�������ýҕ�l

The ongoing government shutdown isn’t just the longest in American history. It’s likely the most damaging, too. Even if the shutdown ends by next week, it will likely slow down the growth of real gross domestic product (GDP) — the broadest measure of economic output, without considering inflation — by 1.15 percentage points during the fourth quarter, according to Goldman Sachs. (Egan, 11/5)

The White House is warning that unemployment benefits are in jeopardy in some states if the shutdown drags on, though the risks are far less dire than for food assistance or SNAP. (Peck, 11/4)

President Trump threatened on Tuesday to deny food stamps for roughly 42 million low-income Americans until the end of the government shutdown, a move that would defy a federal court that had ordered the administration to continue the aid payments this month. ... Hours after that ultimatum, Karoline Leavitt, the White House press secretary, appeared to walk back the president’s comments. She told reporters at a news briefing that the administration is “fully complying” with the court and would provide partial food stamp payments in November. (Romm, 11/4)

The Trump administration is sending notifications to federal staff suggesting that only those who are working during the government shutdown will be paid when it ends, despite a 2019 law that also guarantees pay to furloughed employees. (Natanson, Bogage and Beggin, 11/4)

Food banks and hunger relief organizations are seeing an increase in the number of people lining up for food packages and calling helplines since Supplemental Nutrition Assistance Program (SNAP) benefits were halted on Nov. 1. Nearly 42 million Americans have lost benefits meant to help low-income and vulnerable households pay for groceries. President Donald Trump said Tuesday that no SNAP benefits will go out to Americans until after the government reopens -- a day after the U.S. Department of Agriculture said in court it would make partial payments to recipients. (Kekatos, 11/4)

Also —

President Donald Trump still has Barack Obama’s signature legislative accomplishment on his mind, but the political calendar and environment are not on his side. Pushing a measure to revise — or even replace — the 2010 health care law known as the Affordable Care Act as the nation heads into what will likely be a contentious midterm election year would be among the biggest battles of his turbulent decade-old political career. (Bennett, 11/4)

The Trump administration is negotiating a deal with weight-loss drugmakers Eli Lilly and Novo Nordisk that would allow the lowest doses of some of their obesity drugs to be sold to consumers at $149 for a month’s supply via TrumpRx, according to people familiar with the matter. The deals would also result in Medicare and Medicaid covering the drugs for weight loss, the people said, which would be a boon to the companies. (Essley Whyte and Loftus, 11/4)

Novo Nordisk and Pfizer's multibillion-dollar fight over who gets to buy an anti-obesity biotech has morphed into a narrative argument over which acquisition would be most America First — a framing with clear political implications. (Owens, 11/5)

On tariffs —

US President Donald Trump announced a cut to fentanyl-related tariffs on imports from China and the continued freeze of some of his reciprocal levies on Chinese goods, formalizing key elements of the sweeping trade deal struck with Chinese leader Xi Jinping. The moves, made in a pair of executive orders issued Tuesday, go into effect on Nov. 10. The fentanyl tariff rate will be halved from 20% to 10%, while Trump has also extended for a year a truce that saw him reduce his reciprocal tariff rate from 34% to 10%. (Wingrove, 11/4)

Siemens Healthineers AG expects the impact from tariffs to roughly double to €400 million ($460 million) in fiscal 2026, according to Chief Financial Officer Jochen Schmitz. The German medical-technology company sees good prospects for business in the US, Schmitz said Wednesday in an interview with Bloomberg Television. Still, the manufacturer is managing costs tightly and can “think about potential value-add shifts” to counter the import duties, he added. Tariff headwind was around €200 million in fiscal 2025. (Eckl-Dorna and Mackenzie, 11/5)

This year, as President Trump threatened tariffs, nearly all of the wealthiest pharmaceutical companies have pledged to spend billions of dollars to build factories in the United States. Construction is underway in industry hubs like North Carolina on state-of-the-art plants that will produce blockbuster drugs. But the president’s drug-manufacturing renaissance in America is largely leaving out the production of generic medicines, which account for 90 percent of Americans’ prescriptions. (Robbins, 11/4)

A Food and Drug Administration advisory committee will meet Thursday to explore a topic that’s been taboo during the Trump administration: Regulating artificial intelligence. (Aguilar, 11/5)

Any money collected would go to the 988 Suicide and Crisis Lifeline Fund, which supports mental health crisis response services across Ohio. (Staver, 11/4)

Letters to the editor from writers using chatbots are flooding the world’s scientific journals, according to new research and journal editors. The practice is putting at risk a part of scientific publishing that editors say is needed to sharpen research findings and create new directions for inquiry. A new study on the problem started with a tropical disease specialist who had a weird experience with a chatbot-written letter. He decided to figure out just what was going on and who was submitting all those letters. (Kolata, 11/4)

More on the FDA —

The White House is rallying behind Food and Drug Administration Commissioner Marty Makary after the abrupt ousting of one of his top deputies over the weekend, the latest tumult in an agency that’s seen plenty this year. A new top drug regulator will likely be installed on Wednesday to replace George Tidmarsh as director of the FDA’s Center for Drug Evaluation and Research, according to a Health and Human Services official granted anonymity to discuss personnel planning. (Lim and Gardner, 11/4)

More pharmaceutical developments —

Arena BioWorks, the buzzy research institute that launched nearly two years ago with $500 million to support a decade of scientific R&D, is abruptly shutting down, the institute confirmed to STAT. (DeAngelis and Mast, 11/4)

A common cancer drug has been restructured to make its cancer cell killing abilities up to 20,000 times more effective while also reducing its toxicity. Researchers from the Northwestern University in Illinois re-engineered the structure of the commonly-used chemotherapy drug 5-fluorouracil (5FU) into that of a "spherical nucleic acid" (SNA)—a nanostructure that weaves the drug directly into DNA strands coating tiny spheres. Such makes it far more powerful and targeted—leaving healthy cells unharmed. (Millington, 11/4)

Data from a phase 2 randomized controlled clinical trial indicate that the antiviral drug ensitrelvir is an effective alternative to other COVID-19 antiviral treatments, researchers reported last month in The Lancet Infectious Diseases. The once-daily oral drug, a SARS-CoV-2 main protease inhibitor developed by Shionogi, is registered in Japan and Singapore for treating COVID-19. It has been given to more than 1 million people but is an investigative drug outside those countries and has not been compared with other COVID antivirals. (Dall, 11/4)

The FDA approved an intravenous (IV) formulation of fosfomycin (Contepo) to treat adults with complicated urinary tract infection (cUTI), including acute pyelonephritis, caused by susceptible Escherichia coli and Klebsiella pneumoniae, Meitheal Pharmaceuticals announced. Fosfomycin is an injectable epoxide and sole antibiotic class member with no known cross-resistance to other antibiotic classes. It has demonstrated activity against gram-negative bacteria and other antimicrobial resistant pathogens, the company said. (Rudd, 11/4)

Here are 14 recent drug shortages and discontinuations, according to FDA drug supply databases: Acetaminophen; oxycodone hydrochloride tablet: Multiple strengths of Percocet were discontinued Nov. 3 due to the end of manufacturing. (Jeffries, 11/4)

Voters in Maine approved a “red flag” law on Tuesday, according to The Associated Press, giving families the option to petition a judge to order weapons removed temporarily from a troubled relative. The ballot measure, known as Question 2, passed two years after a gunman in Lewiston used an assault rifle to kill 18 people at a bar and a bowling alley. It was the worst mass shooting in Maine history. (Russell, 11/4)

More election results from Texas and Arizona —

Texas voters on Tuesday are on track to approve Proposition 14, the constitutional amendment that both establishes a Dementia Prevention and Research Institute of Texas (DPRIT) and authorizes the spending of $3 billion to set up the fund. (Langford, 11/4)

Early returns show voters across Maricopa County are divided on Proposition 409, a nearly $900 million bond that would help Valleywise Health, the county’s public health care system. Officials have said the money would be used to build a new 200-bed behavioral health hospital, build a new outpatient specialty center on the main campus, expand pediatric and primary care, enhance physician training, and add observation beds at the medical center. (Valencia, 11/4)

In other health news from across the U.S. —

The pharmaceutical company Amgen has again sued Colorado over a state board’s decision to place a price cap on the blockbuster rheumatoid arthritis drug Enbrel. (Ingold, 11/5)

The US Department of Agriculture's Animal and Plant Health Inspection Service (APHIS) reported several new detections of highly pathogenic avian flu in poultry, including four major outbreaks on commercial turkey farms. In Lamoure County, North Dakota, a commercial turkey farm with 24,700 birds was hit, and in Mcpherson, South Dakota, a facility with 63,800 birds was also affected. South Dakota also had a detection last week on a turkey farm with 56,300 birds in Spink County, as well. In Ottawa County, Michigan, 62,200 birds on a turkey farm were impacted. (Soucheray, 11/4)

Two years ago, Ignacio, a construction worker in Houston, began having frequent headaches and fatigue. Then 40, he initially didn’t go to a doctor because he was uninsured. His wife found a clinic that would see him for free. He was diagnosed with high blood pressure and high cholesterol and sent home. A few hours later, someone from the clinic called, asking Ignacio to return immediately. When he failed to show up, the clinic employee called again. He needed to go to urgent care because his heart could fail while he was asleep, they told him. (Jiménez, 11/5)

Christ Hospital in Cincinnati is investigating two recent cases of Legionnaires' disease in patients in the past 6 week. Legionnaires' disease, a serious lung infection caused by Legionella bacteria, is contracted through inhaling contaminated water droplets. Officials say they're working with local and state health departments to determine if the patients contracted the disease on Christ Hospital's main campus. So far the site of exposure is unknown, but the hospital has initiated environmental testing. (Soucheray, 11/4)

More health industry updates —

As long-revered health institutions come under new scrutiny in President Trump’s Washington, one powerful group is shifting its strategy. The Children’s Hospital Association, which represents more than 200 hospitals and spends millions on lobbying each year, announced Tuesday a new messaging approach and internal changes to support it. (Payne, 11/4)

Four units of Optum, a subsidiary of UnitedHealth Group, are planning to lay off a total of 572 employees based in New Jersey early next year. Optum Care plans to lay off 390 employees, Optum Medical Care 122, Optum Services 49, and Optum Select Management 11, according to Worker Adjustment and Retraining Notification filings from October. The layoffs will be staggered, starting in early February and ending in early March. (DeSilva, 11/4)

Newly released data shows that Minnesota is continuing to lose hospital-based labor and delivery services, increasing the health risks facing people who are pregnant. The data set was published by University of Minnesota’s Rural Health Research Center, a national authority on maternal health care access, particularly for rural areas. According to an MPR News analysis of the data, nearly one in eight Minnesotans lives in a county with no hospital-based obstetrics services. (Work, 11/4)

Virtual nursing is growing beyond the four walls of the hospital. For instance, Chicago-based CommonSpirit Health, one of the leading providers of inpatient virtual nursing, is expanding the care model to its ambulatory practices. Virtual nurses now handle after-hours calls for outpatient offices, triaging patients to urgent or emergency care or scheduling next-day appointments. (Bruce, 11/4)

�������ýҕ�l Health News: �������ýҕ�l Health News’ ‘An Arm and a Leg’: This Health Economist Wants Your Medical Bills
Economist Vivian Ho has been researching the U.S. health care system for four decades. These days, she’s focused on what she thinks are the biggest burdens on the average American: runaway hospital prices and rising health insurance premiums. She has developed a strategy for addressing high insurance premiums — one that’s based on giving patients reliable information about how much they, and their insurer, would have to pay for care. The system is already working in Massachusetts. Could it be a model for the rest of the country? (Weissmann, 11/5)

�������ýҕ�l Health News: While Politicos Dispense Blame, These Doctors Aim To Take Shame Out Of Medicine
The distress that Will Bynum later recognized as shame settled over him nearly immediately. Bynum, then in his second year of residency training as a family medicine physician, was wrapping up a long shift when he was called into an emergency delivery. To save the baby’s life, he used a vacuum device, which applies suction to assist with rapid delivery. The baby emerged unharmed. But the mother suffered a severe vaginal tear that required surgical repair by an obstetrician. (Huff, 11/5)

Also —

Two Massachusetts men were arrested Tuesday in connection with a weekend explosion at Harvard Medical School, authorities said. Logan David Patterson and Dominick Frank Cardoza face charges of conspiracy to damage by means of fire or an explosive, according to the charging document. Patterson, an 18-year-old from Plymouth, and Cardoza, a 20-year-old from Bourne, were arrested Tuesday morning and were due to be arraigned in federal court later in the day. (Casey and Willingham, 11/4)

Facility-based colorectal cancer (CRC) screening among young adults has rapidly increased since U.S. guidelines started recommending that screening begin at an earlier age, according to a population-based cohort study. Facility-based CRC screening among adults ages 45 to 49 increased about 10-fold following guideline changes from the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS), "far exceeding growth" among those ages 50 to 75, reported Alyssa H. Harris, MPH, of Vizient in Chicago, and colleagues in a research letter in JAMA Network Open. (Bassett, 11/4)

More health and wellness news —

Survival rates of people with young-onset dementia -- dementia diagnosed before age 65 -- varied considerably by clinical type, a population-based cohort study in Finland showed. The median survival for young-onset dementia (also known as early-onset dementia) was 8.7 years, said Eino Solje, MD, PhD, of the University of Eastern Finland in Kuopio, and co-authors. (George, 11/4)

Antimicrobial peptides derived from a strain of probiotic bacteria demonstrated the potential to inhibit the most common bacterial cause of foodborne illness in lab and poultry experiments, according to a team of researchers from The Ohio State University. (Dall, 11/4)

Because policies to address pollution are costly to implement and impose social burdens, it is important to understand the full benefits of pollution-reducing programs. An article in Health Economics provides compelling evidence that one such program offered considerable benefits for infant health, especially in vulnerable populations. Based on an analysis of more than a decade of US birth records, the research shows that the Nitrogen Oxide Budget Trading Program—a cap-and-trade initiative to reduce ozone pollution—significantly improved infant health outcomes, particularly among Black, low-income, and single mothers. (11/5)

Far fewer bat species carry viruses with high potential to cause disease epidemics in people than is widely assumed, researchers from the University of Oklahoma and Yale write in Communications Biology. In fact, only certain types—especially those found in coastal South America, Southeast Asia, and equatorial Africa—harbor dangerous pathogens such as SARS-CoV-2, Marburg, and Nipah viruses, they found. (Van Beusekom, 11/4)

�������ýҕ�l Health News: Is Covid During Pregnancy Linked To Autism? What A New Study Shows, And What It Doesn't
A large study from Massachusetts has found that babies whose mothers had covid-19 while pregnant were slightly more likely to have a range of neurodevelopmental diagnoses by age 3. Most of these children had speech or motor delays, and the link was strongest in boys and when the mother was infected late in pregnancy. The increase in risk was small for any one child, but because millions of women were pregnant during the pandemic, even a small increase matters. (Gounder, 11/5)

�������ýҕ�l Health News: Listen To The Latest '�������ýҕ�l Health News Minute'
Arielle Zionts reads the week’s news: Though 13 states cover GLP-1s such as Wegovy for weight loss for people on Medicaid, many eligible people are missing out, and advance planning can help seniors aging alone maintain more control over their final days. (11/4)

Medicaid provisions passed under H.R. 1 will have a cascading impact that threatens the landscape of vital contraceptive care. (Anna Britt, Kate Meyer and Zara Day, 11/3)

While the headaches and life-altering results of insurance pre-authorizations are not new to physicians or patients, lately things have been getting worse. Patients are sending more and more messages to their doctors, scared that they won’t have essential medications renewed in a timely way and pleading for help. (Alexa B. Kimball, 11/5)

Last Friday, the Illinois General Assembly narrowly passed a law allowing terminally ill people to end their own lives. The legislation now awaits Gov. JB Pritzker’s signature. If he signs it, Illinois will join 11 other states (and the District of Columbia) that allow terminally ill adults to choose when and how they want to end their own lives. There’s an element of the macabre in the fact that this bill passed on Halloween, but we digress. (11/4)

Many expectant moms are unaware of the dangers of cannabis use. (Leana S. Wen, 11/4)

Twenty years ago, Science celebrated “a revolution that is fundamentally altering the way the haves of the world assist the have-nots”: Governments and philanthropies were donating tens of billions of dollars to global health annually. “Everyone started dreaming,” no longer “scraping for the pennies that would fall off the table,” declared Jim Yong Kim, who would later become president of the World Bank. (S.L. Erikson, 11/5)