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President Biden implored Congress on Thursday to include strict controls on prescription drug prices in the mammoth social policy bill that Democrats plan to draft this fall, hitting on an issue that his predecessor campaigned on but failed to achieve. Mr. Biden said he wanted at least three measures included in the $3.5 trillion social policy bill that Democrats hope to pass using budget rules that would protect it from a Republican filibuster. He wants Medicare to be granted the power to negotiate lower drug prices, pharmaceutical companies to face penalties if they raise prices faster than inflation, and a new cap on how much Medicare recipients have to spend on medications. (Weisman, 8/12)

President Biden laid out his vision Thursday for reducing the high cost of prescription drugs, and pushed Congress to pass legislation that would allow Medicare to negotiate drug prices for millions of Americans. Medicare, at this point, is prohibited by law from negotiating for the best deal in prescription drugs – something the White House says "needs to change." The president said Medicare should be able to negotiate the price for "subset of expensive drugs that don’t face any competition in the market," and that Medicare negotiators would be provided a framework for what constitutes a "fair price" for each drug. The White House added that there should be "powerful incentives" to make sure drug companies agree to a reasonable price. (Singman, 8/12)

Biden on Thursday lauded drugmakers for their life-saving work developing the COVID-19 vaccines. "But we can make a distinction between developing these breakthroughs and jacking up prices on a range of medications for a range of everyday diseases and conditions," he said in remarks at the White House. Biden said U.S. prescription drug costs were higher than any other nation in the world by two to three times. (Mason and Heavey, 8/12)

Biden’s remarks from the White House were less a set of new policy ideas than a reminder that he is eager to make headway on an issue of keen concern to voters — one he describes as critical to helping Americans recover economically from the pandemic. “Alzheimer’s, diabetes, cancer — they don’t care if you’re Democrat or Republican,” Biden said in the East Room. “This is about whether or not you and your loved ones can afford prescription drugs.” (Wootson Jr. and Goldstein, 8/12)

He also appeared to back a feature of House Democrats' legislation that would impose a steep tax of up to 95 percent if drug companies refused to come to the table and negotiate. Senate Finance Committee Chairman Ron Wyden (D-Ore.) is working on his own drug pricing legislation, which is expected to be somewhat less far-reaching than the House bill, in a bid to keep moderate Senate Democrats on board, given that Democrats cannot lose a single vote in the Senate. There had been some doubts as to Biden's commitment to drug pricing earlier this year when he left it out of his American Families Plan, but the speech on Thursday provided a new jolt of energy to the issue. (Sullivan, 8/12)

KHN: KHN’s ‘What The Health?’: The Senate Acts

The Senate has set the stage for a busy fall that will include debate on a broad array of health issues, such as prescription drug prices, Medicare expansion and further expansion of the Affordable Care Act. Before leaving for a delayed August break, the chamber passed a bipartisan infrastructure bill and budget resolution with an outline of a $3.5 trillion measure to be crafted when lawmakers return. Whether any of those health issues can make it across the legislative finish line remains to be seen, and the path to success is a narrow one. Meanwhile, covid’s delta variant is spreading rapidly around the U.S., particularly in states with large swaths of unvaccinated people. (8/12)

U.S. regulators say transplant recipients and others with severely weakened immune systems can get an extra dose of the Pfizer or Moderna COVID-19 vaccines to better protect them as the delta variant continues to surge. The late-night announcement Thursday by the Food and Drug Administration applies to several million Americans who are especially vulnerable because of organ transplants, certain cancers or other disorders. Several other countries, including France and Israel, have similar recommendations. (Neergaard and Perrone, 8/13)

The Food and Drug Administration is authorizing an additional dose of a COVID-19 vaccine for certain people with weakened immune systems caused either by disease, medical treatments or organ transplants. The move comes after studies have shown these people may not have sufficient immunity to head off the more serious complications of COVID-19 after the standard vaccine regimen. Late Thursday night, the FDA amended the emergency use authorizations for both the Pfizer-BioNTech and Moderna COVID-19 vaccines to allow for an additional dose for certain immunocompromised people, specifically, solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise. The CDC estimates the population to be less than three percent of adults. (Stone and Greenhalgh, 8/13)

"Making the booster shots available to us is imperative," said Michele Nadeem-Baker, a patient with chronic lymphocytic leukemia, a type of blood cancer. "The immunocompromised community has felt forgotten This gives us hope that we have not been." A study in people with solid organ transplants, for instance, showed only about 15% had an immune response to the first dose and roughly half mounted one to a second dose. Later research found a quarter of those with no response to the first two doses responded to a third. Even those who had an antibody response had a lower one than those with normal immune systems. (Weintraub, 8/12)

The action by the Food and Drug Administration means that additional shots could be available as soon as this weekend for patients who have received organ transplants or have certain types of cancer or other illnesses. The move was applauded by medical experts worried about people unable to generate robust anti-virus responses even after being fully vaccinated. Details about how the shots will be administered — and who exactly will be eligible for them — are expected to be hashed out Friday during a meeting of Centers for Disease Control and Prevention advisers. (McGinley and Sun, 8/12)

KHN: Pfizer CEO To Public: Just Trust Us On The Covid Booster 

Pfizer CEO Albert Bourla was confident in June about the ability of his company’s vaccine to protect against the highly contagious delta variant, as it marched across the globe and filled U.S. hospitals with patients. “I feel quite comfortable that we cover it,” Bourla said. Just weeks later, Pfizer said it would seek authorization for a booster shot, after early trial results showed a third dose potentially increased protection. At the end of July, Pfizer and BioNTech announced findings that four to six months after a second dose, their vaccine’s efficacy dropped to about 84%. Bourla was quick to promote a third dose after the discouraging news, saying he was “very, very confident” that a booster would increase immunity levels in the vaccinated. (Tribble, 8/13)

Israel approved the use of the Pfizer-BioNTech booster vaccine for those over the age of 50 from Friday, as the country grapples with its fourth wave of Covid-19. Israel’s Covid-19 national experts advisory team had recommended that the age of eligibility be lowered to 50 from 60, and it was accepted by the Ministry of Health, according to a government statement. Healthcare workers, prisoners, prison wardens and some high-risk patients under the age of 50 will also be offered the third shot. (Avis, 8/13)

The federal government is dramatically expanding the number of its workers that will be required to be vaccinated for COVID-19. More than 25,000 employees of the Health and Human Services Department will be required to get a COVID-19 vaccine and the Department of Veterans Affairs is expanding its vaccine requirement to more employees, contractors and volunteers, the agencies announced. VA Secretary Denis McDonough told CBS This Morning that the updated mandate at his agency will affect 245,000 employees, in addition to 115,000 previously ordered to be vaccinated. (Shivaram, 8/12)

The U.S. Public Health Service Commissioned Corps, which consists of more than 6,000 health workers who respond to public health crises around the country, will also be included under the mandate. “Our number one goal is the health and safety of the American public, including our federal workforce, and the vaccines are the best tool we have to protect people from Covid-19, prevent the spread of the Delta variant and save lives,” HHS Secretary Xavier Becerra said.

Department of Veterans Affairs Secretary Denis McDonough is expanding his previous COVID-19 vaccine mandate. The expanded order, which will be announced Friday, will give “most” Veterans Health Administration employees, volunteers, and contractors eight weeks to provide proof of vaccination or face termination. “We’re now including most VHA employees and volunteers and contractors in the vaccine mandate because it remains the best way to keep Veterans safe, especially as the Delta variant spreads across the country,” McDonough said in a release. (Webb, 8/12)

"We're now including most [Veterans Health Administration] employees and volunteers and contractors in the vaccine mandate because it remains the best way to keep veterans safe, especially as the Delta (B1617.2) variant spreads across the country," said Department of Veterans Affairs Secretary Denis McDonough, according to the Navy Times. This includes psychologists, pharmacists, social workers, nursing assistants, physical therapists, respiratory therapists, peer specialists, medical support assistants, engineers, and housekeepers at the VA. (Soucheray, 8/12)

San Francisco will become the first major city in the country to require proof of full vaccination against the coronavirus for a variety of indoor activities, including visiting bars, restaurants, gyms and entertainment venues that serve food or beverages. Many bars and restaurants around San Francisco have already taken it upon themselves to ask patrons to show their vaccination cards before they enter — a process that has largely gone well. Nearly 80% of the city’s eligible population has been vaccinated, and officials hope the new rule will push holdouts to finally get the shot. The mandate will take effect Friday, Aug. 20. (Thadani, 8/12)

People who want to enter New Orleans bars, restaurants, music halls — or any other inside venue — will soon have to show proof of vaccination against the coronavirus or a recent negative test, according to new rules announced Thursday by the mayor amid a surge in virus cases. Louisiana has become a hot spot for the fourth surge in the pandemic, driven by both low vaccination rates across the state and the highly contagious delta variant of the coronavirus. While New Orleans’ residents are getting vaccinated at slightly higher rates than the U.S. as a whole, the vaccination rate for the entire state is one of the worst in the country. (McGill and Santana, 8/12)

The Superdome remains on track to open at full capacity for New Orleans Saints games this season, but only to fans who provide proof of vaccination or a negative COVID-19 test taken 72 hours prior to games, and who wear masks. The City of New Orleans enacted new rules Thursday for entertainment venues and indoor facilities hosting large social gatherings on the heels of spiking COVID-19 related hospitalizations in the state in recent weeks. That came after the State of Louisiana enacted a mask mandate for such venues. (8/13)

Concert giant AEG Presents, which runs marquee festivals like Coachella and Stagecoach along with local clubs like the Roxy and El Rey Theater, announced a mandatory vaccination policy for staff and fans at its future shows. The policy, which fully kicks in on Oct. 1, will not allow for recent negative tests to substitute — only fully vaccinated ticketholders may attend its concerts and festivals, except in any states where such policies are banned. Effective immediately, and leading up to Oct. 1, proof of a negative test within 72 hours of the show date will suffice for entry. (Brown, 8/12)

The Kennedy Center and Ford’s Theatre will require audience members to show proof of vaccination or a recent negative coronavirus test beginning Sept. 1, the two venues announced Thursday morning. Additionally, all artists, staff, ushers and volunteers will be required to be vaccinated. (Hahn, 8/12)

Maine will be one of the first states to require COVID-19 vaccines for health care workers after Gov. Janet Mills announced an aggressive policy shift on Thursday that sets an Oct. 1 deadline for them to be fully inoculated. The mandate will come through an emergency change to state rules governing vaccinations for workers in health care settings, including hospitals, nursing homes and residential care facilities and home health agencies. Paramedics and dental practitioners would also be covered. Vaccine requirements were amended this year to also mandate the flu vaccine. (Andrews, 8/12)

A growing number of Arkansas hospitals said Thursday they’ll require all staff to get vaccinated against the coronavirus as the state’s COVID-19 hospitalizations dropped after hitting new records three days in a row. CHI St. Vincent and St. Bernards Healthcare System announced they would require employees to be fully vaccinated by Nov. 1. Baptist Memorial Health Care, which operates NEA Baptist in Jonesboro, said it would also require employees at its hospitals in Arkansas, Tennessee and Mississippi be vaccinated by that date. Conway Regional Health System said its vaccine requirement for staff will take effect Oct. 8. (DeMillo, 8/13)

CommonSpirit Health becomes the latest in a growing list of healthcare providers to require its workforce to get vaccinated against COVID-19 as the number of hospitalizations due to current surge continues to rise. The health system announced Thursday employees at all 140 of its hospitals and more than 1,000 care sites across 21 states must be fully vaccinated by Nov. 1 as a condition of their employment but will make available exemptions for medical or religious reasons. (Ross Johnson, 8/12)

Eli Lilly and Co., will require all employees to get the COVID-19 vaccination effective Nov. 15, the company announced Thursday. Lilly said it will consider medical or religious accommodations on an individual basis. "As a science-based company, we have thoroughly reviewed all the data and options available to us," spokesperson Jen Dial said. "We believe this decision helps keep our employees, families and customers safe and healthy, and ensures we can continue making life-saving medicines for people around the world." (Huang, 8/12)

If Pennsylvania nursing homes don’t have at least 80% of their staff vaccinated by Oct. 1, the Department of Health announced Thursday, all employees would have to undergo regular coronavirus testing — but the Wolf administration stopped short of issuing a vaccination or testing requirement. Less than 13% of the 700 nursing homes statewide, excluding Philadelphia, have reached or exceeded 80% of their staff vaccinated, the department said, leaving most facilities at risk for future coronavirus outbreaks. Yet the Wolf administration called the goal only an “expectation” and did not ask nursing homes to have all employees vaccinated. (McDaniel, McCarthy and Burling, 8/12)

Massachusetts assisted living executives, worried about the rapidly rising tide of COVID-19 infections in the state, urged the Baker administration on Thursday to mandate COVID vaccines for workers in their industry. They say thousands of frail elders in assisted living residences, most of them vaccinated but with weak immune systems, are still vulnerable to infections because many workers in the facilities have yet to get their shots. Assisted living residents generally have more independence than those in nursing homes, but face many of the same health risks. (Lazar, 8/12)

Supreme Court Justice Amy Coney Barrett on Thursday refused to block a plan by Indiana University to require students and employees to get vaccinated against COVID-19. Barrett’s action came in response to an emergency request from eight students, and it marked the first time the high court has weighed in on a vaccine mandate. Some corporations, states and cities have adopted vaccine requirements for workers or even to dine indoors, and others are considering doing so. (8/12)

The Supreme Court on Thursday declined to block a COVID-19 vaccine mandate at Indiana University, clearing the way for school officials to require students and faculty members to be vaccinated. Associate Justice Amy Coney Barrett rejected a request from Indiana University students for emergency relief. The case is the first challenge to a vaccine mandate during the coronavirus pandemic. (Phillips and Fritze, 8/12)

Philadelphia officials on Friday are expected to announce that college students and healthcare workers will need to show proof of vaccination by mid-October or be subjected to weekly testing and a double mask mandate. In a virtual meeting on Thursday night, the Philadelphia Department of Health said it wants vaccination rates among college students and healthcare workers as high as 90%. (Keeley, 8/13)

It’s a patchwork system. Unvaccinated students living on campus will be tested before being permitted to move into the dorms next week and will be subjected to weekly COVID-19 testing thereafter. All unvaccinated students (on campus and off) will undergo “regular testing throughout the fall semester,” though the school has provided scant specifics on that process. Penn State’s main campus, in University Park, Pennsylvania, in the borough of State College, enrolls 46,000 undergrad and graduate students. But only 14,500 of them actually live on campus. The remaining 34,500 are largely left to their own devices when it comes to navigating COVID-19. Even if the university were to require all on-campus residents to get vaccinated, it currently lacks a mechanism to keep unvaccinated off-campus students from coming to class and infecting their peers.(Kellermann, 8/12)

A Middle Tennessee State University student has sued the school and the director of her department after the nursing program required students to receive a COVID-19 vaccination. Nursing student Avery Garfield filed her lawsuit in the Rutherford County Chancery Court in early August. Originally, the nursing department had asked all students to receive the vaccine by Aug. 20. (West, 8/12)

The University of Texas at Austin, which has urged students to get vaccines, announced that students living in its residence halls must show proof of a negative coronavirus test before getting keys to their rooms. Arriving on campus with no place to live could be a strong incentive to be vaccinated. Ms. Muñoz, a vice president of the university’s Senate college councils who is vaccinated, says that student leaders are demanding more protection. “We’re going to be advocating for the lives of the 50,000 students on campus to be kept as safe as possible,” she said, describing a “scary feeling” on the campus. (Saul, 8/12)

The National Education Association endorsed Covid-19 vaccine requirements for school workers on Thursday, aligning itself with the Biden administration's push to get more Americans inoculated as the disease sends children to the hospital. Teachers and other educators should have the option to submit to regular virus testing, NEA president Becky Pringle said, but she added her 3 million members should embrace vaccination, particularly as children return to classrooms for the new school year. (Perez Jr., 8/12)

Gov. Ron DeSantis’ administration backed down from its threat to withhold school officials’ salaries if they resist his anti-mask rule, saying instead that the defiant officials should be responsible for the “consequences of their decisions.” The move by the governor’s office represents a tacit acknowledgement that it legally can’t take away the salaries of school board members and others despite previously threatening to. DeSantis could levy hundreds of thousands of dollars in fines against school districts for disobeying his mask orders, but it would be up for the board leaders themselves to cut their own pay. (Atterbury, 8/12)

Students, teachers and staff at public and private K-12 schools must wear a mask while indoors under a new public health order Democratic Virginia Gov. Ralph Northam’s administration issued Thursday. The move came after a handful of school districts in recent days decided to buck the governor’s interpretation of a state law and opt not to require face coverings, against the current recommendations of the U.S. Centers for Disease Control and Prevention. Tension over the politically divisive issue has exploded at one school board meeting after other in the past week. (Rankin, 8/13)

The debate over mask and vaccine mandates in schools is fueling lawsuits, rapidly shifting policies and even sidewalk feuds between parents – leaving a wake of chaos and confusion as students return to classrooms amid a surge in coronavirus cases fueled by the more transmissible delta variant. Education groups in Arizona on Thursday evening sued the state over a ban on mask mandates in schools that the state legislature had passed as part of a budget. The lawsuit filed in state Supreme Court in Maricopa County said the legislation was unconstitutional, alleging that it contained “substantive policy provisions that have nothing to do with the budget.” (Pietsch, 8/13)

In Houston, County Judge Lina Hidalgo required masks in schools and daycares while County Attorney Christian Menefee sued Abbott in state district court, arguing the governor exceeded his authority in prohibiting local officials on July 29 from implementing pandemic restrictions of their own. Fort Bend County Judge K.P. George issued a mask mandate for anyone inside county buildings, though he stopped short of requiring them in schools. (Despart, 8/13)

Hours after the Salt Lake County Council met to repeal its own health department’s mask order for elementary schools, parents, teachers unions, physicians and nurses gathered to share their disappointment. “There’s a lot of anticipation, a lot of anxiety among faculty and support staff in our schools of what to expect,” Brad Asay, president of the Utah chapter of the American Federation of Teachers, said at a news conference outside the County Government Center. “And now, a tool has been taken away from them to be able to protect our students.” (Larsen, 8/13)

More than 80 students were potentially exposed to Covid-19 on the first day of class in Reno, Nevada, on Monday after a parent sent their child to Marce Herz Middle School, despite both the parent and child receiving a positive Covid-19 test just two days earlier, Washoe County Health District officials said. The exposed students had to quarantine at home and started distance learning on Tuesday, the Washoe County School District said. (Boyette, 8/12)

More than 400 students in Palm Beach County, Fla., were required to quarantine just two days after schools began instruction due to an outbreak of the coronavirus, according to local officials. Palm Beach County School Superintendent Michael Burke said in an interview with MSNBC on Thursday that since school began, 51 students and staff had tested positive for COVID-19, WPTV-TV reported. In total, 440 students have had to isolate. (Vakil, 8/12)

Idaho Gov. Brad Little on Thursday said he is directing $30 million to expand COVID-19 testing in K-12 schools. The Republican governor made the announcement at Nampa High School in southwestern Idaho as coronavirus cases spike because of the delta variant just as students prepare to return to class next week. The $30 million is coming from emergency funds set aside by the Legislature to deal with unforeseen events, Little said. “It’s critical now,” he said. “These school districts have got to have some resources.” (Ridler, 8/13)

Arnold Schwarzenegger isn't mincing words when calling out anti-maskers. The "Terminator" star and former governor of California addressed Americans who are still "in denial" about the severity of the pandemic during an interview with CNN's Bianna Golodryga on Wednesday. “There is a virus here. It kills people and the only way we prevent it is: get vaccinated, wear masks, do social distancing, washing your hands all the time, and not just to think about, ‘Well my freedom is being kind of disturbed here.’ No, screw your freedom," Schwarzenegger said. (Ryu, 8/12)

Texas’ most populous county on Thursday joined the legal battle by local officials seeking to override Gov. Greg Abbott’s ban on mask mandates and institute protections against COVID-19 as hospitals around the state continue to swell with patients sickened by the virus. Harris County, where Houston is located, first filed a lawsuit against Abbott’s executive order banning mask mandates by any state, county or local government entity. A few hours later on Thursday, Harris County Judge Lina Hidalgo announced the county health authority had issued an order requiring that people must wear masks when inside any public school, non-religious private school or licensed child care center in the county. (Lozano, 8/12)

Gov. Tate Reeves announced Thursday he is extending the state of emergency order in Mississippi for 30 days, but he will not issue mask mandates despite a warning that hospitals across the state are on the verge of collapse. Tate said the extension is meant to make it easier for the state to seek federal assistance during the current COVID-19 surge. (Sanderlin, 8/12)

Amid a surge in coronavirus variants, The Church of Jesus Christ of Latter-day Saints issued a strong call Thursday to its members to wear masks “in public meetings whenever social distancing is not possible” and to “be vaccinated.” “We find ourselves fighting a war against the ravages of COVID-19 and its variants,” the governing First Presidency wrote to everyone in the 16.6 million-member church. “...We want to do all we can to limit the spread of these viruses. We know that protection from the diseases they cause can only be achieved by immunizing a very high percentage of the population.” (Stack, 8/12)

As Raider Nation converges on Allegiant Stadium Saturday for the first Raiders game at the $2 billion facility with fans, remember “face mask” is not a penalty in this case. It’s a mandatory rule for all that attend. The mandate Gov. Steve Sisolak issued last month requiring masks be worn at all times at indoor facilities will apply to the tens of thousands of fans anticipated to attend the preseason game versus the Seattle Seahawks. The Raiders said they’ll follow state and local guidelines and will require fans and employees to wear masks while inside the stadium. Under the directive, event attendees must wear a mask unless actively eating or drinking. (Akers, 8/11)

With the delta variant surging through the state, nearly all Oklahomans should be wearing a mask again indoors, according to recent guidance from the Centers for Disease Control and Prevention. The fully vaccinated in Beaver and Ellis counties are the exceptions. For the rest of the state, transmission levels are high enough that the CDC recommends vaccinated people still wear a mask in indoor, public spaces. Unvaccinated people — regardless of where they live — are still urged to mask up indoors, too. The Oklahoma Health Department appears out of sync with those recommendations, even as the department says it "has and will continue to follow" CDC guidance. In a statement this week, the state’s top health official framed mask-wearing as a “personal choice." (Branham, 8/13)

Currently, at least four states and Puerto Rico have indoor mask mandates for the vaccinated and unvaccinated: Oregon, Nevada, Hawaii, Louisiana. Most states have not issued new mandates -- focusing on vaccination instead -- but a number, including California, Connecticut, Illinois, Maine, Michigan, New Jersey, New York, North Carolina, Pennsylvania and Washington, have recommended constituents follow the CDC's guidance. Each state's guidelines vary slightly. (Lenthang and Mitropoulos, 8/13)

An internal presentation circulated within the Centers for Disease Control and Prevention last month, and eventually obtained by news organizations, offered clear advice for countering the contagious Delta variant: “Given higher transmissibility and current vaccine coverage, universal masking is essential.” But the recommendation issued by the agency was considerably more nuanced, advising Americans, vaccinated or not, to wear masks in indoor public settings in areas with “substantial” or “high” virus transmission. (Rabin, 8/12)

As the number of coronavirus patients in North Texas continues to climb, hospitals are reporting fewer and fewer empty beds — including no available ICU beds for children in the region. There were 75 staffed intensive-care beds for adults Thursday in the 19-county region, according to the Dallas-Fort Worth Hospital Council. Twenty-three were in Dallas County, 21 in Tarrant County and 16 in Collin County. There are 343 COVID-19 patients on ventilators, the council said, and the majority of patients have not been vaccinated. (Steele, 8/12)

A doctor in Middle Tennessee began his message with a stark and simple warning. “No beds. There are no beds.”Dr. Geoff Lifferth, Chief Medical Officer at Sumner Regional Medical Center in Gallatin, Tennessee, detailed the overwhelming impact of the Delta variant on the state’s healthcare facilities in a Facebook post, which was shared on the official hospital account Thursday night. “In Middle Tennessee right now it is impossible to find an empty, staffed ICU, ER, or med/surg bed. As an ER doc and a healthcare administrator, this past week has been one of the most exhausting and disheartening of my career,” Lifferth wrote. (Spells, 8/12)

The federal government has sent a team of doctors, nurses and medical professionals to Children's Hospital New Orleans to help the facility care for the surge of children hospitalized with COVID. The state requested the help from the U.S. Department of Health and Human Services, according to a statement from the hospital. The recent influx of pediatric COVID patients in New Orleans is "unlike anything observed previously," the statement said. (Kollath Wells, 8/12)

The COVID-19 surge that is sending hospitalizations to all-time highs in parts of the South is also clobbering states like Hawaii and Oregon that were once seen as pandemic success stories. After months in which they kept cases and hospitalizations at manageable levels, they are watching progress slip away as record numbers of patients overwhelm bone-tired health care workers. (Kelleher and Selsky, 8/12)

A “tidal wave” of COVID-19 cases is putting severe stress on Alabama hospitals, medical officials said Thursday, adding the state will likely soon surpass the previous record for hospitalizations. “We need Alabamians to understand we are in a difficult position right now. We are seeing case numbers again as high as we have ever seen,” State Health Officer Scott Harris said in a weekly briefing with reporters. “That has put a severe stress on our hospital situation. We have only 5% of our ICU beds available statewide. many facilities, particularly in the southern part of the state do not have available ICU beds at this time.” (Chandler, 8/13)

Mississippi has broken its single-day records of COVID-19 hospitalizations, intensive-care use and new coronavirus cases. The state Health Department said Thursday that 1,490 people were hospitalized Wednesday and 388 were in intensive care because of COVID-19. It also said 4,412 new cases were confirmed. (Pettus, 8/12)

A Carnival Cruise Line ship that left from Galveston, Texas, has 27 covid-positive people on board, according to the Belize Tourism Board. It is the highest number of publicly reported cases on a ship sailing from the United States since cruises restarted this summer. According to the statement from Belize tourism officials, 26 of the infected people are crew and one is a guest. All are vaccinated and have either mild or no symptoms. The ship is continuing to sail and arrived in Cozumel on Thursday. (Sampson, 8/13)

An estimated 385,000 crowd at the annual Lollapalooza music festival this year did not play a substantial role in spreading COVID-19, Chicago's public health commissioner Allison Arwady said Thursday — two weeks after the first day of the event. "There have been no unexpected findings at this point and NO evidence at this point of 'super-spreader' event or substantial impact to Chicago's COVID-19 epidemiology," Arwady tweeted, adding that the city would have already seen a surge in cases if there would be one. "I do not think we will see anything that will suggest it was any sort of super spreader event," she said. (Powell, 8/13)

Facebook Inc. is delaying its return to office plans due to a resurgence in Covid-19 cases, telling U.S. employees Thursday that they don’t need to return to work in person until January 2022. “Given the recent health data showing rising Covid cases based on the delta variant, our teams in the US will not be required to go back to the office until January 2022,” Tracy Clayton, a Facebook spokesperson, in a statement. “We expect this to be the case for some countries outside of the U.S., as well. We continue to monitor the situation and work with experts to ensure our return to office plans prioritize everyone’s safety.” (Wagner and Leach, 8/12)

Early findings posted ahead of rigorous peer review suggested the Pfizer COVID-19 vaccine declined to 42% effectiveness against infection amid sweeping spread of the delta variant, with the Moderna vaccine declining to 76%. Researchers at the Mayo Clinic and Cambridge-based biotech company nference posted the retrospective study in medrxiv this week, drawing from tens of thousands PCR tests conducted at the Mayo Clinic and affiliated hospitals across nearly half a dozen states. (Rivas, 8/12)

Children experiencing lingering symptoms weeks to months after initial COVID-19 infection, or so-called long COVID, most often face fatigue and headache, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC) said during a White House briefing. Walensky said the health agency is examining the condition among kids, and noted the rates appear to be lower than that among adults, at about 2%-3%, and efforts will continue as the delta variant sweeps the U.S. and exacerbates the country’s case count. (Rivas, 8/12)

Two years ago, a sneeze or a cough wouldn’t have been cause for concern, but now even the mildest of symptoms can leave us wondering, “Do I have Covid?” Early in the pandemic, we learned about the hallmark signs of infection, which can include loss of taste and smell, fever, cough, shortness of breath and fatigue. But what about now, more than a year later? Have symptoms changed given that the Delta variant is currently the most common form of the virus in the United States? (Caron, 8/12)

The Supreme Court on Thursday blocked part of an eviction moratorium in New York State that had been imposed in response to the coronavirus pandemic, a move the law’s supporters said might expose thousands to eviction. “This is a very serious setback for our ability to protect tenants in the middle of a pandemic,” said State Senator Brian Kavanagh, a Democrat and one of the sponsors of the moratorium law. (Liptak, 8/12)

A divided U.S. Supreme Court cleared the way for some eviction proceedings to resume in New York, blocking a provision that gave renters a shield if they said they were experiencing hardships because of the pandemic. Over the dissents of three liberal justices, the court on Thursday sided with a group of landlords who say they have been devastated by what they contend is an unconstitutional law. (Stohr and Robinson, 8/13)

Washington’s Supreme Court issued a key decision Thursday that helps protect people living in their vehicles from having them towed, in a case that drew widespread attention amid Seattle’s housing crisis. The justices held that it was unconstitutionally excessive for Seattle to impound a homeless man’s truck and require him to reimburse the city nearly $550 in towing and storage costs. Further, the court said, vehicles that people live in are homes and cannot be sold at a public auction to pay their debts — eliminating a financial incentive for towing the cars in the first place. (Johnson, 8/12)

How well the American economy performs over the short- and intermediate-term depends on the path of the coronavirus. At issue is the recent surge in new Covid-19 cases and deaths due to the highly contagious Delta variant and the more recent Lambda variant. Another factor is the clash between politics and science. More on that below. As we experience a new wave of infections, one must ask how long Covid will persist? Between March 1918 and the summer of 1919, the world experienced three distinct waves of the Spanish Flu. Covid-19 will likely exceed this number. Regardless, economic growth in the U.S. will suffer, to some degree, unless we take more aggressive measures to combat Covid. (Patton, 8/12)

The world’s major economies have seen their rapid recovery after easing Covid restrictions begin to run out of steam in the past month as a resurgence in the virus depressed consumer spending, according to the Organisation for Economic Cooperation and Development. There are signs that the recovery in the US and Japan is losing momentum, the OECD said, while parts of Europe and China have slowed as consumers remain reluctant to eat out, visit attractions and shop as they did before the pandemic. (Inman, 8/10)

Lisa Grim braced herself as she turned the key to her family’s new apartment.It had taken more than a month to find a landlord willing to accept her — a newly widowed 33-year-old raising two kids, barely making $20,000 a year. None of the other 20 apartments had returned her calls and emails. This unit, which she had rented sight unseen, was the only one that approved her application. ... Nine months had passed since her husband Alan, 37, died of covid-19 in a rural Missouri ICU once again filling with coronavirus patients. Nine months since Lisa realized that without Alan’s salary, they could no longer afford their mortgage, forcing her to put the family’s house on the market and move to this apartment an hour away from everything her boys had known. (Wan, 8/9)

In the 1960s, the drug was given to women during childbirth to dampen their consciousness. In the 1990s, an illicit version made headlines as a “date rape” drug, linked to dozens of deaths and sexual assaults. And for the last two decades, a pharmaceutical-grade slurry of gamma-hydroxybutyrate, or GHB, has been tightly regulated as a treatment for narcolepsy, a disorder known for its sudden sleep attacks. Now, the Food and Drug Administration has approved the drug for a new use: treating “idiopathic hypersomnia,” a mysterious condition in which people sleep nine or more hours a day, yet never feel rested. (Hughes, 8/12)

The Drug Enforcement Administration on Wednesday shut down operations at a Sugar Land pharmaceutical company and seized millions of controlled pills after the company reportedly violated regulations, the agency said. Investigators with the DEA Houston Division served immediate suspension orders to Woodfield Distribution, LLC, and Woodfield Pharmaceuticals, LLC, for failing to control the diversion of controlled substances and creating "imminent danger to public health and safety," according to authorities. ... The company illegally imported more than 200 million opioid pills and failed to account for more than 5 million pills, the DEA said. (Bauman, 8/12)

Purdue Pharma’s quest to settle thousands of lawsuits over the toll of OxyContin and its other prescription opioid painkillers entered its final phase Thursday with the grudging support of many of those who have claims against the company. But the lingering opposition from some state attorneys general took center stage in the first day of a confirmation hearing in U.S. Bankruptcy Court about the company’s reorganization plan. (Mulvihill, 8/12)

Here’s one more lesson from the COVID-19 pandemic: It appears safe to relax restrictions on methadone, the oldest and most stigmatized treatment drug for opioid addiction. Last spring, with coronavirus shutting down the nation, the government told methadone clinics they could allow stable patients to take their medicine at home unsupervised. Early research shows it didn’t lead to surges of methadone overdoses or illegal sales. And the phone counseling that went along with take-home doses worked better for some people, helping them stay in recovery and get on with their lives. (Johnson, 8/12)

For the first time, researchers yesterday reported that a monoclonal antibody can prevent malaria in humans. A team based at the National Institute Allergy and Infectious Diseases (NIAID) Vaccine Research Centers published their phase 1 clinical trial results yesterday in the New England Journal of Medicine. The monoclonal antibody, called CIS43LS, was developed from a neutralizing antibody isolated from the blood of a volunteer who had received an investigational malaria vaccine. Researchers examined whether the monoclonal antibody could safely prompt high-level protection against experimental exposure to infected mosquitoes. (8/12)

A bipartisan group of senators sent a letter to Amazon Friday raising questions about its collection of biometric data. The lawmakers are particularly interested in the expansion of the company’s palm print scanners program, Amazon One. The scanners are used at Amazon stores to let customers pay without having to take out cards or cash if they enroll in the program. (Rodrigo, 8/13)

Five doctors who run departments at Saint Vincent Hospital are calling on Governor Charlie Baker to intervene in the months-long dispute between the Worcester hospital and the union representing hundreds of nurses who have been on strike since March. The physicians issued a letter to the governor on Wednesday criticizing the Massachusetts Nurses Association for “falsely claiming a need for ‘safe staffing’” at the hospital and for going on strike in the midst of a pandemic. (Stoico, 8/12)

A prominent business group is suing HHS and other federal agencies over new price transparency regulations that apply to health insurers. The U.S. Chamber of Commerce argues in a lawsuit filed this week in the U.S. District Court for the Eastern District of Texas, Tyler division that new rules under the so-called Transparency in Coverage Rule are both unlawful and overly burdensome, and urges a judge to throw them out. The lawsuit lists a number of federal agencies defendants, including HHS, CMS, the Department of Labor, the Department of the Treasury and the Internal Revenue Service. (Bannow, 8/12)

ProMedica won a court fight over excluding an Ohio hospital from its insurance subsidiary's provider network Tuesday. The federal court ruling means its insurer Paramount does not have to accept McLaren St. Luke's Hospital in Maumee, Ohio, into its network. The U.S. 6th Circuit Court of Appeals in Cincinnati vacated a preliminary injunction that forced Paramount to keep St. Luke's in its health plans in December. Paramount removed McLarenSt. Luke's from its network after the hospital merged with Grand Blanc, Michigan-based McLaren Health Care. McLaren St. Luke's subsequently filed an antitrust case against Paramount and ProMedica. (Christ, 8/12)

United Healthcare Insurance Co. and United Behavioral Health will pay more than $15.6 million to settle allegations that the companies violated the federal mental health parity law by overly restricting mental health coverage and reimbursement, the U.S. Labor Department and New York Attorney General's Office announced Thursday. The companies will pay $13.6 million to up to 135,000 patients who were wrongfully denied coverage or were overcharged for treatment since at least 2013. They also will pay nearly $2.1 million in penalties to settle private litigation and investigations by the Labor Department and New York Attorney General. (Kacik, 8/12)

Blaming those extra pounds on a slowing metabolism as you age? Not so fast. A new international study counters the common belief that our metabolism inevitably declines during our adult lives. Well, not until we’re in our 60s, anyway. Researchers found that metabolism peaks around age 1, when babies burn calories 50 percent faster than adults, and then gradually declines roughly 3 percent a year until around age 20. From there, metabolism plateaus until about age 60, when it starts to slowly decline again, by less than 1 percent annually, according to findings published Thursday in the journal Science. (Stenson, 8/12)

Everyone knows conventional wisdom about metabolism: People put pounds on year after year from their 20s onward because their metabolisms slow down, especially around middle age. Women have slower metabolisms than men. That’s why they have a harder time controlling their weight. Menopause only makes things worse, slowing women’s metabolisms even more. All wrong, according to a paper published Thursday in Science. Using data from nearly 6,500 people, ranging in age from 8 days to 95 years, researchers discovered that there are four distinct periods of life, as far as metabolism goes. They also found that there are no real differences between the metabolic rates of men and women after controlling for other factors. (Kolata, 8/12)

There is constant squabbling over the virtues of various diets, but a new report published in Cardiovascular Research makes one thing clear: The best way to avoid heart disease is to eat whole and plant-based foods. This is important because people are eating themselves to death: According to the 2017 Global Burden of Disease study, poor food choices account for almost 50 percent of all cardiovascular disease fatalities. (Rosenbloom, 8/12)

Extreme heat continued to grip much of the U.S. on Thursday, with parts of the country facing the prospect of triple-digit temperatures and nearly 200 million people across 34 states under some kind of heat-related advisory. In the mid-Atlantic, the Northeast and New England, baking temperatures and exceptionally high humidity Thursday are forecast to make temperatures in the 90s feel upward of 100 degrees in major cities like Washington, New York, Philadelphia and Boston. (Wong and Prociv, 8/12)

Volunteers scrambled to hand out water, portable fans, popsicles and information about cooling shelters Thursday to homeless people living in isolated encampments on the outskirts of Portland, Oregon, as the Pacific Northwest sweated through a heat wave gripping the normally temperate region. Authorities trying to provide relief to the vulnerable, including low-income older people and those living outdoors, are mindful of a record-shattering heat wave in late June that killed hundreds in Oregon, Washington and British Columbia when the thermometer went as high as 116 degrees Fahrenheit (47 C). (Flaccus, 8/13)

More than a week later, Greenville residents remain in a state of suspended animation. As the Dixie Fire has exploded into the largest single wildfire in California history — consuming more than 500,000 acres in a wildfire season that’s on track to shatter last year’s records — Greenville residents are forbidden to return home. (Iati, 8/12)

The Bay Area Air Quality Management District, through a partnership with Regional Asthma Management and Prevention, or RAMP, will provide home air purifiers to 2,000 lower-income residents in six Bay Area counties who have been diagnosed with asthma. Oakland Mayor Libby Schaaf, speaking Wednesday at the Roots Community Health Center in East Oakland, said the program will help lower-income communities and communities of color. "These air filters will not only address air quality, which is being challenged by the wildfire season, but also will lessen the spread of COVID-19, a double benefit for those who have been most impacted," Schaaf said. (Fitzgerald Rodriguez, 8/12)

For the second time this year, a "murder hornet" has been spotted in Washington state, officials said Thursday. But it's the first confirmed report of a live Asian giant hornet in the state in 2021, the state department of agriculture said. The sighting in Whatcom County was reported Wednesday. Earlier this summer, a dead insect was found north of Seattle. (Helsel, 8/13)

The National Abortion Federation has told doctors in Texas it will stop referring patients and sending money to clinics that offer abortions after about six weeks of pregnancy. In North Texas, the Texas Equal Action Fund will likely “pause” its ride share program that helps women reach abortion appointments. Dr. Bhavik Kumar, an abortion provider for Planned Parenthood, has cleared his schedule to fit in as many patients as he can before the end of the month. (Blackman, 8/12)

The ACLU of D.C. is suing the District and eight unnamed D.C. police officers for spraying chemical irritants and firing stun grenades at racial justice protesters and two photojournalists near Black Lives Matter Plaza last summer. The federal lawsuit filed Thursday in U.S. District Court in Washington on behalf of Oyoma Asinor and Bryan Dozier, two independent photojournalists, seeks a trial by jury and compensation for their injuries. (Silverman, 8/12)

Members of the National Black Lung Association, the environmental group Appalachian Voices and the Appalachian Citizens’ Law Center, a Kentucky-based nonprofit law firm that represents coal miners on black lung and mine safety issues, urged Congress to permanently extend and raise by 25% an excise tax that coal producers must pay when coal they produce is first sold or used. The excise tax is the main source of revenue for the Federal Black Lung Program and the Black Lung Disability Trust Fund, which pays benefits to miners disabled by the disease as well as their eligible survivors and dependents when no responsible coal operator is identified or when the liable operator does not pay. (Tony, 8/12)

New Hampshire health officials recently reported the state's first Jamestown Canyon virus (JCV) case of the season, an adult who died from the infection. The patient is from Dublin, located in the east central part of the state, the New Hampshire Department of Health and Human Services (NHDHHS) said in a statement. The patient was hospitalized with worsening neurological symptoms and died, with JCV as a contributing cause. *8/12)

KHN: Veterans Push For Medical Marijuana In Conservative South 

Each time Chayse Roth drives home to North Carolina, he notices the highway welcome signs that declare: “Nation’s Most Military Friendly State.” “That’s a powerful thing to claim,” said Roth, a former Marine Corps gunnery sergeant who served multiple deployments to Iraq, Afghanistan and Pakistan. Now he says he’s calling on the state to live up to those words. A Wilmington resident, Roth is advocating for lawmakers to pass a bill that would legalize medical marijuana and allow veterans with post-traumatic stress disorder and other debilitating conditions to use it for treatment. (Pattani, 8/13)

KHN: How A Hospital And A School District Teamed Up To Help Kids In Emotional Crisis

In 2019, the Rockville Centre school district in Long Island, New York, was shaken by a string of student deaths, including the suicides of a recent graduate and a current student. “When you get these losses, one after the other, you almost can’t get traction on normalcy,” said Noreen Leahy, an assistant superintendent at the school district. To Leahy, the student suicides exposed a children’s mental health crisis brewing for years. She had observed a concerning uptick in depression, anxiety and suicidal ideation among students. Her school district had a team of mental health professionals, but Leahy said they couldn’t provide the kind of long-term care many students needed. (Chatterjee and Herman, 8/13)

The World Health Organization (WHO) today called on countries to depoliticize the investigation into the origin of SARS-CoV-2 and how it jumped to humans, pressing for more raw data to review and suggesting that more can be done within its current framework to track lab safety around the world, including China. (Schnirring, 8/12)

The World Health Organization’s lead investigator into the coronavirus’ origins in China appears to have contradicted his February statement dismissing the Wuhan lab-leak theory – admitting that it was not "extremely unlikely" as the WHO said at the time, but "probable." On Thursday, the WHO in a new statement admitted that the lab-leak was not "extremely unlikely" after all. (Ruiz, 8/12)

When a World Health Organization-led team traveled to China earlier this year to investigate the origins of the COVID-19 pandemic, a top official said he was worried about safety standards at a laboratory close to the seafood market where the first human cases were detected, according to a documentary released Thursday by Danish television channel TV2.The Wuhan branch of the Chinese Center for Disease Control and Prevention was handling coronaviruses “without potentially having the same level of expertise or safety or who knows,” Peter Ben Embarek said during a conference call in January, according to footage shown by TV2. Ben Embarek is a WHO expert on disease transmission from animals to humans and one of the team’s leaders. (Cheng, 8/12)

A two-dose COVID-19 vaccine from China's Sinopharm was 50.4% effective in preventing infections in health workers in Peru when it was seeing a surge in cases fuelled by virus variants, and booster shots can be considered, a study found. The study involving Sinopharm's BBIBP-CorV vaccine, which looked at data from February through June at a time when Peru was fighting a brutal second-wave of infections fuelled by the Lambda and Gamma variants of the coronavirus, was conducted on nearly 400,000 frontline health workers in live conditions. (Rochabrun and Liu, 8/13)

A vehicle with a flashing siren and "Makassar COVID Hunter" written on the side pulls up to a ship docked at a jetty in the Indonesian port city of Makassar, and masked COVID-19 patients carrying bags board the boat. This ship, called the KM Umsini, used to ply a route ferrying up to 2,000 passengers between Indonesia's island cities. Now, it has been turned into an isolation centre for COVID-19 patients with mild symptoms, amid the spread of the highly infectious Delta coronavirus variant. (Muchtar, 8/12)

The pandemic year has exposed the cost of caregiving on a previously overlooked workforce, almost entirely made up of women, who work for little pay — or in some cases no pay. Who gets paid to be a caregiver is complicated. Medicaid, Medicare and private insurance companies have different rules and requirements for paying family members, as do individual states — and in most states, married caregivers are not counted as workers. Only eight state Medicaid programs allow married people to be paid caregivers to their partners. Eight additional states have private programs that allow spouses to be paid as caregivers. (Ferguson, 8/6)

For Sergio Echeverria, it wasn't just a day at the beach. Nicknamed Aquaman, Echeverria has always considered the ocean to be his second home — but a tractor accident this winter left him paralyzed from the waist down, jeopardizing his ability to do what he loved. "I had my doubts," he said of his ability to get in the water again. But he was proven wrong. Making his dream come true was a small army of volunteers who, once a month, place plastic mats on a stretch of Miami Beach to make it more accessible to wheelchairs or other mobility devices. There are also special floating chairs that transport people with disabilities in the water. (Bojorquez, 8/9)

A centuries-old tradition in which women declared themselves men so they could enjoy male privilege is dying out as young women have more options available to them to live their own lives. (Higgins, 8/9)

It took the deadly disruption of the COVID-19 pandemic to expose a deeper, more intractable U.S. public-health crisis: For more than a decade, the world’s richest nation has been losing the battle against diabetes. Long before the pandemic, Kate Herrin was among the millions of Americans struggling to control their diabetes. Her problems often stemmed from her government-subsidized medical insurance. Doctors routinely rejected her Medicaid plan, and she repeatedly ran out of the test strips she needed to manage her daily insulin injections. She cycled in and out of emergency rooms with dangerously high blood-sugar levels, or hyperglycemia. Then COVID-19 hit. (Terhune, Respaut and Nelson, 8/12)

Diamond Wright says she won’t get the Covid-19 vaccine. The 33-year-old housing worker lost her grandfather to the virus last year. Her neighbors in New York’s Far Rockaway died at a rate nearly 50 percent higher than the rest of the city during the height of the pandemic. And the Delta variant is raising anew the specters of spring 2020. But none of that has changed her mind. “Me, personally, I’m not gonna get it,” she said of the vaccine last week. “It’s something new. They came up with it kinda fast.” She’s not alone. (Kvetenadze, 8/12)

Before the latest surge of the coronavirus, Louisiana neurologist Robin Davis focused on her specialty: treating patients with epilepsy. These days, as virus patients flood her hospital in record numbers, she has taken on the additional duties of nurse, janitor and orderly. “I was giving bed baths on Sunday, emptying trash cans, changing sheets, rolling patients to MRI,” said Davis, who has been coming in on her days off to provide some relief to overworked nurses at Ochsner Medical Center in the New Orleans suburb of Jefferson. (Plaisance, 8/11)

Thomas Hodge III logged on from his hospital bed for what would be his last weekly Zoom meeting with some 200 scientific collaborators. Gaunt and unshaven, he conferred with the group on how to defeat this country’s latest surge of covid-19 — the virus Hodge’s body was battling a second time. The prominent immunologist died two days later of complications from the disease. One state away, mere hours later, a beloved granddaughter succumbed to kidney cancer. He was 69. She was 6. (Kalter, 8/11)

Last week, the CDC played what probably seemed like one of the most obvious cards left in its hand: asking fully vaccinated people to once again mask in public indoor spaces, in places where the virus is surging. This recommendation echoed one the agency had controversially dispensed with in May—and has clearly saddled immunized Americans with a serious case of masking déjà vu. “It’s been an abrupt 180,” Helen Chu, an infectious-disease physician and epidemiologist at the University of Washington, told me, and for many people, “that’s made it difficult.” (Wu, 8/6)

But something is different now—the virus. “The models in late spring were pretty consistent that we were going to have a ‘normal’ summer,” Samuel Scarpino of the Rockefeller Foundation, who studies infectious-disease dynamics, told me. “Obviously, that’s not where we are.” In part, he says, people underestimated how transmissible Delta is, or what that would mean. The original SARS-CoV-2 virus had a basic reproduction number, or R0, of 2 to 3, meaning that each infected person spreads it to two or three people. Those are average figures: In practice, the virus spread in uneven bursts, with relatively few people infecting large clusters in super-spreading events. But the CDC estimates that Delta’s R0 lies between 5 and 9, which “is shockingly high,” Eleanor Murray, an epidemiologist at Boston University, told me. At that level, “its reliance on super-spreading events basically goes away,” Scarpino said. (Yong, 8/12)

After an order of the AstraZeneca coronavirus vaccine from the government never materialized, Quinn On realized on Monday that a busy pharmacy he manages in Western Sydney would soon run out of doses. He raced to pick up shots from one of his other stores, while his wife pleaded with local officials for extra supplies. Their mom-and-pop business has become a vaccination hub where it matters most — in the part of the city where Covid-19 case numbers refuse to decline despite a seven-week lockdown. They had already hired extra pharmacists. They set up a tent on the sidewalk to safely register arrivals. And on Monday, with all their scrambling, they secured a few hundred shots to inoculate a long line of people by day’s end. “It’s costing us money to do this, but I’m doing this for the community,” said Mr. On, 51, who came to Australia from Vietnam as a refugee when he was 8. “I’m just hoping it will work.” (Cave, 8/12)

With the delta variant surging throughout the U.S., Biden administration chief medical adviser Anthony Fauci has advocated for more testing — including for the vaccinated.  More testing is essential, but how we test is important, too. (Max Nisen, 8/12)

Babies hooked to ventilators. Overflow tents pitched outside of hospitals. Parents fretting that sending their kids to school might become an intolerable risk. It’s surreal to write this. Just a few months ago we were celebrating Parkland Hospital’s closing of its COVID-19 intensive care units in Dallas. We noted that Gov. Greg Abbott was right to reopen Texas in the spring, as COVID-19 case numbers slumped and vaccines became widely available in the weeks that followed. (8/13)

The Centers for Disease Control and Prevention (CDC) estimates that more than 114 million Americans had been infected with Covid-19 through March 2021. Factoring in new infections in unvaccinated people, we can conservatively expect more than 15 million cases of long Covid resulting from this pandemic. And though data are still emerging, the average age of patients with long Covid is about 40, which means that the majority are in their prime working years. Given these demographics, long Covid is likely to cast a long shadow on our health care system and economic recovery. (Steven Phillips and Michelle A. Williams, 8/12)

Every day this week we've reported about hospitals treating growing numbers of kids who have COVID-19. This is happening just as schools are resuming, leading to mask mandates, anti-mask mandates, frustrated parents and fed-up students. Here is what is going on. (Nicole Carroll, 8/13)

As a practicing primary-care doctor, I fully empathize with parents who worry about their unvaccinated kids’ potential exposure to the coronavirus. Raising my own children is a daily exercise in vulnerability. One rainy night this summer, my teenage son, a new driver who was running late for a babysitting job, asked for my keys. “Can’t you walk there instead?” I pleaded. He rolled his eyes. I let him use the car, but not before peppering him with reminders to be careful and to use the headlights and wipers. Shielding my kids from danger is a fundamental instinct; tolerating risk for them is hard emotional work. (Lucy McBride, 8/13)

As the parent of two children, I am struggling with the fears of what could happen if they get COVID-19 when they go back to school. However, I also feel certain that the decision my husband and I made to vaccinate our now 9-year-old as part of a vaccine clinical trial was not only best for our family but will help all children who will hopefully have access to the vaccine. (Ruth M. Lopez, 8/13)

The first mandatory vaccination case to reach the Supreme Court comes from Indiana University, which is requiring students to get COVID shots before enrolling for the fall semester unless they have a medical or religious exemption. The lower courts have upheld the requirement under the authority of Jacobson v. Massachusetts, a 1905 case in which the court upheld a smallpox vaccine requirement in my hometown of Cambridge, Massachusetts. It’s unlikely that the justices will issue an emergency order blocking the university’s policy from going into effect. They may not even want to hear the case, preferring to avoid the contentious national conversation about vaccines. (Noah Feldman, 8/12)

President Biden is not the first American chief executive to come up against recalcitrant governors and other officials willing to put their political interests ahead of the well-being of citizens. But the enormous resources of the federal government give him tools to overcome those forces. In figuring out how to effectively flex Washington’s muscle on health care, the 46th president might look to the 36th. (Karen Tumulty, 8/11)

A public option was included in the original ACA legislation the House passed in 2009 but, sadly, didn’t make it into the final bill. It’s time to bring it back. ... The public option can provide commercial plans with the competition that will ensure affordable premiums, as well as equity in care. ... L.A. Care Health Plan, the nation’s largest publicly operated health plan, serving more than 2.4 million members in Los Angeles County, has a unique perspective on how to implement a successful public option. After all, L.A. Care is a real-life example of a public option that has been operating successfully on California’s ACA exchange since 2014, and it remains the only public plan to do so. (John Baackes, 8/12)

In ordinary times, there would be no question about whether a drug with opioidlike effects should be proven safe and effective and approved by the Food and Drug Administration (FDA) before it is widely marketed. But these aren’t ordinary times and the herbal supplement kratom is not a typical drug. In fact, the issue of whether or not to ban kratom is an excellent litmus test of whether the Biden administration will actually use the philosophy of harm reduction to guide drug policy—or just spout the trendy catchphrase as window dressing to hide ongoing engagement in the war on drugs. (Maia Szalavitz, 8/12)

Long before the COVID-19 epidemic hit, the nation's behavioral healthcare system was in crisis, with mental health diagnoses on the rise, coupled with a shortage of providers. The pandemic took a system that was already overtaxed and stressed it even further. Cases of depression, anxiety and substance abuse have risen as a result and will only be further exacerbated with the delta variant surge. America's healthcare leaders must make behavioral health reform a top priority. (Dr. Norman Chenven and Michael Thompson, 8/12)

When you are old and gray and full of sleep and nodding by the fire — whom do you expect to help take care of you? Family? Friends? Paid aides? All of the above? The nation’s caregiving work force is fraying. Paid providers are overworked and undervalued, often forced to take on multiple jobs or turn to public assistance just to scrape by. Many family caregivers are struggling as well, sacrificing their own health and well-being to tend to loved ones for years on end. Consistent, skilled, affordable care is in short supply — and getting shorter — and those who provide it are shouldering an increasingly unsustainable burden. (Michelle Cottle, 8/12)

In 2020, there were 2014 people who applied to the 1443 Ob/Gyn intern positions offered, of whom 1440 matched. Applicants who matched listed a median of 12 Ob/Gyn programs on their rank list; unmatched applicants listed a median of 6.2 I had interviewed at and ranked 13 programs, which gave me a 95% chance of matching that year. And yet somehow, those odds still weren’t enough for me to match. As of 2018, only 5% of the U.S. physician workforce identified as Black, and only 0.7% of matriculating M.D. students identified as transgender or nonbinary. My inclusion in the medical field — as someone who identifies as Black, queer, and nonbinary — is essential: there is strong evidence that the presence of physicians from underrepresented groups improves health outcomes for patients with historically marginalized identities who can see themselves reflected in their clinicians. (Dr. Laer H. Streeter, 8/12)