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Can abortion pills overcome U.S. state bans?

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© Reuters. FILE PHOTO: Dr. Shelly Tien hands a patient the initial abortion inducing medication at Trust Women clinic in Oklahoma City, U.S., December 6, 2021. REUTERS/Evelyn Hockstein/

By Brendan Pierson and Nate Raymond

(Reuters) – Following the U.S. Supreme Court’s June 24 ruling eliminating the nationwide right to abortion that it had recognized nearly 50 years ago in its landmark Roe v. Wade decision, demand for abortion pills, which can be prescribed through online telemedicine visits, will likely rise. However, medication abortion will not necessarily offer a way for most women to avoid the stringent new abortion bans now expected to pass in conservative states, experts say.

WHAT IS A MEDICATION ABORTION?

In a medication abortion, a patient takes a drug called mifepristone, also known as RU-486, followed by a second drug called misoprostol, to end a pregnancy rather than having a surgical procedure. Over half of abortions in the United States are medication abortions, according to the Guttmacher Institute https://www.guttmacher.org/state-policy/explore/medication-abortion, an abortion rights advocacy research group.

HOW DOES THE FEDERAL GOVERNMENT REGULATE MEDICATION ABORTIONS?

The U.S. Food and Drug Administration approved mifepristone in 2000, but until very recently, the FDA mandated that patients get it at a doctor’s office, clinic or hospital. After easing those restrictions during the COVID-19 pandemic, the agency in December permanently did away with the requirement that it had to be dispensed in person, allowing patients to consult with healthcare providers via telemedicine appointments and receive the pills by mail. That increased access to abortion for patients living in remote areas without providers nearby and women unable to take time off from work or not able to get to clinics for other reasons. The drugs are approved for use through the 10th week of pregnancy https://tmsnrt.rs/3yfKSqc.

DO STATES RESTRICT MEDICATION ABORTION?

Yes. Medication abortions have become a target of anti-abortion politicians and activists. Indiana bans medication abortion at 10 weeks, and Texas after seven weeks; other state medication abortion bans have been blocked by courts.

Thirty-two states allow only physicians, and not other clinicians such as nurse practitioners, to dispense abortion pills, according to the Guttmacher Institute. Nineteen states require that the dispensing clinician be in the patient’s physical presence, effectively banning telemedicine.

WHAT IS THE IMPACT OF THE SUPREME COURT’S RULING ON TELEMEDICINE ABORTION?

Before the Supreme Court’s ruling, 13 states had so-called “trigger laws” written to impose new abortion bans immediately or soon after Roe v. Wade was overturned, and other states are expected to follow after Friday’s ruling in Dobbs v. Jackson Women’s Health.

The Guttmacher Institute predicts at least 26 states, including those with trigger laws, will pass new abortion laws. Such state laws have so far not distinguished between surgical and medication abortion, so they are expected to ban medication abortion entirely. Some will ban abortions almost completely, while others outlaw abortion at six weeks or 15 weeks https://tmsnrt.rs/3sbQQEp.

U.S. Senator Tina Smith of Minnesota, a Democrat, on Thursday introduced a bill that would ensure that telemedicine abortion is available in states where abortion remains legal in anticipation of the Supreme Court’s ruling.

CAN A PATIENT IN A STATE WHERE MEDICATION ABORTION IS ILLEGAL GET THE PILLS FROM AN OUT-OF-STATE PROVIDER WHERE IT IS LEGAL?

That depends. It is illegal for a medical professional to prescribe the pills via a telemedicine appointment to a woman in a state where they are illegal, legal experts say.

    “The laws around telemedicine generally say that the location of the patient controls,” said Amanda Allen, senior counsel at the Lawyering Project, an organization that represents abortion providers. Doctors who prescribed abortion pills to a patient in a state where they are illegal could lose their licenses in that state, or even face criminal charges, she said.   

A woman who lives in a state where abortion is illegal could travel to a state where it is legal, have a telemedicine visit, and have the medication mailed to an address there.

    “In some cases, that’s somewhat less burdensome and costly than to travel all the way to a brick-and-mortar clinic in a neighboring state,” she said, noting that patients who travel to clinics in other states have sometimes faced weeks-long waits for appointments.

ARE THERE CURRENTLY LAWSUITS CHALLENGING STATE RESTRICTIONS ON MEDICATION ABORTION?

Yes. GenBioPro Inc, a company that sells mifepristone, has already challenged Mississippi’s restrictions on prescribing abortion pills via telemedicine by arguing that they are “preempted” by the FDA, meaning that the federal approval of the drug overrides any state law. There has not been a ruling in that case, which is pending in Mississippi federal court.

    Similar challenges have succeeded before. In 2014, a Massachusetts federal judge struck down a state law seeking to regulate opioid drugs more stringently than federal law on the grounds that it was preempted.

U.S. Attorney General Merrick Garland appeared to express support for that position in a statement on the Supreme Court’s June 24 ruling, saying that states “may not ban mifepristone based on disagreement with the FDA’s expert judgment about its safety and efficacy.”

Mississippi has argued that FDA approval cannot overcome the Supreme Court’s rulings granting states authority to regulate abortions.

CAN PATIENTS GET ABORTION PILLS FROM OTHER COUNTRIES?

Yes. Women in states cracking down on telemedicine abortion have increasingly turned to ordering pills online from overseas.

While the practice is not legal, state authorities have said they have no effective way of policing orders from foreign doctors and pharmacies.

(This story refiles to change reference from “medical abortion” to “medication abortion”)

Coronavirus

China slashes COVID quarantine time for international travellers

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© Reuters. FILE PHOTO: People line up at a nucleic acid testing station, following the coronavirus disease (COVID-19) outbreak, in Beijing, China, June 16, 2022. REUTERS/Thomas Peter/File Photo

2/2

BEIJING/SHANGHAI (Reuters) – China on Tuesday slashed the quarantine time for inbound travellers by half in a major easing of one of the world’s strictest COVID-19 curbs, which have deterred travel in and out of the country since 2020.

Quarantine at centralised facilities has been cut to seven days from 14, and subsequent at-home health monitoring has been reduced to three days from seven, the National Health Commission said.

The latest guidelines from the health authority also eased quarantine requirements for close contacts of people who have tested positive for the new coronavirus.

China has cautiously eased its COVID curbs on cross-border travellers in recent months, with health officials saying the shorter incubation period of the Omicron variant allows for an adjustment of quarantine periods.

The Chinese capital Beijing in recent months has already reduced the quarantine period at centralised facilities to 10 days from 14.

China, last month, also removed some COVID-19 test requirements for people flying in from countries such as the United States.

“We believe that today’s announcement will be welcomed by the American business community,” the American Chamber of Commerce in Shanghai said on its official WeChat account.

The quarantine adjustment will make it easier for companies to bring staff to China, and for Chinese companies and their executives to visit the United States, AmCham said.

Stock markets rose in Hong Kong and the mainland, with the Hang Seng Index reversing losses and ticking up roughly 0.4% and the CSI300 Index gaining 0.7%.

Shares in mainland tourism companies jumped more than 5%.

China’s aviation regulator said this month it had been in touch with some countries to steadily increase the number of flights in the second half of 2022.

IN THE CLEAR

Beijing and Shanghai reported on Tuesday no new local COVID infections, the first time both cities were in the clear simultaneously since late February, after months of fighting their worst-ever outbreaks.

The milestone for the two cities, achieved on Monday, came after their daily caseloads dropped to single digits over the past week, allowing Shanghai to gradually resume eating in at restaurants and Beijing to reopen some leisure venues including the Universal Beijing Resort.

Shanghai Communist Party chief Li Qiang declared on Saturday that authorities had “won the war to defend Shanghai” against COVID-19.

The Walt Disney (NYSE:DIS) Co’s Shanghai Disney Resort said on Tuesday that it would reopen the Disneyland theme park on June 30; it had been shut for more than three months.

Authorities, however, were adamant the government’s so-called dynamic zero COVID policy, which aims at blocking flare-ups from spreading as they crop up, remains in place.

Beijing would “fight against any new outbreaks at the outset and with speed and resolutely break their transmission channel”, Cai Qi, the city’s top Communist Party chief, was quoted as saying in a report by the party-backed Beijing Daily.

Earlier on Monday, the Beijing Daily apparently misquoted Cai as saying the city would maintain its COVID control effort for “the next five years”.

The newspaper afterwards removed the reference and its chief, Zhao Jingyun, said it was an error but that did not prevent some suspicion among the public.

“Surely it wasn’t a mistake! It’s meant to gauge public opinion!” said a user of the Weibo (NASDAQ:WB) social media platform.

Another Weibo user said even if it was a mistake, “at least the higher-ups are now aware of how helpless we all feel and how we detest the current counter-epidemic policies”.

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Coronavirus

Beijing, Shanghai both free of new local COVID cases for first time in months

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© Reuters. FILE PHOTO: People line up at a nucleic acid testing station, following the coronavirus disease (COVID-19) outbreak, in Beijing, China, June 16, 2022. REUTERS/Thomas Peter/File Photo

BEIJING/SHANGHAI (Reuters) – China’s capital, Beijing, and the financial hub of Shanghai reported on Tuesday no new local COVID infections, the first time both cities were in the clear at the same time since late February, after months of fighting their worst-ever outbreaks.

The milestone for the two cities, achieved on Monday, came after their daily caseloads dropped to single digits over the past week, allowing Shanghai to gradually resume eating in at restaurants and Beijing to reopen some leisure venues including the Universal Beijing Resort.

Shanghai Communist Party chief Li Qiang declared on Saturday that authorities had “won the war to defend Shanghai” against COVID-19, following a crushing two-month citywide lockdown that was finally lifted in early June.

Authorities, however, remained wary and were adamant that the government’s so-called dynamic zero COVID policy, which aims at blocking flare-ups from spreading as they crop up, remains in place.

Beijing would “fight against any new outbreaks at the outset and with speed and resolutely break their transmission channel”, Cai Qi, the city’s top Communist Party chief, was quoted as saying in a report by the party-backed Beijing Daily.

The city would build “a solid virus barrier”, Cai was quoted as saying on Monday.

Earlier on Monday, the Beijing Daily apparently misquoted Cai as saying the city would maintain its COVID control effort for “the next five years”.

The newspaper afterwards removed the reference and its chief, Zhao Jingyun, said it was an error but that did not prevent some suspicion among the public.

“Surely it wasn’t a mistake! It’s meant to gauge public opinion!” said a user of the Weibo (NASDAQ:WB) social media platform.

Another Weibo user said even if it was a mistake, “at least the higher-ups are now aware of how helpless we all feel and how we detest the current counter-epidemic policies”.

Despite easing COVID restrictions in Beijing and Shanghai, their combined 47 million residents have been told to go through COVID testing every few days, to maintain access to public spaces and transport.

Elsewhere in mainland China, a total of 22 domestically transmitted infections were reported for June 27, including five in the southern technology hub Shenzhen.

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Coronavirus

U.S. appeals court vacates federal vaccine mandate pending additional hearing

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© Reuters. FILE PHOTO: A resident over 50 years old and immunocompromised receives a second booster shot of the coronavirus disease (COVID-19) vaccine in Waterford, Michigan, U.S., April 8, 2022. REUTERS/Emily Elconin

WASHINGTON (Reuters) – A U.S. appeals court panel said on Monday it would convene a full panel to reconsider President Joe Biden’s executive order requiring civilian federal employees to be vaccinated against COVID-19, and set aside the order pending that hearing.

The U.S. Court of Appeals for the Fifth Circuit, which is based in New Orleans, had reinstated the vaccine order in April by a 2-1 vote after it was blocked by a district court judge in January. [L2N2W530Z]

The court said on Monday that it would reconsider the case en banc, which means it will be heard by a larger panel of judges. No date was given for the hearing. Pending that hearing, the court said it would vacate the April ruling, which means that Biden’s order cannot be enforced.

Biden said in September he would require about 3.5 million government workers to get vaccinated by Nov. 22, barring a religious or medical accommodation, or face discipline or firing. Despite the legal fight, more than 90% of federal workers were vaccinated by December, the White House said last year.

The president’s vaccine and mask mandates have faced stiff opposition, led by Republicans, which have turned public safety measures endorsed by disease experts into a political and legal battle in the United States.

The United States passed the milestone of 1 million dead from the coronavirus in May. More than 250 people still die of the disease daily, according to the U.S. Centers for Disease Control and Prevention.

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