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“This is taking up every waking moment,” Natasha Bagdasarian, the chief medical executive for the Michigan health department told POLITICO. “No part of the state has been spared.” States across the country are also seeing a growing number of people with breakthrough cases end up in hospitals. In Michigan, for example, 28 percent of hospitalizations and 24 percent of deaths, between Oct. 7 and Nov. 5, were among fully vaccinated individuals. (Goldberg, 11/22)

Schools in New Jersey are seeing increased Covid-19 cases in students K-12 and staff since the second week of November, according to Governor Phil Murphy and health commissioner Judy Persichilli in a Monday briefing. This surge in cases comes as the statewide transmission rate increases to 1.23, signaling an outbreak. “We are concerned about cases in students and staff and among the general public increasing with gatherings for Thanksgiving and the upcoming holidays,” said Persichilli. (Taylor, 11/22)

A sudden spike in season flu cases, on top of rising COVID-19 cases, has the University of Iowa hospital urging Iowans to take extra precautions to avoid overstraining the health care system. Last week, University of Iowa Health Care had more than 150 positive tests for seasonal flu — a figure typically not seen until December, and far more than the single-digit positive flu cases found at the hospital in last year's exceptionally mild flu season. Doctors generally test for flu more aggressively early in the season to gauge its prevalence but don't test every suspicion all season. (Coltrain, 11/22)

Each week in Oregon, state health officials produce a public report documenting how many people have contracted the coronavirus even after getting the vaccine, including data about their ages, races, the counties where they live, which COVID-19 variants they caught, and how sick it made them. That type of postvaccination data has become key: Citing breakthrough case statistics, Washington, D.C., officials last week announced plans for tiered public health guidelines based on vaccination status. In Delaware, state researchers analyzed hospitalization figures to identify a startling number of severe breakthrough cases among seniors and younger immunocompromised people. In New Jersey, they found evidence of waning immunity, leading health officials to encourage booster shots. (McCarthy and McDaniel, 11/23)

Gov. Gavin Newsom said Monday that the state’s coronavirus case rate, which had increased several weeks ago, has recently leveled out, but he urged Californians to remain cautious going into the winter season and to get booster shots. “We saw a few weeks ago some troubling signs with case rates going up,” along with positive test rates and hospitalizations of COVID patients, Newsom said during a stop at Unidos en Salud, a nonprofit offering COVID vaccines and testing in San Francisco’s Mission District. (Beamish, 11/22)

Los Angeles Chargers defensive tackle Linval Joseph entered the league’s COVID-19 protocol on Monday following a positive test. He is the fifth Chargers defensive player over the past two weeks that has either tested positive or had to go on the reserve/COVID-19 list as a close contact. Joseph missed Sunday’s 41-37 victory over the Pittsburgh Steelers because of a shoulder injury and will be out for this week’s game at Denver because he is unvaccinated. Players must miss at least 10 days if they are unvaccinated following a positive test. (11/23)

The deadliest threat facing law enforcement officers in Georgia isn’t being shot, stabbed or run over by assailants — it’s COVID-19. Since the pandemic began, at least 60 Georgia police officers, deputies and jailers have died from the virus, according to The Atlanta Journal-Constitution’s review of death certificates and the Officer Down Memorial Page’s database. That vastly outnumbers other law enforcement deaths since 2020. (Hansen, Peebles, and Bruce, 11/22)

Mississippi's state of emergency order related to the coronavirus has expired, with Republican Gov. Tate Reeves citing increased coronavirus vaccine numbers and declining hospitalizations related to the pandemic. The state of emergency related to the pandemic expired Saturday at 11:59 p.m. Reeves announced earlier this month that he would allow it to run out. (11/22)

Idaho’s top health official has deactivated crisis guidelines for rationing care at most of the state’s hospitals. Idaho Department of Health and Welfare Director Dave Jeppesen issued the decision Monday after health officials said the number of COVID-19 patients remains high but no longer exceeds health care resources in most areas. Crisis standards remain in effect for northern Idaho. Jeppesen and other health care officials during a news conference warned of possible future outbreaks. “We are not sharing a ‘mission accomplished’ message,” said James Souza, chief medical officer for St. Luke’s Health System. “We don’t believe this will be our last surge of COVID. We hope it’s the worst one.” (Ridler, 11/23)

KHN: Etching The Pain Of Covid Into The Flesh Of Survivors

It was Saturday morning at Southbay Tattoo and Body Piercing in Carson, California, and owner Efrain Espinoza Diaz Jr. was prepping for his first tattoo of the day — a memorial portrait of a man that his widow wanted on her forearm. Diaz, known as “Rock,” has been a tattoo artist for 26 years but still gets a little nervous when doing memorial tattoos, and this one was particularly sensitive. Diaz was inking a portrait of Philip Martin Martinez, a fellow tattoo artist and friend who was 45 when he died of covid-19 in August. “I need to concentrate,” said Diaz, 52. “It’s a picture of my friend, my mentor.” (de Marco, 11/23)