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Democratic presidential candidates unleashed withering attacks on Bernie Sanders in a boisterous debate in South Carolina on Tuesday, assailing his ambitious economic agenda and warning his nomination would be a "catastrophe" that would cost Democrats the White House and control of Congress. In a debate that featured candidates repeatedly shouting over one another and ignoring their time limits, Sanders' opponents united in attacking the self-avowed democratic socialist as a risky choice to face Republican President Donald Trump in November. ... Pete Buttigieg, the moderate former mayor of South Bend, Indiana, criticized Sanders for the shifting estimates on the costs of his proposals such as government-run healthcare and warned that the front-runner would bring about chaos. (Renshaw and Hunnicutt, 2/26)

“Bernie is winning right now because the Democratic Party is a progressive party and progressive ideas are popular ideas even if there are a lot of people in this stage we don’t want to say so,” Warren said. “Bernie and I agree on a lot of things, but I think I would make a better president than Bernie,” Warren added, saying that she focuses on details. Using health care as an example, she pointed out that she tried to fill in gaps in Sanders’s Medicare-for-all plan. “I dug in, I did the work, and then Bernie’s team trashed me for it,” Warren said. (Viser, Linskey, Sullivan and Wootson, 2/26)

Sanders stood in the center of the stage for the first time this election, underscoring his front-runner status. He certainly earned front-runner scrutiny. “No, the math does not add up,” Ms. Klobuchar said to Mr. Sanders, saying that his Medicare for All proposal was too expensive. She also said that Democratic Party elders, including former President Obama, had opposed his idea for expansive government proposals. “They are not with you,” she said. He also took heat for his votes against the 1993 Brady Bill, which established mandatory background checks, while Mr. Sanders was a member of the House. Mr. Sanders called it a bad vote. (Jamerson, 2/25)

The urgency of the moment—days ahead of the South Carolina primary and a week from the delegate-rich Super Tuesday contests—was clear as the candidates jockeyed for airtime by interrupting, insulting and provoking one another, often speaking over their time limits and their rival candidates. Mr. Sanders, coming off his resounding win in Nevada last week that cemented him as the front-runner, heightened the stakes for the others on the stage. (Collins, Day and Glazer, 2/26)

WHAT MR. SANDERS: “What every study out there, conservative or progressive says: ‘Medicare for all’ will save money.” False. There have been several analyses of Mr. Sanders’s Medicare for all health care proposal, which would provide every American with generous government-funded health insurance benefits. Those studies have shown a range of potential costs, including several that estimate that the plan would cost substantially more than what the country would otherwise spend on health care.Mr. Sanders is correct that a recent study published in the medical journal The Lancet showed that his plan would cost $450 billion less in a year than the current health care system. But that study made several assumptions that other economists who have examined the plan have considered unrealistic. Other studies have shown that spending would increase as the plan expands coverage to more Americans, and provides them with expensive new benefits, like long-term care, which few health insurance plans currently cover. This article provides an overview of a few of these studies. (2/25)

Kaiser Health News: Bernie Sanders Embraces A New Study That Lowers ‘Medicare For All’s’ Price Tag, But Skepticism Abounds
Largely, the Lancet paper is more generous in its assumptions than other Medicare for All analysis, noted Jodi Liu, an economist at the Rand Corp., who studies single-payer plans. To the researchers’ credit, she said, they acknowledge that their findings are based on uncertain assumptions. For instance, the researchers calculate $78.2 billion in savings from providing primary care to uninsured people — $70.4 billion from avoided hospitalizations and $7.8 from avoided emergency room visits. But previous evidence suggests that the logic is suspect at best. (Luthra, 2/26)

In any case, one study — or even many — can not easily estimate the impact of overhauling one-sixth of the U.S. economy. Sanders has put out a menu of possible options for how to fund Medicare-for-all, though many experts says that he still falls short. One option would require a 7.5 percent payroll tax that employers would pay to help fund the program. Virtually every economist will tell you that a payroll tax paid by an employer largely comes out of the pay earned by the employee, but Sanders argues that the savings on the premiums currently paid by the employer should result in an overall reduction in costs for the employer. He estimates that a company would save more than $9,000 in health-care costs per average employee, but those claims must be viewed with skepticism. (Kessler, Rizzo and Kelly, 2/25)

Sanders has glided through a year of campaigning churning out enormously ambitious and expensive federal policy proposals with little regard to the costs. The total now is estimated to be $60 trillion. When the pressure to cough up some more numbers increased this week, his campaign put out a list of pay-fors that did not come close to matching the scale of his spending. For instance, he identified less than $18 trillion in revenue for his Medicare For All plan, which he estimates will cost $30 trillion and outside estimates peg at much higher. (Lizza, 2/26)

Mr. Biden, fighting for survival in the state on which he has staked his candidacy, delivered perhaps the most searing critique of Mr. Sanders, invoking the 2015 church massacre here in Charleston to confront Mr. Sanders for his mixed record on guns. “Nine people shot dead by a white supremacist,” Mr. Biden said, then rebuked Mr. Sanders for his past opposition to waiting periods for gun purchases: “I’m not saying he’s responsible for the nine deaths, but that man would not have been able to get that weapon if the waiting period had been what I suggest.” (Martin and Burns, 2/25)

JOE BIDEN: “A hundred and fifty million people have been killed since 2007, when Bernie voted to exempt the gun manufacturers from liability.” THE FACTS: Biden vastly overstated gun deaths. The Centers for Disease Control and Prevention reports about 413,000 gun deaths from 2007 to 2018, a far cry from 150 million, which equates to close to half the U.S. population. More than half of the gun deaths in 2018 were from suicide, says the CDC. His campaign acknowledged he misspoke. (2/25)

Sharing her own story of being discriminated against as a pregnant teacher, Warren reduced the former New York City mayor to sputtering outrage. “At least I didn’t have a boss who said to me, ‘Kill it,’ the way that Mayor Bloomberg is alleged to have said to one of his pregnant employees,” she said. He categorically denied ever making the statement. But the strategy lost a bit of its oomph, lacking the surprise factor and dampened by boos from the Bloomberg-friendly crowd. (Barabak and Mason, 2/25)

Kaiser Health News: Democrats Sharpen Health Care Attacks As Primaries Heat Up
The ideal began to get real on Tuesday, as seven of the top contenders for the Democratic presidential nomination sparred over the price tag on health care reform and even revealed similarities on issues like marijuana legalization. With Democrats in 15 states and American Samoa set to cast their primary votes in the next week, the candidates eagerly seized their chances on the debate stage in Charleston, S.C., to jab Sen. Bernie Sanders of Vermont, the current frontrunner, during the party’s tenth debate. (Huetteman, Luthra and Knight, 2/26)

It’s possible you’ve tuned out when the Democrats running for president have tussled over “Medicare for all.” But now that Bernie Sanders, who introduced the Medicare for All Act in the Senate, is ascending in the nominating contest, it’s a good time to take a closer look at what it would mean for the health system, your health insurance and finances, and the federal budget. Here’s our quick primer, with some suggestions for further reading. (Sanger-Katz, 2/25)

Democratic presidential candidate Amy Klobuchar is “in very good health,” according to a medical report the Minnesota senator's campaign released days after she said during a debate over Bernie Sanders' health records that “you should release your records from your physical.” Klobuchar, who is trailing Sanders and most of her other rivals ahead of Tuesday night's debate in South Carolina, released a four-page report late Monday based on a January routine physical and medical records. (2/25)

Kaiser Health News: Past As Prologue: Questioning Buttigieg’s Claim About Keeping Your Health Care
As the Democratic presidential campaign moves to the battleground of South Carolina this weekend, candidate Pete Buttigieg, the former mayor of South Bend, Indiana, is highlighting his health plan as he seeks to slow the momentum of the front-runner, Vermont Sen. Bernie Sanders. In a video ad airing across the state, Buttigieg argues that his health plan — called “Medicare for All Who Want It” — offers Americans their choice of insurance plans, in a way he says Sanders’ more sweeping “Medicare for All” plan does not. (Luthra, 2/25)

The U.S. Centers for Disease Control and Prevention (CDC) on Tuesday alerted Americans to begin preparing for the spread of coronavirus in the United States after infections surfaced in several more countries. The announcement signaled a change in tone for the Atlanta-based U.S. health agency, which had largely been focused on efforts to stop the virus from entering the country and quarantining individuals traveling from China. (Steenhuysen and Bartz, 2/26)

“It’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said in a news briefing. She said that cities and towns should plan for “social distancing measures,” like dividing school classes into smaller groups of students or closing schools altogether. Meetings and conferences may have to be canceled, she said. Businesses should arrange for employees to work from home. “We are asking the American public to work with us to prepare, in the expectation that this could be bad,” Dr. Messonnier said. (Belluck and Weiland, 2/25)

Messonnier advised parents to talk to schools about the possibility of internet-based learning in the event that COVID-19 spreads and students would need to refrain from attending classes in a school building, and for businesses to think about how to use teleconferencing meetings in the event that employees would need to work from home. Messonnier said officials would also need to consider whether large community-based events would need to be canceled in such an event. (Shalby and Peltz, 2/25)

She stressed that the current risk remains low. Almost all the cases that have occurred in the United States have been among travelers who have been infected overseas. In addition, there's always the chance that the coronavirus could begin to subside as spring and summer arrive. Infectious disease experts say that 80% of infections are mild, no more severe than the common cold. (Stein and Wamsley, 2/25)

Messonnier said that, until this point, the CDC's goal has been containment and to slow the spread of the virus, but the strategy will soon have to switch to mitigation. "The most important tools we have for that are non-pharmaceutical interventions," said Messonnier. These include individual, community, and environmental measures that range from closing schools to self-quarantine to cancelling mass gatherings in public spaces, she said. (Soucheray, 2/25)

So far, American public-health systems have sought to contain the virus by isolating confirmed cases while monitoring close contacts of these patients for signs of infection. This strategy is most effective when the case count is relatively low and each case can be epidemiologically linked to each other and traced to an original source, health authorities say. That is the current situation with the confirmed U.S. cases. But if the virus spreads more widely, it might become difficult or impossible to contain it with the current methods, experts say. Instead, the efforts would shift to strategies such as closing schools, canceling mass gatherings and requiring employees to work from home. “The disruption to everyday life might be severe,” Dr. Messonnier said. (Abbott and Armour, 2/25)

Messonnier pointed to a government study, Community Mitigation Guidelines to Prevent Pandemic Influenza — United States, 2017, as the “framework for our response strategy,” saying it provided a guide to what can be done at the individual, community, and environmental level during a pandemic when there’s no vaccine or proven medical treatment. She said the “most important tools" against the virus would be the “nonpharmaceutical interventions,” or NPIs, outlined in the study. The NPIs used would vary by community depending on local conditions. (Finucane, 2/25)

The momentum and nature with which the virus is spreading renders the U.S. travel bans against some foreign nationals obsolete, some public health officials have warned. (Santhanam, 2/25)

The CDC’s messaging seemed to be at odds with the position of the World Health Organization, which reiterated Tuesday that countries could stop transmission chains if they acted swiftly and aggressively. (Thielking and Branswell, 2/25)

The warnings from officials with the Centers for Disease Control and Prevention, the National Institutes of Health and other agencies, contrasted sharply with assessments from President Trump and other White House officials, who have largely dismissed concerns about the virus. The mixed messages continued Tuesday as dire warnings issued to senators and reporters early in the day gave way to a more positive assessment, after the Dow Jones industrial average plunged 3.4 percent, bringing the two-day loss to more than 1,900 points — the worst in two years. “We believe the immediate risk here in the United States remains low, and we’re working hard to keep that risk low,” Anne Schuchat, the CDC’s principal deputy director, said during a hastily convened afternoon news briefing. (Werner, Abutaleb, Sun and Bernstein, 2/25)

American health officials warned on Tuesday that the coronavirus is likely to spread in communities in the United States. They urged individuals to get themselves and their families ready. But what can you do? Infectious disease experts stressed that people should not panic and offered practical advice. “The mantra is, ‘Keep calm and carry on,’” said Dr. Marguerite Neill, an infectious disease expert at Brown University. (Kolata, 2/25)

Major U.S. hospital systems are burning through their supplies of specialized masks needed for a widespread epidemic of coronavirus, in part because federal protocols call for them to be thrown out after a single use in practice sessions, federal officials have told health-care leaders. Some hospitals have just a week’s inventory of the N95 face masks, which filter out 95 percent of all airborne particles, even as a top official with the Centers for Disease Control and Prevention warned Tuesday that spread of the virus in the United States now appears inevitable. (Sun, Rowland and Bernstein, 2/25)

San Francisco declared a local emergency over the coronavirus on Tuesday, despite having no cases, as U.S. officials urged Americans to prepare for the spread of infections within their communities. California's fourth-largest city said it made the move to boost its coronavirus preparedness and raise public awareness of risks the virus may spread to the city. (2/26)

“Although there are still zero confirmed cases in San Francisco residents, the global picture is changing rapidly, and we need to step up preparedness,” Breed said in a statement Tuesday. “We see the virus spreading in new parts of the world every day, and we are taking the necessary steps to protect San Franciscans from harm.” While three people have been treated for COVID-19 at San Francisco hospitals, there have been no confirmed cases of the illness in the city. (Shalby, 2/25)

Declaring a state of emergency allows San Francisco officials to marshal resources and personnel to accelerate emergency planning measures and to expand capabilities for a rapid response to a potential coronavirus case in the city. Santa Clara County declared a state of emergency a few weeks ago for similar reasons. (Fracassa, 2/25)

The novel coronavirus is likely to spread in local U.S. communities in the near future, federal officials warned Tuesday.“It’s not so much of a question of if this will happen in this country any more, but a question of when this will happen,” said Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases. She said there is no way to know whether the outbreak will be mild or severe. (McClurg, 2/25)

A U.S. soldier stationed in South Korea has tested positive for the new coronavirus, the first such case involving a U.S. service member. United States Forces Korea (USFK) said in a statement Tuesday that a soldier stationed in Camp Carroll had tested positive and is currently in quarantine at his off-base residence. (Conradis, 2/25)

The U.S. Forces Korea, which oversees the roughly 28,500 American military personnel in South Korea, had instructed soldiers to not visit off-base establishments and placed its risk level at high. Coming joint military exercises with the U.S. and South Korea could be scaled back due to the coronavirus, the two countries said earlier this week. (Martin and Yoon, 2/26)

The soldier, who is stationed at Camp Carroll which is approximately 20 kilometers (12.4 miles) from the city of Daegu, is the first US service member to test positive for the novel coronavirus. "The patient, a 23-year old male, is currently in self quarantine at his off-base residence. He visited Camp Walker on 24 February and Camp Carroll 21-25 February. KCDC and USFK health professionals are actively conducting contact tracing to determine whether any others may have been exposed," the statement said. (Berlinger, 2/26)

At a performance by the ubiquitous Chinese dance troupe Shen Yun, the only thing audiences risk exposure to is a little culture and some religious and political propaganda. But for the past few days, health officials in Utah have had to quash social media-fueled rumors linking the dancers to covid-19, better known as the disease caused by the coronavirus. Even in states like Utah, which have no confirmed reports of coronavirus infection, concerns over the outbreak have grown as the virus has infected nearly 80,000 people across Asia, Europe, North America and Australia. The growing concerns have prompted significant misinformation — and a rise in anti-Asian prejudice. (Bellware and Wong, 2/25)

A South Korean flight attendant who has been diagnosed with the novel coronavirus may have serviced trips between Seoul and Los Angeles last week, according to several South Korean media outlets. South Korea’s Center for Disease Control said Wednesday local time that a female flight attendant who serviced a flight Feb. 15 from Tel Aviv to Seoul had tested positive for the virus. (Kim, 2/25)

As international markets are left gasping from the effects of the spreading coronavirus — with the Dow shedding another 879 points on Tuesday — one American business is struggling to keep pace with the skyrocketing demand for its products. "It's a madhouse," said Mike Bowen, executive vice president and partner of Prestige Ameritech, the nation's largest surgical mask manufacturer. "We are going as fast as we can." (Legare, 2/25)

The Trump administration confronted a new threat Tuesday in the mounting coronavirus crisis: a fierce bipartisan backlash amid contradictory statements from the federal government about the severity of the outbreak. Administration officials sought to swat away concerns their emergency request for $2.5 billion to address the outbreak was inadequate, even as some Republicans joined Democrats in criticizing the amount — and slamming a lack of transparency around efforts to contain the disease on U.S. soil. (Roubein and Ollstein, 2/25)

Lawmakers in both parties on Tuesday expressed growing alarm that the threat of coronavirus in the United States is serious, and that the Trump administration is not doing enough to fight it. Two Cabinet members at separate hearings were grilled over what lawmakers described as an insufficient response so far, while Senate Appropriations Committee Chairman Richard Shelby (R-Ala.) said the White House's budget request to handle the disease was lackluster. (Sullivan and Hellmann, 2/25)

"If you low-ball something like this, you'll pay for it later," Sen. Richard Shelby (R-Ala.) told Trump's top health official, HHS Secretary Alex Azar. The two faced each other at a budget hearing that turned into a forum for assessing U.S. readiness in the face of a rapidly evolving international health threat. Shelby said if the virus keeps spreading, "it could be an existential threat to a lot of people in this country." He chairs the powerful Appropriations Committee, which sets spending levels for federal agencies. (2/25)

As cases of coronavirus in the United States near 60, U.S. Senators Richard Blumenthal and Chris Murphy came out of a closed-door briefing on the disease Tuesday and said they are alarmed and disappointed by what they heard. In that briefing, and in a conference call with reporters afterward, U.S. health officials warned that the spread of coronavirus across the United States appears inevitable. (Radelat, 2/25)

As the novel coronavirus continues to spread around the globe, Secretary of State Mike Pompeo on Tuesday accused the governments of China and Iran of censoring information about the outbreaks in their countries and putting the rest of the world at greater risk of its spread. The top U.S. diplomat's sharp tone towards Beijing was matched by Health and Human Services Secretary Alex Azar, who told Congress on Tuesday that the world is not getting reliable data out of China on issues like mortality rates. (Finnegan, 2/25)

President Trump defended his administration’s handling of the coronavirus outbreak as the 2020 Democratic contenders hammered him over his response at Tuesday night’s debate. “CDC and my Administration are doing a GREAT job of handling Coronavirus, including the very early closing of our borders to certain areas of the world. It was opposed by the Dems, ‘too soon’, but turned out to be the correct decision,” he tweeted, referring to the Centers for Disease Control and Prevention. (Axelrod, 2/25)

Top White House economic adviser Larry Kudlow told The Washington Post late Monday that investors should consider “buying these dips” in the stock market amid the coronavirus panic. The message was to take advantage of one-day slumps and “buy low.” After all, the Dow Jones industrial average had just fallen 1,032 points. President Trump tweeted similar guidance thousands of miles away in India. Less than 24 hours later, the Dow Jones industrial average would fall another 879 points, bringing Trump and Kudlow’s investment advice — at least in the short term — under greater scrutiny. (Stein and Dawsey, 2/25)

“Investors do not want to catch this falling knife,” said James Athey, a senior investment manager at Aberdeen Standard Investments. “The speed with which equities are declining here is something investors find very troubling. It’s hard to see people willing to step in and buy.” Brent crude, the benchmark for global oil prices, fell 1.1% to $53.67 a barrel. Industrial metals including copper also waned, while gold, which is considered a haven asset, was mostly flat. (Ping and Isaac, 2/26)

There’s a reason most presidents are cautious when talking about the stock market. President Trump is learning it the hard way this week. He is, in effect, experiencing the downside of having spent the last three years personalizing much of what happens in the markets and the economy, saying that the soaring stock values under his watch are a reflection of his special ability, and a central part of his case for re-election in November. (Irwin, 2/26)

It is “still too soon” to say whether the coronavirus outbreak will cause a material change in the U.S. outlook, said Federal Reserve Vice Chairman Richard Clarida, signaling officials won’t be rushed to judgment on the need to cut interest rates. (Torres, 2/25)

The price of safety has rarely looked so high across major asset classes. Confronted with the coronavirus, investors seem more than willing to pay it. U.S. Treasuries are trading close to their most expensive in history by at least one measure, while gold hit a seven-year high on Monday. The entire German yield curve dropped below zero the same day. (Worrachate, 2/25)

India’s $2.1 trillion stock market is drawing increasing foreign investment as the country remains relatively unscathed from the coronavirus outbreak threatening lives and economies around the world. Fund management firms including Eastspring Investments and Northcape Capital are flagging the defensive qualities of India’s domestic-focused market amid softening energy prices and signs of an economic recovery. (Vishnoi, Mookerjee and Acharya, 2/25)

Peter Navarro, the leading China critic in the Trump administration, is seizing the moment. The White House’s director of trade and manufacturing policy and the administration’s other China hawks are pushing to use the coronavirus crisis to press U.S. companies to end their dependence on foreign suppliers. It’s an outcome Navarro and other advocates of U.S. factories in the Trump administration have sought for the past three years — what they see as a core piece of President Donald Trump’s 2016 promise to bring manufacturing jobs back home. (Cassella, 2/26)

Scientists can’t tell yet how deadly the new virus that’s spreading around the globe really is — and deepening the mystery, the fatality rate differs even within China. As infections of the virus that causes COVID-19 surge in other countries, even a low fatality rate can add up to lots of victims, and understanding why one place fares better than another becomes critical to unravel. “You could have bad outcomes with this initially until you really get the hang of how to manage" it, Dr. Bruce Aylward, the World Health Organization envoy who led a team of scientists just back from China, warned Tuesday. (Neergaard, 2/26)

One of the hopes of people watching China’s coronavirus outbreak was that the alarming picture of its lethality is probably exaggerated because a lot of mild cases are likely being missed. But on Tuesday, a World Health Organization expert suggested that does not appear to be the case. (Branswell, 2/25)

Problems with a government-created coronavirus test have limited the United States’ capacity to rapidly increase testing, just as the outbreak has entered a worrisome new phase in countries worldwide. Experts are increasingly concerned that the small number of U.S. cases may be a reflection of limited testing, not of the virus’s spread. While South Korea has run more than 35,000 coronavirus tests, the United States has tested only 426 people, not including people who returned on evacuation flights. Only about a dozen state and local laboratories can now run tests outside of the Centers for Disease Control and Prevention in Atlanta because the CDC kits sent out nationwide earlier this month included a faulty component. (Johnson, McGinley and Sun, 2/25)

The first clinical trial in the U.S. of a possible coronavirus treatment is underway in Nebraska and is eventually expected to include 400 patients at 50 locations around the world, officials said Tuesday. Half of the patients in the international study will receive the antiviral medicine remdesivir while the other half will receive a placebo. Several other studies, including one looking at the same drug, are already underway internationally. (Funk, 2/25)

The NIH-sponsored study is part of public health officials’ race to determine quickly whether the Gilead drug, called remdesivir, is effective in treating Covid-19, the illness caused by the new coronavirus. The study is designed to enroll up to nearly 400 patients globally, who will be randomly selected to receive remdesivir or a placebo. While the illness has led to thousands of fatalities world-wide, most people who become infected experience flu-like symptoms such as fever and cough before recovering on their own, health officials have said. (Walker, 2/25)

Participants in the US treatment group will receive 200 milligrams of remdesivir intravenously when they're enrolled in the study. They will receive another 100 milligrams while they are hospitalized for up to 10 days total. A placebo group will receive a solution that resembles remdesivir but contains only inactive ingredients, the NIH said.(Holcombe, McLaughlin and Almasy, 2/26)

In new research developments, a team from Wuhan, China, reports that even asymptomatic patients with COVID-19 pneumonia have abnormal lung findings on computed tomography (CT), and a group from Beijing noted that viral loads from infected patients appear to peak 5 to 6 days after symptom onset. (Beusekom, 2/25)

And in other news —

Kaiser Health News: As The Coronavirus Spreads, Americans Lose Ground Against Other Health Threats
For much of the 20th century, medical progress seemed limitless. Antibiotics revolutionized the care of infections. Vaccines turned deadly childhood diseases into distant memories. Americans lived longer, healthier lives than their parents. Yet today, some of the greatest success stories in public health are unraveling. (Szabo, 2/26)

Many researchers currently think that bats were the source of the coronavirus (now officially called COVID-19), and that it may have moved through pangolins — the world's most highly trafficked animal — as an intermediate host before moving into humans through the wildlife trade. There are three key ways new diseases find their way into human populations, De Leo says. (Venton, 2/24)

China's massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus. But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it's inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic? (2/25)

Fears that the new coronavirus outbreak is on the verge of becoming a global pandemic have stoked concerns about the Tokyo Games and while the International Olympic Committee says there is no "Plan B" doubts remain the event will go ahead as planned. Five months before the opening ceremony in Tokyo, health authorities around the world are scrambling to contain outbreaks of the flu-like virus which has infected about 80,000 and killed more than 2,700 people, the vast majority in China. (Ransom, 2/26)

The Tokyo Games are scheduled to begin on July 24, but a senior member of the International Olympic Committee raised the possibility of cancellation or postponement if the outbreak wasn’t contained in the next three months, setting an unofficial deadline around the end of May. The last time the Olympics were canceled was during World War II. “This is the new war and you have to face it,” Dick Pound, an IOC member since 1978, told the Associated Press. “In and around that time, I’d say folks are going to have to ask: ‘Is this under sufficient control that we can be confident about going to Tokyo, or not?’” (Robinson, Cohen and Bachman, 2/25)

China and South Korea reported 500 new coronavirus cases on Wednesday, including the first U.S. soldier to be infected, as the United States warned of an inevitable pandemic and an outbreak in northern Italy spread to several European countries. Worsening outbreaks in Iran and Italy, along with China and South Korea, are raising the risk of a pandemic and drove Asian shares down on Wednesday, following falls on Wall Street. (2/26)

Following a pattern set by the MS Westerdam, a cruise ship in the Caribbean has been turned away from two ports over fears of the coronavirus. The ship, with more than 4,500 passengers and 1,600 crew members, was not allowed to dock in Jamaica and the Cayman Islands after it was discovered a crew member onboard was unwell. The MSC Meraviglia from MSC Cruises arrived in Ocho Rios, Jamaica, from Miami on Tuesday morning. After the ship’s command reported one case of influenza onboard, Jamaican authorities, concerned that the man might have the coronavirus, said no one could disembark. (Mzezewa, 2/25)

South Korea’s president visited a virus-stricken city and called the next several days a “clear inflection point,” as the government said it would investigate the roughly 200,000 followers of a mysterious religious sect linked with most of the country’s cases. “We can overcome the coronavirus and fully defeat it,” said President Moon Jae-in, wearing a white face mask as he spoke at the city hall of Daegu, epicenter of the country’s coronavirus epidemic. (Martin and Yoon, 2/25)

Vietnam banned tourists from coronavirus-hit areas of South Korea on Wednesday, a blow to a tourism industry already reeling from a collapse in Chinese visitor numbers. The government said in a news release that people from those areas who needed to come to Vietnam for other reasons must be quarantined for 14 days when entering the country. The move came after the number of cases of the new coronavirus reported in South Korea rose above 1,100. (Nguyen and Duong, 2/26)

Nineteen people have died and 139 people have been infected by coronavirus in Iran, health ministry spokesman Kianush Jahanpur said on Wednesday in an announcement on state TV. (2/26)

Globalization, that awkward catchall for our interconnectedness, was already under assault from populists, terrorists, trade warriors and climate activists, having become an easy target for much that ails us. Now comes the coronavirus. Its spread, analysts and experts say, may be a decisive moment in the fervid debates over how much the world integrates or separates. (Erlanger, 2/25)

Concerns about the novel coronavirus in Tokyo intensified Wednesday after building developer Mitsubishi Estate Co. said a person infected with the virus had been at its Shin Maru Building in the nation’s central Marunouchi business district. The 38 floor office and shopping complex is home to companies including SMBC Nikko Securities, Carlyle Group and Mitsubishi UFJ Lease & Finance. Mitsubishi Estate, whose shares fell as much as 4.5% in Tokyo, says areas visited by the person have been disinfected. (Huang and Nonomiya, 2/25)

Cases in South Korea of the new coronavirus exceeded 1,000 Wednesday, reinforcing concerns the deadly outbreak that began in central China is taking hold on a more global scale. The country confirmed 169 more coronavirus infections, bringing its total number of cases to 1,146. A week ago, South Korea had only 51 cases of the virus, which has killed more than 2,700 people in China and other parts of the world. (Chang, 2/25)

Chevron Corp. asked traders and other staff at its Canary Wharf office in London to work from home as a precaution after an employee was tested for the coronavirus, according to a person familiar with the matter. The employee had flu-like symptoms and coronavirus hasn’t been confirmed, the person said. (Crowley, Ngai, Hurst and Tobben, 2/25)

Some 5,000 miles from Hubei province, the epicenter of China’s coronavirus outbreak, the streets of a northern Sydney suburb that’s home to a large number of Chinese are almost deserted. A chalk board propped outside a small eatery in Eastwood tries to reassure and lure in customers with words written in Mandarin: “The restaurant has been sanitized!” Business is down 70% since late January when the first case of the novel virus was reported in Australia, according to Lily Zhou, 39, who owns the Shanghai-style restaurant with her husband. If things continue as they are now, Zhou said she can only stay in business “at most three months.” (Gross and Cavataro, 2/25)

Italy reported a 45% one-day increase in people infected with the coronavirus as other countries in Europe recorded their first cases Tuesday, producing evidence that travelers are carrying the virus from the European outbreak's current epicenter. Italian officials reported 11 deaths and 322 confirmed cases of the virus, 100 more than a day earlier. While the majority were concentrated in northern Italy, some of the new cases registered outside the country's two hard-hit regions, including three in Sicily, two in Tuscany and one in Liguria. (Winfield, Giles and Zampano, 2/25)

Italian authorities were on the defensive Tuesday as they faced tough questions over the country's handling of the novel coronavirus, which is rapidly spreading across the country's northern regions. Italian Prime Minister Giuseppe Conte has tried to allay fears that the central government is unable to contain the virus, after he was forced to admit that a hospital in the northern town of Codogno had mishandled the region's first coronavirus case and had contributed to the deadly virus' spread. (Dewan, Braithwaite and Ruotolo, 2/26)

Other EU countries have so far imposed few if any restrictions on people arriving from the affected regions of northern Italy. But France has advised its citizens to avoid traveling to Lombardy and Veneto, the two Italian regions at the center of the outbreak. Bulgaria’s flagship carrier, Bulgaria Air, canceled all flights to Milan until March 27. In a sign of the knock-on effects, Paramount Pictures said it had halted production of “Mission: Impossible VII.” The studio had been slated to soon begin a three-week shoot in Venice with a crew of more than 500, according to a spokesman for the city’s mayor. (Sylvers and Rocca, 2/25)

As the coronavirus death toll ticks up day by day in Italy, a picture has emerged of the people most at risk: a 77-year-old found dead in her home, an 84-year-old man who lost his battle with the virus, and another who was 88. The virus can be carried by anybody. But as it spreads through China and accelerates in other parts of the world, it is delivering an unequal demographic blow to the elderly and those already sick. That has set off a race in countries with significant older populations — like Italy — to figure out whether there are ways to protect their most vulnerable: those in hospitals, in nursing homes, and seniors in sealed-off hot-spot towns who are watching television and fearing the worst. (Harlan and Pitrelli, 2/25)

Air Force Gen. Tod D. Wolters, who leads U.S. European Command, told the Senate Armed Services Committee that a “fair amount” of the military’s 35,000 soldiers in Italy are staying home to avoid the virus. The disease was first detected in China, and the World Health Organization in January said the outbreak is a “public health emergency of international concern.” (Kelley, 2/25)

At least four U.S. universities have canceled study abroad programs in Florence and urged students to leave Italy amid fears of the coronavirus spreading further in Europe. Syracuse University, New York University, Fairfield University and Elon University all confirmed in statements their programs have been canceled. NYU is suspending its program until "at least March 29," while the others have done so indefinitely. (Schnell, 2/26)

As the number of people infected by the virus in Italy rises above 300 -- mostly in the rich, industrial north -- restrictions imposed to stem its spread are threatening deeper economic woes. About a third of Italy’s output comes from Lombardy and Veneto, the two most-hit regions that are home to 1.1 million very small businesses with fewer than nine employees. (Speciale, Sirletti and Rotondi, 2/26)

The Spanish authorities scrambled on Tuesday to trace everyone who had contact with an Italian doctor and his partner who tested positive for the coronavirus while on vacation in the Canary Islands, locking down a major resort with hundreds of guests in the hopes of limiting any possible outbreak. While officials said they were acting out of an abundance of caution, the response underscored how quickly the spread of the virus in one European Union nation could become a problem for others in the bloc, which prides itself on frictionless travel across borders. (Peltier and Minder, 2/25)

Ángel Víctor Torres tweeted late Monday that an Italian citizen had tested positive for the coronavirus that has killed more than 2,600 people in China and spread to dozens of countries. "The result of the first tests carried out in the Canary Islands is positive, and tomorrow they will be done again in Madrid," Torres said, adding that the patient had been placed in isolation. Later Tuesday, Torres said the wife of the guest who initially tested positive had also been infected. (Mulligan, Talmazan and Radnofsky, 2/25)

Exhausted medical workers with faces lined from hours of wearing goggles and surgical masks. Women with shaved heads, a gesture of devotion. Retirees who donate their life savings anonymously in government offices. Beijing is tapping its old propaganda playbook as it battles the relentless coronavirus outbreak, the biggest challenge to its legitimacy in decades. State media is filling smartphones and airwaves with images and tales of unity and sacrifice aimed at uniting the people behind Beijing’s rule. It even briefly offered up cartoon mascots named Jiangshan Jiao and Hongqi Man, characters meant to stir patriotic feelings among the young during the crisis. (Yuan, 2/26)

The number of new coronavirus cases in China dropped dramatically in recent days outside the province at the center of the epidemic, but health authorities raised alarms about sharp increases in infections elsewhere in the world. The number of new cases outside Hubei dropped to just nine on Monday, Chinese authorities said, a marked decrease from the peak of nearly 900 new cases that were recorded Feb. 3. (Cheng and Russolillo, 2/25)

Spooked by a sneeze or a cough, Chinese consumers are turning to online consultations in droves for advice about possible coronavirus symptoms - a boon for a fledgling industry that has struggled to win over customers. Due to the epidemic, hundreds of millions of Chinese are stuck at home due to quarantine restrictions imposed by authorities or companies. Even if not under quarantine, many are too worried to venture for long outside or to visit a hospital for other ailments as they fear they might catch the highly contagious virus. (2/26)

Zhang Wendan and her family were celebrating the Lunar New Year when the 27-year-old nurse got a notice from the hospital: report back to work and join the battle to contain the coronavirus outbreak. Ms. Zhang lives in Huanggang, in Hubei Province, where the virus originated. Two days earlier officials had sealed off her city in a desperate attempt to stop it from spreading. Her mother quietly cried while Ms. Zhang and her fiancé went to her room to pack for her trip. The experience at the hospital, Ms. Zhang says, has been harrowing, especially as a woman. (Stevenson, 2/26)

  Sudden pain pierced through the anonymity of hazmat suits and protective masks as a woman in full medical gear chased a black funeral van, letting out a faceless howl. Her husband, Liu Zhiming, director of Wuhan’s Wuchang Hospital and a respected neurosurgeon who’d led the institution’s coronavirus response, was inside the vehicle. A video of the anguished moment went viral, showing Liu’s wife, Cai Liping, a nurse who had been on the front lines with him, staggering forward, arms outstretched, watching as his corpse was driven away to be cremated. (Su, 2/25)

Hong Kong’s government said it would dole out $15.4 billion in cash payouts and other stimulus in its annual budget in an attempt to resuscitate an economy reeling from the coronavirus epidemic and months of antigovernment protests. The city will give each of its adult permanent residents 10,000 Hong Kong dollars ($1,284) in cash—a $9 billion combined payout—and slash salaries tax for close to two million workers, Financial Secretary Paul Chan said Wednesday. He also announced tax breaks and financial aid for companies. (Leong and Wang, 2/26)

Victor Yu is not one of the more than 2,500 people who the Chinese government says were killed by the coronavirus. The 47-year-old resident of Wuhan, epicenter of the outbreak, died Feb. 19 from complications related to renal carcinoma, a common type of kidney cancer. But his family believes that his untimely death is likely related to the coronavirus outbreak. (Feng and Cheng, 2/25)

Senate Democrats on Tuesday blocked action on legislation that would ban almost all abortions after 20 weeks of pregnancy and impose criminal penalties on doctors who fail to aggressively treat babies born after abortions, casting a pair of votes that Republicans hope to use to their advantage in the 2020 elections. The two measures, which both fell short of the 60 votes necessary to advance, were doomed from the start, having already failed in the Senate. (Stolberg, 2/25)

The measures have been defeated multiple times in recent years, but Senate Republicans pushed for renewed votes to allow GOP lawmakers to make an election-year appeal to conservative voters. Senate Majority Leader Mitch McConnell accused Democrats of bowing to “the radical demands of the far left” to “drown out common sense” and the views of millions of Americans. “It almost defies belief that an entire political party could find cause to object to this basic protection for babies,’’ the Kentucky Republican said. (Daly, 2/25)

The vote comes at a busy time for abortion policy. Prior to the Presidents Day recess, the Senate Judiciary Committee held a hearing on protections for infants that survive an attempted abortion, while the House Energy and Commerce Health Subcommittee held a hearing on expanding abortion rights. The House also passed a joint resolution that would extend the deadline for a gender equity constitutional amendment despite fierce opposition from anti-abortion groups who worry it would limit state abortion restrictions. (Raman, 2/25)

In other news —

The American Civil Liberties Union is suing seven Texas towns in federal court over recent anti-abortion ordinances declaring the towns "sanctuary cities for the unborn." The controversial ordinances began popping up in small towns in East Texas last year and gradually spread across the state. Eleven towns, extending as far west as Big Spring, had passed a version of the ordinance. It aims to outlaw abortion at the local level if the U.S. Supreme Court makes it possible to do so, and it grants family members of women who have abortions the ability to sue the provider for emotional distress. (Walters, 2/25)

Colorado officials on Monday unveiled the state's formula for hospital reimbursement rates under the state's proposed public-option insurance program. The Colorado Health Insurance Option formula's base rate is 155% of Medicare rates, but hospitals' individual rates would vary based on hospital type, payer mix and how efficiently they deliver care. Colorado hospitals could cover the costs of providing care at 143% of Medicare rates, according to a state analysis of 2018 Medicare payment data collected by the Colorado Hospital Association and the Colorado Healthcare Affordability Sustainability Enterprise board from the state's hospitals. (Brady, 2/25)

The formula is almost certain to run into stiff opposition from the Colorado Hospital Association. But lawmakers say the rates are better than what some hospitals are currently receiving and the rate-setting will provide more certainty about how much hospitals can expect to be reimbursed for services. And the plan will benefit rural hospitals, said Rep. Dylan Roberts, a Democrat from Avon who is sponsoring the bill. He said he anticipates the state option bill will receive bipartisan support, despite the vocal opposition. Lawmakers wanted to release the reimbursement formula before the bill was introduced to be transparent and explain the process of developing it, he said. (Wingerter, 2/24)

The Colorado Health Insurance Option is the central focus of a much-anticipated document that lays out the administration’s push to tackle the thorny issue of skyrocketing health care costs. Those costs have risen to the top of voters’ concerns in the 2020 election year. It achieves those savings by wrestling down reimbursement rates to hospitals to ones more similar to government programs like Medicare and Medicaid. The new proposed formula released Monday sets a base reimbursement rate of 155 percent of the Medicare rates. That figure is more generous than both the average at which Colorado hospitals break even — currently 143 percent — and at which hospitals nationally turn a profit. (Daley and Cleveland, 2/24)

For Democratic presidential candidates contemplating sweeping health-care overhauls, what happens in Colorado over the next few months will be instructive. Lawmakers in Denver are preparing to vote on a state-sponsored health plan that would compete with private insurance and offer lower premiums. Its approval could embolden Democrats eyeing the White House. (Tozzi and Court, 2/26)

Gov. Andrew Cuomo said the federal government has denied New York's request to extend its signature Medicaid reform program after the state had asked for $8 billion more over four years. The Delivery System Reform Incentive Payment program was conceived in 2014 as a way for New York to use federal money to reduce avoidable hospital use by 25% from 2015 to 2020. (Lamantia, 2/25)

“Every dime matters,” Human Services Commissioner Jodi Harpstead told state state lawmakers at a Senate hearing last year. The embattled state agency has come under fire for recent breakdowns in regulatory oversight. The state agency that oversees Minnesota's Medicaid program disclosed that it incorrectly paid up to $28.9 million over three years to managed care organizations and health care providers for tens of thousands of enrollees with duplicate personal accounts. (Serres, 2/25)

The state Senate quickly considered and passed Gov. Jim Justice’s proposal to take $150 million out of current Medicaid funds to create a trust fund. Senate Bill 633 passed overwhelmingly, 33-0 with one absence. Senators also suspended constitutional rules requiring bills to be considered on three separate days to quickly dispense with the bill Tuesday. The bill now goes to the House of Delegates for consideration. (McElhinny, 2/25)

Meanwhile, in other news from CMS —

The CMS plans to enhance oversight of accrediting organizations in light of conflict of interest concerns and publicized safety issues at provider organizations, according to CMS Administrator Seema Verma. During a speech at the agency's Quality Conference in Baltimore, Verma told the audience accreditors are failing to protect patients from harm and the CMS will be doing more on the issue "in the near future." (Castellucci, 2/25)

A coalition of 39 states will look into the marketing and sales of vaping products by Juul Labs, including whether the company targeted youths and made misleading claims about nicotine content in its devices, officials announced Tuesday. Attorneys general from Connecticut, Florida, Nevada, Oregon and Texas said they will lead the multi-state investigation into San Francisco-based Juul, which also is facing lawsuits by teenagers and others who say they became addicted to the company's vaping products. (2/25)

The probe will also examine Juul’s claims about its products’ nicotine content and their effectiveness in helping longtime smokers quit, the states said in a joint statement. The bipartisan effort is being led by Connecticut, Florida, Nevada, Oregon and Texas. A similar coalition of states announced an investigation of opioid marketing in 2017. Many of those states -- along with thousands of local and municipal governments -- went on to file lawsuits against major opioid manufacturers and distributors, who are expected to pay tens of billions of dollars to settle claims. (Larson, 2/25)

Texas is joining a 39-state investigation into Juul Labs, an e-cigarette maker whose vaping products have become popular with teenagers, Attorney General Ken Paxton announced Tuesday. The bipartisan coalition — which includes officials from Connecticut, Florida, Nevada and Oregon — will look into the company’s marketing and sales practices, specifically whether Juul targeted underage users and misrepresented the health risks. The company is already facing lawsuits by teenagers and others who say they became addicted to the company’s vaping products. (Morris, 2/25)

In other tobacco news —

By mid-March, the Food and Drug Administration is expected to require cigarette packs to carry stark images depicting the health consequences of smoking, but legal challenges are likely to slow the rule from taking effect more than a decade after Congress first called for it. The tobacco industry is likely to challenge the rule in court by pointing to the First Amendment, say lawyers following the rule-making. (Siddons, 2/26)

Taking up exercise could alter our feelings about food in surprising and beneficial ways, according to a compelling new study of exercise and eating. The study finds that novice exercisers start to experience less desire for fattening foods, a change that could have long-term implications for weight control. The study also shows, though, that different people respond quite differently to the same exercise routine and the same foods, underscoring the complexities of the relationship between exercise, eating and fat loss. (Reynolds, 2/26)

The label on Honest Tea’s organic peach-flavored iced tea has a reassuring message for people who want a beverage that is not too sugary: “Just a Tad Sweet,” the label states. But a single serving of the beverage, the amount in one 16.9 ounce bottle, has 25 grams of added sugar, equivalent to six teaspoons of table sugar. That is half the daily limit for added sugar intake recommended by the federal government. (O'Connor, 2/26)

In many ways, Emerson College freshman Meghan Waldron seems like a lot of students in Boston. She adores pop star Ed Sheeran. She loved the latest film version of “Little Women” and wants to see it 10 more times... She also has progeria, one of the world’s rarest diseases. The fatal genetic disorder causes premature aging and has been identified in only 169 children and young adults alive today worldwide, although researchers estimate that as many as 400 have it. (Saltzman, 2/25)

For years, government research agencies have misinterpreted a law that requires them to collect and post clinical trial data, a federal judge ruled this week, leaving behind a 10-year gap in data that now must be made publicly available. Now, potentially hundreds of universities, drug companies, and medical device manufacturers are on the hook to release previously unpublished data. (Facher, 2/25)

Elite runners often turn to sports drinks to keep essential minerals in balance, but a new study shows these products can actually contribute to a dangerous medical condition when temperatures are high. The best way to avoid life-threatening hyponatremia - when the body's sodium levels dip dangerously low - is by training better, keeping fit, and avoiding excess water or sports drink consumption, researchers report in the Clinical Journal of Sports Medicine. (2/25)

Lauren Chan has been in the fashion industry long enough to have a strong opinion about how it contributes to disordered eating. The 29-year old is a former plus-size model and editor at Glamour magazine and says that fashion, entertainment and the media perpetuate the myth of an idealized body type that for most people, is unattainable. “We see 5,000 ads a day, all featuring the same kind of image,” she says. “The message we receive is clear, but if you look around at the people in your life, very few look like that.” (Loudin, 2/25)

Kaiser Health News: U.S. Medical Panel Thinks Twice About Pushing Cognitive Screening For Dementia
A leading group of medical experts on Tuesday declined to endorse cognitive screening for older adults, fueling a debate that has simmered for years. The U.S. Preventive Services Task Force said it could neither recommend nor oppose cognitive screening, citing insufficient scientific evidence of the practice’s benefits and harms and calling for further studies. The task force’s work informs policies set by Medicare and private insurers. Its recommendations, an accompanying scientific statement and two editorials were published Tuesday in the Journal of the American Medical Association. (Graham, 2/25)

Kaiser Health News: Trusting Injection Drug Users With IV Antibiotics At Home: It Can Work
Two mornings a week, Arthur Jackson clears space on half of his cream-colored sofa. He sets out a few rolls of tape and some gauze, then waits for a knock on his front door. “This is Brenda’s desk,” Jackson said with a chuckle. Brenda Mastricola is his visiting nurse. After she arrives at Jackson’s home in Boston, she joins him on the couch and starts by taking his blood pressure. Then she changes the bandages on Jackson’s right foot. (Bebinger, 2/26)

The U.S. Food and Drug Administration issued a warning letter Tuesday to sandwich maker Jimmy John’s and one of its suppliers, saying vegetables the restaurant chain served in the past seven years are linked to five outbreaks of E. coli and salmonella. The agency accused Champaign-based Jimmy John’s of “engaging in a pattern of receiving and offering for sale adulterated fresh produce,” including clover sprouts and cucumbers. (Jimenez, 2/25)

It was the fall of 2015 when researchers from Google and the University of California, San Francisco, first sat down together to hash out a research collaboration in an area that has since exploded with activity: using artificial intelligence to make predictions in the hospital. Those initial discussions resulted in a contract, signed by both parties a few months later, mapping out an agreement under which UCSF would freely share deidentified patient data with Google — and stipulating what the tech giant would be allowed to do with the information, which covered at least 1.4 million patients. The goal was to see whether Google’s algorithms could predict whether patients had died in the hospital or whether they’d been quickly readmitted after discharge. (Robbins, 2/26)

It’s been two years since tech behemoth Amazon launched its joint venture in health care with Berkshire Hathaway and JPMorgan Chase. Called Haven, the initiative is aimed at cutting costs and improving quality with an immediate focus on serving the employees of the three companies. The secretive venture has so far generated lots of buzz but said little about how it will accomplish those goals. (Brodwin, 2/26)

A year after asylum-seekers and other migrants overwhelmed U.S. immigration authorities at the southern border, the Border Patrol is opening a processing facility in Texas that officials say could help it better care for detainees following outcry last year over young children and adults held in squalid, crowded conditions. “This facility is much better for us, (and) most importantly, it's going to provide the adequate care and necessities for those that are in our custody,” said Chris Clem, deputy chief patrol agent for the El Paso Sector, which covers southern New Mexico and West Texas. (2/25)

Nearly two years have passed since the separation of thousands of migrant children and their parents under the Trump administration’s “zero-tolerance” policy. Months after some reunions, experts found that severe psychological trauma remained. On Tuesday, Physicians for Human Rights published a report based on in-depth psychological evaluations of 26 asylum seekers — nine children and 17 adults — who were separated under the policy. Medical experts documented psychological trauma, including post-traumatic stress disorder, depression and anxiety. (Mejia, 2/25)

A Philadelphia nonprofit group said it will open the nation's first supervised injection site next week to combat overdose deaths after a federal judge rejected Justice Department efforts to block the plan. U.S. District Judge Gerald McHugh, in a final ruling Tuesday, said the Safehouse proposal doesn’t violate federal drug laws because the intent is to save lives, not encourage drug use. (2/25)

In the soft glow of the ultrasound machine in the dimly lighted exam room, Dr. Craig Towers offered his patient this assessment: “Your baby is doing great!” But Emily Lenderman barely registered the good news. The 22-year-old was miserable. A raging staph infection had overrun the right side of her face, her skin was clammy and dark bags shadowed her eyes. Her head lolled side to side. (Wilber, 2/26)

Nationwide, two-thirds of the country’s 2.3 million inmates are addicted to drugs or alcohol, according to the National Institute on Drug Abuse. But only a small fraction of those who need treatment behind bars receives it. The vast majority of the nation’s nearly 2,000 state and federal prisons and 3,100 county and municipal jails do not offer addiction treatment that includes any of the three medications — methadone, buprenorphine and Vivitrol — approved by the U.S. Food and Drug Administration. That’s changing, albeit slowly. An estimated 120 jails in 32 states and prison systems in 10 states now offer evidence-based treatment for opioid addiction, triple the number in 2018. (Vestal, 2/26)

The West Virginia Senate on Tuesday approved a bill backed by Attorney General Patrick Morrisey that would restore portions of the Affordable Care Act at the state level if Morrisey’s effort to repeal the federal act is successful. Senate Bill 284 doesn’t have an effective date, meaning it would be dormant until at least 2021, when the U.S. Supreme Court is expected to hear arguments in a federal case challenging the Affordable Care Act, also called Obamacare. (Pierson, 2/25)

Half a dozen Chicago hospital systems and the American Medical Association are doubling down on efforts to improve the health of Chicagoans living on the city’s West Side — by investing money in neighborhood businesses. The hospitals and the Chicago-based trade group for physicians will announce Wednesday that they plan to invest $6 million in businesses on the city’s West Side. (Schencker, 2/26)

The American Medical Association announced Wednesday that it has joined West Side United, a coalition of health systems focused on improving health outcomes on Chicago's West Side. As part of its involvement, the AMA will invest $2 million over two years in community development financial institutions that focus on improving access to healthy foods, affordable housing and help finance small local businesses located on the West Side. (Castellucci, 2/26)

North Carolina faces a flood of people with dementia that will reach 300,000 by 2030. Responses as simple as person-to-person support groups address gaps that big medicine has yet to fill. (Goldsmith, 2/26)

A $13.5 billion settlement between victims of California's catastrophic wildfires and the utility blamed for causing them was supposed to bring some peace and hope to people still reeling from the devastation. Instead, the deal has sparked confusion, resentment, suspicion and despair as the victims, government agencies, and lawyers grapple for their piece of the pie. (2/26)

A Virginia jail guard ignored an inmate's cries of pain and medical personnel did nothing to help him before he died, according to a lawsuit filed by his estate. The lawsuit said that when one officer at Hampton Road Regional Jail spotted Victor Rhea Fountain curled up in the fetal position, he shrugged and moved on to the next cell, The Virginian-Pilot reported Tuesday. (2/25)

The president and CEO of St. Luke's Hospital announced her resignation Tuesday, according to a news release. Christine Candio will resign effective April 1, and plans to move to the East Coast to be closer to her family... Candio has led the hospital since January 2015. Before that, she was CEO of a hospital in northern Virginia for six years. (Merrilees, 2/25)

Health officials want to educate people about hepatitis A after dozens of cases were reported in north Georgia. Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. (2/25)

The Putnam County Health Board chose not to take a vote on medical marijuana Tuesday night, which would’ve either allowed or denied cannabis businesses to operate inside the county. West Virginia’s 2017 medical marijuana law requires each county health board to submit a letter of support for medical marijuana in the county to the state Department of Health and Human Resources. (Severino, 2/25)

A state lawmaker has asked Governor Charlie Baker’s administration to show how the state spent marijuana taxes so far, saying she hopes the money funded new initiatives, not just existing ones.The questions raised by Representative Hannah Kane, a Shrewsbury Republican, coincide with a Boston Globe report this month detailing that since July 2018, none of the $67 million in marijuana excise taxes and fees left over after paying for the cost of regulators has funded any new initiatives or supported many purposes prescribed in state law. Those purposes include public safety and aid for communities hardest hit by the war on drugs. (Martin, 2/25)

The rising cost of prescription drugs is a problem nationwide, but it's particularly acute in South Carolina, pushing the issue to the forefront when Democratic presidential contenders spar in Tuesday night's debate in Charleston. Health care is the dominant issue among women 50 and older in South Carolina, where 78% gave elected officials poor grades in dealing with the costs of health care and prescriptions, according to a Harris Poll survey released by AARP last week. (Gibson, 2/25)

Back in 2006, the FDA launched an effort to force drug companies to win regulatory approval for medicines already on the market that actually were never approved. Numerous treatments had been available for years on a grandfathered basis because they predated stricter requirements. But while the FDA program, called the Unapproved Drugs Initiative, succeeded in ensuring many older medicines are now safe and effective, it has come at a cost. (Silverman, 2/26)

President Trump is campaigning for re-election in 2020 by saying he has made great progress in reducing drug prices. But the issue has been a source of frustration for him recently, according to people familiar with the matter, as polling shows a majority of Americans disapprove of his handling of the issue and Democratic challengers for the White House focus on how his initiatives have stalled. Key parts of the president’s plan to combat prescription costs have been blocked by courts, dropped by the administration or delayed. Meanwhile, drug companies this year have raised prices for hundreds of medications. (Armour, 2/21)

As out-of-pocket costs rise for medicines used to treat certain neurologic disorders — such as dementia and neuropathy — patients are less likely to take their drugs as often as prescribed, according to a new study. And the findings are the latest indication that increasing drug costs may lead to worsening health and, consequently, higher health care expenses in the future. (Silverman, 2/20)

Arkansas defended its law regulating pharmacy benefit managers from an ERISA preemption challenge, telling the U.S. Supreme Court that the law is a necessary attempt to rein in an “obscure but singularly powerful industry.” (Wille, 2/25)

In an unusual move, the Institute for Clinical and Economic Review has reversed course and decided a pair of new drugs for treating acute migraine attacks have greater value than thought initially. And the cost-effectiveness watchdog is pointing to its decision as an example of its willingness to exercise greater flexibility in the face of long-standing criticism of its approach to evaluating new medicines. (Silverman, 2/25)

The Institute for Clinical and Economic Review (ICER), a small but influential Boston-based research group, has signed a deal with private technology company Aetion to help it use patient health data in its reports on whether individual drugs are priced properly. Large national regulators, including the U.S. Food and Drug Administration and United Kingdom's National Institute for Health and Care Excellence (NICE), are considering increasing the use of data gathered outside of clinical trials on the effectiveness of treatments, often referred to as real-world data. (Humer, 2/24)

A leading association of eye doctors has warned its members about safety concerns about Novartis’ new eye drug, sending the company’s stock down sharply Monday while that of Regeneron Pharmaceuticals, which produces a competing product, rose. The American Society of Retina Specialists sent its membership an email about the drug, Beovu, on Sunday, warning that some doctors were reporting not just a known side effect, eye inflammation, but also a new one, vasculitis. (Herper, 2/24)

Canada’s drug pricing agency is contemplating significant changes to how it will apply new regulations aimed at lowering costs, Reuters has learned, as drugmakers unhappy with the policy delay introducing new medicines in the country and blame it for job cuts. (Martell, 2/20)

The drug industry has long been one of the most powerful lobbies in Washington, but in recent years it hasn't packed the punch it used to. WSJ's Brody Mullins explains why the pharmaceutical industry's influence has declined. (2/25)

It is no secret that prescription drug prices are a hot-button issue — and understandably so. When Donald Trump announced his desire to lower prescription drug prices at the this year’s State of the Union, House Democrats chanted “H.R.3,” in reference to House Bill 3, which aims to fulfill the president and the late Elijah Cummings' stated ambition at reducing drug prices. And yet the bill has sat in Mitch McConnell's legislative graveyard in the Senate since its passing through the House. And then, one day after the SOTU, Secretary of Veterans Affairs Robert Wilkie delivered a gut punch to the pharmaceutical industry. (Robert Weiner and Wesam Farah, 2/25)

Four decades after the HIV epidemic began, there’s finally hope it might end. Indeed, “Getting to Zero” — meaning zero new HIV infections — is a slogan used by the World Health Organization and others in fighting the epidemic. A major factor driving this optimism is pre-exposure prophylaxis, commonly known as PrEP, in which people who are HIV-negative take a medication to prevent HIV infection. For Gilead Sciences, the manufacturer of the only two FDA-approved pills for PrEP, the most important zeroes seem to be those the company is adding to its bottom line. (Douglas Krakower, Kenneth Katz and Julia L. Marcus, 2/26)

Nearly 100 years ago, Dr. Frederick Banting used insulin to treat patients with diabetes and shared a Nobel Prize for its discovery. He sold the patent rights to the University of Toronto for $1. “Insulin does not belong to me, it belongs to the world,” Banting proclaimed. Yet, here we are in 2020 and insulin does not belong to the world. Instead, greedy corporations are using it to line their pockets. Who will be the one to release insulin back where it belongs? (Erinne Magee, 2/24)

Government policy changes sometimes have all the subtlety of a steam roller, barreling forward without sufficient regard for everything in its path. Such is the case today with proposed changes to the Medicare prescription drug benefit (Part D), one of health care’s success stories. In an attempt to cut prescription drug costs for some plan participants, now numbering around 45 million, the proposal has the potential to crush an entire, fragile market designed to help some of the most ill among us. (Mike Eging, 2/25)

Cue the inevitable gripes from Congress that this isn’t nearly enough. Speaker Nancy Pelosi called the request “long overdue and completely inadequate.” Senate Minority Leader Chuck Schumer called the Administration’s proposal to tap some of the money from an Ebola preparedness account an example of Mr. Trump’s “towering incompetence.” Senate Appropriations Chairman Richard Shelby, a Republican, worried that the White House was “lowballing” the emergency. We’d take these complaints seriously if they were based on any expertise or factual understanding of the threat. (2/25)

The end result is an inescapable sense that this thing is pretty far from “very well under control.” One huge problem for reassuring both markets and the general public is that Trump has spent his term stripping America’s pandemic-response apparatus for parts. He keeps trying to gouge the CDC’s budget, has defenestrated whole teams of experts, hasn’t bothered to name a coronavirus “czar” and may be seeking too little money for a response. (Mark Gongloff, 2/25)

Doctors have been preparing for 15 years for “the big one,” a pandemic that will rock the global public health system like an earthquake. Now, with the rapid spread of coronavirus, it may be happening. This viral outbreak probably won’t look like anything that most of us have seen. Some schools may be closed; sports schedules will be modified; travel plans will be shelved; and some workers will be advised to stay at home and telecommute. The infrastructure for delivering food and other essentials will be stretched. U.S. public health officials on Tuesday warned of the “inevitable” spread of the virus in the United States. (David Ignatius, 2/25)

The big surprise was not that global markets fell sharply this week on fears of the coronavirus, but that it took so long for them to wake up to the threat. Before Monday, Wall Street was full of instant experts in epidemiology predicting — on the basis of widely circulated charts showing that the number of new cases had peaked in China — that “it’s over.” This sanguine state was symptomatic of a bull market that is now 11 years old, the longest in history, and also one of the calmest. In the past decade, stock prices approached a full 20 percent “correction” only twice, and suffered even minor dips much less frequently than in most previous bull markets. (Ruchir Sharma, 2/25)

It’s the $85 trillion (global GDP) question: Will the coronavirus kill the global economy? What we know is incredibly scary. The disease is a prolific killer and a stealthy one at that. Over 2 percent of its victims die. For people in their 80s, the death rate is around 10 percent. The latest information suggests that the virus can incubate in one’s body for as long as a month before producing symptoms. (Laurence Kotlikoff, 2/25)

Democrats on Tuesday night’s debate stage in South Carolina failed to see the opportunity presented by two days of plunging stock markets. The Dow Jones sank nearly 8% on fears the fast-spreading coronavirus will infect the global economy. Economists are warning the virus may disrupt trade and global supply chains and trigger a recession. If a significant downturn comes, it would undermine President Donald Trump’s greatest argument for reelection — the strength of the economy under his watch. (Nolan Finley, 2/26)

Federal regulatory agencies can’t stand still. They must evolve with industries they regulate. No agency faces more pressure to do this than the Food and Drug Administration. Charged with simultaneously protecting the public’s health from unsafe products and promoting public health by accelerating access to new treatments, it regulates about 20 cents of each dollar in the U.S. economy, all while responding rapidly to emerging health challenges like the disease caused by the novel coronavirus, Covid-19, and new vaping technologies that may reduce risks for smokers but increase nicotine use by youth. (Mark McClellan and Ellen V. Sigal, 2/26)

Government insurance advocates who are skeptical of Medicare for All’s prospects are placing their hopes on the “public option” as an easier-to-enact step in the same direction. All of the leading competitors to Bernie Sanders, who remains unyielding in his commitment to single-payer health care, have embraced some version of what Pete Buttigieg calls “Medicare for all who want it.” In general terms, with a public option, the federal government would run its own health plan in competition with private insurance. (Joseph Antos and James C. Capretta, 2/25)

President  Trump is once again threatening to derail medical cannabis access in the majority of U.S. states that regulate its access and use. In his recently released 2021, the federal budget proposes, the president has called for ending existing federal protections that limit the federal government from interfering in the state-sanctioned regulation of medical cannabis. Doing so would place thousands of medical cannabis providers and the millions of patients who rely on them at risk for criminal prosecution. (Justin Strekal, 2/25)

Four decades after the HIV epidemic began, there’s finally hope it might end. Indeed, “Getting to Zero” — meaning zero new HIV infections — is a slogan used by the World Health Organization and others in fighting the epidemic. A major factor driving this optimism is pre-exposure prophylaxis, commonly known as PrEP, in which people who are HIV-negative take a medication to prevent HIV infection. (Douglas Krakower, Kenneth Katz and Julia L. Marcus, 2/26)

When the top food-producing state moved to ban a pesticide that’s been on the market for decades, you better believe it had good reason. California made that decision last year because of the clear and incontrovertible evidence developed by multiple studies over more than a decade that chlorpyrifos is linked to childhood brain damage. The state had to do it, because the U.S. Environmental Protection Agency failed to despite moving in that direction while Barack Obama was president — a decision that even science skeptics should find despicable. The evidence was so compelling that chlorpyrifos was banned from indoor use nearly a quarter-century ago. (2/25)

The Law Firm of Peter Angelos — the most powerful firm in Baltimore — is using its political muscle to get state legislators to end a hugely successful court procedure that ensures justice for victims, not paydays for plaintiffs’ lawyers. The Baltimore asbestos docket is relativity obscure, but over the past 20 years, it’s clogged Baltimore City courts with questionable lawsuits while giving plaintiffs’ lawyers massive paydays. Currently, there are more than 27,000 active asbestos cases in Baltimore — with about two-thirds of the cases filed by The Law Offices of Peter Angelos. (Harold Kim, 2/25)

Make no mistake about it: The success or failure of the Kansas Legislature’s 2020 session — and maybe even life or death for some Kansans without health care — is riding entirely on the next few days and weeks. The fates of Medicaid expansion and a constitutional amendment limiting abortion have become intertwined with the fate of the legislative session itself. Especially when it comes to Medicaid expansion. If Medicaid expansion isn’t passed this year, as a majority of legislators say they want, then they will have failed utterly. (2/26)

On signs that dot many front lawns in the aforementioned northside neighborhoods, the message is spelled out this way: “We must stop killing each other.” Nearly every time another child loses his or her life in senseless gun violence in the city, angry and heartbroken residents band together to march, to honor the dead and pray for an end to the violence. (Tony Messenger, 2/25)

St. Louis leaders have asked the state to allow a permit requirement to carry within the city. State leaders, in stubborn fealty to Republican dogma, refuse. The city must keep fighting for that reform — and every time a child dies, those state leaders need to ask themselves if it’s a death that reasonable gun policy might have prevented. ...State Republicans can indulge their ideological extremism in their own communities, but they should take the cuffs off St. Louis. (2/25)