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Water poured into hospitals. Ambulances were caught up in roiling floodwaters. Medical transport helicopters were grounded by high winds. Houston’s world-renowned health care infrastructure found itself battered by Hurricane Harvey, struggling to treat storm victims while becoming a victim itself. The coming days will inevitably bring more hazards for storm-damaged hospitals and nursing homes, and their patients and staff. The scenes of turmoil across Texas raised the specter of the extreme flooding following Hurricane Katrina in 2005, when dozens of hospital and nursing home patients died, and doctors awaiting rescue at one stranded, powerless hospital became so desperate, they intentionally hastened the deaths of their patients. (Fink and Blinder, 8/28)

Doctors waded miles through Houston’s flooded roads to reach their clinics. Other medical staff camped out at their hospitals for days, catching some sleep on cots between shifts. One medical facility was forced to evacuate patients by boat. The health-care system in the nation’s fourth-largest city strained to deliver care as floodwaters thwarted cancer and kidney-dialysis treatment, stalled ambulance traffic and left hospital officials worriedly monitoring dwindling supplies of food and medicines. (Evans, Walker and Loftus, 8/28)

In 2001, during Tropical Storm Allison, some of Texas Medical Center's 23 hospitals were devastated, with structural damage and research lost. Texas Medical Center facilities flooded, forcing patients to be evacuated, sometimes in the dark. Animals in the Baylor College of Medicine's basement died in floodwater. If there was a silver lining, it was that the storm catalyzed a slew of flood protections, including new floodgates, above-ground electrical and water-pump systems, animals kept on higher floors, and, for UT Physicians, battery backups for refrigerators that store important medications (such as tetanus vaccines). (Arndt, 8/28)

One of the nation's busiest trauma centers began clearing space Monday for the aftermath of Hurricane Harvey even as the storm continued its days-long onslaught of rain. Ben Taub Hospital personnel transferred a handful of patients to other facilities and took much needed deliveries of food and fresh linens after spending the weekend short-staffed and with dwindling supplies, said Bryan McLeod, a spokesman for the Houston hospital's parent company, Harris Health System. (Marchione and Schmall, 8/29)

Memorial Hermann, one of the largest health systems in the area, said on Monday that it was moving patients at its Sugar Land Hospital to another Houston hospital in its system as a precautionary measure. CHI St. Luke’s Health said Monday evening that it was moving 50 patients from two of its hospitals to other facilities in its network. “The controlled and deliberate evacuations are being conducted according to the system’s disaster management policies and procedures to ensure the well-being of all involved,” said spokesperson Josh Snellgrove in a statement. (Rayasam, 8/28)

The muddy floodwaters now soaking through drywall, carpeting, mattresses and furniture in Houston will pose a massive cleanup challenge with potential public health consequences. It's not known yet what kinds or how much sewage, chemicals and waterborne germs are mixed in the water. For now, health officials are more concerned about drownings, carbon monoxide poisoning from generators and hygiene at shelters. In the months and years to come, their worries will turn to the effects of trauma from Hurricane Harvey on mental health. (Merchant and Johnson, 8/28)

As health departments in Texas try to assist people with immediate medical needs following Hurricane Harvey, they're also looking to ensure those affected can get the prescription drugs they need and stay as safe as possible. "Our best advice is always to avoid floodwater as much as you can," says Chris Van Deusen, a spokesman for the Texas Department of State Health Services. "Of course, people have had to be in the water — they haven't had a choice." (Hsu, 8/28)

Rep. Pete Sessions (R-Texas) said Monday that Texans affected by Tropical Storm Harvey need to take precautionary steps to protect their personal health, like getting tetanus shots after wading through dirty flood water. "I would like to say in watching this there are a couple things as a result of my Boy Scout background: look ahead, look where people are actually going to need to make sure they have their tetanus shots," Sessions said on CNN's "New Day." (Beavers, 8/28)

Health and Human Services Secretary Tom Price on Monday defended Texas officials who did not order an evacuation in the wake of a Category 4 hurricane hitting the state, saying "pointing fingers at this point is not helpful at all." The secretary argued that a large-scale evacuation in the Houston and southeastern Texas region would've been an impossible feat and an inadequate solution when preparing for the charging storm.  (Beavers, 8/28)

New research out of Stanford finds African-American and Hispanic infants in California were more likely than white infants to receive low-quality care. The findings show white infants tend to get higher-quality care in the NICU than others, but the pattern is not uniform. (Gorenstein, 8/28)

An infant’s race and ethnicity affect the quality of care they receive in California neonatal intensive care units, according to a study by the Stanford University School of Medicine. ... Researchers analyzed the quality of care for nearly 19,000 infants in 134 neonatal intensive care units across California — 90 percent of all units in the state — who were born between 2010 and 2014. (Ho, 8/27)

Over the past two decades, even as cancer treatments have become increasingly targeted and refined, a growing number of women with cancer in one breast are opting to go for the more traditional approach of mastectomy. According to a recent analysis, from 2002 to 2012 the number of U.S. women with invasive cancer in one breast who chose double mastectomy tripled. ... And that change is not driven solely, or even primarily, by the so-called “Angelina Jolie effect.” The actress’s preventative removal of both breasts wasn’t made public until 2013. So scientists and surgeons alike are keenly interested in understanding why women are charting a different course for cancer treatment. And their early answers point to a complex interplay of financial, emotional, and practical considerations that are driving a dramatic change in the way breast cancer is treated. (Caruso, 8/29)

Feel free to pour that second, third, or even fourth cup of coffee this morning. Higher consumption of coffee is connected to a lower risk of death, says a study presented by Spanish researchers during the European Society of Cardiology Congress held in Barcelona. (Molina, 8/28)

The ongoing Ohio State clinical trial tests whether nicotine — the highly addictive chemical found in tobacco products — can help sarcoidosis patients. There’s new evidence that nicotine is an anti-inflammatory, Crouser said, and from other studies OSU researchers discovered smokers were less likely to get sarcoidosis. (Renault, 8/28)

A year after the NFL pledged $100 million in support of independent medical research and engineering advancements, a huge chunk of that soon will be awarded to such research, primarily dedicated to neuroscience. A Scientific Advisory Board assembled by the NFL is set to launch its program to solicit and evaluate research proposals for funding. The board, comprised of independent experts, doctors, scientists and clinicians, and chaired by retired U.S. Army General Peter Chiarelli, will provide direction for the $40 million allocated under the league's initiative. (Wilner, 8/29)

For anyone diagnosed with cancer, Alzheimer’s or AIDS, perhaps the best hope for finding cures lies in their own bodies – more specifically, in the cells traveling through their blood. Scientists at major universities and pharmaceutical companies need more of those cells to do their cutting-edge medical research, and Folsom’s StemExpress is leading the way nationwide. (Anderson, 8/28)

Google Glass, not long ago a laughing stock of the tech world, has been reinvented as a hot new accessory for doctors and patients. ... Doctors love to complain that cumbersome electronic health record systems keep them fixated on their screens when they should be talking with a patient. With Glass, doctors can view charts in real time through the eyeglass viewer, while interacting face-to-face with their patients. They can also update the records with verbal commands, which can cut their data entry time. In theory, then, this system — developed by the startup Augmedix — lets doctors spend more time actually delivering care. (Piller, 8/29)

Prominent tech investor Peter Thiel is putting money into offshore testing of an experimental herpes vaccine that circumvents U.S. safety rules on human trials. Thiel, who has advised President Trump, is part of a group investing $7 million into the research, according to Kaiser Health News. (Breland, 8/28)

The Food and Drug Administration announced a crackdown on dangerous stem cell clinics on Monday, while at the same time pledging to ease the path to approval for companies and doctors with legitimate treatments in the growing field. The agency reported actions against two large stem cell clinics and a biotech company, saying that it was critical to shut down “unscrupulous actors” in regenerative medicine, a broad umbrella that includes stem cell and gene therapies and immunotherapies. (Kaplan and Grady, 8/28)

The Food and Drug Administration on Monday announced a crackdown on stem-cell clinics offering on “unapproved and potentially dangerous" treatments, including an outfit in California that has been using the smallpox vaccine on seriously ill cancer patients. U.S. marshals on Friday raided San Diego-based StemImmune Inc. and seized the vaccine, which the FDA said had been combined with stem cells derived from fat to create an unapproved product. The concoction was injected intravenously and directly into patients' tumors at the California Stem Cell Treatment Centers in Rancho Mirage and Beverly Hills, the agency said. (McGinley, 8/28)

Federal authorities raided a California stem cell clinic and seized a smallpox vaccine that is reserved only for the military and high-risk populations, as the Food and Drug Administration expressed “serious concerns” about how the clinic obtained access to the vaccine at all. The U.S. Marshals Service seized five vials of the smallpox vaccine, which is not commercially available, the FDA announced Monday. Four of the vials — which each hold 100 vaccine doses — were unused, but a portion of the fifth vial had been used. (Joseph, 8/28)

U.S. marshals on Friday seized five vials of smallpox vaccine, including one that was partially used. The agency is investigating how the company obtained the vaccine, which has been stockpiled by the government in case of a bioterrorist attack. The vaccine is made with live vaccinia virus, a poxvirus similar to but less harmful than smallpox. The vaccine could cause life-threatening problems in immune-compromised cancer patients, and also in certain unvaccinated people who might be accidentally infected by the patients, the FDA explained. (McCullough, 8/28)

The FDA announced it was crafting rules to govern the development of treatments based on the cells. The FDA also said it was cracking down on a company and three clinics that sold stem-cell treatments the agency said were potentially dangerous. The moves signaled the FDA planned to extend its authority regulating drugs and medical devices to the field known as regenerative medicine, after spending years effectively watching it emerge. (Rockoff, 8/28)

"There are a small number of unscrupulous actors who have seized on the clinical promise of regenerative medicine, while exploiting the uncertainty, in order to make deceptive, and sometimes corrupt assurances to patients based on unproven and, in some cases, dangerously dubious products," FDA Commissioner Scott Gottlieb said in a statement Monday. (Stein, 8/28)

Over the next several months, the FDA plans to clarify which treatments will fall under its oversight, and tell providers of the therapies what they need to do to get regulators’ approval. For example, some individualized treatments where doctors at a clinic remove a patient’s stem cells and put them back in with minimal manipulation likely won’t be subject to FDA review, Gottlieb said. However, when the cells are manufactured on a larger scale, the FDA would police the product, he said. (Edney, 8/28)

Transgender soldiers, sailors, airmen and other members of the military, along with others who want to enlist, sued President Donald Trump on Monday, hoping the federal courts will stop him from preventing their service. One federal lawsuit was filed in Baltimore by the American Civil Liberties Union of Maryland on behalf of six transgender individuals currently serving in the Army, Navy, Air Force, National Guard and Naval Reserve. (Chase and Johnson, 8/28)

The American Civil Liberties Union of Maryland filed its suit in Baltimore on behalf of six currently serving transgender service members. Lambda Legal and OutServe-SLDN filed a separate suit Monday in Seattle on behalf of a currently serving transgender service member, two transgender people who wish to serve, including a male high-school student, and two advocacy groups, the Human Rights Campaign and the Gender Justice League. Both lawsuits list President Trump and Secretary of Defense Jim Mattis among the defendants. The service members listed in the ACLU suit informed the military that they were transgender after President Barack Obama last year lifted a longstanding ban with an “open service” order. (Youssef, 8/28)

Govs. John Kasich of Ohio (R) and John Hickenlooper of Colorado (D) announced Monday that they have reached an agreement on a bipartisan proposal to stabilize ObamaCare markets. The governors, who have been calling for bipartisanship on healthcare in a series of recent interviews, are not yet releasing the details of their stabilization plan. (Sullivan, 8/28)

The Democratic Congressional Campaign Committee is launching a new Facebook ad campaign aimed at nearly all of its 80 GOP targets that highlights the Republican health care bill. The ads are targeted at Republicans who voted for the bill — and even Republicans who voted against it. The committee is delaying launching the ads in the three Texas districts it is targeting in light of the Hurricane Harvey's devastation. But they will eventually run in those districts. (Bowman, 8/29)

The government says about 500,000 fewer Americans had no health insurance the first three months of this year, but that slight dip was not statistically significant from the same period in 2016. Progress reducing the number of uninsured appears to have stalled in the last couple of years, and a separate private survey that measured through the first half of 2017 even registered an uptick. (8/29)

More Americans had health insurance during the first three months of 2017 than before the Affordable Care Act became law in March 2010, according to the National Health Interview Survey released Tuesday — but more have coverage with high out-of-pocket costs, which can discourage patients from visiting the doctor and filling a prescription. (Chang, 8/29)

While Obamacare’s exchanges have survived a rocky four years, the insurance market is quickly melting down for millions of people who earn too much to receive subsidies. ... In just the past year, enrollment of unsubsidized Obamacare customers fell by 17 percent to fewer than 7 million, according to the Kaiser Family Foundation. (Demko, 8/28)

Northwell Health chief executive Michael Dowling said the system's decision to disband its insurance company will not hinder its plans to better manage patients' health in order to capture the savings of reduced costs. Health systems in New York are increasingly striking deals with insurers to be paid for keeping patients healthy and out of hospitals—not for each test and procedure. Northwell had hoped to capitalize on that change by setting up an insurance company. By becoming both the payer and the provider, it could control costs and keep more of the savings. (LaMantia, 8/28)

A Pennsylvania man is suing health insurer Aetna, saying his sister learned he was taking HIV medication after the company mailed him an envelope with a large, clear window that showed information on where to purchase the drugs. The lawsuit filed Monday in U.S. District Court in Philadelphia is seeking class-action status. (8/28)

The federal suit alleges the breach affected as many as 12,000 Aetna customers living in 23 states. “For 40 years, HIV-related public health messages have been geared toward assuring people that it’s safe to come forward to get confidential HIV treatment, and now our clients come forward for HIV-related healthcare and Aetna fails to provide confidentiality,” said Ronda B. Goldfein, executive director of the AIDS Law Project of Pennsylvania, which filed the suit with the Legal Action Center and Berger & Montague P.C., in a written statement. (Facher and Swetlitz, 8/28)

The letters were sent to Aetna customers in July. The incident came to light last week, when the legal groups informed Aetna that it and six other AIDS service organizations had received complaints from the insurer’s customers regarding the mailings. (Weixel, 8/28)

Addiction treatment agencies in Massachusetts are struggling to hire and train enough people to care for their patients. These providers also are having difficulty finding the ancillary services — such as housing and transportation — that patients need to sustain their recovery after leaving. (Freyer, 8/29)

The GBI has identified the pills in the recent Houston County overdoses as similar to the synthetic opioid found in the deadly June counterfeit painkiller cases. The pills that resulted in at least seven overdoses recently in Warner Robins contain cyclopropyl fentanyl, an analogue chemically similar to fentanyl, a powerful opiate, according to the GBI Crime Lab. (Miller, 8/28)

The budget chairman of the Florida Senate is calling on Gov. Rick Scott to allocate another $20 million from state reserves toward the ongoing opioid crisis. ... Opioids were the direct cause of death of 2,538 Floridians and contributed to an additional 1,358 deaths in 2015, the last year data is available. (Clark, 8/28)

Each year, more than 300 patients with chronic pain take part in a three-week program at the Pain Rehabilitation Center at Mayo Clinic in Rochester, Minn. Their complaints range widely, from specific problems such as intractable lower-back pain to systemic issues such as fibromyalgia. By the time patients enroll, many have tried just about everything to get their chronic pain under control. Half are taking opioids. In this 40-year-old program, that’s a deal breaker. Participants must agree to taper off pain medications during their time at Mayo. (Andrews, 8/29)

Just four weeks after clearing it to accept new patients, the state has closed the troubled Westwood Lodge psychiatric hospital, citing “critical safety issues.’’ The Department of Mental Health ordered the hospital closed on Friday, and all 20 adult patients were transferred to other facilities. (Kowalczyk, 8/28)

The price of a pack of cigarettes in New York City is going up — to at least $13 — and the number of places you can buy them is going down under legislation signed Monday by the mayor. The new minimum price law, which takes effect on June 1, will make New York the most expensive place in the U.S. to buy cigarettes, Health Department officials said. (8/28)

A transgender nurse who worked at the Iowa Correctional Institution for Women filed suit Monday against multiple state departments as well as the prison's former warden and a health insurance company alleging discrimination based on his gender identity. Jesse Vroegh, 36, is suing the Iowa Department of Corrections, the Iowa Department of Administrative Services, Wellmark Blue Cross and Blue Shield and Patti Wachtendorf, the previous warden at the women's prison in Mitchellville, where Vroegh worked as a nurse for about seven years. Vroegh's suit claims all four entities treated him differently than other male employees solely because he is transgender. (Crowder, 8/28)

California officials have again slapped health care giant Kaiser Permanente with a multimillion-dollar fine for failing to provide data on patient care to the state’s Medicaid program. The $2.2 million fine comes just months after a $2.5 million penalty in January against Kaiser, one of the largest nonprofit health plans in the country. The California Department of Health Care Services said these are the first fines it has imposed against a Medicaid managed-care plan since at least 2000. (Terhune, 8/28)

By age 75, most people have nestled into retirement, taking it easy. Not Dr. Patrick O’Neal. A physician for almost 50 years, he has been interim commissioner of the Georgia Department of Public Health since Dr. Brenda Fitzgerald left the commissioner’s post to become director of the CDC. And while O’Neal is slated to resign as interim chief when a new governor takes office in 2019, he hopes to continue in his position as the agency’s director of Health Protection. (Miller, 8/25)

The CEO of UHealth, the University of Miami’s health system, is resigning — 18 months into his contract — to “pursue other interests in biotechnology.” Dr. Steven Altschuler will officially serve as CEO and as executive vice president for health affairs until September 15, UM President Julio Frenk wrote in a letter. (Harris, 8/28)

[Brian] Matthys is working with several local companies to develop a fitness wristband that will not only track steps, it will also track sun exposure and tell the wearer when it’s time to put on more sunscreen or find some shade. (Marso, 8/28)

At a meeting Monday in Des Moines to highlight partnerships among farmers, environmental groups, and state and federal agencies, Agriculture Secretary Bill Northey says lawmakers would likely send more money to conservation efforts in the coming years. ... The Environmental Defense Fund, Iowa Soybean Association, Iowa Corn Growers and state and federal partners have taken different approaches to address Iowa’s water quality challenges, but Northey says thanks to them, many conservation practices are now being used. (Mayer, 8/28)

A 54-year-old inmate from the Harford County Detention Center died Saturday at the University of Maryland Upper Chesapeake Medical Center after going into cardiac arrest., according to the county Sheriff’s Office. Just before 12:30 p.m., after speaking with the inmate, John Kobler Burkley II, and evaluating his health, deputies assigned to the Harford County Detention Center and Detention Center medical staff determined he should be taken to the hospital for further evaluation and care, according to a post on the Harford County Sheriff’s Office’s Facebook page Sunday afternoon. (Butler, 8/28)

Ask just about anyone what the most closely held secret is in America, and odds are they’ll either say the nation’s nuclear codes or the 51��Ƶ for Coca-Cola. Yet running a close third is the actual selling price of pretty much everything in health care. The health care industry, especially the large players that dominate the landscape today, keep the actual dollars paid for care hidden amongst themselves, often obscured within complex contract language. Yes, there are “published” prices, but they bear little resemblance to the reimbursements providers and payers are agreeing to behind the curtain. (Greg Borca, 8/29)

The 21st Century Cures Act was hailed as the biggest health-care reform since ObamaCare. It’s easy to see why: The law, which passed both houses of Congress by unanimous consent last December, increased the budget of the National Institutes of Health, designated nearly $2 billion for cancer research, and set aside $500 million in 2017 alone to address the opioid crisis. Unfortunately, the legislation also weakened patients’ privacy rights. (Twila Brase, 8/28)

Ever since Sen. John McCain announced he had brain cancer, a chorus of voices from around the globe has urged him to “fight the cancer.” But McCain reminds us that in the face of life-limiting illness, it's not that you're a fighter that's important. It's what you are fighting for. Families, friends and, yes, doctors of patients with serious or critical illnesses would do well to get clear on the difference. (Kathryn B. Kirkland, 8/28)

A rainbow of thin wires were tangled up in his matted hair, each one connected to a small probe that would measure the electrical activity in his brain. We weren’t sure if Mr. S was having a seizure, or if he was unable to respond to us for some other reason. As he had been for many days, he lay in his hospital bed, frail and slouched, unable to communicate, often asleep with IV lines dutifully carrying his fluids. Standing around his bed with six other doctors, discussing what was looking to be a poor prognosis, I couldn’t help but wonder -- not why Mr. S was so sick -- but who Mr. S had once been. (Abraar Karan, 8/28)

In its recent assessment of the Mayo Clinic’s treatment of the hospital in Albert Lea, Minn., the Star Tribune Editorial Board makes several great points — Mayo’s heavy-handed pronouncements to stakeholders and the community leave much to be desired, and its decision to eviscerate the only hospital in a sizable rural community calls into question Mayo’s commitment to our state and rural communities. But the Editorial Board misses the bigger issue: a seismic shift in our nation’s health care system from a patient motive to a profit motive. (Matthew Keller, 8/28)

An important question as our nation combats the opioid epidemic is what role do wholesalers of pharmaceutical products play in a patient’s care plan? Admittedly, the answer is not clear to many, as most people are unfamiliar with wholesalers and what we do as a part of the health care supply chain. (Gabe Weissman, 8/28)

Gov. Nathan Deal’s veto of legislation to allow PAs (physician assistants) to treat pain more effectively (Senate Bill 125) is an unfortunate setback for Georgians suffering from injuries and other medical emergencies. ... The governor’s veto means that patients with such painful ailments as broken arms and kidney stones will  face unnecessary delays in getting the pain medications they need. (L. Gail Curtis, 8/28)

If we care about the future of Orange County families and the economic engine of our county, we need to start asking a tough question about the mental health of mothers. Instead of wondering why a new mom is depressed or not feeling herself, we need to ask, “What’s keeping you from getting the treatment you need?” (Pamela Pimentel and Patricia De Marco Centeno, 8/28)

The mental health of Donald Trump has been under scrutiny since he began running for president. Now 28 Democratic Congress members have signed on to a bill, introduced in April, that could lead to a formal evaluation of his fitness. The bill seeks to set in motion a part of the 25th Amendment that empowers Congress to establish a body to assess the president’s ability to govern. The commission created by the bill would have 11 members, at least eight of whom would be doctors, including four psychiatrists. If the commission doctors found Mr. Trump unfit to govern and the vice president agreed, the vice president would become acting president. (Peter D. Kramer and Sally L. Satel, 8/29)