaccine, is a victory for public health advocates who had not expected it to make it to the floor. The measure passed 25 to 22 in the Democratic-controlled chamber, after being brought to the floor just minutes before the legislative deadline. No Republicans voted in favor, and two Democrats voted against. (Sun and Bernstein, 4/18)

A Brooklyn judge on Thursday denied a petition seeking to lift New York City's recently-imposed mandatory measles vaccination order, dismissing a court challenge brought by an anonymous group of parents who argued the order was unconstitutional. The judge sided with municipal health authorities who issued the order last week, calling it a rare but necessary step to contain the worst measles outbreak to hit the city since 1991. (4/18)

Judge Lawrence Knipel on Thursday refused parents' request to lift the vaccination order that was imposed last week to stem a severe measles outbreak. "A fireman need not obtain the informed consent of the owner before extinguishing a house fire," Knipel wrote in his ruling as quoted by Gothamist. "Vaccination is known to extinguish the fire of contagion." On the same day, the city announced that it was closing four more schools and issuing three civil summons for parents who had failed to comply with the mandate. (Paris, 4/19)

Fainy Sukenik believes in vaccines, and her four children are up to date on all their shots. That's why she's furious that her baby got measles. Too young to be vaccinated, 8-month-old Shira Goldschmidt developed complications from the virus and had to be hospitalized. Infectious disease experts say the cause is clear: anti-vaxers. (Cohen, 4/18)

In my teaching, I work with students to develop an understanding of the complexity of these issues and encourage them to engage in the public discourse on these topics from balanced and informed perspective. Given all the attention around measles, here’s what people who believe they have been vaccinated should know. (Amiel, 4/18)

More than half of the state's kindergartens have measles immunization rates below the level required to fend off an outbreak. This is the third year in a row that those rates have declined, because the share of Arizona parents exempting their children from school-required vaccines keeps increasing. (Price, 4/18)

Columbine and Parkland. Two high school massacres, two communities changed forever. Two fateful days, two decades apart. Tragic bookends in American history. In all, 30 lives lost: 13 in Colorado in 1999, 17 in Florida in 2018.Hundreds more survived the gunfire. Most escaped the bullets. Still, they carry invisible scars. Any loud sound can shatter their day: Sirens sounding, fire alarms ringing, a car backfiring. Time has done little to heal the triggers. (Drash, 4/17)

A Colorado community changed forever by the attack that killed 13 people at Columbine High School moved ahead Thursday with ceremonies marking the anniversary of the tragedy while awaiting more details on what led a Florida teenager “infatuated” with the shooting to buy a shotgun and kill herself in the snowy foothills nearby. Many questions remained unanswered about 18-year-old Sol Pais, but a friend disputed the contention by authorities that she posed a threat. (Foody and Kennedy, 4/18)

Can a genetic test identify newborns at risk of becoming severely obese by middle age? Researchers say they have come up with one, and that it might allow interventions in childhood to avoid that fate. The test examines more than 2 million spots in a person's genetic code, seeking variants that individually nudge a person's obesity risk up by a tiny amount. The researchers drew on previously published data about those variants to create a risk score. (Ritter, 4/18)

The study subjects had been thin all their lives, and not because they had unusual metabolisms. They just did not care much about food. They never ate enormous amounts, never obsessed on the next meal. Now, a group of researchers in Britain may have found the reason. The people carry a genetic alteration that mutes appetite. It also greatly reduces their chances of getting diabetes or heart disease. (Kolata, 4/18)

The report shows that inside a person’s genome, more than 2 million variations contribute to a “scorecard” that can quantify a person’s potential to become obese. Although the researchers don’t know what each variation does, or how each mutation interacts with another, the team was able to identify a nearly 30-pound difference between people with the highest scores and the lowest. (Stein, 4/18)

A polygenic risk score is a mathematical 51��Ƶ that sums up the cumulative effect of many different gene variants that are believed to play a role in the risk of a disease or condition. “Obesity risk from genes can now be distilled into a single number for each person,” said Sekar Kathiresan, senior author of the study and a geneticist and cardiologist at the Broad Institute of MIT and Harvard and at Massachusetts General Hospital. “It’s like measuring somebody’s cholesterol.” (McKay, 4/18)

The researchers started with a list of 2.1 million common genetic variants and used computer algorithms to derive several possible scores that each gauged obesity risk a little bit differently. They picked the best score by seeing how they fared with data from the U.K. Biobank, a government-backed effort in the United Kingdom to gather genetic information. And when they tested out the winner? The genetic variation was striking. “What this really means is 10% of the population has inherited a genetic factor that makes them 20-30 pounds heavier,” Kathiresan said. (Robbins, 4/18)

Does sugar make kids hyper? Maybe. "If you look at the peer-reviewed evidence, we cannot say sugar absolutely makes kids hyper; however, you can't discount that sugar may have a slight effect" on behavior, said Kristi L. King, senior pediatric dietitian at Texas Children's Hospital and spokeswoman for the Academy of Nutrition and Dietetics. (Drayer, 4/18)

Kaiser Health News: Liver Illness Strikes Latino Children Like A ‘Silent Tsunami’

Saira Diaz uses her fingers to count the establishments selling fast food and sweets near the South Los Angeles home she shares with her parents and 13-year-old son. “There’s one, two, three, four, five fast-food restaurants,” she says. “And a little mom and pop store that sells snacks and sodas and candy.” In that low-income, predominantly Latino neighborhood, it’s pretty hard for a kid to avoid sugar. Last year, doctors at St. John’s Well Child and Family Center, a nonprofit community clinic seven blocks away, became alarmed by the rising weight of Diaz’s son, Adrian Mejia. They persuaded him to join an intervention study run by the University of Southern California and Children’s Hospital Los Angeles (CHLA) that weans participants off sugar in an effort to reduce the rate of obesity and diabetes among children. (Waters, 4/19)

Let’s say you’re walking down the street and coming toward you is someone pushing a baby in a stroller. The baby looks right at you and bursts into a big, gummy grin. What do you do? If you’re like most people, you reflexively smile back and your insides just melt. The baby might react by smiling even more broadly and maybe kicking its feet with delight, which will only deepen your smile and add to the warm feeling spreading in your chest. (Murphy, 4/18)

That wariness may be one reason why African-Americans are underrepresented among blood donors, along with a lack of access to blood drives. In Cook County, less than 7 percent of all American Red Cross blood donations came from black donors last year, though African-Americans made up 24 percent of the population. ....Blood donors of African descent are more likely to have proteins on their red blood cells that are similar to proteins on the red cell membrane of sickle cell patients who are also of African descent. Receiving that blood makes those patients less likely to develop reactions against those donated blood cells. (Schencker, 4/18)

A virus appears to be the cause behind a rash of polio-like illnesses that struck Minnesota last fall, causing paralyzing symptoms in several children, including one girl who lost all motor function and remains hospitalized. Researchers from Minnesota and the U.S. Centers for Disease Control and Prevention reported Thursday that they found Enterovirus-D68 in the spinal fluid of one of six children who suffered acute flaccid myelitis, or AFM. (Olson, 4/18)

Heidi Moline, chief pediatrics resident at the University of Minnesota, examined the cases of the children diagnosed with acute flaccid myelitis, or AFM. Moline said the virus, enterovirus D68, was found in the cerebrospinal fluid of one of the six patients, "which helps explain one of the causes of AFM and better characterize this illness." She said the virus is spread by coughing or sneezing and usually spikes in the fall every couple of years. (Lebens, 4/18)

The device’s name sounds like a character from one of the Transformers movies: EXCOR. If Woods’ plan worked, EXCOR would save BrentLee’s life and sustain him until he could receive a heart transplant. While the device has been used many times before, this would be different. EXCOR would not be asked to help the heart, its normal role. It would have to be the heart. (Johnson, 4/18)

North Carolina Democratic Gov. Roy Cooper vetoed a measure Thursday written by Republicans and backed by social conservatives that addresses a doctor's responsibilities if a later-term abortion results in an infant born alive. Cooper announced his decision two days after the General Assembly sent him a measure telling health care practitioners to grant those newborns the same protections as other patients. Those who don't could face a felony and active prison time, along with fines and potential civil damages. (4/18)

“Laws already protect newborn babies and this bill is an unnecessary interference between doctors and their patients,” Cooper said in his veto message. “This needless legislation would criminalize doctors and other healthcare providers for a practice that simply does not exist.” Cooper’s veto could set up an override attempt in the Republican-controlled General Assembly, though Democrats won enough seats in the 2018 election to take away the GOP's supermajority. (Weixel, 4/18)

Lawmakers in the statehouse gave initial approval to the legislation on Wednesday by a vote of 93-1, with 50 Democrats registered as “present, not voting” in protest of the bill. The Texas Senate approved a similar bill last week. Rep. Donna Howard, D-Austin, criticized what she called a “blatantly false, inflammatory and dangerous bill.” “There have been zero reported instances of any child born alive after an abortion in Texas,” she said from the House floor. (Mekelburg, 4/18)

The CMS finalized a rule on Thursday that would allow health insurers to implement copay accumulator programs to prevent drug manufacturer coupons from applying to a patient's annual limit on out-of-pocket costs in situations where a generic drug is available. Last month, Virginia and West Virginia became the first states to ban such programs on the individual market. Another eight states are considering passing their own laws to ban copay accumulators, which patient advocates say limits access to medication. (Livingston, 4/18)

The CMS is proposing to raise the estimated payments per discharge for inpatient rehabilitation facilities in federal fiscal 2020 by 2.3%, or $195 million, compared to 2019. The proposed rule also would boost payments in urban areas by 2.2% and rural areas by 4.3% compared to the year before. However, payments per discharge for freestanding rehabilitation hospitals are estimated to not increase or decrease in urban areas and decrease by 2% in rural areas, the rule said. (King, 4/17)

Despite early enthusiasm and a brawny push from the nonprofit health community, lawmakers now say a plan to extend state-sponsored health coverage to about 18,000 undocumented children is unlikely to succeed this year. The proposal, hailed by advocates as crucial in protecting some of Connecticut’s most vulnerable people, would open Medicaid and the Children’s Health Insurance Program, known as HUSKY A and HUSKY B in the state, to people younger than 19 regardless of their immigration status. (Carlesso and Phaneuf, 4/18)

Washington is poised to become the first state to establish an employee-paid program creating an insurance benefit to help offset the costs of long-term care, a step advocates say will help an aging population that is likely not prepared for the increasing costs needed for daily assistance. The measure creates a benefit for those who pay into the program, with a lifetime maximum of $36,500 per person, indexed to inflation, paid for by an employee payroll premium. (4/18)

When Arizona lawmakers created the Department of Child Safety, they gave it a dual charge: remove kids from situations where they're being neglected or abused, and prevent neglect and abuse from happening. Five years later, the agency's budget shows where the emphasis remains.Only 1.5% of DCS' spending is for prevention. (Pitzl, 4/18)

Maryland's governor signed fast-tracked legislation Thursday to overhaul a major medical network's board of directors following revelations of numerous questionable financial arrangements involving board members, including Baltimore's mayor. Mayor Catherine Pugh, who joined the volunteer board in 2001, has become the public face of the University of Maryland Medical System's "self-dealing" scandal. (4/18)

A provocative mailer by a deep-pocketed Los Angeles activist equates a state housing bill with “Negro removal,” a comparison that prompted state Sen. Scott Wiener and San Francisco Mayor London Breed to fire back Thursday. The ad, paid for by Michael Weinstein, appeared on cable television, snowballed on social media and popped up in mailboxes throughout the city this week. (Swan, 4/18)

After four years in legislative purgatory, a bill that would grant firefighters cancer coverage — in a stunning reversal brought about by sustained public pressure and allegations of political vendettas — is being fast-tracked to clear the Legislature this year. The bill cleared a key hurdle Thursday morning when the House State Affairs committee agreed unanimously to advance the proposal, after more than an hour of discussion marked by teary testimony and lawmakers’ vocal support. (Koh, 4/18)

In a tentative deal announced Wednesday, the Newsom administration and Los Angeles County said they would sit at the same bargaining table when negotiating prescription drug prices with manufacturers. Newsom said the partnership will hopefully spur other local governments to join the coalition, adding that governors in Rhode Island, Colorado and Illinois have expressed interest in a similar model or joining California’s collective. (Gutierrez, 4/17)

There are just a handful of clinics in Massachusetts where patients can get mental health care on demand and few examples around the country. Eight states are testing a free-standing community center model. Some hospitals are developing walk-in care for addiction during the opioid epidemic, which may include treatment for anxiety and depression. CVS and Walgreen's, two of the largest retail clinic networks, do not offer mental health care. (Bebinger, 4/19)

The drinking water in Paradise, California, where 85 people died last year in the nation’s worst wildfire in a century, is contaminated with the cancer-causing chemical benzene, officials said. Officials said they believe the contamination happened after the November firestorm created a toxic combination of gases in burning homes that got sucked into the water pipes as residents and firefighters drew water heavily, the Sacramento Bee newspaper reported Thursday. (4/18)

Faced with dwindling participation, King County will seek to revamp how it delivers maternity support and nutrition services to low-income women and infants throughout the region, county Executive Dow Constantine said in his State of the County speech Thursday. The programs, which are administered through county public-health centers, have seen participation decline by more than 35 percent in recent years and need to cut 50 to 55 positions — about 20 percent of their workforce, said Keith Seinfeld, a spokesman for Public Health – Seattle and King County. (Gutman, 4/17)

Kaiser Permanente, a health care company with roughly 7,000 employees in Colorado, began negotiations on new contracts with union workers in Colorado and six other states on Thursday. The new contracts would affect 85,000 health care workers across the country and roughly 3,500 in Colorado, Ron Ruggiero, president of Colorado’s chapter of the Service Employee International Union, said. The union is hoping to improve employee benefits and limit the number of jobs that can be outsourced and automated. (Barnett, 4/18)

King County public-health officials are urging vigilance after a local man who was living on the streets was diagnosed with the highly contagious hepatitis A virus. The man, who is in his 40s, was hospitalized following a contagious period that lasted from March 25 to April 16. Public Health – Seattle and King County officials are providing vaccinations to people at homeless shelters, day centers, meal services and unsanctioned camps where the man was known to spend time, as well as cleaning assistance. (Coleman, 4/18)

Hepatitis A cases continue to surge in Georgia, with 31 more cases reported since about a week ago, Public Health officials said Wednesday. ...Georgia is one of 18 states currently experiencing a large number of cases of the highly contagious liver infection. GHN first reported on the Georgia hepatitis A surge last month. (Miller, 4/18)

Many Kansas families may not be following safe sleep practices meant to cut down the risk that infants could die in their sleep. The first survey of its kind in the state found four in five new mothers said their babies sleep primarily on their backs. ...In recent years, nearly 20 percent of infant deaths in Kansas fell into this category, which includes sudden infant death syndrome, or SIDS. Many factors appear to play into SIDS. But pediatricians have reached a broad consensus after studying those and other sleep-related deaths that certain sleep positions and bedding come with higher risks. (Llopis-Jepsen, 4/19)

Buoyed by the biggest gift in its history, $10 million from the Sunderland Foundation, Truman Medical Centers on Thursday launched an ambitious campaign to raise nearly $19 million to upgrade its neonatal intensive care unit. The push to modernize and expand Truman's NICU has locked in pledges of $14 million, according to hospital officials. That includes additional commitments of $2.5 million from the Hall Family Foundation and other contributors such as Waddell and Reed CEO Phil Sanders, the president of Truman’s board. (Margolies, 4/18)

Demoted Cuyahoga County Jail Warden Eric Ivey was indicted Thursday for ordering corrections officers to turn off their body cameras during an investigation into the death of an inmate and lying to investigators, prosecutors say. Ivey, 53, was singled out in a damning November U.S. Marshals Service report as someone who facilitated civil rights violations of inmates at the jail where eight inmates died in 2018. (Ferrise, 4/18)

The president of AFSCME Ohio Council 8 accused Cuyahoga County leaders Thursday of firing unionized medical staff at the county jails without due process and of unfair labor practices. John Lyall made the accusations in a letter to County Council President Dan Brady, responding to a letter Brady sent to another union leader Wednesday regarding nurses at the jails. (Astolfi, 4/18)

People struggling with mental illness also often face problems with addiction and other challenges, but getting comprehensive treatment can be tough. Patients would typically need to visit more than one clinician for help with problems like mental illness and substance abuse. A pilot program in Minnesota and seven other states has had success locating multiple types of treatments under one roof, but it is at risk of ending. Congress and the state Legislature cleared the way in 2015 to create Certified Community Behavioral Health Clinics. Minnesota was picked as a pilot state in 2016 and the program has been underway for about two years. (Magan, 4/18)

When the temperatures dropped below zero for multiple nights last winter, local organizations and community leaders in Rochester came together to open the city's first emergency cold weather shelter. This was after other homeless shelters in the area had already filled up. The mayors of Rochester, Dover, and Somersworth went on to form a regional council to address homelessness. (Biello and Cohen, 4/18)

I was 1 year old in 1949 when polio struck my mother. As I got older and could understand why she was in a wheelchair, she told me about her time in the hospital — more than a year — most of it an iron lung. Late at night she would lie awake, listening to the rhythmic pumping of the iron lungs on her polio ward and to the whooping cries of babies with pertussis that echoed down the hospital’s corridors. (Fred Leonard, 4/19)

Trump’s decision to put health-care reform on hold until at least 2020 signifies another two-plus years of rising costs for Americans who are already living paycheck to paycheck. Rather than sitting idly by, to tame rising health-care costs, there are measures we can take now that work in tandem with the Affordable Care Act or any future program that might replace it. So long as Medicare exists, there’s an economically viable way to extend it to more Americans at little or no net cost to the government, which will ultimately control otherwise rising health-care costs. (Richard Vague, 4/18)

Why Columbine?Why did the April 20, 1999, mass shootings at Columbine High School in Colorado become a blueprint for future shooters? After all, it was hardly the first time that shootings took place on school campuses. This post looks into how “society and culture have reared a Columbine generation,” and what role the media played. It was written by Jillian Peterson, professor of criminal justice at Hamline University, and James Densley, professor of criminal justice at Metropolitan State University. (Valerie Strauss, 4/18)

On March 26 the Senate Judiciary Committee held hearings on extreme risk laws, which allow law enforcement or family members who know that someone is an immediate risk to himself or others to petition a judge that firearms should temporarily be removed from such a person. The hearings were a model of bi-partisan fact-finding that could lead to life-saving federal legislation. At the hearings there was also bi-partisan support for requiring background checks on all gun sales, as in H.R. 8, a bill recently passed by the House. Now it’s time to hold hearings on that issue too. (Griffin Dix, 4/18)

Late last year, a retirement community in Vermont was quarantined after an outbreak of antibiotic resistant bacteria swept through the facility, sickening 70 seniors. In pediatric oncology wards, children beating cancer are increasingly felled by drug-resistant bacteria and fungal infections. Every week, we hear more stories of infections that have become untreatable due to resistance. Such alarms, once rare, are becoming more commonplace. Bacteria, fungi, and other microbes that have become resistant to antimicrobial drugs — often dubbed superbugs — thrive in communities with high antibiotic use like nursing homes, hospitals, and preschools. (Kevin Outterson and Helen W. Boucher, 4/17)

The news last week regarding Amazon’s Health Insurance Portability and Accountability Act (HIPAA) compliance status for health-related Alexa apps begs the question: will Amazon use health data for other purposes? Responding to increased data production and use for health services and other purposes, privacy advocates have urged greater data use restrictions, while tech giants have advocated for a generally applicable privacy law. However, these proposals restrict data use in ways that could adversely impact both individual patient health outcomes and broader public health goals. (Piers Nash and Charlotte A. Tschider, 4/18)

Everywhere you turn in the U.S. these days, there is worried talk of China’s rise and the fading of American pre-eminence on the world stage. Secretary of State Mike Pompeo sees China as “the greatest challenge that the United States will face in the medium to long term.” The U.S. intelligence community is also uneasy, citing China’s growing technological prowess as a prime concern in its 2019 “Worldwide Threat Assessment.” Just this month, six former senior U.S. military commanders released a statement expressing their alarm over the possibility that “a Chinese-developed” next-generation 5G wireless network may be “widely adopted among our allies and partners.” (Ezekiel Emanuel, Amy Gadsden and Scott Moore, 4/19)

The first time I was in an intensive care unit as a medical student, I wondered if I should pray. The patient was unconscious. A tube secured in his mouth connected him to a ventilator, a machine that breathed for him. He was covered by a smooth, white sheet that had been folded over just below his neck. One of my medical school professors had brought several of us to the ICU to learn about lung physiology and the workings of the ventilator. I had never seen anyone in this condition, suspended in the netherworld between the living and the dead. (Colleen M. Farrell, 4/18)

The other day, a columnist for the Detroit Free Press wondered if the sudden spate of measles cases in several parts of the country might be the fault of Amazon.com Inc., because until recently it offered books and videos created by anti-vaccination activists. As a big free speech guy, to say nothing of a working writer, I think I’ll go with no. Does this mean what it sounds like? Yes: I think Amazon should still be selling those nutty books about the dangers of vaccination. No, no, I’m not remotely a part of that movement. When our kids were small, they got every single scheduled shot; my wife and I get ours. And if you’re going to tell me that refusing to have children vaccinated is dangerous to others — well, I agree. (Stephen L. Carter, 4/18)

San Francisco works hard to shake off its stereotype of existing in a bubble. OK, not that hard. Now it’s thinking of extending that splendid isolation to how it gets its power. Mayor London Breed said in an interview with Bloomberg News that she’s “pretty excited” at the prospect of the city taking over its local grid from bankrupt utility PG&E Corp. A feasibility study is due later this month — and it’s not the first one, either. San Francisco has been considering taking its grid out of PG&E’s hands, off and on, since at least the 1990s. (Liam Denning, 4/18)

Last week, singer-songwriter Ariana Grande posted images on Instagram showing a scan of her brain as she battles post-traumatic stress disorder. Grande is correct to say that PTSD doesn't only impact one’s physical and mental health, but it can negatively affect one’s brain. What Grande didn’t say, and what she may not know, is that PTSD is also associated with cognitive impairment and accelerated aging. (Joan Cook and Mario Fahed, 4/17)

Tobacco companies killed 100 million people during the 20th century, according to the World Health Organization. They could kill up to a billion people in the 21st century unless we relegate tobacco addiction to the ash bucket of history. Tonight, the Sacramento City Council has an opportunity to help end Big Tobacco’s reign of death. By banning flavored tobacco, councilmembers can help nip a killer industry’s next generation strategy in the bud. (Gil Duran, 4/16)

On Sunday, college student Andrea Norton, just 20 years old, was repositioning herself for a photo, police said, when she fell to her death on a hiking trip in the Ozarks. The same weekend, college student Sydney Monfries fell to her death after climbing the Fordham University bell tower and sending out a video via Snapchat. The coverage of these two tragedies has been less than solemn. Norton, some early news reports said, died taking a selfie (it actually seems she fell after doing what millions of Americans do every day: positioning herself for a photo in a beautiful place). (Jill Filipovic, 4/18)