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Axios World

By Dave Lawler · Aug 15, 2022

Welcome back to Axios World.

Taliban fighters paraded through Kabul today to mark the one-year anniversary of taking the city.
Tonight's edition (1,980 words, 7½ minutes) focuses almost entirely on Afghanistan. We'll also check in on Kenya's election results.

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1 big thing: Former U.S. envoy on leaving Afghanistan to the Taliban

Khalilzad alongside then-Taliban political leader Abdul Ghani Baradar at the signing of the Doha Accords in 2020. Photo: Giuseppe Cacace/AFP via Getty Images

Zalmay Khalilzad was tasked by two U.S. presidents with negotiating an orderly U.S. exit from Afghanistan. Instead, one year ago, Kabul collapsed, the U.S. mounted a frantic evacuation, and the Taliban took total control.

What he's saying: "It's very unfortunate that we couldn't get a political agreement before the Taliban moved in," Khalilzad tells Axios in a phone interview.

Flashback: There was still a glimmer of hope for a power-sharing deal, he argues, until Aug. 15, 2021.

The Taliban had agreed to halt its advance outside Kabul and meet a delegation of senior Afghan politicians, including former President Hamid Karzai. But when President Ashraf Ghani fled, Khalilzad says, he left a vacuum.
The Taliban initially offered to let the U.S. military secure Kabul temporarily, Khalilzad says. Then-CENTCOM Commander Gen. Kenneth McKenzie later testified that there was no "formal offer" from the Taliban, and "we did not have the resources to undertake that mission.”
Instead, Taliban fighters swept into the city. The militant group later formed a government made up entirely of its own hardliners. The U.S. was out, and Khalilzad's mission was over. He left the government last October.

The backstory: An Afghan-born veteran diplomat, Khalilzad was named by Donald Trump as special representative for Afghanistan reconciliation in 2018 and retained by President Biden.

Both presidents wanted out of Afghanistan. While Khalilzad says he viewed the U.S troop presence as its primary leverage over the Taliban, both presidents saw it as a "burden."

Khalilzad says he and others argued internally that Biden should leave troops in Afghanistan until certain conditions were met — in particular, some form of intra-Afghan agreement on the future governance of the country.

"I said, 'No, I cannot guarantee that there will be a political settlement, but it will provide us leverage with the Taliban,'" Khalilzad recalls. "The president thought we might never get to an agreement and we might get stuck there."
Between the lines: Biden's pessimism was hardly unreasonable, given the lack of progress in intra-Afghan talks prior to the fall of Kabul.

Now in power, the Taliban are held hostage by some of its more hardline elements, Khalilzad contends.

For example, he says most senior Taliban officials believe girls should be allowed an education, and yet the Taliban government has offered a series of shifting explanations as to why schools can't yet be reopened.
"They emphasize unity because they don't want to fight each other, but at the same time there are clear differences inside," Khalilzad says. "That makes it frustrating dealing with them, because ... all factions have to agree before they can give a definitive response."

Until the group moves toward a more inclusive government and society, it won't gain broad acceptance domestically or recognition and sanctions relief internationally, Khalilzad argues.

That means the U.S. still has leverage in Afghanistan, Khalilzad insists. And now the administration isn't operating on a tight timetable or worried about risks to U.S. troops.
"The question is whether there can be a trade-off — what would we do in exchange for what they do."

What to watch: Khalilzad says his understanding is that the U.S. has signaled to the Taliban that it would be open to talks if two conditions are met: that American detainee Mark Frerichs be released and that schools be reopened to girls.

A State Department spokesperson told Axios those were "two key priorities of ours" and that "a lack of progress will hinder improvement in our relationship with the Taliban."

2. Afghanistan after the withdrawal: An economic calamity

Photo illustration: Sarah Grillo/Axios. Photo: Ami Vitale/Getty Images

One year after the U.S. withdrew and the Taliban retook control of Afghanistan, the country remains a nation in anguish, Axios’ Laurin-Whitney Gottbrath writes.

The big picture: The Afghan people have borne the brunt of a collapsed economy, deepening humanitarian crisis and deteriorating human rights situation.

In the year since the withdrawal, life for most of the 40 million Afghans has in many ways only gotten worse.

As of Aug. 15, 2021, "the Afghanistan we knew was gone and it wasn't going to come back," says Obaidullah Baheer, a lecturer at the American University in Kabul.
Per capita income is down to about $375 per year, its lowest level in over a decade. Nearly 20 million people face acute food insecurity.

The economy has imploded, in part because prior to 2021, foreign aid accounted for 75% of public spending.

Sanctions on the Taliban have led many banks outside of the country "to restrict or block the processing of most transactions involving Afghan bank accounts," according to Human Rights Watch.
"The economic withdrawal [in Afghanistan] that followed the military withdrawal was pretty immediate," David Miliband, president of the International Rescue Committee, tells Axios.
The U.S. decision to freeze billions of dollars in foreign reserves belonging to Afghanistan's central bank has left the bank incapable of carrying out many of its essential functions, Axios' Felix Salmon reports.

Go deeper: Taking from Afghanistan's poor

3. Part II: Hopelessness is not a luxury we can afford

Photo illustration: Sarah Grillo/Axios. Photos: Daniel Leal/AFP, Wakil Kohsar/AFP via Getty Images

Meanwhile, the Taliban promised the world they had changed, especially on human rights.

State of play: A year later, the group's promises remain largely unfilled. Schools are still closed to most girls and young women after sixth grade.

Women also face several restrictions reminiscent of the crackdown on freedoms they faced during the last time the Taliban ruled.
At the same time, Taliban officials have cracked down on the media, and human rights groups have documented arbitrary arrests and summary executions of dissidents.
Though the violence has been drastically reduced, deadly attacks and security challenges persist.

Outside of Afghanistan, tens of thousands of Afghans have been evacuated and are either piecing together new lives in the U.S. or stuck in limbo in third countries such as Qatar and the United Arab Emirates, awaiting resettlement.

Inside Afghanistan, hopelessness is "not a luxury we can afford," Baheer concludes, recognizing the long road ahead.

"I don't even want to admit to myself that I feel hopeless because that is the only thing we have. That is what will keep us going."

Go deeper: Afghanistan a year on, in photos

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We’ll start in the capital (No. 1).
Next, we’ll head to Basque Country. First, a trip to the Guggenheim in the region’s largest city (No. 2), then some fine dining on the Bay of Biscay in this city (No. 3) near the French border that glitters with Michelin stars.
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Bonus: If you’ve got the time, why not unwind on the beaches of (No. 11).

Scroll to the bottom for the answers.

4. Evacuation decisions left to last minute: GOP report

Afghans await evacuation at the Kabul airport. Photo: Wakil Kohsar/AFP via Getty Images

The Biden administration left key decisions on how to evacuate civilians from Kabul until the final hours before the city fell to the Taliban, a new report from Republicans on the House Foreign Affairs Committee claims.

Why it matters: Biden acknowledged after the chaotic U.S. withdrawal that his administration had not anticipated that Kabul would fall so quickly, but insisted that "we planned for every contingency." The report contends that delays in that planning proved costly.

Zoom in: According to the report, the U.S. military was ordered to begin planning for a civilian evacuation operation in April, four days before Biden announced the unconditional withdrawal.

Multiple tabletop exercises were held to review the possible scenarios, including one on Aug. 6, the week before Kabul fell, which senior administration officials attended.
But one of the generals tasked with planning the evacuation, Brig. Gen. Farrell J. Sullivan, told Army investigators, “There seemed to be a disconnect between what we were seeing on the ground and the urgency [State Department officials] were displaying."
As of Aug. 14, the day before the Taliban takeover, the U.S. still hadn't worked with third countries to establish transit hubs where evacuees could be temporarily housed, the report claims.

In a lengthy statement to Axios, National Security Council spokesperson Adrienne Watson claimed the report was "riddled with inaccurate characterizations, cherry-picked information, and false claims."

Read the full story.

5. Biden stumbled in Kabul but bounced back in Ukraine, allies say

Taliban celebrate the anniversary of taking Kabul today. Photo: Paula Bronstein/Getty Images

I asked diplomats from two close allies whether the chaotic withdrawal damaged their trust in Biden and whether he had recovered that trust since.

What they're saying:

"It was a shock, and it will remain a shock. There was also kind of brutality in leaving that way, and in the fall," one diplomat told Axios, describing the decision as "another version of America First." Consultations with coalition partners about the withdrawal had been "more cosmetic than profound," the diplomat added.
"We were very surprised, but I don't think we ever thought, 'These people are incompetent,'" the other diplomat said. "I think sometimes they come with a know-it-all approach that leads them to make mistakes."

But both said confidence in Biden had grown significantly since the fall of Kabul, particularly due to his handling of Ukraine.

"You could see the difference in the approach, in the messaging. It was much more coordinated and it was easier to speak with one voice [as allies]," the first diplomat said.
"Definitely we saw an improvement of the U.S. image over the past year, and it definitely starts with Ukraine," the second added. "We see that the U.S. is not withdrawing from the world."

Go deeper.

6. Contentious result in Kenya

Odinga supporters protested in Nairobi after the results were announced. Photo: Donwilson Odhiambo/Getty Images

William Ruto defeated Raila Odinga by a margin of 50.5% to 48.9% to win Kenya's presidential election, the chair of Kenya's electoral commission announced today.

Driving the news: The announcement was contentious.

A scuffle broke out ahead of the ceremony, which four members of the electoral commission boycotted. They said the vote-counting process was opaque and they could not associate themselves with the results.
In Kisumu, an Odinga stronghold, police have used teargas tonight to disperse protests.

The backstory: Ruto is currently serving his second term as deputy to outgoing President Uhuru Kenyatta, but after a public split with Ruto, Kenyatta endorsed his erstwhile rival Odinga. That set the stage for a combative campaign, with Ruto prevailing in a minor upset.

A charismatic populist, Ruto centered his campaign around his humble origins and “hustler” mentality.

What to watch: Kenya saw widespread post-election violence in 2007 and 2017.

The election itself was peaceful, but it's unclear whether Odinga will challenge the results. He was not seen at today's ceremony, which Ruto attended.

More global headlines:

Paraguay Vice President Hugo Velázquez Moreno plans to resign after he was included on a U.S. corruption list.
The Iranian government denied any involvement in the stabbing of author Salman Rushdie, but placed the blame for the attack on Rushdie and his supporters.

7. Stories we're watching

Watching the news in Nairobi, on the eve of Kenya's election. Photo: Ed Ram/Getty Images

Myanmar court sentences Aung San Suu Kyi to 6 more years
Putin critic Alexei Navalny says he's in solitary confinement
Griner to appeal sentence
Fire at Egyptian church kills at least 41
South Korean president pardons Samsung heir Jay Y. Lee
More U.S. lawmakers visit Taiwan after Pelosi trip
Gerhard Schröder sues German parliament over lost allowance

Quoted:

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— Frank Bakke-Jensen, director-general of fisheries in Finland, on the decision to euthanize a beloved walrus named Freya who spent the summer hanging out on boats in a fjord.

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Answers: 1. Madrid; 2. Bibao; 3. San Sebastian; 4. Pamplona; 5. Barcelona; 6. Valencia; 7. Grenada; 8. Malaga; 9. Sevilla; 10. Toledo; 11. Mallorca.

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2022-08-16 Axios

Tue, 16 Aug 2022 10:05:33 GMT

Keep reading for more iconic photo spots

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Axios Chicago

By Justin Kaufmann and Monica Eng · Aug 16, 2022

Happy Tuesday! Today is National Tell a Joke Day.

Here's one: Why does a Chicago-style hot dog always lose races? Because it refuses to ketchup.

Today's weather: Gorgeous. Sunny with a high of 75.

❤️ Thanks to our members for supporting local journalism. Join them by becoming an Axios Chicago member.

Today's newsletter is 807 words — a 3-minute read.

1 big thing: Climate money for Illinois

Illustration: Victoria Ellis/Axios

This week President Biden is expected to sign the Inflation Reduction Act (IRA) which includes an unprecedented $370 billion for climate change mitigation.

Why it matters: Much of the climate money is directed at getting folks like us to switch to more sustainable energy sources for our homes and transportation.

When it comes to Illinois-level effects, many details still have to be worked out, but a few points are emerging.

Zoom in: Illinois Environmental Council executive director Jen Walling says passage of last year's Climate Equity Job's Act puts the state in a good spot to use the money for projects already in the pipeline.

On cars: Illinois currently offers a $4,000 rebate for the purchase of an electric vehicle (EV), but the IRA could boost that rebate to $7,500 for a new EV or $4,000 for the purchase of a used EV.

Some factors that could affect rebate amounts include a buyer's income and where the car and batteries are made.

On energy production: U.S. Sen. Tammy Duckworth's office says it expects the state will benefit from the measure's $10 billion in investment tax credits for new solar and wind energy production.

Her office notes that production would happen statewide, considering that southern Illinois' flat topography is "ideal for large-scale solar and wind installations."

On energy efficiency: The IRA includes 10 years of tax credits and rebates for homeowners to install efficient windows, doors, heat pumps, insulation, water heaters and solar panels that could reduce their energy bills substantially.

Yes, but: Seth Whitehead of the Illinois Petroleum Resources Board contended recently on Chicago Tonight that many battery components still rely on overseas mining that environmentalists oppose.

He also predicted that renewable home energy will be pricier than some assume because their intermittent nature can require "backup with either natural gas or batteries."

The other side: "We have electrified apartment buildings in Logan Square [with electric heat pumps] without backups, and they got through last winter fine," says Ann McKibben of energy nonprofit Elevate.

"Residents of the building said last winter that they were quite comfortable," she said, "but every home is different."

The bottom line: Switching to cleaner energy isn't free, but once the IRA's provisions are finalized, the cost of Illinoisans' investments in sustainable energy is likely to drop considerably.

Share this story

2. Chart of the day: 100+ degrees

Data: First Street Foundation; Map: Erin Davis/Axios Visuals

The resources needed to fight climate change in our area couldn't come soon enough.

Driving the news: A new study suggests that extreme heat and a new Extreme Heat Belt could emerge by 2053, adding one day when the heat index could reach 125°.

The region includes Chicago, St. Louis, Kansas City, Memphis and Tulsa.

Details: The findings come from an analysis of current and future extreme heat events published yesterday by the First Street Foundation and reported on by Axios Generate.

🔎 Search your risk by address, ZIP, city or county.

3. Tips and hot links

Illustration: Brendan Lynch/Axios

🧑‍⚖️ A federal judge denied a request from R. Kelly's defense team that would exclude any potential jurors who have seen Lifetime's "Surviving R. Kelly" docu-series. (Tribune)

🍕 Home Run Inn Pizza is recalling more than 13,000 pounds of frozen meat pizzas due to a high health risk. (ABC 7)

🚔 Police charged a man, who reportedly has confessed, with sexually assaulting women downtown and fleeing on a motorized skateboard. (Tribune)

🏀 The Sky will face the New York Liberty in the first round of the WNBA playoffs. (NBC Sports).

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4. Readers: Spectacular wedding photos

Rachel L: "We took ours in the middle of Lasalle near the Board of Trade."

We recently reminded you about the Magnificent Mile's free wedding contest for couples who want to get married under the Wrigley Building arches. Then we asked for other iconic spots to take wedding shots around town.

Here are some fabulous Chicago area shots from the best readers in town:

Karen and her beau got these shots at Rockefeller Chapel and Lincoln Park.

Karen R. recommended Rockefeller Chapel at U of C.

Barb W. said, "We took ours at the People's Gas Honeycomb Pavilion in Lincoln Park. This is from just after the wedding."

Photos courtesy of Adam and Liane G.

Adam G. (left) sent in his wedding and engagement photos saying "the best shot in the city is standing right at the intersection of the north branch and main branch of the Chicago river, with the Lake St. Bridge in the background."

Liane G. (right) said she and her husband "liked the industrial look of Chicago for our (2007) wedding."

Matt R. recommended the Calder statue and Mies-designed post office in Federal Plaza for a cool location.

Olive Park. Photo: Monica Eng/Axios

Pamela S. chimed in, "We just got married at Olive Park last week."

Pam didn't send a picture, but Monica caught this at Olive as she biked through on Friday.

Over 1 million readers now wake up to Axios Local in their inbox. You can reach these smart professionals in their hometown.

2022-08-16 Axios

Tue, 16 Aug 2022 10:05:34 GMT

Read the rest in Axios Health Tech Pro.

Axios Vitals

By Tina Reed · Aug 16, 2022

Good morning, Vitals readers. Today's newsletter is 982 words or a 4-minute read.

Situational awareness: Biden is due to sign the IRA today, sealing the biggest health legislation since the ACA.

1 big thing: States fed up with feds over monkeypox

Data: CDC, U.S. Census; Chart: Erin Davis/Axios Visuals

The Biden administration is facing increasing criticism from frustrated state health officials over a hard-to-use system for distributing monkeypox vaccines that's slowing their ability to quickly reach patients, Axios’ Arielle Dreher and I write.

Why it matters: Every delay intensifies concern that the government is fumbling the early response to another emerging health threat that could lead to uncontrolled disease spread in the general population.

Typically vaccines, including COVID-19 shots, are distributed through a CDC-run system that is integrated with state databases that track vaccinations and doses, the New York Times reports.

But the monkeypox vaccine is being distributed by the National Strategic Stockpile, overseen by a different agency under the Department of Health and Human Services, which is not linked to state databases, per the Times. It's led to instances in which hundreds of doses were routed to the wrong states or lost in transit.

What they're saying: "We had no way to track vaccine shipments, when they actually shipped or when they were going to arrive," Chris Van Deusen, a spokesperson for the Texas Department of State Health Services, told the Times. "They just showed up with no notice."

Driving the news: HHS announced Monday it's accelerating its planned delivery of additional Jynneos vaccine, making up to 442,000 doses available for states and jurisdictions to order weeks earlier than originally planned.

That's in part a response to the nation's new strategy to stretch supplies via intradermal injection, between skin layers. This will allow providers to use one vaccine vial for five injections.
But there's been limited CDC training to administer shots that way, which could further delay vaccinations, Jennifer Mahn, clinical and sexual health director at the National Coalition of STD Directors, told Axios.
The manufacturer of Jynneos also warned senior Biden administration health officials about splitting the shots due to limited safety data, the Washington Post first reported.

Between the lines: The frustration with the response is spreading to Congress, where some lawmakers are questioning why HHS isn't freeing up a smallpox drug called tecovirimat, or TPOXX, for treating monkeypox from the Strategic National Stockpile.

What to watch: Though the government has ordered more vaccine, the immediate pressure is on local public health providers to get what's available in the arms of people most at risk.

2. Axios-Ipsos poll: Vacations trump COVID worries

Data: Axios/Ipsos poll; Chart: Danielle Alberti/Axios

Americans aren't taking steps to avoid COVID-19 before going on vacation and appear to have little bandwidth for another health crisis like monkeypox, Axios' Adriel Bettelheim writes about the latest installment of the Axios/Ipsos Coronavirus Index.

Why it matters: Our perception of personal risk has fallen to a point where travelers' most common precaution is just to wash or sanitize their hands more frequently — and fewer than half even do that.

"We're dealing with the scar tissue of the pandemic," said Cliff Young, president of Ipsos U.S. Public Affairs. "Public opinion has been beaten down, and many people don't know if it's just easier to go on without taking extra precautions."

By the numbers: Half of the 1,047 adults interviewed said they'd gone on vacation or taken trips to see family or friends in the past three months.

More than seven in 10 said they didn't take precautions like wearing masks or limiting socializing to reduce the risk of getting COVID-19 before vacation.

What to watch: The findings also suggest that while 53% say they've heard about the monkeypox outbreak, the public largely views it as a problem affecting others.

Share this story.

3. Extension is likely for public health emergency

The administration appears headed toward extending the COVID-19 public health emergency for another three months, allowing special powers and programs to continue past the midterm election, Adriel writes.

Driving the news: HHS had extended the emergency declaration through Oct. 13 and pledged it would give states and health providers 60 days' notice before it ends.

Why it matters: Lifting the emergency would bring major policy shifts to insurance markets, drug approvals and telehealth.

It also keeps in place a higher share of federal Medicaid spending if states offered continuous coverage to enrollees, avoiding the program's usual churn.
Ending the emergency would lead states to determine whether their Medicaid enrollees are still eligible for coverage — a huge undertaking that could result in millions of Americans being removed from the program.

Where things stand: After a long plateau, the number of new COVID cases have been falling and wastewater surveillance data has shown declines for three straight weeks, per Evercore ISI.

And yet, about 400 Americans still die every day from COVID-19.

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4. Estimated insulin savings from IRA

Medicare beneficiaries who pay for brand-name insulin would save $840 a year in drug costs to cost-sharing caps included in the Inflation Reduction Act, according to a report from the Council for Informed Drug Spending Analysis.

Zoom in: Under the IRA, Medicare beneficiaries would pay a maximum of $35 a month, or $420 a year, for insulin using their Part D benefit.

Those who use more expensive insulins, like Tresiba, could save more than $1,500 a year, per CIDSA.

Yes, but: Language that would apply the $35 monthly cap on insulin to private insurance was stripped from the bill.

5. Scoop: Dr. B raises $8M for COVID telehealth

Illustration: Gabriella Turrisi/Axios

Vaccine waiting list startup Dr. B raised $8 million as it pivots to the next phase of the pandemic: virtual COVID treatment distribution, CEO Cyrus Massoumi told Axios' Erin Brodwin.

Why it matters: As COVID surges continue and public health agencies relax their safety guidelines, demand for antiviral medications such as Paxlovid is on the rise — but data suggests the drugs aren't getting to those who need them most.

Massoumi, who also founded doctor-patient matching startup Zocdoc, plans to offer the antivirals free to those who can't afford them.
"My greatest regret at Zocdoc is we never did enough to help the people who couldn’t afford coverage," says Massoumi. "I always told myself with my next health care company I’d solve both parts of that equation — accessibility and equity."

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2022-08-16 Axios

Tue, 16 Aug 2022 10:05:40 GMT

Criminal justice reform advocates have long questioned how the lack of access to technology in American prisons can impact an individual's ability to adapt to an increasingly digital society. Join Axios for a virtual event examining the impact technology and connection can have on reducing recidivism and improving social and economic outcomes for those who are incarcerated.

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2022-08-17 Axios

Wed, 17 Aug 2022 10:08:52 GMT

Axios Vitals

By Tina Reed · Aug 17, 2022

Happy mid-week, Vitals readers. Today's newsletter is 1,057 words or a 4-minute read.

1 big thing: Congress isn't done with messy health care fights

Illustration: Aïda Amer/Axios

The Inflation Reduction Act is law. But that doesn't mean major health care interests are done testing their lobbying clout.

Many are already lining up for year-end relief from Medicare payment cuts, regulatory changes and inflation woes, Axios' Victoria Knight writes.

The big picture: Year-end spending bills often contain health care "extenders" that delay cuts to hospitals that treat the poorest patients or keep money flowing to community health centers.

But lawmakers may be hard-pressed to justify the price tag this time, and are seeing an unusual assortment of appeals for help.

Background: 2% Medicare sequester cuts that had been paused by the pandemic took effect last month. Another 4% cut could come at year's end if lawmakers don't delay it.

These automatic reductions in spending come amid health labor force shortages, supply chain problems and other pressures that are making providers jockey for relief.
It will fall to Congress to pick winners and losers among hospitals, physicians, home health care groups, nursing homes and ambulance services. And each says the consequences of not helping are dire.
"The core question is how do they come up with the money and how do they decide to prioritize who give it to?" said Raymond James analyst Chris Meekins.

The other side: Concerns about Medicare's solvency that emerged during the lengthy debate over the Democrats' tax, climate and health package could dampen lawmakers' enthusiasm for extensive payment fixes.

The continuation of the COVID-19 public health emergency and its myriad temporary payment allowances could also lessen a sense of urgency around provider relief.

The bottom line: For all the dire warnings, it's unlikely Congress will do much until December, when it will likely pass a continuing resolution or an omnibus spending bill and could then move to delay the 4% cut.

2. Who wins — or loses — with OTC hearing aids

Photo: Joe Raedle/Getty Images

People with hearing loss could soon buy hearing aids without needing to have an exam, prescription or special fitting first.

Driving the news: In a move years in the making, the FDA on Tuesday issued a final rule allowing over-the-counter sales of hearing aids to adults with mild or moderate hearing loss. Kids and those with serious hearing loss will still need a prescription.

They could become available as soon as October when the rule takes effect.

Who wins with this rule?

Patients with hearing loss: This change officially creates a new category of hearing aid that's expected to reach a far broader audience who may have previously avoided hearing aids due to cost and stigma. It's also expected to shake up prices and spur innovation across the market.
Consumer electronics manufacturers: This will allow more companies to move into a space now dominated by specialty companies like ReSound, Sonova and William Demant, wrote Cowen analyst Eric Assaraf.
Biden and the Dems: We're not trying to be cynical. But along with the health care wins in the Inflation Reduction Act, the timing of this — five years after Congress gave its blessing to the idea and less than 90 days before the midterms — just so happens to work out great for vulnerable Democrats.

Who loses?

Manufacturers/hearing care: As Republican Sen. Chuck Grassley said, this would "lower prices" for consumers and result in "more competition" — which could hurt the bottom line of incumbents. Early estimates say consumers who purchase hearing aids in this category could save $2,800 per pair.
Patients with hearing loss: Industry groups, like the Hearing Industries Association, have backed this move with a caveat, arguing consumers who skip seeing a doctor for hearing trouble may not get timely diagnosis and treatment for more serious problems.

🎙 Listen in: Axios Today podcast host Niala Boodhoo and I discuss OTC hearing aids.

3. Some NIH-funded trials never report results

Illustration: Eniola Odetunde/Axios

The National Institutes of Health did not take action against institutions and labs running government-funded clinical trials that failed to report results despite requirements to do so, Axios' Arielle Dreher writes about a report from a federal watchdog.

Why it matters: Clinical trial results are crucial to pushing science forward, informing future researchers what methods or techniques might or might not work for future study design.

What they found: The HHS Office of the Inspector General reviewed 72 NIH-funded clinical trials from 2019 to 2020.

Half of the trials were conducted in NIH facilities; half were conducted at external universities or research sites.
Just 35 of these trials submitted clinical trial results on time; a dozen trials submitted results late; 25 trials never submitted results.
NIH took "limited enforcement action" against labs and research partners who did not submit results and even continued to fund new research done by these groups, the report found.

Of note: NIH agreed with all of the recommendations from the OIG report, including making needed improvements to its reporting procedures and enforcement methods.

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4. GOP support grows for Medicaid expansion

Note: South Dakota voters will vote on Medicaid expansion in November; Data: KFF; Chart: Axios Visuals

Republican-led states that have resisted expanding Medicaid for more than a decade are showing new openness to the idea, Axios Raleigh's Lucille Sherman and Axios Atlanta's Emma Hurt report.

Driving the news: In the decade-plus since the landmark Affordable Care Act was enacted, 12 states with GOP-led legislatures still have not expanded Medicaid coverage to people living below 138% of the poverty line (or nearly $19,000 annually for one person in 2022).

But there's evidence the political winds are changing in holdout states like North Carolina, Georgia, Wyoming, Alabama and Texas.

State of play: In Georgia, as first reported by Axios Atlanta, conversations about a path forward have been taking place behind the scenes in both parties.

This follows the stunning support of full expansion legislation by North Carolina's top Republican this spring, first reported by Axios Raleigh.

What they're saying: "There is real momentum on Medicaid expansion in these conservative states that have been holding out," said Melissa Burroughs of Families USA, a health care advocacy group working with partners in non-expansion states to push the policy.

5. Catch up quick

President Biden shakes hands with Sen. Joe Manchin after signing the Inflation Reduction Act. Photo: Drew Angerer/Getty Images

🍼 The Centers for Medicare and Medicaid Services approved extending Medicaid and Children's Health Insurance Program postpartum coverage for 12 months in Hawaii, Maryland and Ohio. (HHS)

🏥 Investors are scooping up failing rural hospitals for as little as $100 in exchange for their commitment to restore and keep the facilities open. (NPR)

💰 ICYMI: Drugmakers are launching new medicines at record-high prices, with the median annual price of 13 novel drugs approved for chronic conditions by FDA so far this year topping $257,000. (Reuters)

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2022-08-17 Axios

Wed, 17 Aug 2022 10:08:54 GMT

Read the whole Axios story

Presented By Xero

Axios Chicago

By Monica Eng and Justin Kaufmann · Aug 17, 2022

🐫 Happy Wednesday! You made it to hump day.

Today's weather: Continued gorgeousness. Sunny with a high of 81.

🏀 Situational awareness: Tonight, the Sky start their playoff journey to defend their WNBA title. They take on the New York Liberty at Wintrust Arena in a best-of-three-game series.

Today's newsletter is 940 words — a 3.5-minute read.

1 big thing: A South Side 606

Photo: Chicago Department of Planning and Development

Last week the U.S. Department of Transportation announced a $20 million grant for a nature trail in Englewood along an old railroad corridor.

Why it matters: Like the 606 Bloomingdale Trail, the Englewood Nature Trail could rejuvenate its area with safer recreation and transportation.

But organizers hope to avoid one big pitfall of the 606: gentrification and displacement.

U.S. officials specifically noted planners' work to address "potential impacts such as gentrification, displacement, and equitable employment opportunities," in their announcement.

What they're saying: "We want to create protective measures for residents to help build community ownership and a future here," Grow Greater Englewood (GGE) lead steward Anton Seals tells Axios.

He plans to do so with community engagement, compacts, ordinances and land trusts.

Yes, but: He stresses that Englewood — with its huge rate of vacancies — is starting with a very different real estate landscape than Bucktown and Logan Square did ahead of the 606.

Flashback: Community members started planning the Englewood project more than a decade ago.

But last spring it got a boost when Mayor Lori Lightfoot pledged $6 million in city money and said officials would apply for federal funding.

Zoom in: The trail is projected to run between 58th and 59th streets, stretching for 1.75 miles from Lowe (700 West) and Hoyne (2100 West) Avenues.

It's meant to link local urban farms and "transform a vacated rail corridor into a naturalized space for residents to enjoy and use to connect with nature," according to the GGE website.

What's more: DOT officials see it as "an alternative, safer [travel] option for residents."

They note that within a half-mile of the trail, "there were more than 4,000 crashes between 2016 and 2020 — 11 of which were fatal."

What's next: Community members can attend a planning meeting on Sept. 8 and offer feedback here.

Organizers aim to finish the first phase of the trail by 2027.

2. Survey of the day: Why people leave

Image credit: Data: Axios/Ipsos; Chart: Jacque Schrag/Axios

A lot has been made about people leaving Illinois and where they are heading. But why are most people in the U.S. moving at all?

The big picture: A new Axios/Ipsos Two Americas Index survey finds Democrats and Republicans have more differences than similarities when it comes to reason for relocating from state to state.

Republicans are more likely to move over finances, while Democrats move at higher rates for personal and family reasons.

What's more: The survey also shows Democrats are more likely to move to "blue states" while Republicans stick with "red" ones.

3. Tips and hot links

Illustration: Brendan Lynch/Axios

✈️ Chicago-based United Airlines will hire hundreds of new employees to combat staffing shortages and delays. (ABC7)

🌳 Little Village and Lawndale residents are feeling "sad" and "ignored" by the city and park district over the disrepair of Douglass Park after this summer's music festivals. (Block Club)

🩰 The Joffrey Ballet is launching a contemporary ballet training program, the first of its kind in the country. (Tribune)

⚾️ Justin Verlander outdueled Dylan Cease, but the Sox came from behind for another big win against the Astros. (ESPN)

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4. Exploring those new Wild Fork stores

Frozen canapes and empanadas at Wild Fork. Photo: Monica Eng/Axios

Hey, it's Monica. Last year I noticed a bunch of mysterious "meat and seafood" stores called Wild Fork popping up around the Chicago area, including one on Belmont near home.

After passing by for months, I recently stopped in for a peek.

The intrigue: I was amazed by the offerings from this Brazilian company with a U.S. base in Florida.

Beyond meat and seafood, it offers high-quality plant-based proteins, desserts, pasta, appetizers, vegetables, side dishes, spices, sauces and grilling supplies.

Also there are frozen cassava, plantains and Brazilian cheese balls.

The big picture: Everything here is what they call "blast frozen," which is supposed to keep food super fresh. I don't know much about freezer technology, but I do know most of this stuff tastes great.

In addition to mainstream meats, Wild Fork offers yak, ostrich and venison. Photo: Monica Eng/Axios

The highlights: Grass-fed, dry-aged skirt steak ($22.98/lb) that seared up nicely in a cast-iron pan and gave us two days of tacos.

Juicy Argentine chorizo ($4.48) that paired beautifully with peppers and onions.
Fun, Argentine-style grilling cheeses on a stick ($9.98).
Buttery, skin-on salmon steaks ($7.78/lb) that make dinner easy.

Rare surprises: Elk, bison, ostrich, yak, foie gras, blood sausage and A-5 wagyu beef.

Yes, but: A slightly gritty flan and dryish eggplant parmigiana were both just OK.

Between the lines: As a half-Latina whose partner lived in Argentina for years, I'm thrilled to find a place that lets us host a South American grilling party in a snap, but also offers so much more.

For those looking for dry-aged, grass-fed, pastured, organic, heritage or antibiotic free meat, Wild Fork has your number.

What's next: I'm trying to avoid visiting Wild Fork too often, because there's a lot more that I want to try but that won't fit in my freezer.

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2022-08-18 Axios

Thu, 18 Aug 2022 10:05:15 GMT

Axios Vitals

By Tina Reed · Aug 18, 2022

Good morning, Vitals readers.

💩 We'll start with 1 interesting thing: Curious about all this ado about wastewater and disease surveillance? The New York Times now has a "photographic journey" showing how it works.

Yes, they even have "the gross part."

With that, on to today's newsletter, which is 851 words or a 3-minute read.

1 big thing: CDC's fix-it plan is good, but not enough

Illustration: Megan Robinson/Axios

Public health experts say the CDC's new plan to reform itself is generally a good plan — but without much bigger, more fundamental changes, the U.S. might continue to be caught flat-footed by new threats, Axios' Caitlin Owens writes.

The big picture: Systemic failures at the CDC have sown public distrust in health experts over the past three years, but America's public health problem is much bigger than any one agency — and the politicization of the COVID pandemic only made things worse.

Driving the news: The CDC yesterday vowed to change course after COVID thrust its shortcomings into the spotlight.

The agency's diagnosis of itself as too slow, too academic and too confusing to the public is spot-on, experts told Axios.
"It is undeniably right that a system that is set up to deal with a relatively stable status quo is not equipped to handle rapid change. This recognizes that," Harvard epidemiologist Bill Hanage said.

State of play: The country's public health problems are piling up.

COVID-19 still kills around 400 people a day in the U.S., and around 100,000 new cases are still being reported each day.
Meanwhile, experts are losing hope that monkeypox can be contained, at least in the short term, after the U.S. fumbled its initial response.
A polio case was recently detected in New York, the first reported case since 2013. Wastewater samples indicate the virus may have been circulating since as early as April.
Vaccine rates for other diseases plummeted during the pandemic and anti-vaccine sentiment is on the rise.
On top of all that, the country's public health workforce is short-staffed and burned out.

The bottom line: How the CDC's reforms are implemented will be crucial, experts say, and there's plenty of work outside of the agency to be done.

2. Scramble to make more monkeypox vaccine

Photo: Kobi Wolf/Bloomberg via Getty Images

Bavarian Nordic, the manufacturer of the world's only monkeypox vaccine, is unsure it'll be able to keep up with the demand for the shots, Bloomberg reports.

Why it matters: The company, which produces the vaccine Jynneos, is searching for partners to help it quickly ramp up production, a move it previously said would be too cumbersome and expensive, per Bloomberg.

"Demand keeps rising and it's no longer certain that we can continue to meet the demand we're facing even with the upgrade of our existing manufacturing site in Denmark," Rolf Sass Sorensen, a vice president at Bavarian Nordic, told Bloomberg on Wednesday.

State of play: Infections jumped 20% over the last week, according to the World Health Organization.

There are now more than 35,000 confirmed cases total in 92 countries worldwide.

Zoom in: This week, the U.S. increased its contract with the company for Jynneos vaccines to $1 billion as HHS announced it would make 442,000 new doses available for states.

Bavarian Nordic has previously said it has the capacity to make 30 million to 40 million doses of Jynneos. However, some experts say they believe the company's true capacity is likely as low as 20 million, NPR reported.

3. FDA approves $2.8M gene therapy

The FDA yesterday approved Zynteglo, a gene therapy from Bluebird Bio that treats patients with the blood disorder beta-thalassemia.

Why it matters: The one-time treatment — which helps patients who depend on regular blood transfusions and face decreased life expectancy — comes at a record price of $2.8 million.

It's only the third gene therapy approved by the FDA.

Details: Bluebird estimates there are between 1,300 and 1,500 people with beta-thalassemia, also known as beti-cel.

The company plans to use an outcome-based agreement, saying it'll reimburse insurers up to 80% of the cost of the therapy for any patients who still need regular transfusions after their treatment.

What they're saying: The Institute for Clinical and Economic Review, a group that evaluates drug pricing and effectiveness, said in a statement the drug has high long-term value, even with a price tag over $2 million.

The bottom line: Gene therapies offer a particular source of promise for treating rare diseases. But they've proved costly so far and the growing pipeline of such treatments could lead to staggering health care spending.

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4. Quote du jour

Photo: Fabrice Coffrini/AFP via Getty Images

"I haven't heard in the last few months any head of state talking about the Tigray situation anywhere in the developed world. Anywhere. Why? ... Maybe the reason is the color of the skin of the people in Tigray."

— WHO Director-General Tedros Adhanom Ghebreyesus, speaking yesterday about the humanitarian crisis caused by the ongoing conflict in Ethiopia.

5. Pharmacies must pay $650M in opioids suit

Photo: Paul Weaver/SOPA Images/LightRocket via Getty Images

A federal judge yesterday ordered three of the country's largest pharmacy chains — CVS, Walgreens and Walmart — to pay $650 million to two Ohio counties, claiming the way they distributed opioids caused severe harm and created a public nuisance, Axios' Laura Martinez writes.

Why it matters: It is the first ruling by a federal judge to put a price tag on pharmacies' role in the opioid crisis.

It comes after a jury returned a verdict against the retailers in November, saying they had a hand in hundreds of overdose deaths.
The proceedings could set a precedent for other local governments.

What's next: CVS, Walmart and Walgreens disagreed with the court decision and said they will appeal.

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2022-08-18 Axios

Thu, 18 Aug 2022 10:05:20 GMT

Two more amazing fair foods

Presented By Xero

Axios Chicago

By Justin Kaufmann and Monica Eng · Aug 18, 2022

Happy Thursday! On this day in 1982, the Cubs lost 2-1 to the Dodgers at Wrigley Field. The 21-inning game was played over two days, because Wrigley didn't have lights yet.

🌞 Today's weather: The hits keep coming! Sunny with a high of 83.

Situational awareness: Today's newsletter features stories from Michigan, Wisconsin and downstate Illinois — enjoy!

Today's newsletter is 902 words — a 3.5-minute read.

1 big thing: Dems plan for November

Governor J.B. Pritzker at the Illinois State Fair. Photo: Monica Eng/Axios

State Democrats gathered for a barbecue and old-fashioned campaign rally at the Illinois State Fairgrounds yesterday.

Why it matters: Governor's Day brought speeches from the governor and the statewide slate of candidates, giving us clues on the Democrats' 2022 general election campaign strategy as they try to hold on to statewide offices and the governor's mansion.

What they're saying: "We have one message, and that's that Democrats deliver," Gov. J.B. Pritzker said at the rally. "We've delivered so much over the last four years, I had to bring a cheat sheet."

"Don't let anyone tell you differently: The Democratic party is the party of fiscal responsibility, the party of individual rights, the party of infrastructure and of public safety."

By the numbers: The two biggest issues searched online in Illinois, per Google Trends, are jobs and taxes.

So Democrats may be on to something preaching fiscal responsibility.

Yes, but: The party hasn't had a smooth election year. The election for the state party chairman was controversial, with accusations of racism.

But the governor said yesterday that the party is united and focused on retaining statewide offices and its current majorities in the General Assembly.

Zoom out: After 2021 redistricting, the state's congressional map all but guarantees Democrats will win 14 U.S. House seats.

U.S. Sen. Tammy Duckworth is also up for re-election.

Between the lines: Sen. Darren Bailey's campaign hired a plane to fly a "FireJBPritzker.com" banner over the event.

Only one problem — the website wasn't live as of last night.

The other side: Today is Republican Day at the fair, so we'll be diving into their midterm strategy in tomorrow's newsletter.

2. Fabulous fair food

A horseshoe wrap. Photo: Monica Eng/Axios

👋 Hey, it's Monica. My stomach hurts.

What's happening: I went to my first Illinois State Fair yesterday and tried to jam as much interesting fare down my gullet before heading to the Governor's Day speeches.

Eating the news: I tried 10 things, including sirloin on a stick, pork chop on a stick, and a pork twister featuring grilled tenderloin wrapped in bacon at — where else? — the Pork Patio near the Swine Barn.

But only five dishes make my must-try list:

Walking Deep-Fried Horseshoe ($9): The portable version of Springfield's signature dish of ground beef or chicken, crispy fries and house beer cheese sauce gets wrapped in a flour tortilla and deep-fried with a final flourish of, um, more cheese sauce.
- It's served at the fair's Motorheads Bar & Grill booth, but don't try to find it at their regular restaurant — it's a fair special.

Flamin' Hot Cheeto Burger. Photo: Monica Eng/Axios

2. Flamin' Hot Cheeto Burger ($12): Even if the meat patty looked a little gray, this burger was bursting with cheesy, corny, spicy flavor boosted by hot liquid cheese and pickled jalapenos.

Swiss on a stick. Photo: Monica Eng/Axios

3. Swiss 'N Rye ($7): This offering from the Wisconsin Cheese wagon features a hunk of Swiss cheese on a stick dunked in rye batter that's then deep-fried like a corndog and served with a little tub of German mustard.

The big picture: Our state fair holds its own when it comes to creative chow, but I don't recommend eating everything in a single hour.

3. Tips and hot links

Illustration: Brendan Lynch/Axios

🚙 Are car thieves targeting Kias and Hyundais? The Cook County Sheriff's office is on alert as this becomes a national trend. (Block Club)

🏀 The Sky lost to the Liberty 98-91 in Game 1 of their first-round series. They face elimination on Saturday. (Yahoo Sports)

🧑‍⚖️ Prosecutors in the R. Kelly trial alleged in their opening statements that the singer tried to cover up having sex with minors before his 2008 trial in Cook County. (Tribune)

🥐 The Bulls 2022/2023 schedule was released. The team kicks off the season in Miami and travels to Paris for a game against the Pistons in January. (NBC Sports)

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4. Where to eat, stay and play in Milwaukee

The landmark Milwaukee Public Market is open seven days a week. Photo: Milwaukee Public Market

As Chicagoans come to terms with the new CPS schedule, we might need one last summer spin.

A quick trip north could do the trick, as Axios' Sami Sparber has places to eat, drink and stay in Milwaukee.

1. Explore Milwaukee Public Market

Wind your way through the bustling stalls and pick up a fresh-baked treat or a loaded bloody mary.

Hours: Monday-Saturday 10am-8pm, Sunday 10am-6pm
Address: 400 N. Water St.

2. Visit Lakefront Brewery

Experience 45 minutes of facts and beer on a daily tour, which costs $12 on weekdays and $13 on weekends. Afterward, stop in the beer hall for cheese curds.

Hours: Monday-Thursday 3pm-9pm, Friday and Saturday 11am-9pm, Sunday 11am-5pm
Address: 1872 N. Commerce St.

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5. Market Watch: Holland Farmers Market

The Eighth Street Farmers Market in Holland, Michigan. Photo: Justin Kaufmann/Axios

👋 Hey, it's Justin. On a recent trip to southwest Michigan, I made a quick stop at the renowned farmers market in Holland.

The spot: Unlike markets in Chicago that take over parks or parking lots, this market has a permanent location.

The City of Holland opens the 8th Street Marketplace every Wednesday and Saturday from 8am-2pm.

You know your town is serious about its farmers market when it gets a permanent space at the Civic Center. Photo: Justin Kaufmann/Axios

The vibe: Hundreds of people, locals and tourists alike, spread out and leisurely walk the corridor.

It was packed but easy to maneuver, especially because pets aren't allowed.

The offerings: The extensive market features everything from organic vegetables to fresh fish from the Great Lakes.

Visser Farms, in business since 1902, has great produce like German Butterball potatoes and various root vegetables.
Bowerman Blueberries has been a Holland favorite since 1954, with fresh produce and pastries like muffins and pies — and a blueberry doughnut, of course.

Read the full review

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😬 Monica was supposed to be "getting in shape" for her sister's September wedding. Now she's looking for more stretchy pants.

🚴‍♂️ Justin is ready for tomorrow's Open Office Hours at The Hideout. He is trying to pick his outfit. He's thinking Chi summer chic, which would be an Old Style tank top with gym shoes. It's either that or a full Lance Armstrong spandex bike suit. Decisions.

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2022-08-18 Axios

Thu, 18 Aug 2022 19:07:12 GMT

Get conversational in just three weeks.

Presented By Babbel

Axios World

By Dave Lawler · Aug 18, 2022

Welcome back to Axios World.

We take off tonight (1,870 words, 7 minutes) in Brazil, before stops in Taiwan in Kenya. If you're reading this in Japan, feel free to pop open a beer (see item 6).

New arrival? Subscribe.

1 big thing: Lula leads Bolsonaro as Brazil's campaign heats up

Bolsonaro at a motorcycle rally in Salvador in July. Photo: Arisson Marinho/AFP via Getty

Brazil's election campaign officially kicked off this week, with polls showing former president Luiz Inácio Lula da Silva leading incumbent Jair Bolsonaro in their titanic clash of ideologies and personalities.

Driving the news: A new Datafolha poll out this evening shows Lula up 47% to 32%. Four other recent polls showed him leading by between 7 and 12 points.

The big picture: Gustavo Ribeiro, editor of the Brazilian Report, tells Axios this is "both the most boring and most tense" election he has ever covered.

Boring, because Lula has held a consistent lead ahead of the Oct. 2 vote.
Tense, because of the intense dislike between the candidates and their supporters, and because Bolsonaro has repeatedly claimed the election will be rigged and he's threatened to reject the results.

"It would really surprise me if he doesn't try to pull some stunt like Jan. 6," possibly before the election, Ribeiro says.

The key date to watch is Sept. 7, the 200th anniversary of Brazil's independence, when Bolsonaro has called on his supporters to take to the streets.
Flashback: The far-right leader declared at a similar rally last year that only God could remove him from power. The rally fizzled out before some ardent supporters followed through on plans to storm the Supreme Court.

What they're saying: During a campaign launch Tuesday in the southeastern city where he was stabbed in 2018, Bolsonaro — whose base is comprised largely of evangelicals — proclaimed that "the creator saved my life so I could give my best for our nation as president."

At Lula's launch event, held in the industrial city where he began his career as a union leader in the 1970s, Lula remarked that Bolsonaro might be "possessed by the devil."
Lula was barred from running against Bolsonaro in 2018 due to a corruption conviction, which was later annulled. "I'm returning so we can take our country back," he declared.

Lula oversaw a dramatic reduction in poverty during a presidential tenure (2003–2011) that coincided with a commodities boom.

After a decade of turmoil for Brazil's economy and for his leftist Workers' Party (PT), Lula's pitch is that the good times will return.
Yes, but: "Public accounts are depleted, poverty rates are going up. It's a pretty nasty scenario for the economy," Ribeiro says, and Lula is "trying to avoid any specifics about his economic agenda."

Bolsonaro, meanwhile, is dramatically increasing social spending in an apparent last-ditch effort to win over low-income voters.

Mauricio Moura, a pollster and founder of IDEIA Big Data, expects him to narrow the gap as the remaining undecided voters make up their minds.
"This is an election of rejection — on the one hand of the government, on the other hand of the PT and Lula himself," Moura says. There are more voters who reject Lula but aren't yet backing Bolsonaro than vice versa, he says.

The bottom line: Bolsonaro's unpopularity makes this "a very difficult election" for him to win, Moura says, but he's expecting a close race.

Given Bolsonaro's vote-rigging allegations and the intense polarization in Brazil, a close result would make for tense times, indeed.
If neither candidate wins a majority, there will be a runoff on Oct. 30.

2. China's ambassador to U.S. issues sharp warning on Taiwan

Illustration: Annelise Capossela/Axios

China will view further U.S. arms sales, official travel to Taiwan or naval activity near the self-governing island as provocations that will further destabilize relations and prevent progress on other issues, Beijing's ambassador to the U.S. warned Tuesday.

Why it matters: Ambassador Qin Gang said if Washington doesn’t "show restraint" in the wake of Speaker Nancy Pelosi’s visit to Taiwan, there will be "another round of tensions" — and no dialogue on issues like climate change and nuclear security.

State of play: China conducted weeklong military drills after Pelosi's trip earlier this month. They appeared to be a dress rehearsal for subduing Taiwan and involved newly aggressive steps, like disregarding the median line between Taiwan and the mainland.

After Sen. Ed Markey (D-Mass.) led another delegation to Taipei on Sunday, China launched a fresh set of smaller-scale exercises.
The White House contends that China is using Pelosi's visit as a pretext to change the status quo and "intimidate and coerce Taiwan."
Qin cited his own frantic efforts to prevent the visit — using "every channel possible," he said — as evidence that China had no desire for such a pretext.

Still, both sides acknowledge that tensions over Taiwan are escalating dangerously and poisoning the broader relationship.

The U.S. plans to send naval vessels through the Taiwan Strait in the coming weeks and to approve additional arms sales to Taiwan.
Those steps would be consistent with the practices of past administrations, but Qin warned that China would see them as an escalation of tensions and be "forced to react."

The bottom line: The world's two biggest powers are on track for more rounds of tension and little serious dialogue.

The latest: Beijing warned against sending "wrong signals" after the U.S. and Taiwan today outlined plans for new bilateral trade talks.

Go deeper: U.S. and China spar on Twitter over climate change action

3. Part II: Inside the briefing

Ambassador Qin Gang. Photo: Liu Jie/Xinhua via Getty Images

At a private home in Washington's elite Kalorama neighborhood, Qin spoke on the record with a small group of reporters for 80 minutes, fielding questions on a range of sensitive issues — something of a rarity for senior Chinese officials.

It was a bit jarring to watch him transition from warm greetings to hawkish talking points, particularly on Taiwan. “The U.S. side has done too much and gone too far in this region,” he warned.
But he did concede that Beijing has work to do to improve its image in the U.S., where he found considerable "fear of China," and also Taiwan.

Pressed on the fact that most in Taiwan oppose reunification, Qin said they don't understand what "One Country, Two Systems" would mean in practice. Taiwan could even remain a democracy, he stressed.

But Qin also claimed One Country, Two Systems was alive and well in Hong Kong, despite Beijing's reassertion of direct control there.
He also made clear that Taiwan doesn't really have a choice, as reunification "must be resolved in the course of national rejuvenation," peacefully if possible.
Asked about a comment by China's ambassador to France that China will pursue "re-education" in Taiwan after reunification, Qin said that Beijing had to "reinforce our [shared] national identity."

More headlines:

China warns Israel not to let U.S. pressure hurt relations
China's 20th Party Congress looms closer
China's slowing economy

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Bonus: Where in the world?

Screenshot via Apple Maps

Can you name all 12 cities seen glowing here at night?

Some hints...

1–9 are all capital cities, and No, 1 is NOT Istanbul.
Nos. 2 and 3 are not in Israel, though they're close.
4, 5, 7 and 9 are the biggest cities here, each with over 6 million people.
You may have passed through 6 or 11. They have two of the region's busiest airports.

4. Global news roundup

Catching up on the news in Nakuru, Kenya. Photo: James Wakibia/SOPA Images/LightRocket via Getty

1. Raila Odinga has refused to concede Kenya's presidential election after official results showed him losing to William Ruto by 50.5% to 48.9%. He's planning a court challenge.

The intrigue: Four members of Kenya's electoral commission disowned the results, claiming the process was opaque. But now the chair of the commission has accused them of pressuring him to manipulate the results.
Despite the drama, Kenya has remained relatively peaceful.

2. Salma al-Shehab, a Ph.D. student at Leeds University and a mother of two, was sentenced to 34 years in prison for her Twitter activity, including retweeting Saudi dissidents.

She was first detained in 2021 while visiting her native Saudi Arabia and accused of using social media to “disrupt public order," per WaPo, the sort of charge used in Saudi Arabia to criminalize any public criticism.

3. Former Australian Prime Minister Scott Morrison had a hands-on approach to the pandemic — so much so that he appointed himself as joint head of five government agencies... without telling the country... or his Cabinet colleagues.

He says he wanted to be able to step in if a minister fell ill, but kept it secret because he worried it would be "misconstrued." His critics say that's not how democracy works.

4. A Russian ammunition depot in Crimea blew up this week in another apparent Ukrainian attack on the occupied peninsula. A senior U.S. official told Politico the U.S. has no problem with such attacks.

Meanwhile, Turkish President Recep Tayyip Erdoğan and UN Secretary-General António Guterres traveled to Lviv in western Ukraine today to meet President Volodymyr Zelensky.
ICYMI: WaPo had a good deep dive into the buildup to the war.

5. Estonia and Latvia joined Lithuania in pulling out of a forum designed to deepen China's ties with central and eastern Europe.

Views of China had already turned sharply negative in Western Europe. Beijing's support for Russia during the Ukraine invasion won't improve perceptions in the east.

5. From the Axios files...

Mystery Caps of Mexico collection by Ebbets Field Flannels. Photo: Courtesy of Ebbets Field Flannels.

1. While 81,000 Afghans have been resettled in the U.S., the State Department estimates that more than 74,000 are still in various stages of the Special Immigrant Visa process for Afghans who assisted the U.S. war effort, Axios' Stef Kight reports.

Some are in other countries, including Qatar and the United Arab Emirates. Most are trapped in Afghanistan.

2. Israeli Prime Minister Yair Lapid sent a message to the White House on Thursday that the draft nuclear agreement being discussed with Iran crosses President Biden's own red lines, Axios' Barak Ravid reports.

“In the current situation, the time has come to walk away from the table. Anything else sends a message of weakness to Iran," Lapid said.
State of play: Tehran replied to the EU's "final" proposal with additional requests, mainly on the issue of guarantees if the U.S. were to again leave the agreement. The White House denies it's considering any new concessions.

3. A new collection of re-created vintage Mexican baseball hats almost instantly sold out when it went on sale last week, illustrating the hunger fans have for uncovering the forgotten history of the ball game in Latin America, Axios' Russ Contreras writes.

6. Have a drink for your country

Buy the bottle. Your country will thank you. Photo: Behrouz Mehri/AFP via Getty

The Japanese government has a problem: Young people aren't drinking enough alcohol.

By the numbers: In the good old days of higher booze consumption (1980), alcohol taxes accounted for 5% of government tax revenues. That fell to under 2% by 2020, per The Guardian.

To help plug the gap, the tax agency has launched a competition for ideas to help... promote drinking.
Submissions for the "Sake Viva!" campaign are due Sept. 9.

What they're saying: "Many people may have come to question whether they need to continue the habit of drinking with colleagues to deepen communication,” an official at the National Tax Agency told the Japan Times. "If the 'new normal' takes root, that will be an additional headwind for tax revenue."

7. Stories we're watching

Lining up for a free meal in Yangon, Myanmar. Photo: STR/AFP via Getty

Bombing at Kabul mosque kills at least 21
Abbas faces outrage over "50 Holocausts" remark in Berlin
Narcoterrorism fears in Mexico
WHO chief: Lack of aid for Tigray may be due to skin color
Turkey and Israel restore diplomatic relations
Prosecutors link Plácido Domingo to sex trafficking ring
Syria denies it's holding Austin Tice
Coming attractions: Biden's cybersecurity strategy

Quoted:

"I’ve danced, sung and partied and done perfectly legal things."

— Finnish Prime Minister Sanna Marin responding to videos of her at a party.

A message from Babbel

Learn a new language this summer with up to 60% off

Babbel provides a flexible, fun and easy way to explore and understand a new language quickly, and with confidence.

The strategy: The platform’s speech recognition technology helps you improve your pronunciation and accent right from the start.

Answers: 1. Ankara; 2. Beirut; 3. Amman; 4. Cairo; 5. Riyadh; 6. Doha; 7. Baghdad; 8. Baku; 9. Tehran; 10. Isfahan; 11. Dubai; 12. Jeddah.

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2022-08-19 Axios

Fri, 19 Aug 2022 10:07:18 GMT

Axios Vitals

By Tina Reed · Aug 19, 2022

Happy Friday, Vitals readers! Today's newsletter, which is 849 words or a 3-minute read.

1 big thing: Anti-abortion pregnancy centers are expanding in the post-Roe era

Illustration: Natalie Peeples/Axios

As abortion bans shutter clinics across the country, "crisis pregnancy centers" led by anti-abortion advocates see an opening to expand into the reproductive care void, Axios' Oriana Gonzalez writes.

Why it matters: With promises of free pregnancy tests and ultrasounds, health providers and abortion rights advocates say the non-profit centers falsely imply they provide medical care.

That further limits patients' ability to get accurate information and timely care in the post-Roe landscape, health experts and abortion rights advocates say — and the centers often are subsidized by state funding.

Driving the news: The centers are expanding in states that have restricted or banned abortion — at least 14 of which provide them with public dollars through "Alternatives to Abortion" state programs.

For example, the Guiding Star Project network, an anti-abortion association based in Minnesota, has seven centers and recently launched an "aggressive expansion" plan to open around 20 more. Two of their existing centers are going through the process of becoming medically licensed so that they can offer OB-GYN care. They will not offer abortion or contraception care.
Another group, the Pregnancy Center of the Coastal Bend, is opening a $10 million, 20,000-square-foot facility near Texas A&M University's Corpus Christi campus, offering a sonogram room and counseling office along with a coffee shop and a "man cave," the Washington Post first reported. The center's director told the Post she could not afford to hire doctors.

The big picture: The Charlotte Lozier Institute, an anti-abortion research organization, found that most of the centers' staff are not health professionals. A majority of the facilities do not have medical licenses.

Health experts say the centers often violate principles of medical ethics by misleading patients.

2. COVID costs could fall on insurers, consumers

Illustration: Shoshana Gordon/Axios

Consumers should prepare to soon pay for COVID-19 treatments and vaccines as the federal government prepares to shift costs back to health insurers, Axios' Arielle Dreher writes.

Driving the news: HHS has a meeting scheduled later this month with drugmakers, pharmacies, and state health departments to address the changes, the Wall Street Journal reports.

"We've known at some point we'd need to move over into the commercial market, and we’re approaching that time now," said Dawn O'Connell, assistant secretary at HHS for preparedness and response, per the WSJ.

White House COVID-19 response coordinator Ashish Jha said earlier this week the Biden administration will stop buying vaccines, treatments and tests as early as this fall, CNN reported.

Zoom in: Even as the administration appears to be extending the public health emergency, it's also been signaling its desire to move out of crisis mode — though that may not be easy.

"There are issues of reimbursement, equitable access to vaccines and treatment, and distribution that need to be resolved," Anne McDonald Pritchett, senior vice president at Pharmaceutical Research and Manufacturers of America, told the WSJ.

Our thought bubble: Timing of the cost shift will be crucial. With new boosters rolling out this fall, it might significantly impact the number of people willing to roll up their sleeves if consumers have to pay.

3. Advanced cervical cancer rate jumps in U.S.

The incidence of advanced cervical cancer in the U.S. has jumped fastest among younger women and white women, according to a study published in the International Journal of Gynecological Cancer.

Why it matters: While still considered rare, advanced or stage IV cervical cancer has an approximate five-year survival rate of less than 20%, with limited treatment options.

By the numbers: In the analysis of nearly 30,000 women with advanced cervical cancer, researchers found Black women have a higher incidence, 1.55 per 100,000, of advanced disease compared with white women (.92/100,000).

White women in the south ages 40–44 have the steepest rise in advanced cervical cancer at about 4.5% annually.

Between the lines: Increasing rates of obesity and older age at first birth could be contributing to the rise in this type of cervical cancer, researchers said.

White women have a nearly two-fold higher rate of missed or lack of guideline screening and have lower HPV vaccination uptake, they said.

A message from Axios

Your guide to communicating effectively

Learn how to communicate more effectively with Axios’ new book, Smart Brevity.

Axios’ co-founders share their secrets for the power of saying more with less.

Pre-order today and enter to participate in a workshop with the authors. Details at smartbrevity.com

4. Catch up quick

A robot arm collects COVID-19 swab samples as part of a demonstration during the 2022 World Robot Conference in Beijing Thursday. Photo: Lintao Zhang/Getty Images

💉 The Biden administration is speeding up its monkeypox vaccine distribution effort, federal health officials said Thursday. (Axios)

🦻 Well, that was fast. Days after the FDA made a move toward getting hearing aids available over the counter, retailers are flocking to get devices in stock. (Forbes)

🗣 1 fun thing: Scientists say COVID may be changing the way we hear language. I thought that sounded a bit far-fetched until I listened to the audio samples demonstrating their claims. (Quartz)

🤬 Some patients have had to sell their homes while other drained their retirement accounts. Here's a look at the human toll of America’s medical debt problem. (KHN)

5. Dog of the week

J-Lo. Photo: Caitlin Owens.

Meet J-Lo, a lab redbone coonhound mix currently being fostered by Axios' own Caitlin Owens and her fiancé Luke.

We're not saying she's a diva, but ... we've heard she convinced Caitlin to break the "no dogs on the couch" rule and has very specific requirements such as being allowed to carry shoes and remote controls around in her mouth. Here's her adoption page.

A message from Axios

Your guide to communicating effectively

Learn how to communicate more effectively with Axios’ new book, Smart Brevity.

Axios’ co-founders share their secrets for the power of saying more with less.

Pre-order today and enter to participate in a workshop with the authors. Details at smartbrevity.com

Why stop here? Let's go Pro.

Join the thousands of professionals reading Axios Pro: Health Tech Deals to better understand the forces shaping their industry.

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Sponsorship has no influence on editorial content.

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2022-08-19 Axios

Fri, 19 Aug 2022 10:07:22 GMT

Presented By Xero

Axios Chicago

By Justin Kaufmann and Monica Eng · Aug 19, 2022

Happy Friday! No, those aren't Transformers attacking Chicago. It's just practice for the annual Air & Water Show, which returns this weekend.

🌞 Today's weather: A beautiful day to hang out at The Hideout! Sunny, high of 85.

🚑 Situational awareness: Four people were wounded in a shooting this morning in the Back of the Yards neighborhood. No arrests have been made.

Today's newsletter is 917 words — a 3.5-minute read.

1 big thing: State GOP courts working people

Gubernatorial candidate Darren Bailey arrives at the Illinois State Fair. Photo: Monica Eng/Axios

State Republicans face an uphill battle against incumbent Democrats this November, but GOP candidates are hoping their focus on crime and inflation will resonate with disgruntled voters.

Driving the news: The IL GOP gathered in Springfield yesterday for Republican Day at the State Fairgrounds, touting a party they say is the home of the working class.

"JB Pritzker has never had to choose between filling his car up or putting food on the table," gubernatorial candidate Darren Bailey told supporters, to cheers from fairgoers.

What they're saying: "We're better prepared to take advantage of a red wave than ever before," party chair Don Tracy said, citing:

"More than 100" Republicans running in November including several for Cook County Board and "a credible candidate" in former Ald. Bob Fioretti for board president.
They also aim to win a majority on the Illinois Supreme Court for the "first time in more than 50 years" with two seats in play this fall.

Between the lines: To do this, the party is focused on crime, corruption and working-class finances.

"Under JB Pritzker's watch, crime is skyrocketing in Chicago and all across the state," Bailey said. "Parents don't feel safe letting their kids play in the parks or walk home from school."

What's more: After Bailey called Chicago a "hellhole" again twice during his speech, we asked whether he believes most Chicagoans think they live in a hellhole.

"Actually I believe they do, because it's unsafe," he said, citing the attack on the Walking Man the night he first invoked the term.

The intrigue: Bailey acknowledged that "Joe Biden is president, because the constitutional process was followed."

That public stance puts him out of step with many other candidates backed by former President Donald Trump.

2. State fair food battle

Doughnuts. Photo: Monica Eng/Axios

👋 Hey, it's Monica. This week I got a baptism by fried foods at my first Illinois State Fair. I've since tried more dishes, including:

Tastiest: A bag of warm cinnamon mini doughnuts ($8).
Weirdest: A dill spear wrapped in cream cheese and pastrami ($3).
Worst: Sirloin on a stick with dry, tasteless beef ($10).

Photo: Monica Eng/Axios

The intrigue: Fellow Axios Local reporters have also sampled their share of wacky fair food — maybe even weirder than ours — and they shared their reports.

Iowa: Axios Des Moines' Jason Clayworth indulged in a deep-fried queso burger featuring batter-encased beef chips and Cheez Whiz this year. But it was hard to compete with Linh Ta's 2021 find of Flamin' Hot Cheeto funnel cakes.

Minnesota: Axios Twin Cities' Audrey Kennedy highlighted vegan chorizo balls dipped in corn dog batter last year.

Florida: Axios Tampa's Seline San Felice went to Florida's January State Fair for a Donut Dog featuring a grilled weenie nestled in a Long John drizzled with icing.

Ohio: Axios Columbus' Alissa Wildman Neese praised the garlic stuffed, deep-fried olives on a stick but said to skip the deep-fried, mac n' cheese-stuffed turkey leg on a bone.

3. Tips and hot links

Illustration: Brendan Lynch/Axios

🚲 A new proposed ordinance would tow any car parked in a bike lane. (Block Club)

⚾️ Ex-Cub Joe Girardi, axed as Phillies manager in June, is joining the Marquee Sports Network's announcers booth as an analyst for the Cubs. (ESPN)

🎓 The Big Ten Conference signed a record TV deal for college sports, netting over $1 billion a year. (Axios)

🏈 The Bears dominated the Seahawks in their second preseason game, winning 27-11. (Tribune)

A message from Xero

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4. Best Day Ever: Vic Mensa

Vic Mensa. Photo courtesy of 93 Boyz

Vic Mensa, one of Chicago's leading hip-hop artists, came out of the famed Save Money Army and signed with Jay-Z's Roc Nation Records.

But it's not his music that's making waves this week — it's his weed.

Driving the news: Mensa just launched a recreational marijuana line called 93 Boyz.

Mensa, who co-owns the brand with fellow local hip-hop artist Towkio, says it's the first Chicago-based, Black-owned brand in the local cannabis space.

State of play: For now, the company is selling just pre-rolled joints, but it aims to expand the product line and availability.

What they're saying: "I actually started selling weed when I was around 14 years old, so this is really a natural progression for me," Mensa tells Axios.

Between the lines: Mensa has been a leader in education about the state's cannabis industry, which was touted as the nation's most socially equitable at its launch but has not lived up to the billing.

"Unfortunately, the social equity program has largely been a farce thus far and fallen far short of what it was championed as being," says Mensa.

We were supposed to interview Mensa tonight at the Hideout, but he ran into a scheduling issue. So we asked him to give us his perfect day in Chicago:

Vic Mensa (left) and Chance The Rapper pose backstage during this year's Lollapalooza. Photo: Erika Goldring/WireImage

🧇 Breakfast: "I get 'Monique's Love' at Chicago's Home of Chicken and Waffles."

🥋 Morning activity: " I do mixed martial arts training at iBattle Training on 47th street."

🍚 Lunch: "The Jamaican Beef Patty with rice and peas at 14 Parrish."

🎧 Afternoon activity: "Recording studio."

🐟 Dinner: "Have to go with the catfish at Virtue in Hyde Park."

🏍️ Evening activity: "I ride my motorcycle down Lake Shore Drive."

Over 1 million readers now wake up to Axios Local in their inbox. You can reach these smart professionals in their hometown.

Read how it helped these local businesses.

Job Listings

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Operations Manager at Hyde Park Venture Partners.
Human Resources Partner at Easyship.
Assistant Director, Digital Communications at School of the Art Institute of Chicago.

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Hiring? Post a Job.

5. See you tonight at the Hideout

Photos courtesy of Jacoby Cochran and Mindy Segal

We look forward to seeing all of you tonight at The Hideout! We'll be interviewing:

Jacoby Cochran about storytelling and his great Chicago podcast, CityCast.
Mindy Segal about her new Wicker Park Mindy's Bakery and her line of edibles.

What's more: We will also have food! Monday is National Bao Day, so we will feature tasty buns from Take A Bao Eats.

And of course, the first round is on us — we can't wait to see you!

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Our picks:

🎤 Monica is intrigued by this weekend's Chi Carnival Weekend in Hyde Park, the Glenwood Avenue Arts Fest in Rogers Park and PorchFest on Sunday in Roscoe Village, where musicians perform on neighborhood porches.

🦷 Justin will be rockin' one less tooth tonight at The Hideout. He's just bummed he didn't record a funny TikTok when coming out of anesthesia.

Want free Axios swag? Refer your friends to Axios Chicago and get cool merch like stickers, totes, hats, T-shirts and more!

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2022-08-22 Axios

Mon, 22 Aug 2022 10:03:54 GMT

Presented By PhRMA

Axios Vitals

By Tina Reed · Aug 22, 2022

Good morning, Vitals readers. Today's newsletter is 1,019 words or a 4-minute read.

1 big thing: Surprise billing rule gets new rules for working out disputes

Illustration: Aïda Amer/Axios

A year and a half after Congress protected patients from surprise medical bills, the Biden administration has finalized the process for deciding who'll actually pick up the tab, Axios' Adriel Bettelheim and I write.

Why it matters: Billions of dollars are at stake — either for providers or for insurers and employers.

The big picture: It's the latest chapter in efforts to protect patients from facing unexpected charges from doctors who are not in their insurance networks.

Except the final rules issued late Friday issued could trigger new skirmishes over how to resolve billing differences while holding the patient harmless.

Details: The rules from the Labor Department, HHS and the IRS define the factors arbitrators have to weigh in settling disputes over out-of-network care.

For some context, the administration had already made one attempt at working out the process.
But providers successfully challenged it in court saying it unfairly favored insurers by telling arbiters to select the rate closest to the health plans' median in-network rates for the same or similar services in the geographic region — and preventing meaningful negotiation.
In a move that tips the scales toward making the rule more provider-friendly, HHS said arbiters no longer have to start with that median in-network rate and must consider "all additional permissible information submitted by each party to determine which offer best reflects the appropriate out-of-network rate."

Keep in mind: Many doctors involved in the surprise billing fight are employed by private equity-backed companies. Studies have shown that the doctors that tend to send the most surprise bills tend to get paid more than other specialties.

What we're watching: How arbitrators apply the new rules and weigh the evidence each side submits — and whether the process establishes a measure of predictability in health costs.

2. Another impact of ending the COVID emergency

About 17.4% of Medicaid and Children's Health Insurance Program (CHIP) enrollees — about 15 million people — would lose coverage with the expiration of the COVID-19 public health emergency, according to a federal report.

Why it matters: One of the consequences of unwinding the emergency declaration would be the end of temporary reforms that increased federal spending if states offered continuous coverage to enrollees, reducing the programs' usual churn.

By the numbers: The report from the HHS' Office Assistant Secretary for Planning and Evaluation estimates about 9.5% of Medicaid enrollees — or 8.2 million people — will lose eligibility as states determine who's still eligible for coverage.

7.9% of Medicaid enrollees — or about 6.8 million people — will lose coverage despite still being eligible due to administrative churn, based on historical patterns.
A disproportionate amount of those affected are young people, the report says, projecting 5.3 million children and 4.7 million adults ages 18–34 would lose Medicaid/CHIP coverage.
The redetermination of eligibility would also impact a disproportionate number of people of color, they said. Nearly a third of those predicted to lose coverage are Latino and 15% are Black.

What they're saying: "Facilitating enrollment in alternative health insurance coverage among those determined ineligible for Medicaid through coordination with state and federal [Affordable Care Act] marketplaces and enhanced outreach and education efforts will help minimize potentially harmful gaps," the report states.

3. Birx weighs in on CDC reform

Photo: John Lamparski/Getty Images

The CDC needs to start opening itself up to working with the private sector and more transparently communicating how it makes recommendations, former President Trump's coronavirus response coordinator said on CBS News' "Face the Nation" on Sunday.

Her comments came in the aftermath of CDC director Rochelle Walensky's plans to reform the agency.

What she's saying: "In March of 2020, all of our data that I used to used to warn Americans of who was at risk for severe disease, hospitalization and death came from our European colleagues. That, in itself, should be an indictment of our system."

Zoom in: She pointed to the CDC's poor systems used for data sharing.

"Reporting was coming in extraordinarily slow from hospitals through a system that CDC created. I know this created controversy but for three months I asked the CDC to fix its system and develop a partnership with clinics and hospitals and laboratories and they wouldn't," Birx said.
"Sometimes we hold ourselves back. The private sector is willing to help us," Birx said.

Birx also critiqued the CDC guidance — and the lack of transparency about supporting data — on how long people should isolate after testing positive for COVID.

"They have to change how they collect data, how they present data and how they communicate to the American people," she said.

A message from PhRMA

Improving access to life-saving medicine

Insurance companies and PBMs don’t pay full price for insulin. So why do patients?

Rebates, discounts and other payments from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these discounts directly with patients.

Here’s what you should know.

4. FDA authorizes Novavax vaccine for ages 12 to 17

Illustration: Aïda Amer/Axios

The FDA has authorized Novavax's COVID-19 vaccine for emergency use for adolescents between the ages of 12 and 17, Axios' Fadel Allassan writes.

Why it matters: The news could provide an option for unvaccinated people who prefer a shot that is not based on the mRNA technology used by Pfizer and Moderna.

What they're saying: The development "will hopefully help increase vaccination rates, particularly as we prepare for ongoing surges of COVID-19 with the start of fall and the back-to-school season," said Novavax CEO Stanley Erck in a statement.

"We hope that our vaccine, developed using an innovative approach to recombinant protein vaccine technology, may have a special role in adolescent vaccination based on parents' and caregivers' familiarity with protein-based vaccines used in other disease areas."

Catch up quick: Novavax won $1.6 billion in federal backing in 2020 as part of Operation Warp Speed but was slow getting to a market dominated by Moderna and Pfizer-BioNTech vaccines.

The company sharply cut its revenue guidance this month, with no new COVID-19 vaccine sales expected this year in the U.S.

5. While you were weekending

Illustration: Aïda Amer/Axios

💉 The European Medicines Agency said EU countries may temporarily use smaller doses of the monkeypox vaccine in order to boost supply. (Axios)

👨‍🔬 Researchers are uncovering drivers of long COVID cases — such as low cortisol levels in the blood — which is getting us closer to better being able to fight it, writes Eric Topol, executive vice president of Scripps Research. (Los Angeles Times)

👉 Hundreds of kids see their parents shot to death every year. It leaves anger, guilt and dread that changes their lives. (Washington Post)

A message from PhRMA

Health savings for patients, not middlemen

Rebates and discounts from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these savings directly with patients.

Next steps: Fix harmful insurance practices and lower out-of-pocket patient costs.

Why stop here? Let's go Pro.

Join the thousands of professionals reading Axios Pro: Health Tech Deals to better understand the forces shaping their industry.

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2022-08-22 Axios

Mon, 22 Aug 2022 10:03:58 GMT

Presented By GiveDirectly

Axios Chicago

By Monica Eng and Justin Kaufmann · Aug 22, 2022

Happy Monday! On this day in 2006, the city banned foie gras. But after restaurant industry pushback and some national mockery and ridicule, the city changed course and ended the ban in 2008.

Mayor Richard M. Daley called it "the silliest ordinance ever passed by the city council."

😎 Today's weather: Perfect softball weather. Sunny with a high of 80.

Today's newsletter is 857 words — a 3.5-minute read.

1 big thing: Monumental monument shifts

The Christopher Columbus statue in Grant Park being removed on July 24, 2020. Photo: Derek R. Henkle/AFP via Getty Images

The Christopher Columbus statues might never again see the light of day.

Driving the news: The Chicago Monuments Committee released its long-awaited report Friday recommending the permanent removal of the three Columbus statues and 10 other problematic monuments.

The committee says the monuments were flagged for many reasons, including "promoting narratives of white supremacy" and "presenting selective, over-simplified, one-sided views of history."

Why it matters: The committee's report could fundamentally change the way Chicago handles problematic public pieces in the future.

Flashback: The committee was formed in 2020 after protesters attempted to tear down the Columbus statue in Grant Park, which led to arrests, injuries and violent skirmishes between police and protesters.

In one high-profile case, a police officer knocked out the teeth of an 18-year-old woman.
After their temporary removal, the statues' fate fell to a committee.

What they're saying: "We believe the report's ideas and recommendations will strengthen our City as our public art collection becomes more honest about our history and far more inclusive regarding who is represented and what stories are told," the committee co-chairs said in a statement.

The other side: Ron Onesti of the Joint Civic Committee of Italian Americans told WTTW the recommendations were “preposterous.”

Yes, but: In March, Mayor Lori Lightfoot signaled she was in favor of returning the Columbus statue to Grant Park, and she has final say on the committee's recommendations.

Zoom in: The committee also recommended removing several other public pieces, including the tucked-away Balboa Monument, which Benito Mussolini gave the city in 1933.

The committee recommended removing a statue of Union Gen. Philip Sheridan in Lincoln Park "because of scorched-earth tactics against the American Indians."
And the Marquette-Jolliet Memorial in Little Village because it "reinforces stereotypes of American Indians."

Read the full report

2. Living in a hellhole

Illustration: Brendan Lynch/Axios

👋 Hey, it's Monica. I was a little surprised to hear state Sen. Darren Bailey resurrecting his Chicago-is-a-hellhole trope not once, but twice during his speech at Republican Day in Springfield.

When I later asked Bailey if he really thought most Chicagoans feel they live in a hellhole, he said, "I actually believe they do, because it's unsafe."

Driving the news: The exchange sparked a flood of "hellhole" photos on Twitter from Chicagoans displaying the beauty of our city in parks, neighborhoods, and on the lakefront and river.

Source: Twitter

What he's saying: "It's time to restore sanity, common sense, integrity and safety on the streets."

When asked how he might do that, Bailey suggested following current state weapons statutes, which he erroneously called "the most extensive gun laws in the nation."
"When we don't obey them, then there is certainly no need for more laws."

Between the lines: We can agree Chicago must be safer for its residents, but that's different from believing we live in a hellhole.

📬 Tell us: Share your views in this survey of people who live in the area.

To share a more nuanced view, feel free, as always, to reply.

3. Chart of the Day: Teachers aren't paid enough

Explore the interactive map. Reproduced from EPI; Map: Axios Visuals

CPS welcomes students back to classes today, the earliest start date in recent memory.

Why it matters: The district, like much of the country, is struggling to find teachers.

One reason might be salaries.

Driving the news: A new study by the Economic Policy Institute looks at how much teachers make compared with other careers that require a college degree.

Illinois teachers are paid 23.4% less than their college-educated peers on average, worse than Iowa, Wisconsin, Michigan and Indiana.
Illinois also fares worse than other states with big districts like California (17.6%) and New York (13.2%).

What's more: The study looks at wage growth for public school teachers since 1979.

While other college-educated career salaries have skyrocketed, school teachers have remained flat.

A message from GiveDirectly

Chicago launches basic income program

The City of Chicago’s Department of Family and Support Services is partnering with GiveDirectly on a $31.5 million cash assistance program that will deliver $500 per month to 5,000 households for one year.

The goal: Support families in need and grow the evidence base for guaranteed income policies.

4. Tips and hot links

Illustration: Brendan Lynch/Axios

🎒 It's been just 68 days since CPS kids were in the classroom. (Tribune)

🛠️ CPS CEO Pedro Martinez is touting the importance of the district's Career and Technical Education (CTE) programs amid falling enrollment. (Chalkbeat)

💊 Some state legislators continue to take campaign contributions from big pharma even after the opioid crisis, a new investigation finds. (Sun-Times)

🏈 Bears star Roquan Smith ended his holdout this weekend and is back practicing at Halas Hall. The linebacker told reporters the contract negotiations were "distasteful." (NBC Sports)

Over 1 million readers now wake up to Axios Local in their inbox. You can reach these smart professionals in their hometown.

Click here to learn more and become an Axios Chicago member.

Job Listings

Is a new job in your future?

💼 Check out who’s hiring around the city.

Associate Director, Digital Strategy at School of the Art Institute of Chicago.
Digital Advertising Director at Antenna.
Accounts Payable Manager at Sinch.

Want more opportunities? Check out our Job Board.

Hiring? Post a Job.

5. Family Meal Monday

Spilt Milk's Monday Family Meal featured prosciutto sandwiches and melon salad from Lardon/Union last week. Photo: Monica Eng

Mondays can be slow for restaurants.

But smart folks around town have devised fun ways to liven up Mondays with exciting specials.

The special: Family Meal Monday dinners at Logan Square's Spilt Milk tavern feature a beverage and plate of food from some of the city's most innovative chefs for $20.

The setting: It feels like a family barbecue without the bickering as guests mingle while chefs grill and serve on the spacious, sun-dappled patio.

The schedule: Mondays from 5pm until the food runs out, so get there early if you want some grub. Here's the food lineup for the next four weeks:

Tonight: Birrieria Zaragoza
Sept. 5: PQM
Sept. 12: Kimski
Sept. 19: Hermosa

6. Happy Belated, Lin!

Chicagoans leap for Lin Brehmer for his birthday. Photo courtesy of Joe Nunez

WXRT DJ Lin Brehmer is on a leave of absence for treatment of prostate cancer.

🎂 For his birthday on Friday, Chicago celebrated by giving well wishes from Wrigley Field to Lake Michigan.

Several people gathered on the lakefront to "Leap4 Lin." Happy Birthday!

Daniel T. O'Connor, aka the "Chicago Lake Jumper," holds a sign for Lin Brehmer's birthday. Photo courtesy of Joe Nunez.

A message from GiveDirectly

Feel confident your donation will actually reach people in poverty

GiveDirectly allows you to put cash right into the hands of those who need it the most.

Here’s how: When you donate, GiveDirectly gives about 90 cents of every dollar as cash with no strings attached to people living in poverty. The remaining 10 cents covers delivery costs.

Donate now.

Our picks:

💔 Monica is taking her daughter back to Champaign Urbana on Sunday and Monday. So please excuse the loud weeping.

❤️ Justin thanks you all for coming to The Hideout on Friday night. Great crowd and great fun. Looking forward to the next one in the fall!

Want free Axios swag? Refer your friends to Axios Chicago and get cool merch like stickers, totes, hats, T-shirts and more!

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2022-08-22 Axios

Mon, 22 Aug 2022 16:07:26 GMT

Good afternoon, Chicago.

We’re so grateful that you are part of the Axios Chicago community, and now we’d like to invite you to take your readership to the next level and become an Axios Chicago member.

Why it matters: Smart, trustworthy local journalism should not be an exclusive privilege. That’s why our reporting will remain paywall free.

Membership contributions help fund our local newsroom.

We appreciate the subscribers who have already become members. Their support helps us grow and fuels our mission to help readers get smarter, faster on the news that matters most in Chicago.

Sincerely,

Justin and Monica

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2022-08-22 Axios

Mon, 22 Aug 2022 19:07:28 GMT

Get conversational in just three weeks.

Presented By Babbel

Axios World

By Dave Lawler · Aug 22, 2022

Welcome back to Axios World.

Tonight’s edition (1,820 words, 7 minutes) takes off from Islamabad, with stops in Moscow, Mogadishu and more.

New arrival? Subscribe.

1 big thing: Pakistan launches terrorism case against Imran Khan

Imran Khan at a rally in Lahore on Aug. 13. Photo: Arif Ali/AFP via Getty

Supporters of former Pakistani Prime Minister Imran Khan have surrounded his home to prevent police from arresting him on terrorism charges.

Why it matters: Since being ousted in April, Khan has been mobilizing huge crowds while railing against the government and breaking a long-standing taboo by criticizing the military. The threat of arrest raises the stakes of that showdown dramatically.

Driving the news: At a rally on Saturday, Khan named a police chief and judge involved in a treason case against one of his aides, and said, "We will not spare you, we will sue you," per Reuters.

The police deemed that a direct threat and charged Khan with spreading terrorism. Pakistan's information minister accused him of "inciting the people to violence, lawlessness, rebellion and riot."
Pakistan's media regulator also banned live coverage of Khan's speeches.

Between the lines: Khan's aide, Shahbaz Gill, was arrested after calling on members of the military to reject "illegal orders" from their superiors, hinting at the idea that military leaders have turned on Khan but the rank-and-file stands behind him.

Analysts believe the military, Pakistan's most powerful institution, helped bring Khan to power and later helped remove him.

Khan's removal in a no-confidence vote remains extremely contentious.

The new government, led by Shehbaz Sharif, claims Khan's economic mismanagement was his undoing. Pakistan is in the midst of a debt crisis made worse by spikes in the cost of food and fuel.
Khan claims, without evidence, that his ouster was engineered by the U.S. because he was too close to China and Russia. The U.S. denies that, but Khan's anti-U.S. rhetoric has energized his supporters.

Khan is back in campaign mode with a potent sense of grievance and a devoted base of support — a role to which the former cricket star, who previously spent two decades in opposition, is well-suited.

His party won a crushing upset in regional elections last month, and Khan has been holding huge rallies to pressure the government to hold early elections.
"Every effort Pakistan’s government makes to weaken Imran Khan will only end up making him stronger," contends Michael Kugelman, an expert on Pakistan at the Wilson Center. "[D]ysfunctional and repressive policies play to his strengths as a populist and enable him to channel public outrage to his advantage."

What's next: Khan's lawyer said today that he'd been granted three days of pre-arrest bail, likely meaning he won't be arrested in that time. However, the Islamabad High Court launched separate contempt of court proceedings today over Khan's comments about the judge.

For now, Khan's supporters have vowed to remain outside his home. "Police will have to step over our dead bodies before they get to him. He is our last hope," one man told the BBC.
If Khan is arrested, "we will take over Islamabad," a former senior official from Khan's party threatened.

Worth noting: The government seems more focused on the feud with Khan than on responding to floods that have killed more than 600 people, notes Madiha Afzal of Brookings.

2. Ukraine war latest: Assassination in Moscow

Russian officials at the scene where Darya Dugina's car exploded. Photo: Russian Investigative Committee via Getty Images

A car bomb that may have been intended for Russian ultranationalist ideologue Alexander Dugin killed his daughter and fellow far-right pundit Darya Dugina on Saturday night outside Moscow.

What's happening: Russia's FSB security agency today blamed Ukraine and, more specifically, a Ukrainian woman who was traveling with her 12-year-old daughter and fled to Estonia. Kyiv rejects those accusations as “fictional.”

Other theories include a rogue Russian operation or "a Kremlin hit" — either "to make Dugin a symbolic martyr" or "because they feared ultranationalists like him would stir up protest were Russia to step back from its war in Ukraine,” Russia analyst Mark Galeotti writes in the Spectator.

Whatever the case, Dugin has issued a rallying cry demanding “victory” over the “Nazi Ukrainian regime.”

“My daughter laid her maiden life on its altar,” he wrote. “So win, please!”
Vladimir Putin wrote him a letter condemning the “vile, cruel crime” and calling Dugina a “patriot of Russia.”
Dugina was sanctioned by the U.S. in March for her work editing a “disinformation site.”

The latest:

Russia’s offensive in the east has shown little progress over the past several weeks. Moscow has moved troops south to defend against a potential Ukrainian counteroffensive in Kherson.
Both Moscow and Kyiv have claimed the other side is planning a “false flag” operation near Europe’s largest nuclear power plant in Zaporizhzhia, southern Ukraine. Ukrainian officials claim Russia is preparing to cut the plant off from the Ukrainian electric grid. The UN wants access to the plant and has called the recent shelling there “suicidal.”
Nearly 9,000 Ukrainian soldiers have been killed in six months of war, Ukraine's military chief Gen. Valeriy Zaluzhnyi said today.
The U.S. announced another $775 million in weapons for Ukraine on Friday.

3. Global news roundup

Media gather near the attack on the Hayat Hotel in Mogadishu, Somalia. Photo: Hassan Ali Elmi/AFP via Getty

1. A Catholic bishop and several priests were arrested in Nicaragua on Friday. The Rev. Rolando Álvarez is a leading critic of President Daniel Ortega, who has jailed virtually all prominent opponents. Pope Francis called for dialogue.

2. Security forces in Somalia freed dozens of people from a hotel in Mogadishu after a 30-hour siege by al-Shabab militants over the weekend, but not before at least 21 people were killed.

3. The U.S. Department of Homeland Security has warned of a surge in high-powered firearms being smuggled from the U.S. into Haiti, where police are often outgunned by gangs.

4. The U.S. and South Korea launched their largest joint military exercises since 2017 today in the face of threats from North Korea.

5. China will provide the Solomon Islands with a $100 million loan for telecom towers, to be built by Huawei.

6. Singapore will rescind a colonial-era law banning sex between men but will not allow gay marriage, the government announced.

7. Colombia's new president, Gustavo Petro, has suspended arrest warrants and extraditions for members of the ELN as he seeks a peace deal with the Marxist rebel group.

A message from Babbel

Learn a new language this summer with up to 60% off

Babbel provides a flexible, fun and easy way to explore and understand a new language quickly, and with confidence.

The strategy: The platform’s speech recognition technology helps you improve your pronunciation and accent right from the start.

Bonus: Where in the world?

Screenshot via Apple maps

Today's theme is Shakespeare's settings. We're looking for the city in which the following plays are set.

1. Romeo and Juliet

2. Julius Caesar

3. Richard III

4. The Merry Wives of ___

5. Macbeth

6. Othello

7. Antony and Cleopatra

8. A Midsummer Night's Dream

9. Much Ado About Nothing

10. Measure for Measure

11. The Comedy of Errors

Notes:

Some of these plays (No. 7 for example) are set in multiple cities, but the answer I'm looking for is the one on the map.
No. 11 is an ancient city that's currently in ruins.
You won't find Hamlet, but he'd be somewhere in the "rotten state of Denmark."

4. Angola's election poses rare test for ruling party

A man in an MPLA shirt in the capital, Luanda. Photo: John Wessels/AFP via Getty

Angola is set for a tense election on Wednesday as the People's Movement for the Liberation of Angola (MPLA), which has ruled since independence in 1975, faces an unusually stiff challenge.

State of play: President João Lourenço succeeded strongman José Eduardo dos Santos in 2017 as president and leader of MPLA. Lourenço emphasized the fight against endemic corruption, even investigating dos Santos' children.

But ahead of Wednesday's election, he called on Angolans to honor dos Santos' legacy by voting for MPLA.
Dos Santos died in Spain in July after 38 years in power, but his remains arrived in Angola on Saturday in a pre-election twist.

The other side: The main opposition party, UNITA, looks stronger than ever, particularly in cities and among younger voters, per DW.

The rising cost of living is intensifying dissatisfaction with the government in a country where tremendous oil wealth exists alongside severe poverty.

How it works: Under Angola's system, voters cast their ballots for the National Assembly, and the leader of the largest bloc becomes president.

The government controls most media outlets and previous elections have not been seen as free and fair.

Meanwhile...

In Italy: Squabbling on the left could help a coalition of right-wing parties win comfortably in Italy's Sept. 25 election, led by the far-right Brothers of Italy.
In the U.K.: Foreign Secretary Liz Truss appears to be crushing ex-Chancellor Rishi Sunak among Conservative Party members. Barring a shock, she'll be announced as the next prime minister on Sept. 5.

5. China's unrivaled 71-day heat wave

Illustration: Maura Losch/Axios

The extreme heat and drought that has been roasting a vast swath of southern China for at least 71 straight days has no parallel in modern record-keeping in China, or elsewhere around the world for that matter, Axios' Andrew Freedman reports.

The big picture: More than 260 weather stations saw their highest-ever temperatures during the long-running heat wave, according to state media reports.

It has coincided with a severe drought that has shriveled rivers and lakes and throttled back some of China's hydropower production.
This has led the government to cut power to Sichuan's key industrial hubs, an emergency measure extended on Aug. 21.
There have also been simultaneous extreme heat events and droughts this summer in Europe, East Africa and the U.S.

6. What I'm reading: Malaysia owes $15 billion to a forgotten kingdom

A timber yard in Sabah in 1962. Photo: Keystone Features/Getty Images

The heirs to an extinct throne could cost Malaysia $15 billion and become a factor in the country's domestic politics, the Economist reports.

The last sultan of Sulu, Jamalul Kiram II, died in 1936, and the sultanate's territory on the island of Borneo eventually became part of Malaysia.
But Sulu had signed a treaty in 1878 effectively granting the U.K. access to the resources of those lands for an annual fee — which Malaysia continued to pay to Kiram II's heirs after independence. It's highly unusual for such an arrangement to survive so long.
The annual payments of $1,200 stopped in 2013, after a pretender to the Sulu throne staged a bizarre invasion of the territory that ultimately left dozens dead.

The heirs (who are now mainly middle-class Filipinos) took Malaysia to a European court for breach of contract and won a whopping $15 billion judgment.

The Malaysian government boycotted the hearings, but may be forced to comply with the ruling. A court in Luxembourg has already seized assets from Petronas, Malaysia's state oil company.
What to watch: "The news has provoked outrage in Malaysia, where an election is expected to be called soon," the Economist notes.

In other monarchy news... The heart of former Brazilian emperor Dom Pedro I — who declared independence 200 years ago next month — arrived in Brazil today from Portugal. It was preserved in formaldehyde after his death.

7. Stories we're watching

A medieval bridge and a dry riverbed in drought-stricken Villarta de los Montes, Spain. Photo: Thomas Coex/AFP via Getty

Indiana governor visits Taiwan
U.K. inflation could hit 18%
Hezbollah threatens "escalation" over Lebanon-Israel border dispute
U.S.-Israel tensions over Iran deal
ISIS "Beatle" gets life in prison
Look familiar? "Stars" replaces Starbucks in Russia
Rodman to Russia? State Dept. hopes not

Quoted:

"It’s famous for its 123-meter spire, it’s famous for its clock."

— Ruslan Boshirov, one of the Salisbury poisoning suspects, claiming in a 2018 interview with RT editor Margarita Simonyan that he and his fellow suspect had only been in Salisbury to visit its famous cathedral.

“I am sure we can find professionals willing to admire the famous spires in the vicinity of Tallinn."

— Simonyan today, referring to the Russian claims that Dugina's assassin fled to Estonia and seeming to laugh off Moscow's previous stance that the Salisbury suspects were innocent.

A message from Babbel

Prepare for your next summer adventure with Babbel

This summer — whether you’re preparing for a trip abroad or looking for a new hobby — you could be speaking a new language in three weeks with Babbel.

Even better: Explore the culture behind the language with special courses on topics like sports, travel, festivals and more.

Get up to 60% today.

Answers: 1. Verona; 2. Rome; 3. London; 4. Windsor; 5. Inverness (Scotland); 6. Venice; 7. Athens; 9. Messina; 10. Vienna; 11. Ephesus.

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2022-08-23 Axios

Tue, 23 Aug 2022 10:07:18 GMT

Presented By PhRMA

Axios Vitals

By Tina Reed · Aug 23, 2022

Happy Tuesday, Vitals readers. Today's newsletter is 1,086 words or a 4-minute read.

1 big thing: Fauci's successor will inherit a polarization problem

NIAID director Anthony Fauci. Photo: Anna Moneymaker/Getty Images

NIAID director Anthony Fauci's retirement will leave a gaping hole in the nation's flagship biomedical research agency and tee up a test of whether his successor will be an equally public figure — and as controversial, Axios' Caitlin Owens writes.

Why it matters: Fauci's consistent presence as the public face of the pandemic response over the last two and a half years has been a source of comfort for some Americans while enraging others. What happens in his absence will reveal whether such deep polarization stems more from Fauci or is a function of today's political environment.

What they're saying: In an interview with Axios, Fauci said that his notoriety is largely attributable to circumstances that put him "right in the eye of the hurricane of some very important emerging infectious disease outbreaks."

Throughout a career responding to the HIV/AIDS crisis, the Zika virus, Ebola and the COVID pandemic, it's been important to "try and explain [the science] to the American public in a way and a form in a way they can really appreciate. Whether or not someone else can and wants to do that, I imagine they could," he said.

State of play: The NIH still doesn't have a permanent director following former director Francis Collins' retirement from the agency last year. Lawrence Tabak is currently acting director.

Fauci's departure leaves another large hole to fill in the midst of several public health crises.

Between the lines: While Fauci has drawn plenty of praise for his relentless public persona and straight talk, he's become an avatar of government overreach to many on the political right. Republicans have attacked him as being too eager for media attention and for offering inconsistent advice as the pandemic wore on.

Yes, but: The challenge for Fauci's successor will be to communicate the science to Americans without alienating a third of the country — if such a thing is possible today.

2. Fauci's future spotlight

Photo illustration: Brendan Lynch/Axios. Photo: Shawn Thew-Pool/Getty Images

Fauci's time in the spotlight likely won't end with his retirement: Republicans plan to investigate his role in the COVID pandemic if they take control of the House or Senate next year, Axios' Victoria Knight and Caitlin write.

The intrigue: Although the GOP could always subpoena Fauci as a civilian, they may not need to.

"I have never had any problem defending what I've done and I have nothing to hide," Fauci said in an interview with Axios. "I've testified before the Congress hundreds of times over the last 38 years. I have no trouble testifying before Congress."

Republicans have tried to link Fauci to so-called gain-of-function research — in which a virus can be tweaked to become more virulent — and connect NIH-funded work to the pandemic. They've also stepped up personal attacks on Fauci, to tap into voter frustrations with the pandemic.

Share this story.

3. Chronic conditions and poor finances linked

Data: Becker, et al., 2022, "Association of Chronic Disease With Patient Financial Outcomes Among Commercially Insured Adults"; Note: The study analyzed insurance claims data from January 2019 to January 2021 and commercial credit data in January 2021; Chart: Axios Visuals

Individuals with a higher number of chronic conditions have a higher chance of encountering financial hardship like medical debt, according to a study published in JAMA Internal Medicine.

Why it matters: It further cements the connection between well-being and financial stability.

University of Michigan researchers analyzed insurance claims data from January 2019 to January 2021 linked to commercial credit data in January 2021 for adults in Michigan.

Among more than 2.8 million commercially-insured adults, rates of delinquent debt in collections, low credit scores and recent bankruptcy went up with the number of chronic conditions like cancer, heart disease and depression that people experienced.

Zoom in: The adjusted amount of medical debt in collections jumped 60%, from $784 for individuals with no chronic conditions to $1,252 for individuals with seven to 13 chronic conditions.

Chronic conditions associated with the greatest increases in medical debt in collections were severe mental illness ($274), substance use disorders ($268), stroke ($235), congestive heart failure ($234) and liver disease ($228).
"These results have important implications for patients, as worsened financial health is associated with increased rates of forgone medical care, worse physical and mental health, and increased mortality," the researchers wrote.

A message from PhRMA

Improving access to life-saving medicine

Insurance companies and PBMs don’t pay full price for insulin. So why do patients?

Rebates, discounts and other payments from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these discounts directly with patients.

4. EDs aren't testing overdoses for fentanyl

Illustration: Allie Carl/Axios

Only 5% of overdose patients brought to emergency departments are tested for fentanyl, Epic Research and the University of Maryland's Center for Substance Abuse Research (CESAR) report.

Why it matters: An all-time high of more than 100,000 people died from drug overdoses in the U.S. last year driven by synthetic opioids such as fentanyl. But we're not tracking the sheer magnitude of the problem.

By the numbers: Researchers analyzed more than 315,000 emergency department overdose visits between 2017 and 2022 using deidentified data from Cosmos, a data set held by the EHR company Epic.

They found the opiate testing rate is nearly 50%.
When patients were tested for fentanyl, the positivity rate exceeded 40%, more than three times that of opiates like morphine, heroin and codeine, they said.

Testing may be low, they said, because standard urine toxicology screening panels offered by commercial labs like LabCorp and Quest include a test for natural opioids but require a separate test for synthetic opioids.

What they're saying: "Our findings highlight the need for a centralized overdose surveillance system and a nationwide standard for toxicology screenings in overdose treatment," said Eric Wish, director at CESAR and co-author, in a statement.

5. U.S. life expectancy drops

Data: Arias, et al., 2022, "U.S. State Life Tables, 2020"; Map: Simran Parwani/Axios

Life expectancy in the U.S. dropped by 1.8 years from 2019 to 2020, according to new CDC data.

The decline was mostly due to the COVID-19 pandemic and increases in unintentional injuries, specifically drug overdose deaths.

6. Pfizer-BioNTech apply for updated COVID shot

Photo illustration: Nikos Pekiaridis/SOPA Images/LightRocket via Getty Images

Pfizer and BioNTech said Monday they submitted an application to the FDA for an updated COVID-19 booster that targets the Omicron BA.4 and BA.5 subvariants, Axios' Adriel Bettelheim writes.

The big picture: The Biden administration has been pressing to have updated boosters widely available by mid-September.

What they said: The companies said the data supports emergency use authorization of a 30-microgram booster dose for individuals 12 years of age and older.

The "bivalent" shot is aimed at protecting against both the original COVID strain in the current Pfizer-BioNTech vaccine, along with the Omicron BA.4/BA.5 subvariants.
Preclinical data showed a booster dose "generated a strong neutralizing antibody response against Omicron BA.1, BA.2 and BA.4/BA.5 variants, as well as the original wild-type strain."

Our thought bubble: The latest of the Axios/Ipsos Coronavirus Index found 80% of those who've received the vaccine say they're likely to get an Omicron-specific booster — and polling has found higher interest among older Americans.

But the unvaccinated aren't likely to jump on board with this latest round and with interest in taking precautions waning, it's unclear how great the uptake will ultimately be, especially among the younger crowd.

A message from PhRMA

Congress should address the system we use to pay for medicines

Insurers and PBMs receive discounts on insulins from manufacturers but don’t usually pass these savings directly to patients.

The impact: Patients are burdened with higher than necessary out-of-pocket costs.

Why stop here? Let's go Pro.

Join the thousands of professionals reading Axios Pro: Health Tech Deals to better understand the forces shaping their industry.

Axios thanks our partners for supporting our newsletters. If you’re interested in advertising, learn more here.
Sponsorship has no influence on editorial content.

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2022-08-23 Axios

Tue, 23 Aug 2022 10:07:21 GMT

Axios Chicago

By Justin Kaufmann and Monica Eng · Aug 23, 2022

Happy Tuesday! Today is National Ride the Wind Day. At first we thought it was a day to celebrate Christopher Cross, but instead it's for you to get out and enjoy the waning days of summer. So let's ride…

🌞 Today's weather: Sunny, high of 84. Perfection. Remember this day in January.

🏀 Situational awareness: The Chicago Sky play the New York Liberty tonight in Brooklyn. It's the final game of their first-round series; the winning team advances to the WNBA semifinals, and the losers go on vacation.

Tipoff is at 8pm on ESPN. #RecrownSkytown

Today's newsletter is 924 words — a 3.5-minute read.

1 big thing: Tech diversity

Illustration: Aïda Amer/Axios

Chicago's tech startup diversity outpaces the national average, but a new report says more must be done to support founders who are women, Black and/or Latino.

Why it matters: The tech community makes up 8% of Chicago's workforce and is among the city's fastest-growing sectors.

By the numbers: The report from World Business Chicago's Research Center says that from 2019 to 2021, capital raised by women, Black and Latino founders increased 159%.

Underrepresented founders made up 23.4% of total 2022 VC capital so far, up from 8.2% for all of 2019.
Since 2019, Chicago has more startups with a Black or Latino founder participating in venture capital deals (5.1%) than the national average (2.5%).

Yes, but: A lot of that money comes from two Series D funding rounds: Loadsmart raised $200 million and Kin Insurance raised $82 million. Both have Latino founders.

For Black founders, only seven deals closed in the first half of 2022, down from 28 total in 2021.
According to the report, over 20% of Black entrepreneurs report a lack of access to capital.
Just three Black-founded startups have landed VC deals exceeding $10 million since 2019.

What's more: There are nearly 70 Black- and Latino-founded startups here, plus over 350 founded by women.

Reality check: Women-founded startups are still raising less capital; their median VC deal in 2022 was $1.01 million, compared with $1.65 million for all companies.

Zoom out: Overall, the tech sector has raised less money in 2022 than in 2021. There has been $2.5 billion in capital raised for startups in the first half of 2022, on pace to fall way short of the overall $11.8 billion raised in 2021.

Of note: The report uses data from Pitchbook and Crunchbase, which does not give information on LGBTQ+, Asian, Native American and Middle Eastern founders.

2. The missing Mary Miller

U.S. Rep. Mary Miller gives remarks after receiving an endorsement from former President Trump in June in Mendon, Illinois. Photo: Michael B. Thomas/Getty Images

The Illinois GOP gathered last week in Springfield for the big Republican Day rally at the State Fair, but one prominent Republican up for reelection in November was noticeably absent — Rep. Mary Miller.

Why it matters: At a time when IL GOP party leaders are publicly acknowledging that President Joe Biden fairly won the 2020 election, journalists wonder whether Miller's robust enthusiasm for former President Donald Trump would have struck a sour note at the rally.

Flashback: Trump endorsed Miller in her primary victory over Rep. Rodney Davis.

She has called the Jan. 6 committee the "witch hunt committee."
Miller also spoke at a rally on Jan. 6, 2021, invoking a quote from Adolf Hitler.

What they're saying: When reporters repeatedly asked IL GOP chair Don Tracy about her absence at the rally, he responded, "I don't know where Mary Miller is."

When asked whether Miller's vote against certifying the 2020 election was an issue for the GOP, Tracy said, "You'd have to ask Mary Miller about her vote."

Yes, but: Miller's office did not respond to our questions.

Between the lines: "The sooner all GOPers repudiate all Trump's actions, the better we can identify with average Americans who have been pummeled by Biden's bitter policy failures," GOP analyst and former Chicago commissioner of elections Chris Robling tells Axios.

"Trump belongs in the rear-view mirror, getting smaller all the time."

3. Tips and hot links

Illustration: Brendan Lynch/Axios

❌ CTU President Stacy Davis-Gates says she will not run for mayor in 2023. (Tribune)

🚨 Nineteen counties in Illinois are suing pharmacy chains including Walgreens, CVS, Walmart, Kroger, Meijer and Albertsons for allegedly contributing to the opioid crisis. (Tribune)

🧑‍⚖️ The R. Kelly trial has turned to testimony over hush money paid to parents. (CBS 2)

✈️ United landed third in a new ranking of best airlines. (Axios)

🖌️ Police have a way to keep thieves from stealing catalytic converters: Paint them pink. (Sun-Times)

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4. Take "meat" out of the ballgame

A nacho helmet with plant-based chicken. Photo: Monica Eng/Axios

👋 Hey, it's Monica. I've been trying to eat less meat for a while, so I was thrilled to hear that Wrigley Field expanded plant-based versions of popular snacks in late July.

Driving the news: OZO Foods (owned by Brazilian meat giant JBS) just inked a three-year deal to become the "official plant-based food choice of the Chicago Cubs."

But is this stuff any good? I went to the Cubs-Brewers game on Saturday to see.

Veggie dogs at Wrigley Field on Saturday looked like they'd spent too much time under a heat lamp. Photo: Monica Eng/Axios

The dishes: Nachos (both helmet and regular) with OZO "chicken strips" and "ground beef," veggie dogs and planterra burgers — all at the same price of their meaty counterparts.

The ingredients: OZO products are made from a blend that includes non-GMO pea protein, soy protein, rice, wheat gluten and fermented shiitake mushrooms.

The verdict: Despite the shriveled look of the weenies, the dogs offered a surprisingly nice bounce and taste, albeit when covered in traditional Chicago hot dog toppings.

The faux ground beef and chicken in my nacho helmet was so covered in other stuff that its flavor was hard to distinguish. But the texture was good.
I didn't love the aftertaste and texture of the planterra burger, which required a long-ish custom preparation, compared with other burgers on the menu.

The bottom line: The weird looks and long waits I encountered while ordering these items at Wrigley tell me concession staffers (and visitors) may need more time to get used to these vegetarian-friendly options.

Of note: After I finished my tasting, I learned that the veggie dog is not made by OZO, but instead by Beyond Meat.

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5. Where in the world is Monica?

Photo: Monica Eng/Axios

Where's Monica this week? Here's a hint:

'Twixt Von Steuben and Roosevelt,
I'm at the end of the line.
This was once a Jewish belt,
Then Korean and Levantine.

📫 Reply with the correct answer, and you could win some Axios swag! Good luck!

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Our picks:

🧐 Monica is just starting "Better Call Saul" and wonders when it gets exciting.

🤯 Justin's head still hurts from the amazing yet challenging finale of "The Rehearsal" on HBO. It is like nothing he's ever seen before on television. Four stars.

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2022-08-24 Axios

Wed, 24 Aug 2022 10:08:20 GMT

Presented By PhRMA

Axios Vitals

By Tina Reed · Aug 24, 2022

Good morning, Vitals readers. Today's newsletter is 997 words or a 4-minute read.

🚨 Situational awareness: A federal judge in Texas agreed to block HHS from enforcing its July guidance which told providers who perform abortions in emergencies they are protected under the federal law known as EMTALA.

Texas officials had filed a lawsuit challenging the guidance.

1 big thing: New drug pricing law puts cancer drugs in the spotlight

Illustration: Aïda Amer/Axios

Democrats' new drug pricing law will likely deliver a financial blow to one of the fastest-growing and most lucrative segments of the pharmaceutical industry: cancer drugs, Axios' Caitlin Owens and Victoria Knight write.

Why it matters: The drug industry argues the new law will keep oncology treatments from reaching some patients who need them.

But experts say the current system lets companies profit from developing drugs that yield only incremental advances — and that cancer drugs will still be valuable enough for companies to pursue.

The big picture: The dispute over how Medicare drug price negotiations affect cancer care is a microcosm of a larger debate, in which the pharmaceutical industry argues that price controls will reduce their incentive to bring new drugs to market.

But the cancer market is unique, both in terms of its recent growth trajectory and in how drugs' uses typically evolve once they’re already on the market.

What they’re saying: Research on cancer drugs after initial approval "will be gutted by this bill," Stephen Ubl, CEO of PhRMA, wrote in an Aug. 4 letter to Congress.

The other side: Some experts dismiss the industry's concerns as fear mongering, countering that expanding the market for a particular oncology drug will still be more than profitable enough to justify R&D costs.

The bottom line: Capping the price of a new drug after a certain amount of time "certainly does decrease the incentive of a manufacturer to pursue different indications, because functionally they have significantly less revenue per unit," said Avalere Health's Massey Whorley.

But a decreased incentive isn’t the same as no incentive.
"What the calculus then shifts to ... is it going to continue to allow them to fully recoup their costs of pursuing a new indication," Whorley added.

2. Cancer top driver of employer health costs

Cancer care has become the top driver of large employers' health care costs due to an increase in late-stage diagnoses, according to a new survey from the Business Group on Health.

Why it matters: It's one of the early signs of how deferred care during the pandemic is resulting in more complex and resource-intensive cases.

After actual health costs stayed flat from 2019 to 2020, employers saw a median 2021 increase of 8.2%.

In the survey of 135 large employers across varied sectors who cover more than 18 million people in the U.S., 13% of companies said they have already seen more late-stage cancers.
Another 44% said they anticipate seeing an increase in the future because of those pandemic-related delays.
Musculoskeletal conditions and cardiovascular disease are also among the top cost drivers.
Employers indicated the leading health-related impact of the pandemic is long-term mental health concerns among their workforce with about 43% already observing the trend and another 39% anticipating such increases.

What else: Despite the increased costs, employers are reluctant to shift costs to employees in the short-term and are instead looking at delivery system reforms such as advanced primary care and the use of centers of excellence to curb costs.

3. Social media misinformation hits 988

Illustration: Allie Carl/Axios

The new 988 number for the national mental health hotline was supposed to be as easy to remember in an emergency as calling 911.

But that similarity may also be inspiring misinformation to proliferate on social media, experts say.

Driving the news: In the month since it launched, 988 has become subject to a number of widely circulated claims to discourage people from calling, including that it will result in police response to mental health calls.

The way people dubbed the number the 911 for mental health sowed confusion and fear, Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness told Axios.

"What happens when you call 911? Emergency services are dispatched," she said. "But 988 is different. Trained crisis counselors are answering the phone and they can resolve the vast majority of crises on the phone."
What's more, she said, claims that 988 can geolocate callers are also untrue since calls are routed to community services based on the caller's area code.

The big picture: The Substance Abuse and Mental Health Services Administration said call centers saw a 45% spike nationwide in the first week 988 was launched.

It's not released call volumes since the launch, but reports nationwide indicate call volumes have since normalized, Wesolowski said.

A message from PhRMA

Improving access to life-saving medicine

Insurance companies and PBMs don’t pay full price for insulin. So why do patients?

Rebates, discounts and other payments from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these discounts directly with patients.

Here’s what you should know.

4. Moderna seeks FDA OK for updated COVID shot

Illustration: Sarah Grillo/Axios

Moderna announced yesterday that it requested emergency authorization for its updated COVID-19 vaccine from the FDA, Axios' Sareen Habeshian writes.

Doses of the updated vaccine, which better targets new coronavirus variants, will be ready to ship next month if the FDA grants clearance, according to a Moderna news release.

Why it matters: It comes just a day after Pfizer and BioNTech similarly announced that they applied for FDA emergency use authorization for their new booster dose.

Be smart: The Biden administration is seeking to launch a booster campaign shortly after Labor Day, the New York Times reports.

Peter Marks, the top vaccine regulator for the FDA, said his team was close to authorizing the updated doses, saying he was "extremely confident" the doses would be safe and effective, per the Times.
The CDC has scheduled a meeting for its vaccine advisory panel for Sept. 1 and 2.

5. Catch up quick

A drone carries human tissue from one hospital in Belgium to another for analysis on Tuesday, a first in Europe that could save valuable time during surgery. Photo: Kenzo Tripboulliard/AFP via Getty Images

💻 Yelp has begun flagging listings for crisis pregnancy centers, identifying the sites as places that provide "limited medical services" in order to distinguish them from abortion clinics. (Insider)

🐓 The H5N1 flu, which spread in both wild birds and poultry, has persisted in the U.S. and Canada this summer when many believed it might peter out, making experts worry it may be here to stay. (Science)

💊 Two clinical trials to test tecovirimat, the monkeypox treatment known as TPOXX, are under way: one at the University of Oxford and one at NIAID in collaboration with the AIDS Clinical Trial Group. (National Institute for Health and Care Research) (ACTG Network)

👉 Despite the FDA ordering hundreds of vape products off the market, an investigation shows companies that make and sell the products are flouting the law — with few consequences. (STAT News)

A message from PhRMA

Health savings for patients, not middlemen

Rebates and discounts from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these savings directly with patients.

Next steps: Fix harmful insurance practices and lower out-of-pocket patient costs.

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2022-08-24 Axios

Wed, 24 Aug 2022 10:08:24 GMT

Axios Chicago

By Monica Eng and Justin Kaufmann · Aug 24, 2022

Happy Wednesday! Today is National Waffle Day. Iron 'em if you got 'em.

☀️ Today's weather: Sunny and warm with a high of 85.

Today's newsletter is 881 words — a 3.5-minute read.

1 big thing: Portillo's takes indirect swipe

Portillo's in River North reopened for dine-in service in 2020. Photo: Zbigniew Bzdak/Chicago Tribune/Tribune News Service via Getty Images

Portillo's is expanding in the Sun Belt, with a Texas debut later this year and additional locations in Florida and Arizona.

That should be a point of pride for Chicago, except CEO Michael Osanloo is indirectly criticizing us in the process.

Driving the news: In a recent press blitz, Osanloo said the expansion is driven by local population losses and a stagnant business environment.

"We're going to places where the population is growing, where the economy is healthy," Osanloo told Yahoo Finance.
He also said that, anecdotally, hiring is easier in states such as Florida.

Why it matters: Portillo's started in 1963 in Villa Park and is one of the most successful fast-food restaurants operating today.

There are over 40 Portillo's locations in greater Chicago.

What they're saying: "It's a punch in the face," Osanloo said to Bloomberg about the city's population loss.

"And it's not like people aren’t building restaurants in Chicago. So it’s a dog fight."

Between the lines: The Bloomberg article implies that because of Chicago's population loss, Portillo's is going the way of Boeing and Citadel by setting up business elsewhere.

Yes, but: "While there is certainly increasing competition for restaurants in Chicago — as there would be in any area with urban population decline — Portillo's isn't seeing an impact to sales at our restaurants in the area as a result of that movement," a spokesperson tells Axios.

"Our growth across the Sun Belt, and in the Midwest, is part of Portillo's long-term strategy. In addition, we will continue to grow in the greater Chicagoland area at a measured pace."

What's more: Osanloo also told Bloomberg that diners here are more cautious about returning to work and eating indoors during the pandemic.

According to OpenTable restaurant data, Chicago's restaurant recovery has been slower than other cities'.

By the numbers: Portillo's went public last October. After the initial spike, stock prices have dipped in 2022.

Caption: Chart: Axios Visuals

💭 Justin's thought bubble: Chicagoans love that Portillo's is expanding. The brand is a point of pride. But we're not OK with you blaming us for it!

This seems like basic business: If you saturate a market, the uniqueness wears off. Put 40 of any restaurant in Phoenix and see what happens.

2. Not so hellish after all

Data: Axios Chicago reader survey; Chart: Sara Wise/Axios

Breaking news — most of you don't think we live in a satanic underworld.

Why it matters: The results of our survey run counter to Illinois gubernatorial candidate Darren Bailey's remarks last week that most Chicagoans agree with his portrayal of their city as a hellhole.

More than 93% of our respondents say they don't agree with Bailey.

Yes, but: Most respondents — 55.2% — acknowledge Chicago "does have some issues."

The other side: Nearly 7% agreed with Bailey.

What you're saying: "Chicago is not a hellhole, and Bailey is using bad faith to appeal to his base," reader Mike C. says. "But Twitter users replying with scenic skyline pics isn't really a rebuttal."

"The city has real problems we can't just downplay."

3. Tips and hot links

Illustration: Brendan Lynch/Axios

📱 Illinois TikTok users could see money from a lawsuit settlement over privacy. (ABC 7)

⚖️ Ex-Ald. Patrick Daley Thompson has begun serving his four-year sentence at a federal prison. He was convicted this year for tax evasion and lying to banking regulators. (Tribune)

🏛 Tavis Dunbar has been charged with three counts of first-degree murder after he allegedly struck multiple pedestrians with his car in front of Jeffrey Pub in South Shore, one of the nation's oldest Black gay bars. (Sun-Times)

📺 Mayor Lightfoot called out a pro-Darren Bailey ad featuring an image that she said darkened her skin. (Tribune)

🏀 If you're in the market for Bulls championship rings, an auction house is selling Horace Grant's. They could go for $100k each, but Grant won't see any money, because he sold the rings years ago for charity. (TMZ Sports)

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4. Sky move on to semifinals

Kahleah Copper drives to the basket during last night during the Sky's victory in Brooklyn. Photo: Evan Yu/NBAE via Getty Images)

The Sky fended off the Liberty for a 90-72 victory last night, and will move on to the semifinals in the WNBA playoffs.

Driving the news: The starters were all in double figures while they played ferocious defense to stifle the Liberty late in the 4th quarter.

Star Candace Parker had 14 points, 13 rebounds and 8 assists.

What's next: The defending champs will play the winner of the Connecticut Sun vs. Dallas Wings matchup.

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5. Where's Monica? The Kimball L station

Passengers rest on a functional sculpture called Hope and Renewal at the Kimball station. Photo: Monica Eng/Axios

👋 Hey, it's Monica. Dozens of you guessed correctly that I was visiting the Kimball L stop at the end of the Brown Line, where I spent many a high school winter night shivering and waiting for a bus.

Flashback: The station opened as part of the Northwestern Elevated Railroad's Ravenswood branch in 1907 when Albany Park was still barely developed.

The area soon had so many families that the city built Roosevelt High School in 1922, followed by Von Steuben less than a mile away in 1930.
The station got its first makeover in 1974 and another in 2007 when this functional tandem sculpture by Josh Garber, called Hope and Renewal, was unveiled.
Albany Park, which has hosted waves of different immigrant groups over the years, remains one of the most culturally diverse neighborhoods in the nation.

👏 Congratulations to Brian E. and Frank S., whose names we picked out of a conductor's hat. Pick up some sweet Axios swag at our next event!

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Our picks:

🎤 Monica is excited to talk about the future of food in the U.S at the Food Tank Chicago Summit today at UIC.

📽 Justin is looking forward to Destroy Your Art at the Music Box on Thursday. It's a great series that tasks filmmakers with creating short films that will be demolished right after the audience sees them.

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2022-08-24 Axios

Wed, 24 Aug 2022 16:08:23 GMT

Exclusive: Nitra raises $62M seed for doctor payment platform

🔒 Axios Pro exclusive:

This story was first broken by Axios Pro reporter Erin Brodwin.

Launching a Visa Business card for physicians, fintech startup Nitra raised $62 million in debt and equity, CEO Jonathan Chen tells Axios exclusively.

Why it matters: Health care's outdated payments ecosystem means doctors rely heavily on manual tasks and accountants to buy medical supplies and handle office upkeep — cutting into the time they spend on patient care.

Read the analysis

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2022-08-25 Axios

Thu, 25 Aug 2022 10:07:27 GMT

Presented By PhRMA

Axios Vitals

By Tina Reed · Aug 25, 2022

Good. morning, Vitals readers. Today's newsletter is 998 words or a 4-minute read.

Situational Awareness: Just weeks after agreeing to buy hybrid primary care company One Medical, Amazon announced yesterday afternoon that it is shuttering Amazon Care. Here is Axios' Erin Brodwin's take.

1 big thing: Hospitals press for more federal help

Illustration: Annelise Capossela/Axios

Some of the biggest hospital chains are seeing business rebound to pre-pandemic levels, but the industry as a whole is pressing for more federal relief before year's end, citing inflation, labor and supply cost pressures, Axios' Arielle Dreher writes.

Why it matters: Hospitals are the biggest driver of U.S. health care spending, and the pandemic has tested Washington's willingness to take on the powerful industry.

The biggest focus is a scheduled 4% Medicare payment cut due to take effect at the end of the year unless Congress delays it.

Driving the news: Second quarter earnings reports show how well some of the industry's biggest names have weathered the COVID-19 crisis.

Yes, but: Hospitals say people who deferred care for non-COVID reasons during the pandemic are now showing up sicker and in need of longer stays and more intense treatment.

Patient volumes are back up to pre-pandemic levels in many hospitals, especially emergency departments, a July Kaufman Hall flash report shows.
Volatility in financial markets is also driving some hospital operators' investments underwater.
And facilities are grappling with more spending on high-cost specialty drugs. A recent American Hospital Association report noted Humira, used to treat patients with rheumatoid arthritis, had a 21% price increase between 2019 and 2021.

Zoom in: Hospital groups fear that the combination of inflation, a changing health care landscape and the staffing crisis could ruin facilities operating on the margins.

2. Millions out of work from long COVID: Brookings

Illustration: Maura Losch/Axios

As many as 4.1 million people may remain out of work due to long COVID symptoms, according to a new estimate from Katie Bach, a nonresident senior fellow at the Brookings Institution.

Why it matters: That figure, which incorporates four new questions about long COVID from the Census Household Pulse Survey, is more than twice an earlier estimate and could help explain the lingering labor shortages in America.

It's also particularly concerning since we still don't know why some people get long COVID, how long those symptoms can linger and how to treat the condition.

By the numbers: About 16.3 million working-age Americans, or about 8%, reported they have long COVID.

Between 1.8 million and 4.1 million can't work because of it.
The annual cost of those lost wages alone is around $170 billion a year.

"If long COVID patients don't begin recovering at greater rates, the economic burden will continue to rise," Bach wrote.

3. The impact of loan relief on docs

President Biden's student loan forgiveness may help medical students chip away at the mountains of debt they accumulate, especially if they still owe from their undergraduate studies, Axios' Victoria Knight writes.

Why it matters: Almost three quarters of all medical school students had education debt when they graduated in 2021, most of it usually tied to federal loans.

By the numbers: On average, medical students graduated with $203,062 in education debt according to data for the class of 2021 from the Association of American Medical Colleges.

30% had debt left from before medical school, with a median amount of $27,000.
In 2022, medical residents made on average $64,200 per year, according to a 2022 Medscape Resident survey. That means many should qualify for Biden's forgiveness program since the salary cut-off is $125,000.
Fully trained doctors will likely be shut out. The Bureau of Labor Statistics estimates that a pediatrician makes around $198,000 while a cardiologist makes around $331,000.

A message from PhRMA

Improving access to life-saving medicine

Insurance companies and PBMs don’t pay full price for insulin. So why do patients?

Rebates, discounts and other payments from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these discounts directly with patients.

4. Health prices rising faster in the private sector

Illustration: Sarah Grillo/Axios

Health care prices overall may be lagging inflation, but there's a widening divergence between what's being paid in Medicare and the private sector, Axios' Caitlin Owens writes about a new Altarum analysis.

Why it matters: Privately insured Americans are about to pay more for their health care if they aren't already.

The big picture: Economy-wide inflation has outpaced health care inflation over the last year — an anomaly since medical prices typically rise faster.

Last month, overall prices were 8.5% higher than in July 2021, but prices for medical care were only 4.8% higher, per KFF.

Yes, but: July also saw a substantial divergence in what Medicare and the private sector pay for goods and services, which essentially canceled each other out in the aggregate, according to Altarum.

5. Panel documents pressure campaign on FDA

Former Trump White House adviser Peter Navarro. Photo: Drew Angerer/Getty Images

The Trump White House coordinated a pressure campaign for the FDA to authorize the antimalarial drug hydroxychloroquine to fight COVID-19 after it was shown to be ineffective and potentially dangerous, a House investigative report charges.

Why it matters: The Select Subcommittee on the Coronavirus Response report offers more evidence of political tactics targeting the coronavirus response including blocking guidance on vaccines and the role of Trump's economic adviser Peter Navarro, Axios' Adriel Bettelheim reports.

What they found: Navarro and Steven Hatfill, an outside adviser on the COVID response, coordinated with representatives at Henry Ford Health on a July 2020 request from the health system to reauthorize hydroxychloroquine while obscuring the White House's involvement. The FDA denied the request.

Navarro and Hatfill courted outside groups and Sen. Ron Johnson (R-Wis.) to apply pressure on FDA officials while coordinating with officials including White House chief strategist Steve Bannon and conducting official business on private email accounts.

Henry Ford Health said in a statement it would launch an investigation after reviewing the report.

A spokesperson for Johnson said in a statement the findings were an attempt to smear the senator's "good faith attempts to promote early treatment."

6. Major breakthrough in psychedelics research

Illustration: Aïda Amer/Axios

The key ingredient in magic mushrooms, combined with psychotherapy, resulted in "robust decreases" in heavy drinking by adults diagnosed with alcohol dependence, according to a study published in JAMA Psychiatry.

Why it matters: It's a promising development for the understanding and treatment of alcohol abuse — which has few effective medication options — as well as addiction more generally.

This double-blind trial led by the researchers at NYU Langone compared the effectiveness of 12 weeks of psychotherapy delivered with two day-long medication sessions of either psilocybin or an active placebo.

The percentage of heavy drinking days during a seven-month period was 10% for the group that received psilocybin compared to 24% in the placebo group. The consumption of drinks per day was also lower in the psilocybin group.

A message from PhRMA

Congress should address the system we use to pay for medicines

Insurers and PBMs receive discounts on insulins from manufacturers but don’t usually pass these savings directly to patients.

The impact: Patients are burdened with higher than necessary out-of-pocket costs.

Why stop here? Let's go Pro.

Join the thousands of professionals reading Axios Pro: Health Tech Deals to better understand the forces shaping their industry.

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2022-08-25 Axios

Thu, 25 Aug 2022 10:07:31 GMT

Pre-order today at SmartBrevity.com.

Axios Chicago

By Justin Kaufmann and Monica Eng · Aug 25, 2022

Happy Thursday! It's National Secondhand Wardrobe Day, so go find something cute at your local thrift store and feel good about it.

☔️ Today's weather: Rain in the forecast. High of 82.

Today's newsletter is 885 words — a 3.5-minute read.

1 big thing: The new Big Ten

The Big Ten Conference logo at the football Media Days in July. Photo: Michael Hickey/Getty Images

The Big Ten has gotten a whole lot bigger since the last time the conference took the football field.

Driving the news: After adding USC and UCLA — which will become the conference's 15th and 16th universities in 2024 — and signing the most lucrative broadcast contract in TV history, reports say Oregon could be next.

Why it matters: The conference's headquarters is in Rosemont, and sports bring big revenue to schools like Northwestern and the University of Illinois.

Context: In 2014, the Big Ten expanded outside its traditional Midwestern schools by adding Rutgers and Maryland — or, more accurately, the markets of New York City and Washington, D.C., respectively.

The recent expansion to include USC and UCLA will bring in California for the first time.

The big picture: Gone are the days of the Big Ten as a Midwest juggernaut.

To compete with the SEC, the conference has set its sights on bigger cities and bigger markets — and doesn't seem to be stopping there.
According to Big Ten commissioner Kevin Warren, schools like Notre Dame, Florida State and Stanford are possibilities.
He suggested the conference could eventually expand to 20 schools.

What they're saying: "I think it's changed the narrative on the Big Ten Conference,” Warren told Sports Illustrated last month.

"We shrunk the United States in one announcement."

What's next: NU kicks off its 2022 season on Saturday against Nebraska in Dublin, Ireland.

The Illini host Wyoming.

2. Sweet, sweet loan relief

Illustration: Maura Losch/Axios

The Biden administration is canceling up to $20,000 in student debt for Pell Grant recipients and up to $10,000 for individual borrowers who make under $125,000 per year.

The pause on student loan repayments that began under former President Donald Trump has been extended another four months.

The big picture: Over 1.6 million Illinoisans have more than $62 billion in student loan debt.

What they're saying: "Today's announcement by President Biden is a crucial step to enable low- and middle-income borrowers — especially communities of color — to eliminate their debt so they can buy a home, start a business, save for emergencies, and fully participate in our economy," Sen. Dick Durbin wrote in a statement.

The other side: Downstate U.S. Rep. Mary Miller, who has been missing from recent GOP messaging, put out this statement: "Joe Biden announced a $300 billion taxpayer-funded bailout for leftist colleges and universities that prey upon young people by selling them worthless 'humanities' degrees so they can become foot soldiers in the Marxist revolution destroying America."

What's next: Details on applying for the program will be released in coming weeks.

More information, notifications

Data: Federal Student Aid; Note: Includes outstanding principal and interest balances from Direct Loans, Federal Family Education Loans and Perkins Loans; Table: Simran Parwani/Axios

3. Tips and hot links

Illustration: Brendan Lynch/Axios

🚨Four people were shot during an apparent drive-by shooting across the street from Schurz High School on the Northwest Side. Two of the victims are 15-year-old boys. (ABC 7)

🚌 Parents say buses for CPS special needs students are late, slow or no-shows so far. (BlockClub)

💰 Gov. Pritzker donated $5.5 million to the Illinois Democratic Party and its candidates. (Tribune)

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Axios’ founders wrote a book to share their methods for punching through the noise to get people to pay attention to what matters most.

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4. ChicagoNow is now Chicago history

The Tribune Tower. Photo: Scott Olson/Getty Images

👋 Hi, it's Justin! Late last week, the Chicago Tribune-run blog network, ChicagoNow, quietly shut down.

The bloggers were not told beforehand, and the Trib decided not to save their archived material.
Former ChicagoNow manager Jimmy Greenfield wrote that the move "was done in a cowardly and horribly unprofessional way."

Flashback: When ChicagoNow launched in 2009, it was considered the future of digital journalism. Unpaid writers penned daily posts on everything from crime and fashion to local history.

Over time, the blog network lost out to other online channels.

Between the lines: ChicagoNow should be remembered for its role in a local digital news revolution that included other innovative ventures, including:

Gapers Block: Started in 2003 with bite-size news links and a robust calendar, the independent site shut down in 2016. But you can still read its archives.
Chicagoist: Featured great local coverage until Joe Ricketts shut down that national network in 2017. Chance the Rapper bought it four years ago with plans to relaunch but for now, it's still just archives.
Vocalo Blogs: Launched in 2009, the WBEZ-owned blog network featured writers like Robert Feder, Jim DeRogatis, Lee Bey and Amy Krouse Rosenthal. After it was shut down in 2012, the archives were not saved.
- Full disclosure: I ran that site.

The bottom line: I'd argue if it weren't for enterprises like ChicagoNow or the Vocalo Blogs, there wouldn't be newsletters like the one you're reading.

Over 1 million readers now wake up to Axios Local in their inbox. You can reach these smart professionals in their hometown.

Pre-order today at SmartBrevity.com.

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5. Food Fight: Iced coffee

The Military Latte from Sawada. Photo: Justin Kaufmann/Axios

In honor of trying to finish summer strong, we're focusing on the cool elixir that powers us through the dog days — iced coffee.

Justin's pick: My favorite is the Military Latte from Sawada in the West Loop.

It's technically a matcha latte with vanilla syrup, cocoa powder and a shot of espresso ($5.95).
Swada is part of the Hogsalt empire and takes up a sliver of the Green Street Smoked Meats space across from Soho House.

Monica's pick: At home we steep big glass jars of cold brew on our counter and go through a gallon a week.

But the very best iced coffee in town comes from master brewer Justin Doggett, who crafts smooth, chocolatey Kyoto Black cold brew using a special Japanese method.
You can find it at coffee shops all over, sold in $39.95 pouches that make about a dozen cups.

📫 Reply with your favorite local iced coffees for our list next week.

A message from Axios

Say more with less.

Axios’ founders wrote a book to share their methods for punching through the noise to get people to pay attention to what matters most.

Order the book and enter to participate in a Smart Brevity workshop with the authors. No purchase necessary.

🐀 Monica called 311 on Aug. 1 to replace her lid-less garbage cart, which attracts rats. Three weeks later, she's still waiting for the replacement. And she's taking detailed notes.

🔌 Justin is excited to moderate a breakfast panel for the Chicagoland Chamber of Commerce in the Loop today. Topic: EVs!

Want free Axios swag? Refer your friends to Axios Chicago and get cool merch like stickers, totes, hats, T-shirts and more!

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2022-08-25 Axios

Thu, 25 Aug 2022 19:07:25 GMT

Presented By PhRMA

Axios Science

By Eileen Drage O'Reilly · Aug 25, 2022

Welcome back, science readers!

Alison Snyder returns from her sabbatical next week (yay!).
Let me know your feedback as well as what topics you're most interested in.

Today's newsletter is 1,557 words, a 6-minute read.

1 big thing: Why explaining virus spread is a balancing act

Illustration: Maura Losch/Axios

Public health messaging on both COVID and monkeypox has been too disjointed, confusing Americans on what steps they need to take to mitigate their risks.

Between the lines: Viruses often have multiple routes of transmission, and educating the public on the likeliest route to infection can be a balancing act for officials who want to cover all their bases and have to account for unknowns and public mistrust, several experts tell Axios.

Why it matters: The CDC and other public health agencies need to offer clear information on both potential and present risks that each outbreak poses and explain what they know — and don't know — before they lose more credibility.

Context: It can take time to gather enough data to yield answers about how the majority of infections are happening, particularly when it's a novel pathogen, like Sars-CoV-2, which officials didn't immediately recognize as spreading asymptomatically — a fact that would have altered COVID guidance significantly.

"Oftentimes, you get a list of ways [the virus] can transmit, but there's a difference between how you list it in the textbook versus what's actually driving transmission," says Amesh Adalja, senior scholar for Johns Hopkins University's Center for Health Security.
"There may be some very, very small chance of getting it a certain way in a certain circumstance — but is that actually behind how people are getting infected?" Adalja asks.
For example, he says, monkeypox can be spread via surfaces, but "if we remove all the doorknobs from every door, will we still have a monkeypox problem? Yes."

Yes, but: The waiting period while data is gathered is a time when fear and misinformation can foment and people can start to take misguided actions. Misinformation about monkeypox appears to have spread faster than the virus itself.

This was also seen with the COVID-19 pandemic, where "the message got lost" that public health officials didn't know everything at the start, says Sarah Bauerle Bass, director of Temple University's Risk Communication Laboratory.
"The messages seemingly just kept changing, and then [public health officials] lost that trust in the public's eye," Bass says.
"You have to rate [behaviors] from the most risky to the least risky. Because it is possible to contract [monkeypox] from a surface or shared clothing or bedding. ... But, is it as risky as having close sexual contact with someone where you are skin-to-skin? No," she adds.

Respiratory viruses are the most vexing because it's hard to determine if the virus is airborne and can hover or transmit over distances, or if it can spread via aerosols that remain in the air for shorter distances. Plus, something that could be shown in a lab with animals may not be happening in the real world.

"You can infect a monkey with monkeypox in laboratory conditions by aerosol, but the epidemiology doesn't indicate that's how it's been primarily transmitted in the real world," says Angela Rasmussen, a virologist at the University of Saskatchewan's Vaccine and Infectious Disease Organization.
Another factor is that there are a limited number of institutions that can safely study airborne transmission of a virus, says Julie Fischer, microbiologist and senior technical adviser for CDGF Global.

The big picture: Three main ways to determine transmission are looking at "historical lines of evidence," "epidemiological evidence in the real world," and experimental evidence of potential avenues, Rasmussen says.

"But there's also the need to explain that risk is not binary. It's not that you're either not at risk or you're almost certainly going to get monkeypox. Everything exists in a shade of gray in between those two extremes."

Read the full story

2. Zoom in: What we know about monkeypox spread

Data: CDC, U.S. Census; Chart: Erin Davis/Axios Visuals

There are multiple transmission routes for a virus that's now in every state and has become a public health emergency.

What's happening: While the majority of cases are concentrated among men who have sex with other men, there are signs of spillover into the general population, including to children.

This has led to concern that the virus is spreading via airborne particles, like COVID-19, or on surfaces, like smallpox.

While close bodily contact is the main risk, particularly via lesions that are thought to have high concentrations of viral DNA, "there is some evidence that monkeypox can be transmitted by droplet transmission," Fischer says.

People can transmit it by other means to household members, but that's not seen as a primary mechanism, Rasmussen says.
As for close bodily contact, it's unknown "whether that's due to sexual transmission by semen or other body fluids, or whether that's just close skin-to-skin contact. It could be a combination of both," Rasmussen says.

Surface transmission, via shared bedding, clothing, or other objects, is also possible, but it doesn't appear to be a main transmission route, Rasmussen says.

The CDC says it is researching if the virus can be spread via an asymptomatic person.

It's also looking at the role of respiratory secretions as well as if they can transmit via semen, vaginal fluids, urine or feces.

Read more and see Axios' Erin Davis' interactive map

3. Psychedelic may help with alcohol addiction

Illustration: Aïda Amer/Axios

Psilocybin from mushrooms combined with psychotherapy — a growing field of therapeutic research — may also help adults with alcohol use disorder, Axios' Tina Reed writes.

What's new: Researchers found "robust decreases" in heavy drinking by adults diagnosed with alcohol dependence, per the small study published in JAMA Psychiatry.

Details: The trial compared the effectiveness of 12 weeks of psychotherapy delivered with two day-long medication sessions of either psilocybin or an active placebo.

The 95 participants were adults diagnosed with alcohol dependence who had at least four heavy drinking days during the 30 days prior to screening but were not currently receiving treatment.
During the seven-month period following the treatment, the percentage of heavy drinking days was 10% for the group that received psilocybin compared to 24% in the placebo group. The consumption of drinks per day was also lower in the psilocybin group.

The bottom line: While further research is needed, it's a promising development for the understanding and treatment of alcohol abuse, which has few effective medication options, as well as for addictions more generally.

Go deeper: Read the full story and check out Tina's newsletter, Axios Vitals.

A message from PhRMA

Improving access to life-saving medicine

Insurance companies and PBMs don’t pay full price for insulin. So why do patients?

Rebates, discounts and other payments from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these discounts directly with patients.

Here's what you should know.

4. What (threats) we're watching

California firefighters remove duff, or decomposing forest floor vegetation, in an effort this month to reduce fuels and decrease wildfire risk around giant sequoias. Photo: Mario Tama/Getty Images

Valley fever: The invasive Coccidioides fungus that's been named a growing threat in the U.S. is endangering wildland firefighters in California when they don't wear respiratory protection and don't wet the ground before digging, the CDC weekly report warns.

Polio: Scientists are on alert for polio, the highly contagious virus that can lead to permanent disability and death and has been found in New York and other countries, threatening a planned global eradication.

Weather extremes: Areas around the world are reporting sometimes deadly weather events, including China's unprecedented heat wave and flooding in the U.S. Southwest.

"Tomato flu": This very contagious but rare viral infection that's spreading in children in India could be a variant of foot-and-mouth disease.

5. What (advances) we're watching

Illustration: Rebecca Zisser/Axios

Brain stimulation: Long-term memory was improved for up to a month after non-invasive, high-frequency electrical stimulation of the dorsolateral prefrontal cortex near the front of the brain, per a study in Nature Neuroscience.

Working memory was also boosted by stimulating the inferior parietal lobe, farther back in the brain, with low-frequency electrical currents.
The technology, called tACS, holds potential, but many hurdles remain before this could be approved as a therapy, STAT writes.

Artemis: NASA's Space Launch System is expected to lift off Aug. 29, a move that will test whether the agency is "still on the cutting edge" of where it would need to be for human space exploration.

Mini robot: A new robot called MiGriBot was 10x faster at micromanipulation than current models — potentially advancing microscale industrial assembly, per a study in Science Robotics.

PFAS: Researchers may have discovered a way to get rid of toxic "forever chemicals," nearly 5,000 types of chemicals that resist degradation and are pervasive in drinking water.

6. Something wondrous

The galaxy NGC 7727 seen by the Very Large Telescope. Photo courtesy of the ESO

About 1 billion years ago, two galaxies merged, creating a new galaxy seen in a photo taken by a telescope in the Southern Hemisphere, Axios' Miriam Kramer writes.

Why it matters: Galaxies can grow and evolve through collisions like this one, giving scientists a glimpse into the diversity of these types of objects out there in the universe.

What they found: The galaxy — called NGC 7727 — began to form when two galaxies danced around one another, disrupting their gas and dust, changing the way they each look.

The "tangled trails" in the photo taken by the European Southern Observatory's Very Large Telescope were produced during the merger as stars and dust were stripped from their home galaxies and combined into one, the ESO said.
"The core of NGC 7727 still consists of the original two galactic cores, each hosting a supermassive black hole," the ESO said in a statement. "Located about 89 million light-years away from Earth, in the constellation of Aquarius, this is the closest pair of supermassive black holes to us."
The two black holes are about 1,600 light-years away from one another and will merge within 250 million years, producing a more massive black hole, the ESO added.

The big picture: The Milky Way is heading toward its own slow-speed cosmic collision with the Andromeda Galaxy billions of years from now, so learning more about these kinds of crashes could help scientists understand more about our own galaxy's future.

Check out Miriam's weekly Axios Space newsletter.

A message from PhRMA

Health savings for patients, not middlemen

Rebates and discounts from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these savings directly with patients.

Next steps: Fix harmful insurance practices and lower out-of-pocket patient costs.

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2022-08-25 Axios

Fri, 26 Aug 2022 06:10:28 GMT

Axios World

By Dave Lawler · Aug 25, 2022

Welcome back to Axios World.

Tonight's edition (1,853 words, 7 minutes) starts with a look at all the countries that have prosecuted their former leaders since 2000.
Mea culpa: I messed up Monday's answer key for Where in the World. No. 7 (Antony and Cleopatra) was Alexandria; No. 8 (Midsummer Night's Dream) was Athens. Thanks for keeping me honest!

1 big thing: Ex-leaders have been jailed or charged all over the world

Data: Axios Research; Map: Nicki Camberg/Axios. Does not include impeachments. "Complicated" includes cases that are unclear, or where a former leader was temporarily detained (often following a coup) but never formally charged.

Former President Donald Trump and a number of his close allies have argued that the multiple investigations he's facing, and in particular the search of his Mar-a-Lago property, are something out of a "banana republic."

The big picture: Investigations into former leaders are hardly rare around the world. In at least 76 countries, leaders who left office since 2000 have been jailed or prosecuted — including in democracies like France, Israel and South Korea.

Since 1980, around half of the world's countries have had at least one such case, and that's not counting impeachments or coups.

Driving the news: Investigations into former leaders have been in the news around the world lately.

Former Pakistani Prime Minister Imran Khan is facing arrest on terrorism charges for comments he made at a rally. He maintains he did nothing wrong, and his pre-arrest bail was extended today through Sept. 1.
Former Malaysian Prime Minister Najib Razak is heading to prison after his conviction for corruption in the multibillion-dollar 1MDB scheme was upheld on Tuesday.
Former Brazilian President Luiz Inácio Lula da Silva is contesting an election after his corruption conviction was thrown out. Meanwhile, former Israeli Prime Minister Benjamin Netanyahu is leading his party into an election while his own corruption trial is ongoing. He says he is a victim of a "witch hunt."
A prosecutor in Argentina this week requested a 12-year sentence in corruption proceedings against former President Cristina Fernández de Kirchner, though she has legal immunity in her current role as vice president. She's denied any wrongdoing.

Several ex-leaders from wealthy democracies have found themselves on trial in the past two decades.

Like Trump, Former French President Nicolas Sarkozy had his home searched after leaving office. He was convicted in two separate cases last year and sentenced to prison (he's appealing).
In South Korea, former President Park Geun-hye was sentenced to 24 years for corruption. She was pardoned by her successor in December after serving five.
In Taiwan, former President Chen Shui-bian was convicted of bribery in 2009.
Former Italian Prime Minister Silvio Berlusconi has been in and out of court for three decades and was temporarily barred from seeking office due to a tax fraud conviction. But he'll still be a kingmaker in next month's election, at the age of 85.
- He's far from the only leader for whom a trial or even conviction was not career-ending.

For obvious reasons, the countries that are least likely to be filled in on our map are monarchies or dictatorships where leaders are long-serving and untouchable.

In some countries, leaders may be inclined to cling to power due to the risk of prison if they don't. That's one explanation for the trend of African leaders seeking third terms.
But the region where the most countries have jailed or prosecuted former leaders over the last two decades is Latin America. In Peru, every president but one who served between 1985 and 2018 has been arrested or charged.
Former Mexican President Enrique Peña Nieto is under investigation for alleged corruption but has not been charged.

In the vast majority of cases all over the world, the charges former leaders have faced relate to corruption.

Worth noting:

Because we were looking at cases where leaders were jailed or prosecuted after leaving office, we didn't include impeachments and didn't automatically include coups — though cases where leaders were detained following coups are in the "complicated" category.
We did include cases where ex-leaders were prosecuted in absentia or faced charges that were later dropped. We didn't include cases where leaders left office before 2000 but were charged more recently (Chile's Augusto Pinochet, for example). We didn't include cases where the charges came solely from international courts.
In the vast majority of these cases, the ex-leader was prosecuted or jailed for their activities in office, rather than before or after.
We were only considering leaders who held the most powerful political office in each country, though that required judgment calls in a few cases.

Thanks to Laurin-Whitney Gottbrath and Ivana Saric for helping to compile the data.

2. Global news roundup

Casting a ballot in Luanda, Angola. Photo: John Wessels/AFP via Getty

1. Fighting erupted in Ethiopia's Tigray region on Wednesday between government forces and the Tigray People's Liberation Front, ending a months-long cease-fire, Axios' Ivana Saric writes.

2. Japan is considering a major pivot back to nuclear power 11 years after Fukushima.

3. Angola’s ruling party is on course for victory with 51% of the vote with nearly all ballots counted, 7 points ahead of the main opposition.

4. Thai Prime Minister Prayuth Chan-ocha was suspended pending a Constitutional Court ruling on whether he has violated term limits.

He took power in a coup eight years ago, the maximum tenure for a PM, but he argues the clock started later. Analysts say the court is unlikely to remove him.

5. Taiwan is planning a big increase in defense spending.

6. The Biden administration has urged the Palestinian Authority not to pursue a vote at the UN Security Council on gaining full UN membership, stressing it will likely veto any such move, Axios' Barak Ravid reports.

7. Police in Brazil conducted several raids after text messages leaked showing prominent Jair Bolsonaro supporters expressing support for a coup if he loses in October.

8. El Salvador President Nayib Bukele plans to swiftly build a huge prison to house 40,000 gang members.

9. French President Emmanuel Macron promised to “look back at the past with humility” today during a fence-mending trip to Algeria, a former French colony.

Restoring relations is important for French influence in Africa, and Algeria’s energy exports to Europe are also taking on additional importance.

3. Breaking: Near miss on nuclear disaster, Zelensky says

The Zaporizhzhia nuclear power plant. Photo: Xinhua via Getty Images

Ukrainian President Volodymyr Zelensky said this evening that there was nearly a “radiation accident” today when Europe’s largest nuclear power plant was temporarily disconnected from the electric grid.

How it happened: Ukraine's state nuclear company said this morning that the Zaporizhzhia nuclear power station had lost its connection to Ukraine's power grid "for the first time in the history of the plant." Fires had damaged power lines outside the station.

Zelensky blamed Russian shelling, while Russia blamed Ukraine. Power outages were reported in the region.
"If the diesel generators hadn't turned on, if the automation and our staff of the plant had not reacted after the blackout, then we would already be forced to overcome the consequences of the radiation accident," Zelensky said.
The UN’s nuclear watchdog is desperate to gain access to the plant. “Almost every day there is a new incident at or near the Zaporizhzhia nuclear power plant. We can't afford to lose any more time," IAEA chief Rafael Grossi said in a statement.
Flashback: Russia occupied Zaporizhzhia early in the war and forced Ukrainian workers at the plant to keep it operating.

What to watch: The plant supplies one-fifth of Ukraine’s electricity, but U.S. and Ukrainian officials have warned that Russia might try to redirect the electricity to Russia’s own electric grid.

In related news…

Russian opposition politician Yevgeny Roizman said he was detained Wednesday for calling the invasion an “invasion.”
Ukraine’s top soccer league returned Wednesday, which was Ukraine’s independence day and the six-month mark since the invasion. Boris Johnson also visited Kyiv.
Also on Wednesday, at least 25 people were killed and another 31 were wounded in an attack by Russian forces, Zelensky's office said, and President Biden announced another $3 billion in weapons.

Go deeper: State of the war, six months on

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Bonus: Where in the world?

Illustration: Natalie Peeples/Axios

I've got a puzzle for you tonight. Can you name the two countries to which all five rules apply?

Has a Z in its name (15 countries left).
NOT in Europe (12 countries left).
English is an official language/lingua franca (5 countries).
NOT landlocked (3 countries).
Population under 10 million (2).

Scroll to the bottom for the answers.

4. Fears of violent escalation as Iraq's political deadlock deepens

Supporters of Iraqi Muslim Shiite cleric Muqtada al-Sadr gather outside the Supreme Judicial Council. Photo: Ahmad Al-Rubaye/AFP via Getty Images

The deep political deadlock in Iraq has entered its 10th month with no solution in sight and fears of potential civil war, Mustafa Alrawi writes for Axios.

The big picture: Iraq held early elections in October 2021 in response to a nationwide, pro-reform protest movement that began in late 2019. Shiite cleric Muqtada al-Sadr's Sadrist movement became the largest bloc in Parliament.

His rivals — the Coordination Framework grouping of Shiite parties, which includes Iran-backed former Prime Minister Nouri al-Maliki — have thwarted al-Sadr’s efforts to form a coalition government with leading Sunni and Kurdish parties.
Al-Sadr has ordered his own MPs to resign and blocked the Framework from nominating its own prime minister.

State of play: Both camps, which command heavily armed militias, have organized protests in the capital Baghdad in recent weeks.

Al-Sadr's followers have breached the secure Green Zone on multiple occasions and protested outside the Supreme Judiciary Council on Tuesday.
He has demanded the country's judiciary dissolve Parliament, but this has been rejected.

Driving the news: Outgoing Prime Minister Mustafa al-Kadhimi hosted a national dialogue last week that the Sadrist movement refused to take part in, though most other major groups did. For now, the deadlock grinds on.

5. Five years of trauma for the Rohingya

Rohingya refugees take part in "Genocide Remembrance Day" rally to mark five years since fleeing Myanmar. Photo: Munir uz Zaman/AFP via Getty Images

Hundreds of thousands of Rohingya in Bangladesh and elsewhere continue to suffer "unimaginable consequences" five years after fleeing the Myanmar military's bloody campaign against them, Axios' Laurin-Whitney Gottbrath writes.

The big picture: The Rohingya, the majority of whom are Muslim, have been described as the "world's most persecuted minority." Thousands were killed and 745,000 displaced in 2017 as Myanmar's military intensified its yearslong campaign against the ethnic minority in what the U.S. and other countries have declared a "genocide" — a declaration Myanmar rejects.

Today, nearly 1 million Rohingya — half of whom are children — continue to live in squalid conditions in overcrowded refugee camps in Bangladesh, where they are largely unable to work, their movements are restricted and rights groups say their human rights are violated.
Previous attempts to allow the Rohingya to safely return to Myanmar have failed, and the security situation in the southeast Asian nation has only deteriorated since last year's military coup.
Meanwhile, hundreds of thousands of others are displaced in Myanmar, where they continue to face persecution and violence.

6. The rise of unsanctioned saints

From left: Saint Jude, Santa Muerte and Jesús Malverde in Colonia Doctores of Mexico City. Photo: Courtesy of Andrew Chesnut

Devotion to unsanctioned Catholic folk saints is one of the fastest growing religious movements in Latin America, Axios' Russell Contreras reports.

The big picture: Some Latinos who feel alienated by Christian traditions are turning to saints not sanctioned by the struggling Catholic Church for spiritual guidance around love, crime and money.

Catholic leaders worldwide have denounced unofficial "narco" saints as sinful, but makeshift shrines continue to pop up.
Believers say unsanctioned saints offer divine assistance to steal gas, move a drug shipment, cross a border, or bless an LGBTQ+ romance.

7. Stories we're watching

Celebrating Ukraine's Independence Day, in Warsaw. Photo: Anek Skarzynski//AFP via Getty

Putin signs decree to boost size of Russian forces
Over 900 killed by floods in Pakistan
International show of support for Taiwan grows
WHO: Monkeypox cases dropped 21% over last week
Australia announces inquiry into ex-PM Morrison
U.S. launches airstrikes on Iran-backed groups in Syria
France mulls regulations on private jets

Quoted:

"We are witnessing the end... of abundance. And for those who might have enjoyed it, it is also the end of a carefree time. Our freedom, the liberty we have grown accustomed to in our lives, has a price."

— French President Emmanuel Macron on Wednesday. France has faced severe drought this summer, and energy prices are now spiking due to the war in Ukraine.

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2022-08-26 Axios

Fri, 26 Aug 2022 10:07:25 GMT

Presented By PhRMA

Axios Vitals

By Tina Reed · Aug 26, 2022

😎 Happy Friday, Vitals readers. Today's newsletter is 973 words or a 4-minute read.

1 big thing: Dems tout their health care bonafides in midterm stretch run

Rep. Abigail Spanberger (D-Va.) at a campaign event in Woodbridge, Va. Photo courtesy of Abigail Spanberger for Congress

With the midterms looming, vulnerable congressional Democrats are wagering the health care provisions in the just-passed $740 billion reconciliation bill will give them an edge and possibly preserve their razor-thin majorities, Axios' Victoria Knight writes.

Why it matters: Recent projections show Republicans likely to flip control of the House.

But Democrats are trying to reprise their 2018 health care-focused campaign playbook with messaging around bill language allowing Medicare to negotiate the price of some drugs and extending enhanced Affordable Care Act subsidies for three years.

Driving the news: Rep. Abigail Spanberger (D-Va.), who's locked in one of the most competitive House races in the country, told Axios the difference this time is that Democrats delivered on their promises.

Her "mission accomplished" message is one of several that Democrats are deploying on the campaign trail.

Democratic Senatorial Campaign Committee Chair Gary Peters (D-Mich.) portrays the passage of the bill as a victory over the pharmaceutical industry and entrenched Washington interests.
"Every Republican voted against the bill because it holds Big Oil, Big Pharma, and other corporations that have been jacking up prices accountable," Peters said in a statement.
Sen. Michael Bennet (D-Colo.), took a similar tone, touting the way Democrats finally “overcame the pharmaceutical industry” during a Thursday campaign event.
Rep. Val Demings (D-Fla.), who won a Democratic primary this week to challenge Sen. Marco Rubio (R-Fla.), has contrasted her support for the bill with Rubio's opposition and how the Inflation Reduction Act helps the working class.

The big picture: Capping prescription drug prices is the most popular provision in the bill, according to a recent Morning Consult poll, which said 76% of voters supported the measure, including 86% of Democrats, 71% of independents and 69% of Republicans.

Yes, but: None of the bill's provisions will take effect before the elections. And the economy and making ends meet will still be foremost on voters' minds, despite falling gas prices and slowing inflation.

2. Drugmakers failed to report problems

Photo: Sarah Silbiger/Getty Images

Half of the drugmakers required to report information about significant quality problems with products they shipped failed to do so between 2018 and 2021, Axios' Adriel Bettelheim writes about a new FDA report on pharmaceutical quality.

Why it matters: The so-called field alert reports (FARs) are a key barometer of drug plant quality and are used to assess the risk to the public and the adequacy of a company’s response.

What they found: 49.1% of the 1,143 sites eligible to submit a FAR didn't over the four years the FDA reviewed.

More than six in 10 were foreign plants, and the plants reviewed had a median of three new drug applications.
97% of sites that did submit a FAR submitted at least one follow-up report on the quality problem and corrective actions.

Go deeper: FARs have to be submitted within three days of when a manufacturer receives information that a drug or its labeling may be mistaken for another product.

Reporting is also required when manufacturers learn about bacterial contamination, significant chemical or physical deterioration or any failure of a batch to meet specifications laid out in a drug application, per Regulatory Focus.

Flashback: The FDA during the Trump administration imposed tougher safety and testing requirements, with a focus on raw ingredients.

Reasons generally cited for problems range from poor quality controls to weak management oversight.

3. EMTALA fight heats up

A pair of conflicting court decisions this week intensified the battle between the Biden administration and some red states over health providers who perform abortions in emergency situations.

Why it matters: At the heart of this is the decades-old Emergency Medical Treatment and Labor Act, or EMTALA, which is designed to keep hospitals from turning away uninsured patients by requiring Medicare facilities to provide stabilizing care to patients with emergency conditions.

The law become a flashpoint after Roe v. Wade was overturned and questions arose about how it applied to medical emergencies that require terminating a pregnancy.

This week, a federal judge in Texas blocked the Biden administration's guidance outlining hospital staff and physicians' responsibilities under the law in that state. It effectively froze the argument the federal law preempts a state abortion ban in Texas.

But a day later, a federal judge in Idaho came to the opposite conclusion, blocking Idaho's abortion ban when it conflicts with providers' obligations under EMTALA.

Driving the news: The Biden administration today plans to reiterate to governors, except in Texas, its view that state abortion bans don't negate providers' responsibilities under the federal law in emergencies.

"We will continue to enforce the federal law across the country. No matter where patients live they have the right to emergency care, including abortion care if their doctor determines that's necessary," an administration official said in a call with reporters.
"The consequences for providers that violate EMTALA are real," another administration official said.

A message from PhRMA

Improving access to life-saving medicine

Insurance companies and PBMs don’t pay full price for insulin. So why do patients?

Rebates, discounts and other payments from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these discounts directly with patients.

Here’s what you should know.

4. Private market takes on Medicare

Reproduced from KFF; Chart: Axios Visuals

As Medicare's open enrollment season approaches, it's entirely possible a majority of seniors will choose a Medicare Advantage plan for next year rather than traditional Medicare, according to a KFF report.

Why it matters: Medicare Advantage has been growing quickly thanks to promises of capped out-of-pocket costs, vision and dental benefits, and perks like fitness classes.

But as Axios previously reported, while the private alternatives to traditional Medicare coordinates care for people within a more narrow network of doctors and hospitals, promises of saving taxpayer dollars have not panned out.

In 2022, nearly half of (48%) eligible Medicare beneficiaries, or 28.4 million people out of 58.6 million Medicare beneficiaries overall, are enrolled in Medicare Advantage plans.

5. Dog of the week

Bogey. Photo: Jim Huffman.

Meet Bogey, a 1-year-old Golden Retriever and the furry embodiment of the joy found in soaking up those precious final moments of summer fun.

Bogey lives in Boston with — surprise, surprise — a golfing family.
His name "was either going to be Bogey or Birdie," writes his human Jim Huffman. "You can tell what type of golfers we actually are!"

A message from PhRMA

Health savings for patients, not middlemen

Rebates and discounts from manufacturers lower the cost of insulins by more than 80% on average — but insurers and PBMs usually don’t share these savings directly with patients.

Next steps: Fix harmful insurance practices and lower out-of-pocket patient costs.

Why stop here? Let's go Pro.

Join the thousands of professionals reading Axios Pro: Health Tech Deals to better understand the forces shaping their industry.

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2022-08-26 Axios

Fri, 26 Aug 2022 10:07:27 GMT

Full semifinal schedule

Axios Chicago

By Justin Kaufmann and Monica Eng · Aug 26, 2022

Happy Friday! Today is National Cherry Popsicle Day. What, no love for green? Wait … is that even a flavor?

⛅️ Today's weather: Not bad. Partly cloudy with a high of 75.

Today's newsletter is 870 words — a 3.5-minute read.

1 big thing: Shortchanged on lead money

Illustration: Allie Carl/Axios

Illinois has more lead water-service lines than any other state, but the formula used to allocate federal lead removal money fails to take that into account.

Why it matters: Lead lines can leach brain-damaging toxic substances into drinking water, and Chicago's problem alone will cost billions to fix.

Last year, Illinois received just $106 million of the $15 billion earmarked for lead removal in President Joe Biden's massive infrastructure bill.

Driving the news: A group of 50 bipartisan members of Congress, including several Illinois representatives, sent a letter to EPA officials urging them to update the 2015 formula they use to allocate lead removal money.

Specifically, they want that $15 billion allocated according to the number of lead lines in each state.

By the numbers: Under the current formula, the seven states with 52% of the nation's lead service lines would receive just 18% of the lead removal funding, according to a survey cited in the congressional letter.

Another analysis by a water safety engineering firm calculated that Utah would get $1,229 per service line while Illinois would get $157.

What they're saying: We must "ensure that allocation is equitable and states with the greatest need, like Illinois, receive the necessary funds to protect our communities from the dangers of lead exposure," U.S. Rep. Brad Schneider said in a statement.

The other side: EPA officials told Axios they expect to use new lead line inventory "to inform funding allotments for FY 2023 and beyond."

They didn't, however, say whether all that data would be in place in time for the next batch of payments.

2. Sky back in WNBA semifinals against the Sun

Candace Parker during the Sky's Game 3 win in the first round over the New York Liberty. Photo: Chris Marion/NBAE via Getty Images

👋 Hi, Everett here. I'm an editor at Axios Chicago here to tell you to cancel your Sunday night plans.

What's happening: The defending champion Chicago Sky survived the first round to again face the Connecticut Sun in the WNBA semifinals.

Tip: 7pm at Wintrust Arena, and on ESPN2.
Resale tickets start at $24.

Flashback: The Sun had the WNBA's best record, the No. 1 seed and home-court advantage last year against the sixth-seeded Sky, but Chicago pulled out a couple of nail-biters to win the series, 3-1.

Eleven days later, the Sky beat the Phoenix Mercury to win their first WNBA championship.

The intrigue: This year, the tables are flipped. No. 2 Chicago is the higher seed, has home court advantage and dominated the regular-season series.

Chicago won all four matchups, though each by a single-digit margin and two by just three points, per ESPN.
The WNBA has not, incredibly, seen a repeat champion since 2002.

Yes, but: The Sky are better than last season.

Veteran forward Emma Meesseman has been a revelation playing alongside Candace Parker, while coach/general manager James Wade was named 2022 Executive of the Year for improving an already loaded roster.

3. Tips and hot links

Illustration: Brendan Lynch/Axios

😷 CDPH commissioner Allison Arwady tested positive for COVID-19. (Tribune)

⚖️ Eric Zorn interviews inmate Marilyn Lemak about her bid for clemency after murdering her three young children in their Naperville home in 1999. (Picayune Sentinel)

🐕‍🦺 The CTA signed a $30 million contract for private K-9 units to return to trains. (Sun-Times)

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4. Best Day Ever: Dave Eanet

Dave Eanet. Photo courtesy of WGN Radio

The Northwestern Wildcats kick off their football season tomorrow across the pond in Dublin.

Kickoff is 5:30pm in Ireland, 11:30am CDT.

Why it matters: We're blessed to have Dave Eanet calling games on WGN radio for "Chicago's Big Ten Team."

Tomorrow's game will launch Eanet's 32nd season in the broadcast booth.

What he's saying: "I love the anticipation of that first game of the season," Eanet tells Axios.

"Everybody is undefeated, and with high hopes. The night before a game? Nervous excitement."

We asked Dave to give us his perfect day in Chicago.

🍳 Breakfast: "I am not a fancy breakfast eater, and most days it's an energy bar and a banana (and coffee). But I do like the omelets at Wildberry on Randolph, not far from the WGN studios."

🏃‍♂️ Morning activity: "A run along the Riverwalk, or the flyover to the lakefront and either north to Oak Street or south to the Adler."

🥗 Lunch: "True Food Kitchen. I'll have the True Food Salad with grilled chicken. My wife makes it at home. Love it."

🌲 Afternoon activity: "Most days my wife and I take a nice walk in a forest preserve near our home in the 'burbs. I love being outside, and we have some great spots for that. And occasionally maybe a round of golf."

🍥 Dinner: "Really like the sushi at Sushi Kushi in Lake Forest. They also make an excellent Saketini, or so I've been told! Try the Brittle Tuna appetizer. I also enjoy the restaurants along Bangs Lake in Wauconda."

❤️ Evening activity: "Sitting on the deck, reading or listening to some music or entertaining our kids and friends. That's perfect."

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New jobs to check out

💼 See who’s hiring around the city.

US Program Associate at GiveDirectly.
Assistant Director, Digital Communications at School of the Art Institute of Chicago.
Sr. Supply Chain Initiative Planner at Bel.

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5. Photos of the day: The 1968 DNC

Police and protesters battle near Conrad Hilton Hotel on Michigan Avenue on Aug. 28, 1968. Photo: Bettmann archives/Getty Images

👋 Hi, it's Justin. This weekend marks the 54th anniversary of the 1968 DNC protests.

The convention was held Aug. 26-29 in Chicago, where police violently clashed with anti-war protesters in Grant Park.
Protesters coined the haunting phrase, "The whole world is watching."

We know this event. We've seen the photos and videos.

But as I searched Getty Images, so many pictures illuminate how massive and chaotic this event was. It still takes my breath away.

Students crowded around the Logan Monument in Grant Park in 1968. Photo: Peter Bullock/Chicago History Museum/Getty Images

Protesters use benches as barricades during battle with police at the Grant Park bandshell on Aug. 28. Photo: Bettmann archives/Getty Images

Cigar-smoking police officers arrest a protester. Photo: Santi Visalli Inc./Getty Images

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Editor's note: Wednesday's hot link on Ex-Ald. Patrick Daley Thompson was corrected to note his federal prison sentence is four months, not four years.

Our picks:

🌽 Monica didn't get enough fair food in Springfield, so she's thinking of heading down to Corn Fest in DeKalb or the Will County Fair in Peotone this weekend.

🎤 Justin recommends going to the Untapped Talent showcase at Artifact Events on Ravenswood tonight. Not just because my old buddy John Bolger is performing, but because the proceeds go to help young adults fighting cancer.

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2022-08-29 Axios

Mon, 29 Aug 2022 10:04:09 GMT

Presented By Humana

Axios Vitals

By Tina Reed · Aug 29, 2022

Welcome back from the weekend, Vitals readers. Today's newsletter is 988 words or a 4-minute read.

🍺 On tap this week: Both the FDA and the CDC are expected to OK reformulated COVID-19 boosters.

And HHS is holding a meeting Wednesday to plan the transition of COVID-19 therapies and vaccines to the commercial market.

1 big thing: Why Moderna is suing Pfizer now

Illustration: Gabriella Turrisi/Axios

Moderna's unexpected patent infringement lawsuit against Pfizer-BioNTech over COVID vaccine technology says more about the future market for mRNA shots than the current pandemic, Axios' Adriel Bettelheim writes.

The big picture: With the government's vaccine purchasing likely to drop off, experts see top manufacturers jockeying for customers and using the technology for other conditions.

"Moderna looks at Pfizer's success as a threat to market share," said Jacob Sherkow, an authority on intellectual property and the life sciences University of Illinois' College of Law and College of Medicine.

"Filing suit may slow that down and be one way to ensure Moderna's share of product is going to remain a leader in this particular space."
Moderna has said it is using its platform to develop medicines in four areas: infectious disease, cancer, rare diseases and auto immune disease.
"They're trying to protect the franchise," Erik Gordon, a University of Michigan business professor, lawyer and expert on the drug industry, told Axios' Nathan Bomey. "They do want money — but I think the bigger money is money they hope to get in the future based on this platform."

Be smart: The company in legal papers filed Friday is not seeking monetary damages for sales prior to March 8, 2022 or asking for Pfizer's vaccine to be removed from the market. Nor is it seeking financial gains from vaccine distribution in 92 developing countries.

"We are filing these lawsuits to protect the innovative mRNA technology platform that we pioneered, invested billions of dollars in creating, and patented during the decade preceding the COVID-19 pandemic," Moderna CEO Stéphane Bancel said in a statement.

2. Keeping up with the COVID variants

Illustration: Aïda Amer/Axios

The first updated coronavirus vaccines — and likely the last purchased by Uncle Sam — are about to become available across the U.S., and will ideally provide more targeted protection against the dominant strain that's circulating, Axios' Caitlin Owens writes.

What's happening: The updated vaccines will go through the regulatory approval process this coming week, and the shots are expected to become available soon after — likely the week after Labor Day, according to a senior Biden administration official.

The intrigue: The FDA has prioritized speed — which is necessary if the goal is keeping up with the virus' mutations — over having all of the data on how the vaccines work in real life.

The annual flu vaccine is updated using non-human data, so there's a precedent for the FDA's approach. Preclinical data suggests the shots elicit a strong neutralizing antibody response.

Yes, but: Some experts warn this risks dampening enthusiasm for the shot.

What they're saying: "The FDA should be commended for wanting to take an aggressive, expedient approach," Eric Topol, executive vice president of Scripps Research, wrote on Substack.

"But we also need to acknowledge the uncertainties about efficacy and the response from the public," he added.

3. HHS cybersecurity office overwhelmed

The federal office in charge of investigating cyber attacks against the nation's health system is far under-resourced and overwhelmed, Politico reports.

Why it matters: Cybersecurity is a fast-growing, expensive problem for health providers and has begun threatening the safety of patients.

One cyberattack and data breach cost Tenet Healthcare $100 million in lost revenue and mitigation costs in the second quarter of 2022, HIPAA Journal reported.
Last week, a French health system reverted back to pen and paper after it fell victim to a ransomware attack and hackers demanded $10 million.

What they're saying: The HHS Office of Civil Rights, which has been charged to lead the response, is operating on a shoestring budget.

Put it in perspective: "The office had a budget of $38 million in 2022 — the cost of about 20 MRI machines that can cost $1 million to $3 million a pop," per Politico.

My thought bubble: If cybercriminals have taught us nothing, it's that they have a lot to gain and so far, little to lose with these attacks.

Not devoting enough resources — and accountability — to finally push health care to catch up with other industries like banking stands to become a far more expensive and deadly problem.

A message from Humana

Members can save on quality care with Medicare Advantage

Medicare Advantage can provide better health outcomes and lower costs.

The proof: Members have a 43% lower rate of avoidable hospitalizations and savings of nearly $2,000 a year compared to those who choose fee-for-service Medicare.

4. Twitter's medical information problem

Illustration: Maura Losch/Axios

Twitter played an outsized role in disseminating public health information during the COVID pandemic, but it's coming under fire for the gatekeeping role it's had elevating — or quieting — qualified voices.

The big picture: Recently, the accounts of multiple doctors, scientists, and patient advocates were suspended and factual health tweets flagged as false, the Washington Post reported.

Many of the tweets have since had the misinformation labels removed, and the suspended accounts have been restored, per the Post.
"We acknowledge the mistakes made in these cases and are reviewing our team's protocol to safeguard against such mistakes in the future," Twitter spokeswoman Celeste Carswell said in an email to Axios.

Be smart: It's an example of the unwieldy challenge of conveying the most accurate information from authoritative voices during a global health crisis.

A recent study published in JAMA Network Open found Twitter's decision to reopen blue verification badges for trusted health experts early on in the pandemic may have ended up reflecting bias.
Verified physician sources were far more likely to be male (71%) rather than female (29%), the study found. Americans were also overrepresented.

What they're saying: "This may promote what we already know in medicine which is male voices are promoted more, they're elevated more and they are given a bit more weight," said Fumiko Chino, a co-author and radiation oncologist at Memorial Sloan Kettering Cancer Center told Axios.

5. While you were weekending

Illustration: Aïda Amer/Axios

👉 Black COVID long-haulers felt invisible to the health care system, so they formed their own support groups. (NBC News)

🏥 It wasn't surprising to many experts that Amazon is planning to shut down Amazon Care in the wake of its planned acquisition of primary care company One Medical. Now, they say, we should be watching for more health care acquisitions. (CNBC)

💰 The U.S. government plans to pause free at-home COVID tests by Sept. 2. (Axios)

A message from Humana

Older Americans are choosing Medicare Advantage

Medicare Advantage can help provide better health outcomes and lower costs.

With Medicare Advantage, members see a 43% drop in avoidable hospitalizations and save nearly $2,000 a year compared to those who choose fee-for-service Medicare.

Why stop here? Let's go Pro.

Join the thousands of professionals reading Axios Pro: Health Tech Deals to better understand the forces shaping their industry.

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Sponsorship has no influence on editorial content.

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2022-08-29 Axios

Mon, 29 Aug 2022 10:04:12 GMT

Axios Chicago

By Monica Eng and Justin Kaufmann · Aug 29, 2022

Happy Monday! On this day in 1968, "fake news" was born.

🌤 Today's weather: Thunderstorms likely in the afternoon. High of 89.

🏀 Situational awareness: Last night, the Sky lost Game 1 to the Connecticut Sun 68-63 at the Wintrust Arena. The best-of-five series continues on Wednesday night.

Today's newsletter is 856 words — a 3.5-minute read.

1 big thing: IL's EV takeover

Illustration: Gabriella Turrisi/Axios

California recently banned the purchase of gas-fueled cars by 2035.

With recent investments in EV tech and infrastructure, Illinois could follow suit.

Why it matters: Federal and local governments are investing heavily in electric vehicles to curb fossil fuel use, and California's ambitious ban puts pressure on automakers to ramp up EV production nationwide.

What's happening: General Motors, Mercedes-Benz and Volvo have committed to transition to EVs by 2035.

Other states, including Massachusetts and Washington, are following California's lead.

Zoom in: Illinois hasn't banned gas-powered car purchases but seeks to register 1 million EVs by 2030.

State officials didn't respond to our questions about banning gas-powered vehicles.

Be smart: It's not just car production — it's infrastructure. If consumers are going to shift to EVs, charging stations must be plentiful, regulated and accessible.

State government leaders and private businesses are convening to determine best practices and standards for charging stations.

What they're saying: "The law's framework for a national EV charging network encourages us to scale up chargers and scale up fast," Siemens USA CEO Barbara Humpton tells Axios.

"Through cross-sector partnerships, we can drive transformation so much faster than any one entity ever could alone."

Justin moderates a Chicagoland Chamber of Commerce panel on the future of EV infrastructure. Photo courtesy of the chamber

The intrigue: If infrastructure is keeping planners up at night, heightened electricity demands could worsen that insomnia.

One solution might be the microgrid, which can disconnect from the main grid to ensure that power flows during overloads, extreme weather and other outages.
ComEd recently unveiled a microgrid on IIT's Bronzeville campus, the nation's first utility-operated microgrid cluster.
It's one way utilities are scaling and preparing for greater electricity use once EVs predominate on the roadways.

2. Insta Review: Electric boats

Photo: Justin Kaufmann/Axios

👋 Hi, it's Justin. Summer fun is winding down, but there's still time to head to the river and charge up … a boat.

Renting boats by the hour has become all the rage, letting you experience the Chicago River's renaissance while working on your tan.

What's happening: Chicago Electric Boat Co. offers use of its fleet, from pontoons to Duffy boats.

With just a driver's license and a basic understanding of water safety rules, you can fulfill your dream of piloting a boat.
You could hire a captain instead, and even a tour guide.

How it works: They rent by the hour, so I chose the Duffy boat — closer to a gondola than a speedboat — for a two-hour family trip to enjoy both the South and North branches of the river, as well as downtown.

You can't go into Lake Michigan.
The boats are not fast.

The experience: Nothing beats looking up at the majestic buildings along Wacker Drive.

Yes, but: It's busy. If you aren't already stressed by the huge boats conducting architecture tours, the kayakers will positively freak you out.

The bottom line: $179 an hour is totally worth it for the memories, people-watching and Instagram stories.

Captain Justin helms the vessel with his family. Photo courtesy of the Kaufmann family

3. MMQB: Undefeated preseason

Justin Fields with head coach Matt Eberflus after Saturday's game. Photo: Nick Cammett/Getty Images

The Bears beat the Browns, 21-20, Saturday night in Cleveland.

It's the Bears' first undefeated preseason since 1994.

Why it matters: Players, including Justin Fields, were auditioning for the new coaching staff for regular season roster spots.

The second-year quarterback played deep into the first half, throwing for three touchdowns.

What's more: The Bears defense kept the Browns' starters out of the end zone.

There were great efforts from rookie cornerback Kyler Gordon and new defensive tackle Justin Jones.
And that was with over 20 players on the injury report, including several projected starters, such as Roquan Smith and Eddie Jackson.

Yes, but: The backups, including QB Trevor Siemian, struggled.

What's next: The Bears' roster must be cut to 53 players by 3pm tomorrow.

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4. Tips and hot links

Justin surveys the aftermath of "drifting" this weekend in the West Loop. Photo: Justin Kaufmann/Axios

🏎️ Hundreds of cars participated in street racing and drifting meet-ups this weekend at various locations, including downtown, McCormick Place and the West Loop. (WGN)

🧑‍⚖️ Reporter Jim DeRogatis penned a special column describing how he obtained the video of R. Kelly having sex with a minor. (Sun-Times)

🍸 Jeffrey Pub is banning customers under age 30 and closing an hour earlier, a response to the hit-and-run that killed three people outside the establishment this month. (Block Club)

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Job Listings

Now hiring: New job openings

🔥 Hot and fresh local job listings.

DevOps Architect at ClearBlade, Inc.
Senior Copywriter at Upshot.
Product Manager at Mediafly.

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5. Bite Club: Korean beef sandwich

A bulgogi sandwich from J's Corner Hot Dogs. Photo: Monica Eng/Axios

👋 Hey, it's Monica. Thanks to "The Bear," the whole world is finally wising up to Chicago's Italian beef sandwiches.

But what about our Korean beef (bulgogi) sandwiches?

Context: Korean bulgogi is made with marinated and griddled beef, usually served with rice and vegetables or on top of bi bim bop — not so much in a sandwich.

The bite: But a bulgogi sandwich from J's Corner Hot Dogs on Elston in Irving Park features beef, lettuce, tomatoes, mayo and onions on an Italian roll ($7.59) and is very tasty.

Prepared by the stand's Korean-American proprietors, the sandwich is sold alongside hot dogs, hamburgers, Italian beef, cup ramen and egg rolls.
J's Corner has been selling the dish for at least five years, but I just heard about it from food writer Dennis Lee.

The verdict: With its fresh soft bun and caramelized onions, it delivers a comforting, sweet, meaty and carby bite.

Yes, but: I was dying for the cool, sharp counterpoint of kimchi the whole time I was eating the sandwich.

Next time I'll bring a jar with me.

A message from Axios

Get eyes on your brand

If you're a marketer or business owner interested in supporting local journalism and reaching civic minded Chicago leaders like yourself, we'd love to speak with you.

Click here to learn more about advertising with Axios Local.

Our picks:

😎 Monica was so impressed by WBEZ's Sunday PrisonCast.

🥎 Justin is excited for the Kup League softball playoffs to start tonight. But he gets to rest his fingers, because the Axios team has a first-round bye.

Want free Axios swag? Refer your friends to Axios Chicago and get cool merch like stickers, totes, hats, T-shirts and more!

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2022-08-29 Axios

Tue, 30 Aug 2022 06:07:45 GMT

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Presented By Babbel

Axios World

By Dave Lawler · Aug 29, 2022

Welcome back to Axios World.

Tonight's edition (1,869 words, 7 minutes) starts with a Ukrainian offensive before stops in Baghdad, Tripoli, Islamabad, and the South Pacific.

Thanks for reading.

1 big thing: Ukraine launches Kherson counteroffensive

Ukrainian artillerymen on the frontlines near Kherson. Photo: Metin Aktas/Anadolu Agency via Getty Images

Ukrainian forces today launched what appears to be their first major counter-offensive of the war, aiming to retake Kherson in the south of the country.

Why it matters: Ukrainian forces bombarded Russian ammunition depots, command-and-control centers, and river crossings. The scale of the operation is not yet clear, but Ukrainian officials claimed to have breached Russia’s “first line of defense” outside of Kherson.

Kherson (pre-war pop. 300,000) was taken in the early days of the invasion by Russian forces advancing north from occupied Crimea. It remains the only provincial capital to fall in six months of fighting.
Ukrainian officials have been foreshadowing an offensive in Kherson for weeks, and Russia in preparation has roughly doubled its own force in the region, according to Poland-based firm Rochan Consulting.
National Security Council spokesperson John Kirby noted that in order to do so, Russia has been forced to “deplete certain units in the East" — where a major Russian offensive has largely stalled — and is facing “manpower challenges.”

Between the lines: So is Ukraine. Both sides have suffered heavy losses in four months of grinding warfare in the eastern Donbas region and are scrambling to train (and in Russia’s case, to enlist) reserve forces.

While Ukraine has been successfully deploying longer-range rocket systems provided by the U.S. to conduct strikes far behind the frontlines, some analysts doubt that Ukraine has assembled the requisite manpower or materiel to conduct a major offensive on a well-defended city.
Others have noted that Kyiv may have political incentives to move now, to lift morale, and reassure foreign backers by demonstrating momentum, even if the military outlook is dicey.

The big picture: Lacking the numerical advantages typically needed for a successful offensive, Ukraine may focus on cutting off Russia’s forces in Kherson, rather than attempting to steamroll them.

Ukrainian President Volodymyr Zelensky offered no hints in an address tonight, insisting that Russian forces would be expelled from Ukraine, but adding, “You won’t hear specifics from any truly responsible person. Because this is war.”
Even if Ukraine does proceed cautiously, the offensive likely marks the start of a third phase of the war, following Russia’s initial three-pronged assault and the grinding battle in the Donbas.

What to watch: Another twist could come within days if Russia announces a sham referendum in Kherson as a pretext to annexing the territory into Russia, as Kirby has warned might happen.

Russia has already installed a puppet government, restricted the internet, mandated the use of the ruble, and started issuing Russian passports.
The latest: Russian investigators confirmed today that a former Ukrainian lawmaker who defected to join that puppet government had been murdered in his home.

Meanwhile… The launch of the offensive comes as inspectors from the International Atomic Energy Agency (IAEA) head to Zaporizhzhia in southern Ukraine for an urgent examination of Europe's largest nuclear power plant, which has been damaged by shelling.

2. Global news roundup

Supporters of Shiite cleric Muqtada al-Sadr enter the government palace in Baghdad during a protest on Aug. 29. Photo: Ameer Al-Mohammedawi/picture alliance via Getty Images

1. At least ten people have been killed and more than two dozen injured in violent clashes in Baghdad sparked by Shiite cleric Muqtada al-Sadr's announcement Monday that he is quitting politics due to the country's political deadlock.

Driving the news: Hundreds of protesters loyal to al-Sadr stormed the palace today where the Iraqi Cabinet meets in Baghdad's Green Zone. Police responded with tear gas and live bullets.

2. Clashes in Tripoli over the weekend between forces loyal to Prime Minister Abdulhamid al-Dbeibah and to a rival claimant left 32 people dead and sparked fears of renewed civil war.

The effort to oust al-Dbeibah failed, but further violence is likely as the power struggle continues. Elections have been repeatedly delayed, contributing to the legitimacy crisis.

3. Supporters of Cristina Fernández de Kirchner, Argentina's former president and current vice president, clashed with police on Saturday after prosecutors requested that she be sentenced to 12 years in prison for alleged corruption.

4. Colombia's new leftist president, Gustavo Petro, has restored diplomatic ties with Nicolás Maduro's government in Venezuela.

That leaves just three countries in the region — the U.S., Canada, and Brazil — without formal relations with Caracas, per the WSJ.

5. Turkish pop star Gülşen is under house arrest on charges of “inciting hatred and enmity” after making a joke about religious schools.

6. One of three Dutch soldiers shot in Indianapolis on Saturday has died, per AP. The soldiers were in Indiana for training and were shot outside their hotel.

3. Pakistan's triple crisis

Village and fields before and after flooding in Rajanpur, Pakistan as of August 28, 2022. Photo: Maxar

The death toll from Pakistan’s floods has crossed 1,100, and the country’s climate minister said today that “one-third of Pakistan is underwater right now.”

Officials estimate that over one million homes have been destroyed, and 33 million Pakistanis have been affected by the floods. The government is appealing for international aid.
This is the heaviest rainfall Pakistan has recorded since 2010 when a previous monsoon killed more than 2,000 people and follows a prolonged period of drought. Pakistan is considered particularly vulnerable to climate change.

The big picture: The catastrophic flooding comes as Pakistan is already grappling with economic and political crises.

Pakistan is expected to avert an imminent default on its debt thanks to a $1.2 billion bailout announced Monday by the IMF. To secure the bailout and avoid default, Prime Minister Shehbaz Sharif’s government has implemented austerity measures.
But Pakistanis were already facing spiking prices for food and fuel, and the flooding threatens to make those struggles far worse in the near term. A factory worker in Karachi told the NYT that the price of tomatoes and other basic food items has quadrupled since the rains began.
What to watch: Pakistan's finance minister was quoted in domestic media as saying Pakistan will re-open trade with India due to the flooding and price spikes.

Meanwhile, former Prime Minister Imran Khan is facing terrorism charges for remarks he made at a rally earlier this month. He’s currently free on bail, but it expires on Thursday. Some of his supporters have threatened drastic steps if he is arrested.

Go deeper: The flooding, in photos.

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Bonus: Where in the World?

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For dinner this evening, let's take a culinary trip around France.

Set out on the table, we'll have sparkling wine (#1), sheep's milk blue cheese (#2), this creamy cow's cheese from Normandy (#3), and charcuterie. You'll also find this condiment (#4).

We'll enjoy a summery salad (#5), and you can help yourself to a slice of this classic tart with eggs and bacon (#6).
Next up, a hearty meat stew (#7) paired with a red blend from this renowned wine region (#8).
Finally, this dessert involves a pear and red wine (#9), paired with this variety of brandy (#10).

Scroll to the bottom for answers.

4. Solomon Islands turns away U.S. Coast Guard ship

Solomon Islands Prime Minister Manasseh Sogavare (R) meets with visiting Chinese Foreign Minister Wang Yi in Honiara in May. Photo: Xinhua via Getty Images

The Solomon Islands did not allow a U.S. Coast Guard vessel to make a routine stop to refuel and resupply at a port in the Pacific island nation that has lately fallen under China's sphere of influence, Bethany Allen-Ebrahimian and I write.

Why it matters: The Solomon Islands signed a security pact with China in April that the U.S. and Australia fear could allow Beijing to dispatch security forces there or even establish a naval base.

Driving the news: The U.S. government requested diplomatic permission for the Oliver Henry, a Guam-based Coast Guard cutter, to make a routine stop in Honiara on Aug. 23 but received no response.

Coast Guard spokesperson Cmdr. Dave Milne told Axios the Coast Guard "respects the sovereignty of our foreign partners" and looks forward to "future engagement opportunities with the Solomon Islands."
But National Security Council spokesperson John Kirby said the White House was "disappointed" by the "regrettable" decision, noting that the ship ultimately diverted to Papua New Guinea.
"Clearly we've seen the Chinese try to bully and coerce nations throughout the Indo-Pacific to do their bidding and to serve what they believe their selfish national security interests are rather than the broader interests of a free and open Indo-Pacific," Kirby said, clarifying that he was not referring to this specific incident but China's actions more broadly.
Read the full story.

5. Europe moves toward wartime footing on gas usage

Illustration: Annelise Capossela/Axios

Amid a full-on energy crisis exacerbated by the war in Ukraine, European countries are taking a range of steps akin to wartime restraints to cut consumption, Axios' Matt Philipps writes.

Here's a sampling:

In Germany, landmarks including the Brandenburg Gate and Cologne's magnificent cathedral will no longer be lit at night. Hot water is being shut off in public buildings, and Augsburg is even turning off some traffic lights.
Spain is ordering shops and public buildings to shut off the lights at 10pm and banning air conditioning below 80 degrees Fahrenheit. Italy is also limiting air conditioning in schools and public buildings.
France is forcing air-conditioned shops to keep their doors closed, and banning illuminated signs between 1am and 6pm.
- Yes, but: France gets 70% of its energy from nuclear power, putting it in a better position than Germany, which is shutting down its remaining nuclear plants.
The U.K.'s energy regulator is raising the cap on household energy bills by a whopping 80%.
The EU's 27 member states agreed in July to voluntarily cut gas consumption by 15% between August and March. Mandatory cuts could be imposed if the energy supply situation worsens.
Meanwhile... Norways' Nordic neighbors are protesting Olso's "nationalistic" decision to curb exports to protect its own supply.

What we're watching: Whether the energy crisis — which could worsen during winter — reduces public and political support for sanctions on Russia.

What's next: Russia's Gazprom says it will shut down the Nord Stream 1 pipeline on Wednesday for three days of unscheduled maintenance.

Go deeper on the energy crisis.

6. Two to watch: U.S. looks to the Arctic; Russia-China war games

Russian, Chinese, and Mongolian troops during the 2018 Vostok exercises. Photo: Mladen Antonov/AFP via Getty Images

1. The Biden administration announced Friday it will nominate an ambassador-at-large for the Arctic, raising the profile of American policymaking for the region, Axios' Andrew Freedman writes.

Why it matters: The move comes at a time of increased militarization in the far north, with NATO members squaring off against Russia, and at a time of rapid climate change that is making the Arctic more accessible.

In recent years, Russia has moved to establish multiple military bases in its Arctic territory, while NATO members have conducted drills and worked to counter the Russian threat.

2. Russia and China will hold joint military exercises this week in Russia's Far East, underscoring the partnership between Washington's most powerful rivals.

Yes, but: The Russian military's footprint will be dramatically scaled down from the previous exercises in 2018 due to the strains of the Ukraine war, Reuters reports.
12 other countries will take part, including India, six former Soviet republics, Nicaragua, and Syria.

7. Stories we're watching

The Milky Way over the Atacama Desert, Chile. Photo: John Moore/Getty Images

U.S. warships sail through Taiwan Strait for first time since Pelosi visit
Airstrike hits kindergarten in Ethiopia's Tigray region
The new Jackson Hole consensus
Study: Greenland ice melt to raise sea levels nearly one foot
Military option against Iran?
Israel ramps up pressure on U.S. over Iran deal
Launch delayed for NASA moon rocket

Quoted:

“In the eyes of men, the humble are seen as weak and losers, but in reality, they are the real winners because they are the only ones who trust completely in the Lord and know His will."

— Pope Francis, praising the humility of a 13th-century pope who resigned — and thus fueling speculation that he will soon step down himself — during a visit to the former pontiff's burial site.

A message from Babbel

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Answers: 1. Champagne; 2. Roquefort; 3. Camembert; 4. Dijon mustard; 5. Salad Niçoise (from Nice); 6. Quiche Lorraine; 7. Beef Bourguignon (from Burgundy); 8. Bordeaux; 9. Poire à la Beaujolaise (from Beaujolais); 10. Cognac.

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2022-08-30 Axios

Tue, 30 Aug 2022 10:05:13 GMT

Presented By Humana

Axios Vitals

By Tina Reed · Aug 30, 2022

Happy Tuesday, Vitals readers. Today's newsletter is 1,011 words or a 4-minute read.

Situational awareness: President Biden will travel to Wilkes-Barre, Pennsylvania, today to tout gun violence legislation.

This speech was rescheduled from last month because the president was diagnosed with COVID.

1 big thing: Monkeypox messaging at issue as outbreak enters new phase

Data: CDC, U.S. Census; Chart: Erin Davis/Axios Visuals

Monkeypox cases may be slowing in the U.S., but the perils of communicating who is most at-risk and getting those people the resources they need is still challenging public health officials and providers, Axios' Arielle Dreher writes.

Why it matters: Monkeypox infections are seen primarily among men who have sex with men, but emphasizing that transmission route risks stigmatizing gay and bisexual men.

State of play: After three months of rising caseloads, the global outbreak may be peaking amid evidence that gay and bisexual men are curbing risky sexual behavior and more people are getting vaccinated, the Washington Post reported, citing its own tracking over seven days.

Messaging about the risk is becoming even more critical as the virus spreads to smaller outlying communities and vaccine supplies tighten.

"There's a concern that people getting vaccines may not be the ones most at-risk," Anna Person, a physician at the Vanderbilt Comprehensive Care Clinic, which serves HIV patients, told Axios.

Between the lines: A key point of contention is whether to classify monkeypox as a sexually transmitted infection, like HIV, or herpes, which also have multiple modes of transmission.

It's important to understand how infections are transmitted sexually to understand disease spread and prevent transmission whenever possible, wrote Northwestern University professor Steven Thrasher in Scientific American.
But that STI categorization could downplay how monkeypox can be transmitted through other types of close contact and risks stigmatizing sex between men, other experts say.

The bottom line: Whether or not cases keep falling largely depends on the ability of providers to get vaccines out to those who need them most, and raising awareness in communities at risk.

2. FTC sues data broker

Illustration: Shoshana Gordon/Axios

The Federal Trade Commission is suing an adtech company for selling geolocation information from mobile devices used to track individuals' movements near sensitive locations like reproductive health clinics, Axios' Ashley Gold reports.

Driving the news: The FTC voted 4-1 to authorize the suit in an Idaho federal court against data broker Kochava for selling location data from hundreds of millions of phones that also showed when users were in the vicinity of domestic violence shelters and addiction recovery centers.

"Where consumers seek out health care, receive counseling or celebrate their faith is private information that shouldn’t be sold to the highest bidder," Samuel Levine, director of the FTC's bureau of consumer protection, said in a release.

Our thought bubble: It's the latest example of how technology has become a central force in how abortion is both accessed, as well how abortion laws could potentially be enforced.

There are countless data brokers out there. This could be the start of a lot of new lawsuits from the FTC, especially as it considers new rules around commercial surveillance.

3. Study: Costlier MA plans aren't always better

Higher-cost Medicare Advantage plans don't always result in higher quality, according to a study published in JAMA Health Forum.

Why it matters: The private market for Medicare plans may become more popular than traditional Medicare among seniors this year.

Zoom in: Researchers at Rand analyzed more than 700 Medicare Advantage plans between 2016 and 2017 against 15 different quality measures.

Quality varied substantially within each premium cost tier studied, Rand experts said.
People enrolled in the two higher-premium plan tiers reported similar or slightly better experiences on average than enrollees in the lower-premium categories. For example, they were more likely to receive annual flu shots.

Yes, but: People enrolled in lower-tiered plans received better care on average for osteoporosis than those in higher-premium plans.

What they're saying: "Given that many high- and low-quality plans were found in each of the premium tiers we studied, the premium cost is a poor proxy for assessing the quality of a Medicare Advantage plan," said lead author Amelia Haviland, a professor of statistics and public policy at Carnegie Mellon University and adjunct statistician at Rand.

Seniors should look at metrics, such as the government's star ratings, she said.

A message from Humana

Medicare Advantage: Better care, better savings

Eligible members don’t have to choose between better health outcomes and savings.

Here’s why: Medicare Advantage members benefit from 43% lower avoidable hospitalizations and save nearly $2,000 every year compared to those who choose fee-for-service Medicare.

Read the rest of this story from Axios Health Tech Pro.

4. Global health facility hygiene problem

Photo: Fabrice Coffrini/AFP via Getty Images

Half of the health care facilities around the world lack basic hygiene services like water and soap, Axios' Oriana Gonzalez writes about a new WHO and UNICEF report released Tuesday.

Why it matters: Poor hygiene conditions put the approximately 3.85 billion people who depend on the facilities at greater risk of disease and infection, WHO and UNICEF said.

The report says that unsanitary environments and health workers play a "significant" role in pathogen transmission and could prolong health crises, like the COVID-19 pandemic.

What they're saying: "Hygiene facilities and practices in health care settings are non-negotiable. Their improvement is essential to pandemic recovery, prevention and preparedness,” said Maria Neira, director of WHO's Department of Environment, Climate Change and Health.

Hospitals and clinics without safe water and basic hygiene are "a potential death trap for pregnant mothers, newborns, and children," said Kelly Ann Naylor, a UNICEF director overseeing risk reduction. She noted around 670,000 newborns lose their lives to sepsis each year.

By the numbers: Only 51% of health care centers had hygiene facilities at points of care and hand washing facilities.

11% of health care facilities globally — which serve around 688 million people — don't have any hygiene services.

5. Digital period tracking's dark future

Reproduced from Rock Health; Chart: Axios Visuals

Almost one-third of menstruating respondents used at least one digital tool to track their periods and/or fertility, Axios' Erin Brodwin writes about a Rock Health report on digital period tracking.

Why it matters: The personal right to privacy was embedded in Roe v. Wade, and its reversal is already threatening those protections — including when it comes to the use of digital products that track fertility and ovulation, the Rock Health analysts note.

6. Catch up quick

🤒 Paid sick leave is associated with lower mortality rates among U.S. workers. (The Hill)

💊 A study of 6,000 people found a diabetes drug cut the number of deaths and medical emergencies associated with heart failure, Brigham and Women's researchers say. (Boston Globe)

👉 New laws in New York and California are seeking to make National Cancer Institute-designated Comprehensive Cancer Care centers available to Medicaid and ACA exchange enrollees. (Modern Healthcare)

A message from Humana

Members can save on quality care with Medicare Advantage

Medicare Advantage can provide better health outcomes and lower costs.

The proof: Members have a 43% lower rate of avoidable hospitalizations and savings of nearly $2,000 a year compared to those who choose fee-for-service Medicare.

🪗 1 fun thing: The trailer for the movie "Weird: The Al Yankovic Story" made waves yesterday in part for its depiction of Madonna. In honor of that, this one goes out to all you Vitals readers out there who are surgeons.

Why stop here? Let's go Pro.

Join the thousands of professionals reading Axios Pro: Health Tech Deals to better understand the forces shaping their industry.

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2022-08-30 Axios

Tue, 30 Aug 2022 10:05:15 GMT

Go deeper for what Amoaku misses most about Chicago

Axios Chicago

By Monica Eng and Justin Kaufmann · Aug 30, 2022

Happy Tuesday! It's National Toasted Marshmallow Day. Now we know what's for dinner.

☀️ Today's weather: A nicer, dry day with sun and a high of 82.

🎂 Happy birthday to our Axios Chicago member Patrick Kansa!

Today's newsletter is 892 words — a 3.5-minute read.

1 big thing: First school week sees COVID increase

Illustration: Aïda Amer/Axios

CPS reported three times as many COVID-19 cases during the first week of this school year as it did a year earlier.

Why it matters: The highly contagious BA. 5 variant is dominating local cases, and CPS has weakened COVID precautions. That irks at least one local doctor.

"I don't think it's surprising we have higher numbers of COVID compared to last year," Dr. Tina Tan of Lurie Children's Hospital told ABC-7, noting the surge of BA.5 and reduced protocols.

Driving the news: CTU rank and file voted last week to adopt a new COVID safety agreement that largely mirrors the last agreement. It's expected to be signed this week.

Chicago Teachers Union vice president Jackson Potter says the union has advocated to "immediately re-impose a mask mandate if they see a spread," but did not indicate what level of spread would warrant a renewed mandate.

The other side: CPS officials currently "strongly recommend" masking and say it will be required for:

Individuals who return to class for 10 days after their positive COVID test.
Entire elementary school classes for 10 days after students are exposed in the classroom.
Entire high school classrooms for 10 days after exposure if the class has more than three cases.

Of note: A judge on the Illinois Educational Labor Relations Board ruled Friday that CPS had violated state law by unilaterally dropping the district's mask mandate last March.

Zoom out: As one of the last states to drop school mask mandates, Illinois saw a smaller percentage of children develop COVID.

While all other Midwestern states have seen child infection rates higher than 80%, Illinois' checks in at 76.9%, according to the CDC.

Image credit: Data: CDC; Map: Simran Parwani/Axios

2. Kwame Amoaku on his new job in NYC

Kwame Amoaku. Courtesy of the NYC Mayor's Office of Media and Entertainment

After 25 years in Chicago film and TV, Kwame Amoaku shocked the city this spring by stepping down as director of the Chicago Film Office.

Some assumed it was connected to the severe injuries he suffered after confronting three criminals trying to steal his car.

Why it matters: Amoaku tells us that his departure was more about landing a dream job in New York City as deputy commissioner of the Mayor's Office of Media and Entertainment.

"If anything needs to be filmed [in NYC], I'm the person that permits and facilitates it and advises them on production," Amoaku said during a recent call from his office in The Ed Sullivan Theater.

By the numbers: The volume of film work he handles in NYC is "eight times the amount of work I handled in Chicago," he says.

"In 2019 we had 15 episodic projects going on in Chicago at one time with a record breaking $575 million in revenue," he explained. "At the same time here, there were 80 episodic projects, 315 feature films and $81 billion of revenue."
OK, we get it.

The intrigue: When asked whether he left because of crime — specifically the attack last spring — Amoaku said: "Not at all. This was something that was in the works before the incident. I think the crime issue in the city needs to be dealt with, but I wouldn't say it was the reason I left at all."

The bottom line: Despite his fancy NYC credentials, Amoaku's heart remains here.

"South Side until I die," he proclaimed. "I'm still rocking my White Sox cap here even though they're trying to get me to switch it up for the Yankees. That will never happen."

3. Tips and hot links

Illustration: Brendan Lynch/Axios

✈️ Airlines are increasing staff for the fall travel season. Industry analysts are worried that if fall is anything like the chaotic summer of cancellations and delays, consumers may adjust their holiday travel plans. (Tribune)

🖍 An investigation looks into why Chicago parents aren't signing kids up for free universal preschool. (Sun-Times/WBEZ)

🏈 Today is cut day for the Bears. The focus will be on wide receiver Dante Pettis and linebacker Jack Sanborn, who both excelled in the preseason. (NBC Sports)

A message from Axios

Get eyes on your brand

If you're a marketer or business owner interested in supporting local journalism and reaching civic minded Chicago leaders like yourself, we'd love to speak with you.

Click here to learn more about advertising with Axios Local.

4. Your favorite iced coffee

Iced coffee gets the work done. Photo: Monica Eng/Axios

We poured out our hearts last week on top spots for local iced coffee.

Justin chose the Military Latte made with matcha, vanilla syrup, cocoa powder and a shot of espresso at Sawada in the West Loop.
Monica voted for Kyoto Black cold brew sold around the city.

As usual, you perked up with plenty of cool java favorites around town:

Monica H.: "Stroll up to the window at Charmer's Cafe near the Jarvis L stop and order an iced lavender latte and a pup cup. You'll both be so happy to sit and enjoy your treat on their lovely patio."

Margret-Ann N.: "The best iced coffee comes from Coffee Lab & Roasters in Lakeview. Conveniently located across from two daycares, the perfect stop for all the sleepy-eyed parents."

Jennifer K: "My favorite iced coffee in Chicago is Dark Matter's Chocolate City on draft. It makes my brain sparkle."

All your iced coffee picks

Over 1 million readers now wake up to Axios Local in their inbox. You can reach these smart professionals in their hometown.

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5. Where in the the world is ... Justin?

Photo: Justin Kauffman/Axios

We've been doing our little Chicago area scavenger hunt for almost a year, and it's time for these to get more difficult.

We can't just give Axios swag away for nothing 😂.

Where's Justin this week? Here's a hint:

North of the city where the deer run free.
TikTok famous for all the world to see.
Measured in square feet but barely wider than a tree.
A home closer to apple, peach, chocolate or cherry.

📬 Answer correctly to enter a drawing and win swag!

A message from Axios

Get eyes on your brand

If you're a marketer or business owner interested in supporting local journalism and reaching civic minded Chicago leaders like yourself, we'd love to speak with you.

Click here to learn more about advertising with Axios Local.

😊 Monica's neighborhood held its first-ever block party over the weekend. And she didn't let her age stop her from goofing in the bouncy house — after the kids left.

🍽 Justin is happy he got to spend time with his old college friend and his family this past weekend. He took them to Daisies, Kurimu, Quimbys, Dos Urban Cantina, Sawada and Duck Inn.

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2022-08-30 Axios

Tue, 30 Aug 2022 19:07:25 GMT

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The intrigue: Below are the prizes for the three winners.

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2022-08-31 Axios

Wed, 31 Aug 2022 10:09:53 GMT

Presented By Humana

Axios Vitals

By Tina Reed · Aug 31, 2022

Good morning, Vitals readers. Today's newsletter is 741 words or a 3-minute read.

👀 What we're watching: The FDA could authorize Omicron-specific COVID vaccines as early as today.

1 big thing: The fight over drug copays

Illustration: Sarah Grillo/Axios

Groups representing HIV and diabetes patients are trying to kill a Medicare rule they say leaves sick patients stuck with higher drug costs, by preventing them from applying billions of dollars in assistance against their insurance deductibles.

The big picture: A federal suit filed by the groups on Tuesday takes up the bigger question of whether pharmaceutical companies can cover Medicare copays for expensive drugs, or whether covering patients' costs that way amounts to a kickback.

Zoom in: The suit in U.S. District Court for the District of Columbia centers around "copay coupons" offered by drug companies to offer patients a better deal and ultimately boost sales of their drugs — at least, until their insurance deductibles are met.

Insurers have begun using so-called co-pay accumulators to stop patients from applying those discounts toward their deductibles.
But the patient groups — including the HIV+Hepatitis Policy Institute, Diabetes Leadership Council, and the Diabetes Patient Advocacy Coalition — argue federal regulations define cost-sharing as "any expenditure required by or on behalf of an enrollee with respect to essential health benefits."
"It should not matter whether the assistance comes from a friend, charity, or drug manufacturer," they write.

A CMS spokesperson said the agency does not comment on pending litigation.

What they're saying: Due to increasing deductibles and cost-sharing requirements, patients often rely on copay assistance to help them afford their prescriptions, said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.

The other side: Studies have shown drug coupons raise costs across the board, by encouraging patients to seek specific companies' drugs. Physicians are willing to prescribe them, knowing patients won't be burdened by cost. But taxpayers could pick up the bulk of the tab.

Medicare prohibits copay coupons, essentially calling them kickbacks. The groups are suing to change that interpretation.
Yes, but: "We're talking about pharmaceutical manufacturers ... seeking to circumvent cost-sharing mechanisms that have some ability to constrain pharmaceutical prices and direct utilization to more cost-effective care," Leemore Dafny, a health economist at Harvard, told Axios.

2. What's killing Americans?

Data: National Center for Health Statistics; Chart: Erin Davis/Axios Visuals

Life expectancy at birth in the U.S. declined nearly a year from 2020 to 2021, according to new provisional data from the CDC.

Why it matters: It's the latest evidence of the toll the COVID pandemic took on Americans' health and takes the U.S. life expectancy at birth to its lowest level — 76.1 years — since 1996.

Together with recent data showing life expectancy fell 1.8 years between 2019 and 2020, that means life expectancy at birth fell by 2.7 years over two years — the largest two-year decline since 1921–1923.

Be smart: COVID-19 was the biggest driver, followed by unintentional injuries and heart disease.

The losses were offset in part by decreases in deaths attributed to the flu and pneumonia, which is likely tied to COVID mitigation measures such as masking and social distancing.

3. Early arbitration issues between insurers, providers

A lot of hay has been made out of the process insurers and providers use to settle billing disputes under the surprise billing law — and it turns out that process is already causing some ... friction, Modern Healthcare reports.

Why it matters: As we've told you before, billions of dollars are at stake — either for providers or for insurers and employers.

And it's the predicted fallout now that patients are protected from facing unexpected charges from doctors who are not in their insurance networks.

What's happening: Insurers have accused providers of submitting every possible claim for mediation to settle billing disputes, even ones that aren't eligible, while providers say it's the insurers who are holding up the process, Modern Healthcare reports.

"I'm a generally optimistic person. But I'm not so optimistic," said Lisa Maurer, a physician at Emergency Medicine Specialists in Milwaukee, per Modern Healthcare.

Our thought bubble: Is anyone really surprised?

A message from Humana

Older Americans are choosing Medicare Advantage

Medicare Advantage can help provide better health outcomes and lower costs.

With Medicare Advantage, members see a 43% drop in avoidable hospitalizations and save nearly $2,000 a year compared to those who choose fee-for-service Medicare.

4. Pic du jour

Photo: Asif Hassan/AFP via Getty Images

A doctor examines a 4-month-old at a free medical camp run by Al-Khidmat Foundation for flood victims on the outskirts of Sukkur, Pakistan on Tuesday.

Tens of millions of people have been affected by relentless monsoon rains that have submerged a third of the country and claimed more than 1,100 lives.

5. Catch up quick

💧 The flooding crisis in Jackson, Mississippi, is causing schools and local governments to shift their weekly plans as residents remain unable to drink fresh water. (Axios)

👉 Texas health officials on Tuesday confirmed the death of a person diagnosed with monkeypox, which, if confirmed as the cause, would be the first known death from the virus in the U.S. (Axios)

A message from Humana

Medicare Advantage: Better care, better savings

Eligible members don’t have to choose between better health outcomes and savings.

Here’s why: Medicare Advantage members benefit from 43% lower avoidable hospitalizations and save nearly $2,000 every year compared to those who choose fee-for-service Medicare.

Editors note: The second item in the Aug. 26 Vitals incorrectly stated drugmakers are required to report quality problems with products through FDA field alert reports. 1,143 manufacturing sites are eligible, but not required, to submit the reports. 49.1% of them didn't over a four-year period the FDA reviewed.

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2022-08-31 Axios

Wed, 31 Aug 2022 10:09:55 GMT

Axios Chicago

By Monica Eng and Justin Kaufmann · Aug 31, 2022

💪 Happy Wednesday! On this day in 1919, the Communist Labor Party was founded in Chicago to unite workers of the world.

☀️ Today's weather: The skies are clear. High of 85.

🤝 A special thanks to our members for supporting our local journalism! Join them.

Situational awareness: The Sky hope to rebound against the Connecticut Sun tonight. Game 2 of the best-of-five WNBA semifinals tips at 7pm at Wintrust Arena, with coverage on ESPN2.

Today's newsletter is 911 words — a 3.5-minute read.

1 big thing: Art Smith returns with a mission

Art Smith. Photo courtesy of Reunion

Chef Art Smith once loomed large in Chicago as Oprah's personal chef, a regular on her show, the proprietor of Table 52 (now Blue Door) in the Gold Coast and the founder of nonprofit Common Threads.

Then in 2015, he returned to his home state of Florida to open Homecomin,' his dream restaurant in Disney World.

Why it matters: Smith is now back to launch his latest project — Reunion, the inviting new anchor restaurant at Navy Pier.

We recently chatted with the chef in the Reunion dining room, lined with paintings by his husband, Jesus Salgueiro.

What's happening: Reunion mixes Chicago with his Florida childhood of "sandy roads, fish camps, chicken and dumplings, fried chicken and greens," Smith says.

Expect his famous fried chicken and hummingbird cake alongside rotating seasonal items.

Between the lines: Smith wants to blend Southern comfort with celebrations of diversity.

"We have several transgender kids [working] here, and to me it was a sign that I need to do something for transgender people, particularly because of what's happening in Florida," he said.
"So once a month, we're going to have a Reunion Pride party right here for the whole community."

Flashback: Smith famously called former Florida attorney general Pam Bondi "Cruella De Vil" for her stance on marriage equality. But he's also worked for two Florida governors, Bob Graham and Jeb Bush.

The intrigue: He says he's recently been asked to cook for current Florida leaders, including Gov. Ron DeSantis. And he's considering it.

"You let me feed them, and I'll change them," he says. "I mean it."
"As my friend told me, 'Artie, you can be that little Chihuahua biting at their ankles, or you can be that big dog looking them in the eyes.'"

2. Illinois loves digital privacy

Illustration: Annelise Capossela/Axios

A federal judge recently approved a $92 million settlement for TikTok users over data privacy, with Illinois users expected to receive the biggest portion of the return.

Distribution details haven't been announced, but affected Illinois residents are expected to receive five more shares of the settlement than other U.S. residents will.

Why it matters: You can thank Illinois' Biometric Information Privacy Act, which imposes stricter privacy rules than federal law and is considered the toughest in the nation.

The push for BIPA was led by the Illinois ACLU in early 2008 — just months after the first iPhone was introduced.

Context: Passed in October 2008, it prohibits sites from collecting biometric data and sharing it with third-party companies without consent.

Biometric data includes facial recognition, fingerprints and voice prints.

The big picture: Four unnamed Illinois teenagers brought the TikTok suit in 2020, and the company agreed to settle earlier this year. But it's not the only one.

Facebook paid out $397 checks to Illinois users this year.
Snapchat recently reached a $35 million settlement with Illinois users.
And Google settled a lawsuit for an undisclosed amount, with details expected in September.

3. Tips and hot links

Illustration: Brendan Lynch/Axios

🗳 Ald. Tom Tunney (44th) becomes the latest alderperson to announce he's not running for re-election, saying the City Council is "not a good place to work these days." Could he be eyeing a run for mayor? (Tribune)

⚖️ The prosecution rested its case yesterday in the R. Kelly trial. The defense could begin today. (Sun-Times)

💰 A glitch in the tip-processing system at the Sacred Rose Music Festival in Bridgeview resulted in attendees being charged thousands in mistaken credit card transactions. The organizers said the venue will be refunding the charges in full. (ABC7)

✂️ The Bears trimmed their roster to 53 players, though some players could be signed to the practice squad. Notable cuts were offensive lineman Michael Schofield and defensive end Mario Edwards Jr. (BearsWire)

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4. Insta-review: Immersive. Cocktail. Experience.

Peeking out from the grassy clock cave at WHIM Chicago. Photo: Monica Eng/Axios

👋 Hey, it's Monica. I recently got news that local artists have transformed Stage 773 in Lakeview into WHIM Chicago, an "Immersive. Cocktail. Experience."

Finding the description confusing, I naturally accepted a press invitation to check it out.

What's happening: My partner Colin and I stepped in wearing masks and feeling a bit like the couple in "Eyes Wide Shut."

A nice hostess welcomed us to a bar and lounge right out of "Alice in Wonderland."

The drinks: Colin waited in line for 20 minutes to score a Chain Smoker cocktail (mezcal, tequila reposado, bitters, agave syrup) and a beer.

Meanwhile, I strolled around, Instagramming the stunning decor, including:

A constellation of action figures.
A door arch made of a dozen-plus stacked chairs.
A bathroom hallway painted in an Edvard Munch and Vincent Van Gogh style.
A flock of paper airplanes.
And a grass-lined clock cave.

Chain smoker cocktail and toy mobile at WHIM Chicago. Photo: Monica Eng/Axios

The entertainment: WHIM also features an adjacent theater, which hosted a colorful drag revue the night of our visit.

The rotating lineup features Thursday Karaoke Nights.

What's next: WHIM representatives say they plan to add more than 30 "spaces that awaken your imagination" in coming months.

The bottom line: For now, WHIM offers delicious cocktails, intensely Instagrammable set pieces and vibrant entertainment, to boot.

Reservations recommended.

The trippy lounge in WHIM Chicago. Photo: Monica Eng/Axios

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5. Where's Justin? The Pie House in Deerfield

Justin in front of the Pie House.

Have we mentioned that you are the smartest, best-read readers in the Chicago area?

More than 100 of you guessed correctly: Justin was in Deerfield at the "Pie House."

The slice: Designed like a piece of pie, the 1,122-square foot home narrows to a width of just three feet on one end.

A tour of the interior went viral on TikTok in 2020.

👏 Congrats to Molly F. & Tim T., whose names we pulled from a pie dish. Collect your swag at our next Axios Office Hours event!

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Our picks:

🎷 Monica looks forward to the Chicago Jazz Festival starting tomorrow and the African Festival of the Arts this weekend.

🎤 Justin remembers where he was the day Princess Diana died. He was directing a live broadcast of The Jazz Festival for WBEZ. After the fest, he went to Borderline in Wicker Park. How about you?

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2022-08-31 Axios

Wed, 31 Aug 2022 16:12:41 GMT

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2022-09-01 Axios

Thu, 01 Sep 2022 10:08:09 GMT

Presented By Humana

Axios Vitals

By Tina Reed · Sep 01, 2022

🍁 It's the first day of September. How did that happen?

Today's newsletter is 775 words or a 3-minute read.

1 big thing: What to know about new COVID boosters

Illustration: Aïda Amer/Axios

The first updated COVID-19 boosters are days away from going into the arms of Americans. But the expedited way in which they're being rolled out, and unknowns on how well they'll work, have left many people leery and full of questions, Axios' Adriel Bettelheim and I write.

Why it matters: Experts generally agree COVID vaccinations were in need of an update to target strains like Omicron, which now accounts for the majority of U.S. cases. And the evidence suggests the reformulated Pfizer-BioNTech and Moderna shots should protect those at greatest risk from hospitalization and death.

Be smart: With a CDC vaccine advisory panel set to meet today to consider recommending the shots, Vitals checked in with leading public health experts to suss out the biggest lingering questions:

Should we get these shots right away?

It depends. People who haven't been vaccinated should get the original shots first, said Andrew Pekosz, co-director of the Johns Hopkins Center of Excellence for Influenza Research and Surveillance. The boosters were designed just to top people off with a lower dose of mRNA.
The consensus for people who decided to get a booster over the summer or caught COVID then is to wait at least 60 days before getting these shots, Megan Ranney, academic dean at the Brown University School of Public Health, wrote on Twitter.
For still others, it's a calculation based on what could lie ahead. Some people could reasonably hold off until closer to October or November, to maximize protection ahead of an expected surge during the holidays. That might also buy a little time to see how well the shots are working.

Keep reading.

2. Scoop: COVID vaccine pill gets positive results

Illustration: Gabriella Turrisi/Axios

San Francisco-based biotech Vaxart, an underdog in the COVID response that's developing a vaccine that would be delivered in a pill, is reporting promising Phase 2 clinical trial data today, the company told Axios exclusively.

Why it matters: The two-dose vaccine candidate was "safe and well-tolerated" and produced immune responses against the wild strain of the virus, as well as subsequent strains including Omicron, officials said.

It also showed what's called a mucosal antibody response which can provide an added layer of protection and help reduce viral transmission, they said.

Be smart: As the first part of a Phase 2 study, this is still a relatively small study. It was based on 66 people. But it's an important milestone as the first time an oral COVID vaccine has concluded a Phase 2 trial, they said.

They say the pill could be ultimately "groundbreaking" for the global delivery of COVID vaccines and help get ahead of new COVID variants.

What they're saying: "We believe that the positive findings for multiple immunologic responses may ultimately translate to enhanced protection against infection with, and/or transmission of, SARS-CoV-2," said Sean Tucker, Vaxart's founder and chief scientific officer.

3. America's hypertension problem

Data: National Center for Health Statistics; Chart: Erin Davis/Axios Visuals

Nearly 60% of emergency department visits in the U.S. in the years leading up to the arrival of COVID-19 were adults with one or more chronic conditions, according to new CDC data.

Why it matters: This data not only provides a better look at the connection between chronic conditions and hospitalizations but a glimpse at America's vulnerabilities heading into the pandemic.

Overall, hypertension was the most frequently observed chronic condition (33.8% of ED visits by adults) between 2017-2019.

The most frequently observed pair of chronic conditions was hypertension and diabetes (33.2% of ED visits with at least two chronic conditions.)

A message from Humana

Members can save on quality care with Medicare Advantage

Medicare Advantage can provide better health outcomes and lower costs.

The proof: Members have a 43% lower rate of avoidable hospitalizations and savings of nearly $2,000 a year compared to those who choose fee-for-service Medicare.

4. Telehealth reforms hiked access to opioid meds

Illustration: Aïda Amer/Axios

Pandemic-era reforms allowed more Medicare beneficiaries to use telehealth to obtain opioid-use disorder drugs, stay in treatment and avoid overdoses, Axios' Arielle Dreher writes about a study published in JAMA Psychiatry.

Why it matters: The vast majority of people who need treatment for a substance-use disorder don't get it, and the researchers fear the addiction crisis could worsen if emergency COVID-19 reforms on telehealth and prescribing aren't made permanent.

What they found: Researchers compared two cohorts of Medicare beneficiaries before and during the pandemic.

More people during the pandemic had access to treatments like methadone, buprenorphine and extended-release naltrexone and had lower odds of having to be treated for overdoses, they found.

Yes, but: Very few people were still receiving treatment 80 days after initiating it.

5. Catch up quick

🏛 Florida is suing the FDA, claiming that the agency is delaying the state's attempts at importing cheaper prescription medications from Canada, Republican Gov. Ron DeSantis announced Wednesday. (Axios)

🫁 The federal government should improve its oversight of the cybersecurity of the United Network for Organ Sharing, which manages the U.S. organ transplantation system, according to a watchdog report. (OIG)

🔥 A brutal heatwave is scorching the U.S. west this week, sparking fires and health warnings. (The Guardian)

A message from Humana

Older Americans are choosing Medicare Advantage

Medicare Advantage can help provide better health outcomes and lower costs.

With Medicare Advantage, members see a 43% drop in avoidable hospitalizations and save nearly $2,000 a year compared to those who choose fee-for-service Medicare.

Why stop here? Let's go Pro.

Join the thousands of professionals reading Axios Pro: Health Tech Deals to better understand the forces shaping their industry.

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2022-09-01 Axios

Thu, 01 Sep 2022 10:08:13 GMT

Axios Chicago

By Justin Kaufmann and Monica Eng · Sep 01, 2022

Happy Thursday! It's got that new month smell.

☀️ Today's weather: Sunny with a high of 88.

Situational awareness: Texas Governor Greg Abbott announced he has bused migrants to Chicago from Texas. Approximately 60 people arrived at Union Station late last night. Chicago now joins New York City and Washington D.C. as "drop off locations" as part of a busing strategy to protest President Biden's border policy.

Today's newsletter is 923 words — a 3.5-minute read.

1 big thing: Children's hospitals harassed

The Ann & Robert H. Lurie Children's Hospital of Chicago. Photo: Jeff Schear/Getty Images

Pediatric facilities nationwide, including Chicago's Lurie Children's Hospital, are facing harassment and false claims about the gender-affirming care they offer.

Why it matters: The harassment is driven by Libs of TikTok, a Twitter account whose posts are amplified by the conservative group Awake Illinois.

It targets hospitals that provide crucial gender care ranging from talking to children about their identities to hormone treatments and surgery for those over 18 years old.

Flashback: The American Medical Association last year asked governors to oppose legislation that limits gender-affirming care for youth, calling it "medically necessary, evidence-based care that improves physical and mental health."

What's happening: A man calling himself Billboard Chris showed up at Lurie last week with a sign suggesting children are being given puberty blockers against their will.

The Awake Illinois Twitter account called him a hero for it. (He also attended their rally in Springfield.)
Other hospitals targeted by Libs of TikTok include a Nebraska children's hospital and Phoenix Children's Hospital.
And Boston Children's Hospital is stepping up security following threats over its program for treating transgender and nonbinary youth.

Source: Twitter

What they're saying: "We stand in solidarity with our transgender patients and families, community, and colleagues who are providing gender-affirming care," Lurie said in a statement. "We strongly condemn any threats on and harassment toward the transgender community."

The intrigue: An anonymous Twitter account urged "foodies" to boycott Lettuce Entertain You Enterprise (LEYE) restaurants because Awake Illinois leader Jessica Hockett, an outspoken opponent of school masking and LGBTQ+ equity programs, is married to Wow Bao executive Tim Hockett.

Reality check: LEYE representatives say Tim Hockett hasn't worked there since 2020.

Wow Bao, previously owned by LEYE, was acquired by a private equity firm in 2017. LEYE says it no longer manages the brand, but lists it on the Lettuce site because it holds a minority stake.

Of note: Wow Bao did not make Tim Hockett available for comment, and Awake Illinois and Libs of Tik Tok did not respond to interview requests.

2. Chart of the Day: Middling life expectancy

Data: Arias, et al., 2022, "U.S. State Life Tables, 2020"; Chart: Simran Parwani/Axios

Illinois ranks No. 26 nationally in life expectancy from birth, according to the latest CDC analysis.

By the numbers: Illinois' average life expectancy of 76.6 years falls just below the U.S. average of 77.

Illinois women have an expectancy of 79.8 years, while men fare much worse, at 73.8.

The big picture: Life expectancy declined in all states from 2019 to 2020.

Steepest decline: New York, at three years.
Longest life: Women in Hawaii, at 83.6 years.
Shortest life: Men in Mississippi, at 68.6.

3. Tips and hot links

Illustration: Brendan Lynch/Axios

💉 The FDA authorized new COVID-19 vaccine boosters that could be available next week. (Axios)

🏀 The Sky defeated the Sun 85-77 in Game 2 of the WNBA semifinals at Wintrust Arena. They head to Connecticut on Sunday for Game 3 of the best-of-five semifinal series. (Tribune)

🚿 Dixmoor has seen nine water main breaks since Friday. The suburb's crumbling infrastructure has left over 1,000 residents without water. (ABC 7)

🏈 The Bears claimed six players off waivers, including the Raiders' 2021 first-rounder, offensive tackle Alex Leatherwood. (CBS Sports)

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4. White Sox raise white flag

Chicago White Sox manager Tony La Russa. Photo: Chris Sweda/Chicago Tribune/Tribune News Service via Getty Images

Last year's surprising AL Central crown drove expectations that the White Sox could compete for a World Series championship this year.

Reality check: Heading into the final month of the regular season, the Sox are two games under .500 and 5 games back in the division.

They won last night, stopping a 5-game losing streak.

What's happening: The 2022 squad has underachieved dramatically. You have to go back to the 1985 White Sox — also managed by Tony La Russa — for this kind of disappointment.

Offense: A team built on the long ball has hit just 111 homers this season.

That's fifth-worst in the league.
No White Sox player has more than 14.

Defense & pitching: This dramatic late-inning loss in Baltimore is a perfect example of the team beating itself all season.

The pitching staff has a 4.07 ERA, which ranks in the bottom half of the league.
The Sox are fifth-worst in the league in errors (62).

Injuries: Luis Robert, Tim Anderson, Yoán Moncada and Michael Kopech are all currently out of the lineup.

Meanwhile, La Russa was just hospitalized for an undisclosed medical condition and has no timetable to return to the team.

He's also created controversy with strange managerial decisions, like intentionally walking batters with two strikes and falling asleep in the dugout.

💭 Justin's thought bubble: The Sox swagger melted away in the summer heat. Fans suffered through the recent brutal rebuild for this?

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5. Secret hammock spots for Labor Day

Hammock spot near Northerly Island. Photo: Monica Eng/Axios

👋 Hey, it's Monica. I always keep a hammock in my bike basket and car, just in case I find two perfect trees with a view.

Driving the news: Over the years, I've gathered a mental list of ideal spots for a hammock-centric mini-vacation.

As we head into the ultimate hammock stretch — Labor Day Weekend — I'm sharing them for the first time ever.

The list: Each area features several trees and/or poles to set up one or more hammocks:

Grassy area between the bike path and lake along Lakefront Trail between McCormick Place and Northerly Island.
The far east end of Olive Park has rows of trees that look like they were planted specifically for hammocking. The west end also has some nice spots right next to the lake.
Upper picnic area above 31st Street Harbor with lots of poles around picnic tables and nearby prairie grass gardens.

📬 Reply with your favorite hammock spots around the Chicago area.

And we hope you have a restful Labor Day weekend — preferably with some hammock time!

Hammock heaven in Olive Park. Photo: Monica Eng/Axios

Monica enjoys winter hammock time with Belle the dog at 31st Street Harbor. Photo courtesy of Colin McMahon

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Our picks:

🧘‍♀️ Monica checked out the press preview of Taste of Iceland, which runs today through Sunday and features delights like smoked arctic char on rye with Icelandic wasabi. Other events include Nordic yoga, music and a photo exhibition.

📖 Justin wants to go to ZINEmercado this Sunday. The annual outdoor festival takes place at Comfort Station in Logan Square. It's a celebration of homemade zines and zine culture.

Want free Axios swag? Refer your friends to Axios Chicago and get cool merch like stickers, totes, hats, T-shirts and more!

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2022-09-01 Axios

Thu, 01 Sep 2022 19:10:40 GMT

Check out a visualization of the findings.

Axios Science

By Alison Snyder · Sep 01, 2022

Welcome back — to you and me! I spent some vacation time in Iceland where there was a lot of talk about volcanoes. We start today on that subject, look at climate risk to the planet's forests, and get a new glimpse of an exoplanet image. There are 1,514 words — about a 6-minute read.

Send your feedback and ideas to me at alison@axios.com.
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1 big thing: How some volcanoes erupt with little warning

Illustration: Annelise Capossela/Axios

The inner workings of volcanoes that erupt with little warning are being revealed, exposing potentially new ways to monitor them.

The big picture: The science of volcanoes — and the monitoring and forecasting tools it informs — is largely based on what's known about a handful of the world's most studied volcanoes, including Mount Etna in Italy, that typically show signs of eruption.

There are an estimated 1,350 volcanoes on Earth that are potentially active — and about 100 observatories. Some monitor multiple volcanoes but many volcanoes are under-studied and unmonitored.
"Eruptions don’t happen often so being able to have different eruptions to study from a lot of different contexts and volcanoes will help us to understand the general physics of eruptions and improve our models of the insides of volcanoes," says Emily Montgomery-Brown of the United States Geological Survey.

What's new: In a paper published this week in the journal Nature, researchers used extensive satellite data, measurements from a nearby network of seismometers and other tools to study the 2021 eruption of Mount Nyiragongo near the city of Goma in the Democratic Republic of Congo.

Nyiragongo is a bit of a special case: It behaves as an open vent with a large lake of lava in the crater at its top. Because magma isn't bottled up in these types of volcanoes, pressure generally doesn't build up over time and trigger signals of an impending eruption. Typically the shape of the volcano itself changes, small earthquakes occur and the volcano anomalously releases gasses in the days and weeks before an eruption.
But in Nyiragongo, there wasn't a signal until less than an hour before the eruption.
Delphine Smittarello of the European Center for Geodynamics and Seismology in Luxembourg and her colleagues describe what may have happened in the new paper: Magma stored close to the surface of the crater opened a path or dike on the flank of the volcano. The dike quickly ruptured the stressed surface of the volcano, the eruption started and lava flowed from the volcano — "less than 40 minutes after the first detectable anomalous seismic event."
“Being already close to the surface, the magma only had to propagate laterally for a short distance before erupting, leaving little time to detect and interpret the associated signals,” Smittarello and her colleagues write.
After the eruption, cracks formed in the surface nearby, the volcano deformed and small earthquakes occurred.

"We show that an eruption can start with only tiny and very short-term precursors," Smittarello said in an email.

"There is still a lot to do to improve the detection and real-time interpretation of these tiny signals," Smittarello said.
Similar mechanisms occur in Ambrym in Vanuatu and Kilauea in Hawai'i, where signs of dike formation have been used to forecast eruptions. But it is unclear if the technique can work elsewhere, Montgomery-Brown notes in an accompanying article.

How it works: Most eruptions come with warnings that can be monitored by networks of seismometers and other tools. But many volcanoes are in remote areas without seismic networks.

Satellite data is increasingly being tapped to try to forecast volcanic eruptions by observing the deformation of volcanoes and the flow of magma under the surface.
A study published earlier this year used radar data from satellites to measure Nyiragongo's lava lake levels as an indicator of changes in the volcano's plumbing that could aid forecasting.

Read the entire story.

2. Where forests are at climate risk

Boreal forest in Quebec, Canada.

Climate change is putting the forests of western North America, the southern boreal regions and the southern Amazon at high risk in the 21st century — but the vulnerability of forests in other areas is less clear, according to a new global assessment.

Why it matters: Climate change may be harming forests' carbon-capturing capabilities, which underpins some approaches to mitigating climate change by conserving and restoring forests.

"If forests are tapped to play an important role in climate mitigation, an enormous scientific effort is needed to better shed light on when and where forests will be resilient to climate change in the 21st century," William Anderegg of the University of Utah and his colleagues write today in the journal Science.

How they did it: Anderegg and his colleagues looked at three different approaches modeling carbon storage, biodiversity and the risk that a forest will be disturbed.

They found carbon storage on average will increase globally by 2100 but there was a higher risk of carbon loss in drier areas of the tropics, including southeast Amazonia, and the southern boreal forests of Canada.
The risk of ecosystems shifting was highest at the edges of forests.
Boreal forests and the tropics are also at the highest risk of being disturbed by fires, drought or insect damage.

What they found: When the approaches were combined, there was large uncertainty in most areas but some — including forests in western North America, the southern Amazon and the southern boreal regions — were "consistently at high risk," they report.

"One of the most surprising findings was how little the three different approaches agreed in their spatial patterns and at a global scale, they didn't agree very well at all," Anderegg says.
"That tells us that there's a huge uncertainty across our different scientific approaches for illuminating the future of climate risks on Earth's forests."

What's next: The researchers say models of forest disturbance — and how they can recover from it — need to be improved.

3. Study: Greenland ice melt will raise sea levels by nearly a foot

Ice covered fjords and mountain landscapes last month on Greenland. Photo: Britta Pedersen/picture alliance via Getty Images

The Greenland Ice Sheet is on course to lose hundreds of trillions metric tons of ice and contribute close to a foot in average global sea level rise through 2100, regardless of the magnitude of greenhouse gas emissions cuts during the period, glaciologists found in a new study published Monday, Axios' Jacob Knutson writes.

Why it matters: The study indicates human-caused global warming driven by greenhouse gas emissions has effectively locked in a certain amount of sea level rise from the melting of the Greenland ice sheet.

Already with sea level rise seen so far, coastal flood events are far more common in cities like Miami and Charleston, and future storms are expected to have more damaging storm surges.

By the numbers: The researchers estimated the ice sheet will lose about 3.3% of its total volume within this century, which corresponds to 110 trillion metric tons of ice and an average global sea level rise of at least 270 millimeters, or 10.6 inches.

For comparison, that amount of ice loss could cover the entire U.S. with 37 feet of water, the study, published in the journal Nature Climate Change, finds.

Our thought bubble, via Axios' Andrew Freedman: This study is significant since it relies on observations during two decades of studying Greenland, rather than just computer modeling.

In addition, the findings illustrate how hard it is to press the brakes on ice melt even if emissions were to halt completely now.

What they're saying: Jason Box, the study's lead author and a professor at the National Geological Survey of Denmark and Greenland (GEUS), said the study actually puts forward low estimates on the Greenland Ice Sheet's future, as the world will not instantly stop burning fossil fuels.

"It is a very conservative rock-bottom minimum. Realistically, we will see this figure more than double within this century," Box said in a statement Monday.

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4. Worthy of your time

The loneliest trees (Aisling Irwin — Nature)

Monkeys look for patterns that aren’t there—just like humans do (Dan Robitzski — The Scientist)

The first private mission to Venus will have just five minutes to hunt for life (Jonathan O'Callaghan — MIT Technology Review)

A somber search (Tess Joosse — Science)

5. Something wondrous

Exoplanet HIP 65426 b in different bands of infrared light. The star indicates the location of the planet's host star. Credit: NASA/ESA/CSA, A Carter (UCSC), the ERS 1386 team, and A. Pagan (STScI)

This is the first direct image taken by the James Webb Space Telescope of a planet outside our solar system.

The big picture: More than 5,000 exoplanets have been discovered over the past 30 years, giving astronomers hints about the variety of worlds in the universe. Direct images of these distant planets are expected to provide more details about their composition and formation — and open the next chapter in the search for life beyond Earth.

“This is a transformative moment, not only for Webb but also for astronomy generally,” Sasha Hinkley, associate professor of physics and astronomy at the University of Exeter in the United Kingdom, said in a NASA news release.

Details: JWST captured the image of exoplanet HIP 65426 b in four different bands of infrared light. The feat is accomplished using small masks on JWST that block bright light from the exoplanet's host star, HIP 65426.

The planet, which was discovered using an instrument on the European Southern Observatory’s Very Large Telescope in Chile in 2017, is a gas giant about 6 to 12 times the mass of Jupiter, according to NASA.
It is just 15 million to 20 million years old and about 100 times farther from its star than Earth is from our Sun.
The research has not been peer-reviewed.

What to watch: Infrared images are expected to give astronomers unprecedented information about the temperatures and masses of exoplanets and to help them spot weather on the far-off worlds.

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