Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

The pilots association that represents 9,000 Southwest Airlines pilots is asking a federal judge to block the airline from carrying out the vaccination mandate required by the federal government.

The airline insists that its cancellation of hundreds of flights and more than a thousand flight delays is in no way related to the pilots’ vaccination protests. The Southwest Airlines Pilots Association said it was “aware of operational difficulties” but it “has not authorized, and will not condone, any job action.”

We will soon see if Southwest’s problems are foreshadowing further airline interruptions as holiday travel ramps up. Southwest, as an example, has about 7,000 fewer employers than it did before the pandemic, according to the U.S. Department of Transportation. All of the airlines cut staff during the pandemic, largely with buyouts of senior workers.

COVID toe: a footnote

A long time ago, the phrase “COVID toe” made headlines and then kind of went away as a story of interest. But it is still a problem for people, mostly children and teens, who develop red lesions on their toes and fingers as a side effect of COVID-19.

Now, British scientists say they think they understand what is happening and wrote their conclusions in the British Journal of Dermatology.  

In short, the scientists say, the lesions happen when the body tries to attack the virus, but the immune system makes a mistake and attacks cells instead. One interesting fact, the researchers say, is that vaccinations seem to lower the incidence of COVID toe.

120,630 COVID orphans

The Journal of Pediatrics published some sad statistics about the enduring cost of the pandemic. Read the data slowly and take in the gravity of each number. And keep in mind that this data was gathered before the delta variant took even more lives:

• 120,630 children in the U.S. experienced death of a primary caregiver.
• 22,007 children experienced death of secondary caregivers.
• Children in racial/ethnic minority groups experienced death of a primary caregiver more often than Non-Hispanic White children (91,256 vs 51,381).
• States with the largest populations had the highest number: California (16,179), Texas (14,135), and New York (7,175).

The study uses the UNICEF definition of “orphanhood,” which is the death of one or both parents. There are examples of children who lost both unvaccinated parents to COVID-19.

Remember that 23% of American children live in single-headed households and 4.5 million children live with their grandparents in the United States.

The not-so-pretty autumn colors of the seasonal flu map

The goal here is to keep the map dark green. Lighter greens and brighter yellows mean flu cases are rising. You can see two states with rising cases already and we are early in the seasonal flu season.

(CDC)

You can see the local hot zones if you turn up the intensity on the map.

(CDC)

FDA advisors meet this week to consider boosters for J&J and Moderna recipients

The Food and Drug Administration’s vaccine advisory committee meets Thursday and Friday to consider whether people who got Johnson & Johnson and Moderna COVID-19 vaccines should get in line for boosters. One story to watch is whether the FDA recommends boosters for groups that are different from what is recommended for Pfizer vaccine recipients.

Is your kid’s school ‘spying’ on school-supplied computers?

Veronica Esquivel, 10, finishes her homework after her virtual school hours while her brother Isias Esquivel sits in front of the computer, Wednesday, Feb. 10, 2021, at their residence in Chicago. (AP Photo/Shafkat Anowar)

The Guardian uses the provocative word “spying,” which amps up emotions about this topic, but a new study by the Center for Democracy and Technology says school systems are tracking usage of the computers, laptops and tablets they loaned out to kids.

When you drill down into the story, you find what kind of surveillance the schools are using.

Thousands of school districts across the United States have installed surveillance software on school-provided devices to monitor their students’ online interactions. If a student emails or chats with another student saying they’ve been thinking of hurting themselves or that there is trouble at home, an AI bot or a human moderator watching over the messages in real time can send an alert to a teacher or administrator, allowing the teacher to jump in within minutes and ask if everything is OK.

These programs, such as Bark, Gnosis IQ, Gaggle, and Lightspeed, can cost the schools tens of thousands of dollars to implement, and they can be set up to search for language and online behavior indicating the possibility of violent tendencies, suicidal ideation, drug use, pornography use, or eating disorders.

Wired reported on this issue during the summer and found some schools use programs that allow a teacher to monitor what tabs a student has open on a school-issued device. The teacher can even close open tabs that might be interfering with schoolwork. Wired found that teachers are only supposed to have that power during school hours.

I come back to the Guardian headline. If a teacher is looking at a student’s school-issued computer during school hours, is that “spying” or is that more like a teacher trying to keep kids on task and learning?

TV station finds doctors and a hospital sending out big bills for COVID tests

Free-standing emergency rooms in some places are making a killing off of COVID-19 tests.

KPRC in Houston dug around and found one insurance company had paid $18,000 for two tests that are supposed to be free. The station found:

… doctors gouging patients and insurance companies for tests that are supposed to be free.

Nasal swabs, mouth swabs, rapid tests, and PCRs: There’s more than one way to get tested for COVID-19.

The station found Katie Hillborn, who went to a drive-in clinic run by a local emergency room.

“$3520 for me and $3520 for my daughter,” said Hillborn, referring to the amount Clear Creek Emergency Room billed her insurance company on the first claim it sent.

On top of the $3,250 Hillborn’s insurance was charged for herself and her daughter, there were two more claims for $3,700 each for the doctor’s services.

That was not the only case.

Ruth Kurian’s explanation of benefits showed the River Oaks Emergency Room charged her insurance company $8900 each for her and her husband.

Broken down, the claims were $4,200 for emergency service and another $4,700 for ancillary services totaling $17,861 for two drive-thru COVID-19 tests. The entire bill was paid in full by Anthem Blue Cross Blue Shield.

“I was flabbergasted! I never set foot in the building. I spent maybe 5 minutes with a nurse through my car window,” said Kurian.

The New York Times’ terrific reporter Sarah Kliff has been on this story for a while.

Patients, whether with or without insurance, are beginning to find holes in those new coverage programs. Nationwide, people have been hit with unexpected fees and denied claims related to coronavirus tests, according to dozens of bills that The New York Times has reviewed. Insurers have told these patients they could owe from a few dollars to thousands.

About 2.4 percent of coronavirus tests billed to insurers leave the patient responsible for some portion of payment, according to the health data firm Castlight. With 77 million tests performed so far, it could add up to hundreds of thousands of Americans who receive unexpected bills.

In some cases, the charges appear to violate new federal laws that aim to make coronavirus tests free for privately insured patients. In other cases, insurers are interpreting gray areas in these new rules in ways that work in their favor.

Kliff demonstrates how important it can be to teach your audiences to be smart consumers. Spend some time and space in your reporting to tell people how the system is supposed to work.

Experts say federal law requires the insurer to cover the antibody test in full, even out of network. But the rules around the other tests are less clear: The law states that insurers must cover services related to obtaining a coronavirus test but doesn’t identify what type of care makes the cut. Some providers seem to tack on unrelated lab tests. Patients at a drive-through coronavirus testing site in Texas, for example, were unknowingly tested for sexually transmitted diseases. Without clear federal guidance, insurers are left to sift through charges to decide what is related to coronavirus and what isn’t.

No vaccination, no transplant

UCHealth in Colorado says if patients want to be considered for transplants, they must get vaccinated. Local politicians raised questions about the practice but miss the fact that transplant programs around the country have similar thresholds. Most require all sorts of other vaccinations and conditions.

Keep in mind that the requirement is common but not universal.

The protocols are in place because an unvaccinated person would have a poorer chance of surviving a COVID-19 infection.

Should alcoholics be required to be six months sober before kidney transplants? New thinking.

Generally, a person who is both an alcoholic and in need of a liver must show they can be sober for six months before being considered for transplantation. About two-thirds of liver transplant hospitals follow that guideline. The notion is a person must remain sober after transplantation to have a chance of the new liver being able to heal.

But NPR just ran a story that says new data shows the six-month mark does not show a person will remain sober and a lot of people die in the six months they are trying to hit the mark that the transplant programs require. The NPR story explains:

As the understanding of addiction evolves — to view it as a disease rather than a personal failing — many surgeons and families say the six-month wait unfairly penalizes those with substance use disorder. And with alcoholic liver disease rising among young adults and pandemic-related drinking exacerbating those numbers, it has become a pressing concern.

“We have to move beyond denying people lifesaving therapy because we think they don’t deserve it,” says Dr. Andrew Cameron, head of the liver transplant program at Johns Hopkins Medicine in Baltimore. Doctors don’t withhold treatment from people with diabetes who are obese or people with sexually transmitted infections who had unprotected sex, he adds.

Cameron and his colleagues published a study this August, which examined patients with alcoholic liver disease who were made to wait six months and those who were not. The study found:

• About 20% in each group returned to drinking one year after their transplants.
• That means about 80% stayed sober, regardless of how long they abstained from alcohol before the surgery.

12,000 people are waiting for liver transplants in the United States.

Ignore scary headlines about a mega comet ‘heading for us’ unless you live on Saturn

A telescope stands on the shore of Lake Geneva in Geneva, Switzerland, early Thursday, June 17, 2021. (AP Photo/Michael Probst)

Sometime around 2031, a big comet — big as in 60 to 100 miles across — will pass between Saturn and Uranus. The internet rumormongers are having a ball saying it is heading toward us, which in a relative kind of way might be true given our proximity to Saturn compared to the universe. But we are 889 million miles from Saturn, so you have a decade to find a telescope but you won’t need a helmet.

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