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The Trump administration is taking steps to give telehealth a broader role under Medicare, with an executive order that serves as a call for Congress to make doctor visits via personal technology a permanent fixture of the program. The order President Donald Trump signed Monday applies to one segment of Medicare recipients — people living in rural communities. But administration officials say it’s intended as a signal to Congress that Trump is ready to sign more significant legislation that would permanently open up telehealth as an option for all people with Medicare. Trump says his administration is “taking action to make sure telehealth is here to stay.”"When the invisible enemy struck our shores, we took immediate action to eliminate regulatory barriers to telehealth, making it easier for patients to consult with doctors from safety and convenience and really, they have great safety and great convenience right from their homes," Trump said. While the CDC said in June it was working on expanding access to telehealth, it did list some drawbacks to the service:Situations in which in-person visits are more appropriate due to urgency, underlying health conditions, or inability to perform an adequate physical examThe need to address sensitive topics, especially if there is patient discomfort or concern for privacyLimited access to technological devices (e.g., smartphone, tablet, computer) needed for a telehealth visit or connectivity issuesLevel of comfort with technology for HCP and patientsCultural acceptance of conducting virtual visits in lieu of in-person visits by HCP and patientsInterstate licensure challenges and other regulatory issues that may vary by state 1701

The US Centers for Disease Control and Prevention warned US consumers on Tuesday to not eat romaine lettuce, as it may be contaminated with E. coli.Thirty-two people, including 13 who have been hospitalized, have been infected with the outbreak strain in 11 states, according to the CDC. One of the hospitalized people developed hemolytic uremic syndrome, a potentially life-threatening form of kidney failure. No deaths have been reported.People have become sick in California, Connecticut, Illinois, Massachusetts, Maryland, Michigan, New Hampshire, New Jersey, New York, Ohio and Wisconsin.The Public Health Agency of Canada has identified an additional 18 people who have become sick with the same strain of of E. coli in Ontario and Quebec.If you have any romaine lettuce at home, you should throw it away, even if you have eaten some and did not get sick, the CDC cautioned."This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad," the CDC said in its announcement.All types and brands of romaine lettuce are suspect because no common grower, supplier, distributor or source company has been identified by the CDC.Retailers and restaurants also should not serve or sell any until more is known about the outbreak.Symptoms of E. coli infection, which usually begin about three or four days after consuming the bacteria, can include watery or bloody diarrhea, fever, abdominal cramps, nausea and vomiting, according to the CDC. Most people infected by the bacteria get better within five to seven days, though this particular strain of E. coli tends to cause more severe illness.People of all ages are at risk of becoming infected with Shiga toxin-producing E. coli, according to the US Food and Drug Administration, which is also investigating the outbreak. Children under 5, adults older than 65 and people with weakened immune systems, such as people with chronic diseases, are more likely to develop severe illness, but even healthy children and adults can become seriously ill.Illnesses started in October. This outbreak is not related to a multistate outbreak linked to romaine lettuce this summer.The-CNN-Wire 2311

The restrictions will remain in the same terms as implemented since March 21. Both countries will continue coordinating sanitary measures in the border region. The measures will be in force until July 21, 2020.2/2— Embassy of Mexico in the US (@EmbamexEUA) June 16, 2020 278

The U.S. has now recorded more than 3 million new cases of COVID-19 in the month of November alone, according to a database kept by Johns Hopkins University.According to Johns Hopkins, the U.S. has recorded at least 3.1 million cases of COVID-19 since Nov. 1 — more than 25% of all the cases the country has seen since the pandemic began.The spike in cases has led to a concerning jump in virus-related hospitalizations across the country. According to the COVID Tracking Project, more than 83,000 people across the country are currently battling the coronavirus in a hospital — the most the country has seen since the pandemic began. The COVID Tracking Project reports that while the entire country is seeing a spike in hospitalizations, the Midwest and South have been hit particularly hard — 69% of all COVID-19 hospitalizations across the country have occurred in those two regions.The spike has led to a concerning increase in hospital resources. In some rural hospitals in the Upper Midwest, there aren't beds to spare.The COVID Tracking Project also reports that there has been a significant uptick in deaths since the start of November. Since Oct. 31, the 7-day average of daily deaths has increase from 810 to 1,470. The current rate of deaths per day hasn't been seen in the U.S. since mid-May. The concerning spike occurs as much of the country sees the weather turn colder ahead of winter months, and comes as Americans prepare to celebrate the holiday season — something health officials warn could further facilitate the spread of the virus. The CDC has recommended that Americans not travel to celebrate Thanksgiving with loved ones and recommends against hosting large gatherings this year.It also comes as several drug companies, including AstraZeneca, Moderna and Pfizer have all reported encouraging results from their COVID-19 vaccine trials. While the companies are all pre-producing millions of doses of the drugs prior to authorizaiton, health experts say they likely won't be widely available until spring 2021. 2049

The United States and China are acting tough over trade, but they're also busy talking to try to stop the situation spiraling out of control.President Donald Trump ramped up tensions last week by ordering tariffs on about billion worth of Chinese goods just weeks after announcing of sanctions on steel and aluminum imports. Beijing has responded with plans to target billion worth of US products and warnings that it's ready to inflict more pain.The moves have fueled fears that the situation could escalate into a full-blown trade war between the world's two largest economies. But Treasury Secretary Steven Mnuchin said Sunday that he's been talking to Chinese officials in an effort to prevent that."We're not afraid of a trade war, but that's not our objective," he said in an interview on Fox News."We are going to proceed with our tariffs ... we're also working on investment restrictions," Mnuchin said. "But we are simultaneously having negotiations with the Chinese to see if we can reach an agreement."The US government wants China to do a lot more to open up its vast economy to US businesses and bring down the massive trade deficit between the two countries.Trump has set a target of cutting the deficit in goods with China by 0 billion. It soared to 5 billion last year, according to US figures.Mnuchin said the United States wants China to do away with rules that require foreign companies to set up joint ventures with Chinese firms in many industries, such as automobiles, and to stop forcing American businesses to hand over valuable intellectual property in order to operate in China. Intellectual property theft is the reason the Trump administration gave for the planned billion in tariffs on Chinese goods.Mnuchin and US Trade Representative Robert Lighthizer detailed the US requests in a letter to a top Chinese economic official late last week, according to the Wall Street Journal. They included asking Beijing to reduce tariffs on American cars, increase spending on US semiconductors and provide greater access to the Chinese financial sector, the Journal reported, citing unidentified people with knowledge of the matter.A Treasury Department spokesperson declined to confirm the report."We are having very productive conversations with them," Mnuchin told Fox, adding that he was "cautiously hopeful" that the two sides could reach a deal. But in the absence of "an acceptable agreement that the president signs off on," the Trump administration will press ahead with the tariffs and other measures, he warned.China's point man for the talks is Liu He, a Harvard graduate who is one of President Xi Jinping's most trusted advisers. Liu was in Washington for talks with US officials the week that Trump announced plans for the tariffs on steel and aluminum and was recently appointed to the position of vice premier.Mnuchin and Liu spoke as recently as this weekend."Secretary Mnuchin called Liu He to congratulate him on the official announcement of his new role," the Treasury spokesperson said. "They also discussed the trade deficit between our two countries and committed to continuing the dialogue to find a mutually agreeable way to reduce it."China's official news agency Xinhua also reported the conversation, saying that Liu criticized the US allegations of Chinese intellectual property theft and warned Mnuchin that China "has the capability to safeguard its national interest."But Liu also said that China "hopes to see both sides remain sensible and work together to preserve the overall stability of China-US trade relations," according to the Xinhua report.Some experts are skeptical that Beijing will give Trump what he wants."China may be able to come up with some big ticket imports to allow it to appear to be trying to reduce the bilateral trade imbalance," Mark Williams, chief Asia economist at research firm Capital Economics, wrote in a note to clients on Friday. "But China won't be able to reduce the annual imbalance by 0bn as Mr Trump has demanded."And "the chances of China making substantive changes to its practices on intellectual property are also low," Williams said, adding that the practices are seen in Beijing as "a key element" of efforts to develop the Chinese economy.  4274