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The delta variant of the coronavirus appears to cause more severe illness than earlier variants and spreads as easily as chickenpox, according to an internal federal health document that argues officials must “acknowledge the war has changed.” The document is an internal Centers for Disease Control and Prevention slide presentation, shared within the CDC and obtained by The Washington Post. It captures the struggle of the nation’s top public health agency to persuade the public to embrace vaccination and prevention measures, including mask-wearing, as cases surge across the United States and new research suggests vaccinated people can spread the virus. (Abutaleb, Johnson and Achenbach, 7/29)

Dr. Rochelle P. Walensky, the director of the agency, acknowledged on Tuesday that vaccinated people with so-called breakthrough infections of the Delta variant carry just as much virus in the nose and throat as unvaccinated people, and may spread it just as readily, if less often. But the internal document lays out a broader and even grimmer view of the variant. The Delta variant is more transmissible than the viruses that cause MERS, SARS, Ebola, the common cold, the seasonal flu and smallpox, and it is as contagious as chickenpox, according to the document, a copy of which was obtained by The New York Times. (Mandavilli, 7/30)

CDC Director Dr. Rochelle Walensky confirmed the authenticity of the document, which was first reported by The Washington Post. "I think people need to understand that we're not crying wolf here. This is serious," she told CNN. "It's one of the most transmissible viruses we know about. Measles, chickenpox, this -- they're all up there." The CDC is scheduled to publish data Friday that will back Walensky's controversial decision to change guidance for fully vaccinated people. She said Tuesday the CDC was recommending that even fully vaccinated people wear masks indoors in places where transmission of the virus is sustained or high. (LeBlanc, Fox and Cohen, 7/29)

Concerns over the threat of the Delta variant were raised after an internal document from the U.S. Centers for Disease Control and Prevention (CDC) revealed further details about the variant, including how it compares to Ebola. According to the confidential CDC document published Thursday, which was obtained by The Washington Post, the Delta variant is more contagious than the virus that causes Ebola as well as viruses that cause MERS, SARS, smallpox, seasonal flu and the common cold. (Kim, 7/30)

Professional sports leagues are uniquely positioned to track breakthrough Covid cases because they test thousands of athletes consistently, according to Dr. Robby Sikka, a physician who has worked with numerous NBA and NFL teams. Sikka told CNBC that the highly transmissible delta variant is “absolutely” driving most of the Covid breakthrough cases he’s studied. (DeCiccio, 7/29)

The patchwork nature of the coronavirus vaccination campaign in the United States has left people in many parts of the country still vulnerable to the virus and the fast-spreading Delta variant. Even areas with high vaccine uptake or those that were hit hard in previous waves of the pandemic could see new outbreaks if vaccination rates do not increase, an analysis conducted for The New York Times shows. (Smart, 7/29)

The recommendation that vaccinated people in some parts of the country dust off their masks was based largely on one troublesome finding, according to Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention. New research showed that vaccinated people infected with the Delta variant carry tremendous amounts of the virus in the nose and throat, she said in an email responding to questions from The New York Times. (Mandavilli, 7/29)

Do I need to get tested for COVID-19 if I’m vaccinated? Yes, if you’ve been around someone who has COVID-19. The latest guidance from the U.S. Centers for Disease Control and Prevention says people who are fully vaccinated should get tested three to five days after a potential exposure, even if they don’t have symptoms. (Perrone, 7/30)

The United States is facing a COVID-19 surge this summer as the more contagious delta variant spreads. More than 612,000 Americans have died from COVID-19 and over 4.1 million people have died worldwide, according to real-time data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. (Shapiro, Pereira, Deliso and Winsor, 7/30)

More than 94% of Washington’s recent COVID-19 cases, deaths and hospitalizations have been among not fully vaccinated people, according to a new report from the state Department of Health. The data released Wednesday shows that between February and June, residents 12 and older who weren’t fully vaccinated made up about 97% of COVID-19 cases, 96% of hospitalizations and 94% of deaths in the state, The Seattle Times reported. (7/30)

A jarring reality check is taking place in intensive care units across the country as thousands of COVID-19 positive patients, nearly all of them unvaccinated, are streaming into hospitals in need of care. This is particularly true in Florida, where virus-related hospitalizations have skyrocketed in recent weeks. The situation has escalated rapidly, now nearing peak levels, with nearly 7,900 patients hospitalized with the virus across the state, up by more than 320% in the last month, according to data from the Centers for Disease Control and Prevention. (Mitropoulos, Ault and Baur, 7/30)

Georgia’s COVID case numbers jumped by 4,800 in the state figures reported Thursday, continuing a recent upswing that’s apparently fueled by the Delta variant. “It is believed that the Delta variant is highly prevalent throughout Georgia,” said Dr. Charles Ruis, health director in the Southwest Health District, which is based in Albany. “The best way to prevent a COVID-related death is to get vaccinated, and vaccines are widely available in our region.” Urgent care centers in the metro Atlanta area were slammed Wednesday with patients, many asking for COVID tests. (Miller, 7/29)

A steady stream of vehicles flowed through the Covid-19 testing site in American Fork, Utah, a town in the youngest county of the state that has the youngest population in the U.S. On this recent Friday, many were minivans packed with children. Just around the corner, a vaccination site sat empty, closed for lack of demand. (Shah, 7/29)

Agriculture Commissioner Nikki Fried plans to have her department release daily reports on COVID-19 cases, deaths and hospitalizations because the Florida Department of Health - under her political foe, Gov. Ron DeSantis - has switched to providing such information once a week. Fried, the only Democrat holding a statewide office and a 2022 candidate for governor, said she is still working on how the information will be provided, through press conferences, news releases or online posts. (Turner, 7/29)

Sitting in her hospital room in Baton Rouge, Louisiana, Aimee Matzen struggled to breathe as she described how exhausting it is to have Covid-19. "The fact that I am here now, I am furious with myself," she told CNN between deep, deliberate breaths. "Because I was not vaccinated." Matzen, 44, finds herself in the Covid-19 intensive care unit at Our Lady of the Lake Regional Medical Center in Baton Rouge. She is receiving oxygen treatments and hopes she stays well enough to avoid getting hooked up to a ventilator. (Marquez, Andone and Boxer, 7/29)

Preliminary research presented at the Alzheimer’s Association International Conference in Denver this week suggests that coronavirus infections might lead to lasting cognitive impairment, especially among older people. But Heather M. Snyder, the Alzheimer’s Association’s vice president of medical and scientific relations, cautioned that while the findings from three studies are a step toward understanding how covid-19 affects the brain, more research is needed. (Haupt, 7/29)

In a longitudinal cohort of 25 children with multisystem inflammatory syndrome in children (MIS-C), all were asymptomatic and at their functional baseline at 6-month follow-up, according to a Pediatrics study yesterday. The study included a total of 50 children, with some lost to follow-up, but during all intermediary follow-ups, symptoms were improving. All study participants were admitted to Cohen Children's Medical Center with MIS-C from Apr 17 to Jun 20, 2020 (median age, 8.5 years; range, 9 months to 17 years). Most patients exhibited rapid clinical improvement, with an average hospital stay of 5 days. At discharge, 69% of 26 patients with left ventricular (LV) systolic dysfunction had resumed normal function, 15% had persistent but improved dysfunction, and 15% had mild dysfunction at admission but no available discharge data. (7/29)

The Texas doctor who became famous in 2020 for promoting the use of Hydroxychloroquine [HQC], an anti-malarial drug, as "a cure" for COVID-19 has filed a defamation lawsuit against CNN and CNN anchor, Anderson Cooper in the amount of $100 million. Dr. Stella Immanuel filed a federal lawsuit on Tuesday claiming that, "in an effort to vilify, demonize and embarrass President [Donald] Trump, Cooper and CNN published a series of statements of fact about Dr. Immanuel that injured her reputation and exposed her to public hatred, contempt, ridicule, and financial injury." (Pedroja, 7/29)

The Centers for Disease Control and Prevention (CDC) said on Thursday that 69.3% of U.S. counties had transmission rates of COVID-19 high enough to warrant indoor masking in public spaces and should immediately resume the policy. The transmission rate was up from 66.6% as of Wednesday. In total, 52.2% of U.S. counties have high COVID-19 community transmission rates and 17.1% have substantial rates, the CDC said. (Shepardson, 7/29)

Congressional aides and visitors to the House side of the Capitol will face arrest if they're not wearing masks, the head of the U.S. Capitol Police announced this week. In a Wednesday letter to his officer corps, Capitol Police Chief Thomas Manger ordered that they enforce the new mask guidelines across the Capitol complex. Those new rules, installed by the Capitol physician earlier in the week, include a mask mandate on the House side of the Capitol and all House office buildings. (Lillis, 7/29)

Nearly 40 maskless House Republican lawmakers walked across the Capitol and onto the Senate floor in protest of the Capitol physician’s decision to reinstate a mask mandate in the lower chamber but not in the upper chamber. Republicans complained that the policy, backed by Speaker Nancy Pelosi (D-Calif.) and other Democrats, is inconsistent, infringes on personal liberty, and is based on politics, not science. (Wong, 7/29)

Masks will again be required indoors in D.C. beginning Saturday, Mayor Muriel E. Bowser ordered, in a reversal of recent policy driven by new federal guidelines that recommend indoor masking in areas where coronavirus transmission is high. The new requirement, which Bowser (D) announced Thursday, will apply to vaccinated and unvaccinated people over the age of 2. (Zauzmer and Elwood, 7/29)

Starting Friday, all visitors — even those who are vaccinated — must wear masks at the Smithsonian Institution’s museums and indoor spaces, it said Thursday. The move is a reversal from the Smithsonian’s announcement last month that visitors who have been vaccinated didn’t need to wear masks indoors. (Hedgpeth, 7/29)

Texas Gov. Greg Abbott issued an executive order Thursday, reiterating his opposition to mask mandates, Covid-related business restrictions and vaccination requirements and issuing fines of up to $1,000 on those who fail to comply. The governor also called on state hospitals to deliver daily reports on their capacity to the Texas Department of State Health Services to send to the Centers for Disease Control and Prevention. (Towey, 7/29)

A day after the Centers for Disease Control and Prevention reported more than 16,000 new COVID cases in Florida, Gov. Ron DeSantis slammed the agency's new masking guidance while speaking at a conservative conference in Utah. On Tuesday, the CDC recommended that even vaccinated people return to wearing masks indoors if they live in areas with high rates of virus transmission. DeSantis told the American Legislative Exchange Council on Wednesday that Americans are free to live their lives free of government-imposed restrictions. (7/29)

Florida’s Covid wars are starting again. Local officials across Florida are bucking Gov. Ron DeSantis and his anti-mandate coronavirus strategy as infections soar in the state and nation. They’re imposing vaccine and mask requirements for government workers and even declaring states of emergency. In a sign of how worrisome the new Covid-19 surge is, Disney World is ordering all guests over 2-years-old to wear masks indoors at its Florida theme park, regardless of vaccination status. (Dixon, 7/29)

Nevada health officials said Thursday that they understand the return of an indoor mask mandate is frustrating but that it’s a necessary step to protect people as the number of coronavirus infections rises. “Many may feel over having to put a mask back on. We don’t like it either,” said Candice McDaniel, a director in Nevada’s health department. (Price, 7/30)

New federal guidance that everyone wear face coverings indoors in areas of high or substantial transmission applied to only one county in Maine on Friday. ... The CDC rates counties as “low,” “moderate,” “substantial” or “high” based on their level of community transmission. Every county in Maine was listed as moderate except Waldo County, which was listed substantial. (7/30)

When Faisal Khan left the St. Louis County council meeting Tuesday after promoting a new mask mandate, he said he was shoulder-bumped and pushed by people in the aisle. When he made it through the door, the St. Louis County Department of Health’s acting director said things got worse. Khan was surrounded by an “angry mob,” he said, and called an expletive and a brown b-----d. Others mocked his accent. (Harkins, 7/29)

North Carolina Gov. Roy Cooper on Thursday decided to reverse course from guidance he issued last week and will now urge all K-12 public school students and staff to be masked, even if they have been fully vaccinated for COVID-19. The Democratic governor and the state's top public health official, Dr. Mandy Cohen, pinned much blame on unvaccinated people and renewed calls for them to get the shot. (Anderson, 7/29)

Schools should make sure to require indoor mask wearing for all teachers, staff, students and visitors to K-12 schools, regardless of vaccination status, Kentucky Gov. Andy Beshear said. Administrators should have layered strategies in place to prevent COVID-19 infection and transmission, he added Thursday. (7/30)

Students, staff and visitors in K-12 schools across Oregon will be required to wear COVID-19 face masks in the upcoming school year. Salem-Keizer Public Schools will follow this guidance but is still seeking input from families and community members around other safety precautions and back-to-school plans for the fall. Thursday, Gov. Kate Brown announced the requirement that masks be worn indoors at K-12 schools statewide for the 2021-22 school year. (Pate, 7/29)

Schools will open this fall in much of the Washington region a little less normal than expected — with mask requirements now planned for Fairfax and Arlington counties, along with D.C. and Montgomery and Prince George’s counties. School systems are issuing the mandates regardless of vaccination status — to the relief of some families and teachers, and to the dismay of others. (St. George and Stein, 7/29)

New federal guidelines prompted by a surge in coronavirus cases have left school leaders across the country embroiled in debates over whether to require masks in schools, muddling a long-sought return to normalcy for millions of children. The wrangling over masks, considered by pediatricians and epidemiologists to be one of the most effective ways to stop school spread, has turned deeply personal and political, fueling vitriol at school board meetings that have left board members fearing for their safety. Several Republican-led states have barred school districts from requiring masks, threatening to fine school leaders or cut state funding if they attempt it. (Balingit, St. George and Strauss, 7/29)

The U.S. has seen a wave of COVID-19 outbreaks linked to summer camps and health officials fear it could be a preview of what's to come in the new school year. In rural Hudson, New York, where 67% of those 12 and up are fully vaccinated, news of a COVID-19 outbreak at nearby Camp Pontiac has rattled the community. "By Monday, it was 23," said Jack Mabb, the health director of Columbia County. "By Wednesday, it was 31, all in the seven to 11 age group. So they're of course unvaccinated." "Our reaction is we haven't seen this," he said. (Battiste, 7/29)

President Joe Biden has announced sweeping new pandemic requirements aimed at boosting vaccination rates for millions of federal workers and contractors as he lamented the “American tragedy” of rising-yet-preventable deaths among the unvaccinated. Federal workers will be required to sign forms attesting they’ve been vaccinated against the coronavirus or else comply with new rules on mandatory masking, weekly testing, distancing and more. The strict new guidelines are aimed at increasing sluggish vaccination rates among the huge number of Americans who draw federal paychecks — and to set an example for private employers around the country. (Jaffe, Alonso-Zaldivar and Lemire, 7/30)

“I think you’re going to find the patience of businesses, and the patience of other people, running thin,” Biden said, his voice at times rising in exasperation. “Because the fact is, if we had a higher vaccination rate, we wouldn’t be in this position.” He added, “If in fact you are unvaccinated, you present a problem — to yourself, to your family, and to those with whom you work. . . . You want to know how we put this virus behind us? I’ll tell you how. We need to get more people vaccinated.” (Linskey, Wagner and Kim, 7/29)

Federal workers and contractors will have to declare their vaccination status against COVID-19 or use additional public health precautions, President Joe Biden announced Thursday, signaling a more aggressive stance against the evolving virus. “With freedom comes responsibility, and your decision not to get vaccinated impacts someone else,” Biden said in a national address highlighting the risks for unvaccinated people and society at large. (McIntire and Kopp, 7/29)

President Joe Biden’s requirement for federal workers to reveal their COVID-19 vaccination status is likely to force uncomfortable questions not only at government agencies but at private companies as well. Right now, there’s a lack of clear answers. Getting the policy right will take time, and vary across government agencies. The same holds for private companies, for which the White House is trying to provide a guide. It’s not like there’s a cheat sheet. Nothing on this scale has been attempted before in the face of a virus morphing in real time to become a bigger threat. (Alonso-Zaldivar, 7/30)

Key points in President Joe Biden’s plan to increase COVID-19 vaccination among federal employees and encourage more Americans to get shots. (7/29)

President Joe Biden is calling for state, local and U.S. territorial governments to provide $100 payments for every newly vaccinated American to boost COVID-19 inoculation rates, the U.S. Treasury Department said on Thursday. ... The Treasury also said it was expanding a tax credit that employers could claim for wages paid to employees to give them paid time off to get vaccinated or to assist family members and certain other individuals with COVID-19 vaccinations. (7/29)

President Biden wants states to give $100 to people who get vaccinated against Covid-19. He wants to require federal workers to get immunized. He wants the same for members of the military, too. It remains entirely unclear, however, whether he has the power to achieve those goals. (Facher, 7/29)

Biden also called on state, territorial and local governments to use coronavirus relief funding to offer $100 to anyone who gets a shot. Polling and anecdotal evidence shows cash incentives have motivated some unvaccinated Americans to roll up their sleeves. The President announced that small- and medium-sized businesses will now be reimbursed for offering their employees paid leave to get their family members, including their kids, vaccinated. In April, the President announced that, thanks to the American Rescue Plan, the federal government is fully reimbursing any small- or medium-sized business that provides workers with paid time off to get vaccinated. (Gardner, 7/29)

Unions representing hundreds of thousands of federal workers — including many in Maryland — said Thursday that they back nationwide vaccination efforts to slow COVID-19, but stopped short of endorsing President Biden’s new plan to compel government employees and contractors to get the shots. Several labor leaders said it would be premature to endorse Biden’s approach before they can bargain with employers over how it will be implemented. One large labor group — the National Treasury Employees Union — said the president’s plan raised concerns about how employees’ rights and privacy would be protected. (Barker, 7/29)

Nearly two-thirds of Americans say they'd support federal, state or local governments requiring everyone to get a coronavirus vaccine, according to a new survey conducted by The COVID States Project. This kind of blanket mandate hasn't even been proposed, at any level of government. But more piecemeal requirements are rapidly becoming more popular, and the survey suggests Americans are fine with that. (Owens, 7/30)

The federal government may not try to force people to get the Covid vaccine. And it may not have to. Your employer, the restaurant where you want to eat, the concert venue you want to visit or the country where you want to travel may do it for them. (Wolf, 7/29)

The vaccination rules for federal workers mark an escalation in efforts to incentivize vaccination as a new covid-19 wave mounts. They are part of a growing trend around the world to require — or nearly require — vaccinations for certain categories of people to stem the tide of variant-fueled infections and get the pandemic under control. ... Here’s how four countries have handled vaccination requirements. (Parker, 7/29)

Defense Secretary Lloyd Austin will begin consulting military medical professionals, as well as the Joint Chiefs of Staff, to “determine how and when to make recommendations to President Joe Biden” about adding the COVID-19 vaccines to the full list of requirements for military personnel, the Pentagon announced Thursday evening. ... “The Department of Defense is moving quickly to meet President Biden’s commitment to defeat COVID-19, and that includes being able to ensure every member of our civilian and military workforce is protected,” Jamal Brown, deputy Pentagon press secretary, said in a statement. “In accordance with the guidance the President issued today, all military and civilian DoD personnel will be asked to attest to their vaccination status. Personnel unable or unwilling to do that will be required to wear a mask, physically distance, comply with a regular testing requirement and be subject to official travel restrictions.” (Myers and Altman, 7/29)

In comments at the White House, [President] Biden stopped short of imposing a vaccine mandate right away. But he said he has asked the Defense Department to look into how, and when, the military will add vaccines to protect against COVID-19 to the list of other vaccinations service members must receive. Biden said making the vaccines mandatory is important because troops often serve in places where vaccination rates are low and COVID is prevalent. "Men and women in uniform, who protect this country against grave threats, should be protected as much as possible from getting COVID-19," he said. (Losey, 7/29)

The Pentagon said Thursday it will begin internal talks on making the coronavirus vaccine mandatory for military personnel, after President Biden called on defense leaders to examine "how and when" to mandate the vaccine for U.S. troops.“ Secretary Austin will also begin consulting our medical professionals, as well as the Joint Chiefs of Staff, to determine how and when to make recommendations to the President with respect to adding the COVID-19 vaccines to the full list of requirements for military personnel,” deputy Pentagon press secretary Jamal Brown said in a statement Thursday evening. (Lonas, 7/29)

California National Guardsmen will be ordered to get vaccinated against COVID-19 by early August or face regular testing, Military.com has learned. The mandate comes despite the fact that the Defense Department does not have a vaccination requirement for the rest of the force. Gov. Gavin Newsom on Monday announced California will require all state employees to be vaccinated or face a weekly testing. That will include the state’s National Guard, for which Newsom serves as its commander-in-chief, a spokesman for the Guard confirmed Tuesday. (Beynon, 7/28)

Two sailors have died from COVID-19 complications in the last week, the Navy announced Wednesday. Capt. Corby Ropp, 48, died on July 23 at Duke University Hospital in Durham, North Carolina, and Navy Reserve Master-at-Arms First Class Allen Hillman, 47, died on July 26. Both deaths were attributed to complications associated with COVID-19. (Toropin, 7/28)

At least 115 soldiers have tested positive for COVID-19 during a critical National Guard training exercise this month, Military.com has learned. The Arkansas Guard's 39th Infantry Brigade Combat Team has been training at the Joint Readiness Training Center, or JRTC, at Fort Polk, Louisiana, since early July, and the training will last for about another week. Soldiers are mostly in the field, and the events are built to mimic austere conditions to prepare for combat abroad. COVID-19 has run rampant, and leaders warn there is little they can do to mitigate risk in the field as they push for soldiers to get vaccinated. (Beynon, 7/28)

Emergent BioSolutions announced Thursday that the Food and Drug Administration is allowing its Baltimore plant to resume manufacturing materials for vaccines after it was shutdown in April due to contamination problems. The plant, which had been producing vaccine materials for Johnson & Johnson and AstraZeneca, conflated ingredients between the two different types of vaccines last year and destroyed 15 million doses of J&J's vaccine. (Knutson, 7/29)

The green light from the FDA is just the first step in the plant’s return. The vaccines produced still must receive authorization from the agency to be released to the public. “The American people should have high expectations of the partners its government chooses to help prepare them for disaster, and we have even higher expectations of ourselves,” Emergent CEO Robert Kramer said. “We have fallen short of those lofty ambitions over the past few months but resumption of manufacturing is a key milestone and we are grateful for the opportunity to help bring this pandemic to an end.” (Condon and Miller, 7/29)

A year ago, U.S. health professionals felt helpless. The coronavirus had been identified but was poorly understood. Thousands were dying daily and the tools available -- ventilators, experimental therapies, testing kits -- were limited and often ineffective. The president was dismissive of masks and social distancing. Today, even though the death rate has plummeted, those same professionals feel worse. The virus, while mutating, has been mapped; tests and highly effective vaccines are readily available, and the White House is on message. But, propelled by the delta variant, infection rates are increasing in 90% of the U.S. (Torrence, 7/29)

Hundreds of thousands of COVID-19 vaccine doses have been saved from the trash after U.S. regulators extended their expiration date for a second time, part of a nationwide effort to salvage expiring shots to battle the nation’s summer surge in infections. The Food and Drug Administration on Wednesday sent a letter to shot maker Johnson & Johnson declaring that the doses remain safe and effective for at least six months when properly stored. The FDA’s move gives the shots an extra six weeks as public officials press more Americans to get inoculated. (Catalini, 7/30)

Uber announced Thursday that its employees must be fully vaccinated as the rideshare company plans its return to the office for this October. The announcement comes a day after other Big Tech companies, including Google, Twitter and Facebook said their employees must receive the vaccination in order to enter the office. (Rouhandeh, 7/29)

[Florida's] Leon County is requiring all employees to get vaccinated for COVID-19 or be fired. And the mayors of Miami-Dade and Orange counties announced their own mask and vaccine mandates for county facilities. Leon County Administrator Vince Long said he's not concerned about blowback from Gov. Ron DeSantis' office. DeSantis is against vaccine mandates and a new law gives the governor the power to invalidate local measures and block government entities from requiring vaccinations. (7/29)

KHN: Bus Stop By Bus Stop, Denver-Area Officials Microtarget Vaccine Hesitancy

John Letson had seen too many apocalyptic movies to feel comfortable getting a covid-19 vaccine initially. “I was completely against it,” the 40-year-old movie buff said, referencing “I Am Legend” and “Children of Men,” in which humanity is in jeopardy, as examples of what could go wrong. “I think an untested thing during a pandemic has later effects that we don’t know yet.” (Hawryluk, 7/30)

KHN: Amid Covid Booster Debate, West Virginia To Check Immunity Of Vaccinated Nursing Home Residents 

West Virginia raced ahead of the country last winter to get people in nursing homes vaccinated against covid-19, but with cases and hospitalizations on the rise again, state officials want to know whether immunity levels are falling for residents who had their shots. Starting in August, the state plans to begin measuring the levels of disease-fighting antibodies in the blood of vaccinated nursing home residents, which could help indicate whether they need a booster shot. The process will be voluntary and the data will be shared with federal health agencies evaluating the need for boosters. (Galewitz, 7/30)

KHN: KHN’s ‘What The Health?’: Hot Covid Summer 

Predictions of a “hot vax summer” that would let Americans who had their covid immunizations celebrate the waning of the pandemic are turning out to have been premature. Covid-19’s delta variant is driving up cases in all 50 states, prompting new recommendations for masks and a growing number of vaccine requirements, including one for most federal workers. Meanwhile, official Washington celebrated the anniversary of the 1990 Americans with Disabilities Act, which sought to guarantee an array of protections, as concerns grow that people with covid aftereffects could dramatically expand the population needing those protections. (7/29)

The 27 member states of the European Union altogether have now administered more coronavirus vaccine doses per 100 people than the United States, in another sign that inoculations across the bloc have maintained some speed throughout the summer, while they have stagnated for weeks in the United States. (Peltier, 7/29)

The Biden administration announced Thursday it will allow a nationwide ban on evictions to expire Saturday, arguing that its hands are tied after the Supreme Court signaled the moratorium would only be extended until the end of the month. The White House said President Joe Biden would have liked to extend the federal eviction moratorium due to spread of the highly contagious delta variant of the coronavirus. Instead, Biden called on “Congress to extend the eviction moratorium to protect such vulnerable renters and their families without delay.” (Casey, 7/30)

House Democratic leadership on Thursday struggled to build support for a five-month extension of the nationwide eviction moratorium that's set to lapse this weekend after running into opposition from more than a dozen Democratic lawmakers, according to two sources familiar with the situation. With the ban set to expire Saturday and millions of Americans at risk of losing their homes, House Majority Leader Steny Hoyer (D-Md.) confirmed that Democrats in favor of extending the moratorium were still working to lock down backing for a possible last-minute vote Friday. The House is set to leave town at the end of this week until September. (O'Donnell, 7/29)

Money is available for tenants who could face eviction as early as this weekend as pandemic protections expire, and Nevada’s governor and advocates called Thursday for affected renters to quickly contact programs set up to help. “We will see landlords evicting tenants for non-payment of rent,” and courts may be flooded, said Bailey Bortolin, director of the Nevada Coalition of Legal Service Providers and a board member at the Legal Aid Center of Southern Nevada. The center encourages property owners to work with renters through a coronavirus relief housing assistance program, commonly known as CHAP. (Ritter, 7/30)

The number of Americans collecting unemployment benefits slid last week, another sign that the job market continues to recover rapidly from the coronavirus recession. Jobless claims dropped by 24,000 to 400,000 last week, the Labor Department reported Thursday. (7/29)

Rep. Cheri Bustos (D-Ill.) said at at Axios event Thursday that she's calling on local communities to help Congress address "negative social determinants" like food deserts or unsafe housing. Social determinants are social factors that harm long-term health. Bustos, who introduced the Social Determinants Accelerator Act, wants local communities to tell Congress directly what they need to tackle problems. (Frazier, 7/29)

Senate Majority Leader Chuck Schumer said Thursday that all 50 Democrats will vote to move forward on the party’s $3.5 trillion social spending proposal. Schumer’s remarks come after the Senate took the first step to advance a $550 billion bipartisan infrastructure framework Wednesday evening. The New York Democrat has long insisted that the Senate will pass both the bipartisan bill and a budget blueprint for the multitrillion-dollar legislative package before the chamber leaves for the August recess. (Levine, 7/29)

The $3.5 trillion reconciliation plan is only a loose outline for now that will take months to fill in. For one thing, there's no guarantee it stays $3.5 trillion, and finding enough revenue and savings to pay for it could be difficult. Sen. Kyrsten Sinema, D-Ariz., said in a statement Wednesday that she wanted to spend less (by how much is unclear) drawing a sharp rebuke from Rep. Alexandria Ocasio-Cortez, D-N.Y. (Todd, Murray, Kamisar and Sarlin, 7/29)

Just hours after Georgia voters elected two Democrats, flipping the Senate majority, on Jan. 5, Sen. Charles E. Schumer reveled in the victory and said his caucus — handed power for the first time in six years — was “committed to delivering the bold change and help that Americans need and demand.” In the months since, Schumer has repeatedly promised “big and bold” solutions to the problems ailing America. He now may be on the cusp of delivering them amid his most perilous test of leadership yet, with a bipartisan infrastructure deal moving closer to fruition, a multi-trillion-dollar economic and social policy plan waiting in the wings, and the fate of President Biden’s governing agenda hanging in the balance. (DeBonis, 7/29)

Providers can breathe a sigh of relief: Congress isn't planning on repurposing unspent money from the pandemic provider relief fund, at least not yet. The White House finally reached an infrastructure deal with a bipartisan group of senators yesterday, paid for in part with health care policies. (Owens, 7/29)

President Biden’s success at propelling an infrastructure deal past its first major hurdle this week was a vindication of his faith in bipartisanship and a repudiation of the slash-and-burn politics of his immediate predecessor, President Donald J. Trump, who tried and failed to block it. Having campaigned as the anti-Trump — an insider who regarded compromise as a virtue, rather than a missed opportunity to crush a rival — Mr. Biden has held up the promise of a broad infrastructure accord not just as a policy priority but as a test of the fundamental rationale for his presidency. (Tankersley, 7/29)

President Biden said on Thursday night that he supported a plan championed by congressional Democrats to use a legislative process intended for budget-related measures to bypass Republican opposition and legalize millions of undocumented immigrants. Senator Chuck Schumer, Democrat of New York and the majority leader, has been quietly exploring whether it would be possible to attach a broad revision of immigration laws to a $3.5 trillion budget plan that Democrats intend to pass unilaterally through a fast-track process known as budget reconciliation. (Karni, 7/29)

President Biden and the top Democrats in Congress are expected to meet at the White House on Friday to discuss their party’s faltering efforts to pass major voting rights legislation, according to two congressional aides familiar with the plans. Mr. Biden’s meeting with Speaker Nancy Pelosi of California and Senator Chuck Schumer of New York comes at a crucial moment, as activists are pushing the president to use his power and Democrats’ control of Congress to protect voting rights while they have the chance. Republican-led states have enacted at least 30 new laws containing a host of new restrictions on voting, and G.O.P. senators have blocked consideration of a Democratic bill that would impose sweeping new federal mandates aimed at overriding them. (Fandos and Corasaniti, 7/29)

First Lady Dr. Jill Biden had a sharp object removed from her left foot by doctors at Walter Reed National Military Medical Center on Thursday, her office said. “Last weekend, prior to her two official events in Hawaii, the First Lady stepped on an object on the beach which became lodged in her left foot,” said spokesman Michael LaRosa. LaRosa said Biden underwent “a procedure today at [Walter Reed] to remove the object.” (Wilkie, 7/29)

For the second time this year, President Biden has cleared his schedule to accompany his wife, Jill Biden, to a medical procedure. ... After meeting with lawmakers about immigration, the president left the White House in Marine One just after 7 p.m. to be at the first lady’s side. “I’m late for a very important date” he joked, after jogging up to reporters. While at the hospital he walked outside to his SUV for about ten minutes to make a phone call. He and the first lady left the hospital at about 9:45 p.m. to return to the White House. (Yuan, 7/29)

Medicare Advantage beneficiaries can't access the care they need as they get sicker, a new report from federal watchdogs suggests. People enrolled in Medicare Advantage plans are switching to Medicare fee-for-service at an alarming rate during their last year of life, according to a Government Accountability Office (GAO) report published Wednesday. Medicare Advantage customers in their last year of life were more than twice as likely to drop their policies and enroll in Medicare fee-for-service than other Medicare Advantage enrollees. (Brady, 7/29)

New legislation aims to eliminate the cost-sharing requirement for Medicare beneficiaries to get chronic care management services and reimburse providers for 100% of the payment. The legislation, reintroduced Thursday, intends to boost access among seniors to chronic care management services that include creating a care plan and medication reconciliation and adherence. “Chronic health conditions account for 90% of our nation’s healthcare spending and this is a meaningful way to lower costs and improve health outcomes,” said Rep. Suzan DelBene, D-Washington, a lead sponsor of the Seniors’ Chronic Care Management Improvement Act. “It’s unfortunate so few seniors access this benefit and I believe dropping the cost-sharing requirements will change that.” (King, 7/29)

Access to Medicaid may help address racial disparities in insurance coverage, access and self-reported outcomes, according to a new study. The research, published in JAMA Internal Medicine, tracked more than 2.4 million Americans and found that immediately after turning 65, and thus becoming eligible for Medicare, coverage for Black respondents increased from 86.3% to 95.8%.Among Hispanic respondents, coverage increased from 77.4% to 91.3%. (Minemyer, 7/29)

The latest Medicare payment rules for inpatient rehabilitation, inpatient psychiatric, hospices and skilled nursing facilities are out, and there's good news for those healthcare providers. Under a final rule CMS published Thursday, inpatient rehab facilities will get a 1.9% pay bump in 2022, raising their reimbursements by $130 million. Inpatient psychiatric facilities will get a 2% hike, an increase of $80 million. Hospices also will get paid 2% more, which amounts to an additional $480 million. Skilled nursing facilities will get a rate increase just over 1%, or $410 million. (Brady, 7/29)

In 1965, President Lyndon B. Johnson signed Medicare into law, dedicating it to former President Harry Truman, who "planted the seeds of compassion." (7/30)

Health insurance companies are pushing back against President Joe Biden's plan to lengthen the annual open enrollment period on the exchanges, according to comments the trade group AHIP made on a proposed regulation. CMS published a draft rule last month that would give consumers 30 extra days to sign up and establish monthly special enrollment periods for low-income people to enroll in subsidized low-cost or no-cost health plans. Comments on the regulation closed Wednesday. (Brady, 7/29)

In 2015, global groups set ambitious goals to stem the HIV/AIDS epidemic. They aimed to bring down the number of new cases, particularly among children, teens and young women, by 2020 – and to bring up the number of people on HIV treatment. On July 21, the final report came out. No targets were met. (Wu, 7/29)

The federal government is making it much easier for Americans to get their hands on a potentially life saving treatment, if you have health insurance. It's called PrEP, a once-daily pill that is 99% effective at preventing HIV infections. PrEP has been around for nearly a decade, and health officials have long advocated for high risk people to take it, but usage has been limited due to the costs. Truvada, one of the medications authorized for PrEP, recently went generic, but used to cost upwards of $1,800 a month. The doctor's visits and lab tests can cost hundreds more. (Saloway and Benk, 7/29)

Lawmakers pressed a top Food and Drug Administration official Thursday for answers on why the agency has balked at approving medicines to treat the fatal neurodegenerative condition ALS. Two key politicians even called out specific drug candidates by name, a rare congressional boost for the biotechs behind them. The questions came during a hearing on neurodegenerative diseases hosted by the House Energy and Commerce committee that featured testimony from the National Institutes of Health, as well as patients and caregivers for conditions like Huntington’s disease and Alzheimer’s. But the lion’s share of questions were directed to the FDA’s drug center chief, Patrizia Cavazzoni. And most were about ALS. (Florko, 7/29)

For only the second time, the Food and Drug Administration is threatening to fine a drug maker for failing to submit required information about a clinical trial to a U.S. government registry. In a July 26 letter, the agency noted results of Phase 2 clinical test of a drug for treating acne rosacea had not been posted, even though the FDA contacted Accuitis last October about the issue. Acne rosacea is a condition that causes pus-filled bumps on the face and mostly affects middle-aged women with fair skin. Accuitis now has until Aug. 26 to post the data. (Silverman, 7/29)

Six months ago, Angela Simmons Alvarez got a letter in the mail from her insurer, asking her to please stop taking ah drug she has relied on for nearly 20 years. She's not alone. Health insurers have been increasingly cracking down on members' use of high-cost biologic drugs, with UnitedHealthcare, Aetna and Cigna unveiling policies this year that force patients to switch to biosimilars or restrict the drug dosage an individual can receive. (Tepper, 7/29)

New research into the microbiomes of centenarians reveals a potential clue to their longevity, adding to the scientific understanding that bacteria in the gut have major implications for our ability to fight disease. People who live past their 100th birthday are more likely to carry certain bacteria in their gut that produce powerful antimicrobial compounds, according to new research published Thursday in Nature. (Sheridan, 7/29)

The Food and Drug Administration’s decision on Wednesday to approve a long-acting insulin called Semglee (insulin glargine-yfgn) as the first interchangeable biologic licensed for the U.S. market represents a major step forward to greater competition and access for patients. What it means in practice, however, depends on where you sit. (Gillian Woollett, 7/29)

KHN: Diabetes Drug’s New Weight Loss Formula Fuels Cost-Benefit Debate

The long list of side effects that follow ads for the newer expensive drugs to treat Type 2 diabetes sometimes include an unusual warning: They might cause weight loss. That side effect is one that many people — especially those with Type 2 diabetes, which is associated with obesity — may desperately want. So it’s no surprise that some of the same drugs are being reformulated and renamed by manufacturers as a new obesity treatment. No longer limited to the crowded field of treatments for Type 2 diabetes, which affects about 10% of Americans, they join the far smaller number of drugs for obesity, which affects 42% of Americans and is ready to be mined for profit. (Appleby, 7/30)

The outcome of a landmark federal opioid trial in West Virginia that reached closing arguments this week rests on two legally thorny questions. Was it "unreasonable" for three of America's biggest corporations — the drug wholesalers AmerisourceBergen, Cardinal Health and McKesson — to ship roughly 81 million highly addictive opioid pills to pharmacies in one small Rust Belt city on the Ohio River? (Mann, 7/30)

The endgame of the sprawling mass of opioid lawsuits is starting to come into focus: Already, a settlement with Johnson & Johnson and three major drug distributors will pour billions of dollars into communities to combat the addiction crisis, with more to come. But what that looks like, exactly, will vary from place to place. States are likely to see lump sums of money doled out for years, and they will be left to decide how to spend it under the guideposts set up in the settlements. (Joseph, 7/30)

As fatal overdoses once again rise — accounting for 92,183 deaths in 2020, a 30% increase from the year before — public health researchers are racing to develop better tools to prevent them. Some see promise in models that pull in data and spit out predictions about who is at highest risk of developing opioid use disorder or overdosing, giving health officials and physicians an idea of where to target strained prevention resources. But experts say that a scattered and siloed system to collect data on overdoses and outcomes is hamstringing efforts to further develop and deploy those models. (Lin, 7/30)

There are 55 winners of Illinois’ lottery for licenses to operate marijuana retail stores officials said Thursday, but the licenses can’t be awarded until a judge rules on a challenge to the process. Awarding of the licenses by the Illinois Department of Professional Regulation have been delayed for more than a year, initially because of COVID-19-related issues. Problems with scoring the applications added to the delay. (7/30)

Two New Jersey Transit conductors, including one who sits on the board of directors, took part in a fraud scheme involving expensive prescription drugs, according to charges announced Thursday by the Essex County prosecutor’s office. ... According to federal authorities involved in the larger probe, the scheme exploited the fact that some New Jersey state and local government employees had insurance that covered expensive compound medications such as pain, scar, antifungal and libido creams. Reimbursements ran as high as thousands of dollars for a one-month supply. Conspirators recruited government employees like teachers, police and firefighters to submit claims for prescriptions, based solely on the amount of money the insurance company would pay for them. (Porter, 7/30)

More Florida hospitals are postponing elective surgeries as COVID-19 hospitalizations in the state reach record highs. ... Several Florida health systems, including Health First in Rockledge, Baptist Health in Jacksonville and AdventHealth in Altamonte Springs, already postponed or limited nonemergency surgeries. Now, more hospitals in the state are limiting these surgeries to free up bed space and staffing resources. BayCare Health System in Clearwater will scale back elective procedures at some of its facilities later this week, the Tampa Bay Times reported July 28. The changes will affect overnight hospital stays. (Paavola, 7/29)

St. Joseph’s Hospital in Tampa and other BayCare Health System facilities will scale back their elective procedures later this week as COVID-19 cases surge, spokesperson Lisa Razler confirmed Wednesday. The changes will impact elective procedures that involve an overnight visit in an inpatient bed, and will take place in various Hillsborough and Polk County facilities as a response to an increase in patients in the hospitals. (Weber, 7/27)

Despite investor fears of a telehealth slowdown, the market banked a record-setting $5 billion in 163 funding deals in the second quarter of 2021. Global telehealth investment rose for the fourth consecutive quarter, growing 17% quarter over quarter and 169% year over year, according to a new report from market intelligence company CB Insights. (Landi, 7/30)

Avera Health is selling its clinician-to-clinician telehealth business Avera eCare to a private-equity firm in a deal expected to close this year. Aquiline Capital Partners, a private equity firm based in New York and London, will acquire Avera eCare, which connects specialists to local clinicians at facilities across the U.S. The new owners will rename the operation Avel eCare and carve it out from its own business. (Cohen, 7/29)

The Icahn School of Medicine at Mount Sinai is launching a three-year project under which other schools can test its antiracism model for medical education, according to a July 29 news release. Up to 10 medical schools in the U.S. and Canada can participate in Icahn Mount Siani's Anti-Racist Transformation in Medical Education model. The virtual model includes assessments, outcome and performance monitoring and coaching to address racial inequities in medical education. (Haefner, 7/29)

Kaiser Permanente's health plan has filed suit against Merck and the company manufacturing generics of two of its popular products over delays in the launch of those generics. Kaiser Foundation Health Plan's suit claims that the insurer paid hundreds of millions more for cholesterol drugs Zetia and Vytorin because the companies agreed to delay the launch of generic competitors. (Minemyer, 7/29)

UnitedHealth Group, HCA Healthcare and Pfizer have been the most notable health care companies to post Q2 earnings so far, but this week has been chock-full of others. The second quarter for Universal Health Services was so profitable that it returned $189 million in federal coronavirus bailout funds. But executives cautioned higher COVID cases may lead to labor shortages. Meanwhile, Community Health Systems is eking out profits in large part due to bailout money. (Herman, 7/29)

University of Houston College of Medicine plans to open a low-cost direct primary care clinic for the city's uninsured population, thanks to $1 million donation received Wednesday. The Cullen Trust for Health Care made the donation in an effort to increase access to primary care for vulnerable residents. The clinic is set to open in fall 2021. (Gellman, 7/29)

Case Western Reserve University and MetroHealth have agreed to extend their education and research partnership for another decade, continuing medical students' clinical learning opportunities through June 30, 2031. The announced agreement also includes a shared commitment to identify additional education options for CWRU's allied health students within MetroHealth and signals the hospital's commitment to increasing its research efforts, according to a news release. (7/29)

Oklahoma and Louisiana health officials said that a surge in cases of a virus more frequently seen in winter is filling hospital pediatric wards as children emerge from Covid isolation. Respiratory syncytial virus usually causes mild coldlike symptoms and most people recover in weeks, according to the U.S. Centers for Disease Control and Prevention. Symptoms include runny nose, loss of appetite, fever and wheezing. Infants and older adults are at heightened risk of severe disease from the pathogen. (Maglione and Tozzi, 7/29)

Bright Farms yesterday expanded its recall of packaged salad greens that have been linked to a Salmonella outbreak that has now sickened 11 people in 3 states, according to federal health officials. The recall involves products packaged at its Rochelle, Ill., facility and were sold in Illinois, Iowa, Indiana, and Michigan, the Food and Drug Administration (FDA) said in a recall update. In addition to several products that were subject to a Jul 15 recall, the expansion yesterday includes baby spinach that was sold in 4- and 8-ounce packages. The product is past its expiration date. The expiration date for the previously recalled products is today. (7/29)

Allergy season in North America has been the lengthiest and the most severe in decades, and experts say the millions of disproportionately male trees planted in urban areas are partly to blame for high pollen counts. Prolonged exposure to pollen is disrupting the lives of an increasing number of people who are developing allergies that can lead to lifelong treatments for respiratory problems. (Fernandez, 7/29)

If you’ve been told to avoid coffee because it might make your heart beat irregularly, recent research suggests it may be time to rethink that recommendation. “There’s this quite pervasive conventional wisdom” that people who have or are at risk of arrhythmias, or abnormal heart rhythms, should avoid caffeine, said Gregory Marcus, a cardiologist and professor of medicine at the University of California at San Francisco. Many patients who come to see him have already been told by other doctors to steer clear of caffeinated products, such as coffee, he said. (Chiu, 7/29)

Just two months after the Vessel, a honeycomb-like spiral of staircases in Hudson Yards, reopened with design changes meant to lower the risk of suicides, a 14-year-old boy died by suicide there on Thursday afternoon, the police said. The death, which was the fourth suicide at the tourist attraction in a year and a half, angered community members who have repeatedly called on developers to build higher barriers on the walkways and raised questions about the effectiveness of the structure’s suicide-prevention methods. (Wong and Gold, 7/29)

Israel's Prime Minister has announced a program to roll out a third dose of the coronavirus vaccine to people over the age of 60, becoming one of the first countries in the world to make such a move. People over 60 will need to show they received their second dose of the vaccine at least five months ago. Thursday's announcement follows a strong recommendation from the government-appointed team of experts on the pandemic to offer older adults a third dose. The experts' advice, which came overnight on Wednesday, was based on data suggesting significant waning immunity from infection over time. (Tal, Howard and Carey, 7/30)

Saudi Arabia will reopen its borders to tourists on Sunday for the first time in 18 months after imposing restrictions at the start of the pandemic to curb the spread of the coronavirus. The historically closed-off kingdom introduced electronic visas for tourists in late 2019, just before the pandemic struck. (7/30)

With coronavirus deaths rising in Myanmar, allegations are growing from residents and human rights activists that the military government, which seized control in February, is using the pandemic to consolidate power and crush opposition. In the last week, the per capita death rate in Myanmar surpassed those of Indonesia and Malaysia to become the worst in Southeast Asia. The country’s crippled health care system has rapidly become overwhelmed with new patients sick with COVID-19. (Rising, 7/30)

New Zealand introduced a new bill on Friday that, if it becomes law, will make “conversion therapy” aimed at LGBTQ people an offense punishable by up to five years in prison. Conversion therapy can refer to a wide range of efforts to alter a person’s sexual orientation, gender identity or gender expression. (Pannett, 7/30)

Japan expanded a coronavirus state of emergency to four more areas in addition to Tokyo on Friday following record spikes in infections as the capital hosts the Olympics. Prime Minister Yoshihide Suga declared an emergency in Saitama, Kanagawa and Chiba, near Tokyo, as well as in the western city of Osaka, effective Monday until Aug. 31. Emergency measures already in place in Tokyo and the southern island of Okinawa will be extended until the end of August, after the Olympics and well into the Paralympics which start Aug. 24. (Yamaguchi, 7/30 )

It doesn’t mean a lockdown. In fact, Japan has never had a lockdown. Its “emergency” measures are centered around having bars and restaurants close early. Under the latest emergency, extended through the end of August, serving alcohol is restricted. The measures have been widely criticized as arbitrarily targeting a sector without scientific foundation. Some establishments are ignoring requests and staying open. Theaters and clubs limit crowd size. (Kageyama, 7/30)

They spit. They wait. They hope. About 30,000 people from scores of nations are spitting into tiny plastic vials at the Olympics in a daily routine that’s grown crucial in going ahead with the pandemic-era Games, according to organizers. If you do the math for the two-week duration of the Olympics, that adds up to a half million saliva samples collected for athletes, who get tested daily, as well as other venues, in an extraordinary effort to curb the spread of COVID-19 infections. At about 1 milliliter per sample, that would be ... well, a lot of spit. (Kageyama, 7/30)

The Tokyo Olympics is running a village for athletes and coaches where more than 80% are vaccinated against the coronavirus, testing is compulsory and movement is stringently curtailed. None of that is true for the giant Japanese capital that surrounds the Olympic "bubble". The athletes’ village and Olympic press centre represent a huge, strict COVID-19 control zone for the more than 50,000 competitors, coaches, staff and journalists. Meanwhile, outside the fence, host city Tokyo - despite labouring through its fourth coronavirus lockdown as infections spike to record highs - is leading something like life as pandemic-normal. (Slodkowski and Takenaka, 7/29)

U.S. BMX racer and defending Olympic gold medalist Connor Fields was carried off the course on a stretcher after crashing Friday at the Tokyo Games. "We can confirm that Connor Fields is awake and awaiting further medical evaluation," a Team USA doctor said in a statement. "We will share additional updates as they become available." Fields, 28, of Las Vegas, was racing in the semifinals when he landed hard off a jump heading into the first turn in the third run. (Helsel, 7/30)

Star U.S. gymnast Simone Biles on Friday spelled out her struggles to perform, days after pulling out of the team and women's all-around competitions in Tokyo, but shed no clear light on whether she would take part in further individual events. ... "It's honestly petrifying trying to do a skill but not having your mind & body in sync," she wrote on Instagram, in what appeared to be a series of answers to questions from followers, noting that she'd had similar periods before. (Lies, Tetrault-farber, 7/30)

Argentinian pole vaulter German Chiaraviglio described his days in the Olympic village as a sleep-robbing, emotional Covid rollercoaster. First, he tested positive, setting off a mandatory isolation. Several hours and a negative test later, he was set free, allowed to resume normal life, he posted on Instagram. That freedom was short-lived. The next day, the same sequence of events played out. And the day after that too, until finally on July 28, both tests came back positive. He knew then that his Olympic dreams were over. He would have to go into quarantine.  “It’s really hard to process something like this. It’s likely going to take me a long time,” he said.  (Hernandez, 7/30)

In the United States, this pandemic could’ve been over by now, and certainly would’ve been by Labor Day. If the pace of vaccination through the summer had been anything like the pace in April and May, the country would be nearing herd immunity. With most adults immunized, new and more infectious coronavirus variants would have nowhere to spread. Life could return nearly to normal. Experts list many reasons for the vaccine slump, but one big reason stands out: vaccine resistance among conservative, evangelical, and rural Americans. Pro-Trump America has decided that vaccine refusal is a statement of identity and a test of loyalty. (Frum, 7/23)

The petite blonde bartender in ripped jean shorts bounced to each side of a square-shaped bar as women in bikinis and shirtless men lined up on a sweltering afternoon to order Bud Light, vodka and soda, and piles of nachos at this dockside retreat in the Lake of the Ozarks region. In a county designated a Covid hot spot, in a state with one of the lowest vaccination rates in the nation, and in a region where hospitals are nearing capacity as the Delta variant takes hold, Erin, a bartender at Backwater Jack’s, couldn’t be in a more vulnerable position. She interacts closely with hundreds of maskless customers—sometimes on a single day. She knows most of them are probably not vaccinated. And she doesn’t care. She isn’t either. (Korecki, 7/27)

Oxford-AstraZeneca’s coronavirus vaccine had been spurned by some rich countries in preference for messenger RNA shots like those made by Pfizer-BioNTech and Moderna. But the Anglo-Swedish vaccine is getting a second look as much of the world scrambles to inoculate itself against the highly transmissible delta variant. Amid a prolonged outbreak in Sydney, Australia’s vaccine authority now advises all adults in the country’s largest metropolitan area to “strongly consider getting vaccinated with any available vaccine including covid-19 vaccine AstraZeneca.” (Pietsch, 7/28)

I first started noticing them in December during one of the many walks, hikes and bike rides that became part of my routine during the pandemic: Sad little face masks that once served as the last wall of defense against unwanted germs were now unceremoniously tossed to the side. I saw this new trash on sidewalks, in the streets, on hiking trails, in parks and on the beach. There was even one hanging from a tree branch — I assume placed there so the owner could recover the lost item if retracing his or her steps? Using my iPhone and Hipstamatic app filters — which transform otherwise simple images into textured pieces of art — I began a pandemic project of documenting each one I found along the way. (Kinney, 7/28)

Human connection lies at the heart of addiction treatment. From the “inebriate homes” of the 19th century to the church basements later colonized by Alcoholics Anonymous, systems of mutual support and accountability have long been a vital part of achieving and maintaining sobriety. When America shut down in the spring of 2020 in an effort to stop the spread of the virus, those systems disintegrated. Treatment centers closed, and recovery meetings went virtual. Former drug and alcohol users who had long been warned that isolation was a precursor to relapse were suddenly instructed not to leave their homes. (Jamison, 7/29)

Leslie Lyons is a veterinarian and specialist in cat genetics. She is also a cat owner and general cat partisan who has been known to tease her colleagues who study dog genetics with the well-worn adage that “Cats rule. Dogs drool.” That has not been the case with research money and attention to the genetics of disease in cats and dogs, partly because the number of dog breeds offers variety in terms of genetic ailments and perhaps because of a general bias in favor of dogs. But Dr. Lyons, a professor at the University of Missouri, says there are many reasons cats and their diseases are invaluable models for human diseases. She took up the cause of cat science this week in an article in Trends in Genetics. (Gorman, 7/28)

Charlotte Cho first came face to face with pimple patches while working in Seoul more than a decade ago. The Korean American entrepreneur, who was an international corporate communications manager for Samsung at the time, was fascinated to see co-workers dressed in suits and heels arrive at work and attend important meetings with little round stickers on their faces. “It was very common for both men and women to have these clear hydrocolloid patches on their skin to treat a blemish or after a laser treatment,” Cho recalled. (Hydrocolloids are thin, film-like dressings.) (Mandell, 7/27)

Almost a decade after the daily HIV-prevention pill hit the market, long-acting forms of this public health tool, including a drug-infused implant meant to last a year, have shown promise in clinical trials. Experts believe such medications could launch a new era in HIV prevention, one that is long overdue for Black, Hispanic and younger people, who have been particularly prone to missing doses and dropping out of prevention programs. (Ryan, 7/28)

The United States has a narrow window to prepare for a safe and productive school year. On May 10, the Food and Drug Administration expanded the Emergency Use Authorization of the Pfizer COVID-19 vaccine to children ages 12 to 15. This added 17 million people to the eligibility pool for vaccination. Combined with 16- and 17-year-olds, who were previously eligible for Pfizer’s vaccine, the 25 million people in this age group are critical to slowing the spread of COVID-19. Yet this age group has among the lowest vaccination rates nationally. (Rebecca Weintraub, Benjy Renton and Georges C. Benjamin, 7/29)

I like to drive fast. But, as we all know, driving fast can be dangerous. So rules of the road are in place to protect all of us. All of us pay taxes, because it's mandatory to pay for the military, public safety, safety net programs, infrastructure, etc. But if taxes were voluntary, very few would pay. I could go on and on, but I think you get my point. (Chris Van Gorder, 7/29)

Since the Centers for Disease Control and Prevention first came out with its misguided policy to lift masking requirements in May, I have been calling on it to reverse course. On Tuesday, it did, but the new guidance remains just as confusing and the communication just as muddled. (Leana S. Wen, 7/29)

I breathed a sigh of relief when I saw that governments and major workplaces like Google and Facebook had started to mandate Covid-19 vaccinations. President Joe Biden announced Thursday that all federal workers will be required to get them or face regular testing, following in the footsteps of employee mandates imposed by New York City, where I live, and California. Both were coronavirus epicenters in which tens of thousands were killed. Among them was my uncle, who shared my name and died of the virus in January, mere days before he qualified for a lifesaving vaccine as a senior. (Michael T. Luongo, 7/29)

What is the difference between doubt and distrust? Doubt can be overcome by evidence. Distrust cannot. According to a recent Washington Post poll, refusal to get the COVID-19 vaccine has now become completely politicized in the USA. Among Democrats, 93% report that they’ve already gotten at least one shot or are likely to, compared with only 49% of Republicans. (McIntyre, 7/30)

The Delta variant is spreading rapidly in California and nationwide, but happily so are crackdowns by public and private employers aimed at limiting the ability of their unvaccinated workers to infect others with COVID-19. On Monday, Gov. Gavin Newsom announced new rules requiring vaccination or regular testing and masking for the 246,000 state government employees; the rules will apply as well to workers at both private and public healthcare and long-term care facilities. Similar workforce rules have popped up around the nation, including in the city of Los Angeles. (7/29)

Unions have enjoyed a substantial rise in public support in recent years — but especially last year, when many at-risk workers most needed allies. As workers faced severe illness and financial devastation, organized labor notched its highest approval ratings in nearly two decades. But now some unions seem keen on frittering away that goodwill by opposing coronavirus vaccination mandates. In so doing, they’re jeopardizing public health, the safety of their members and, ultimately, their own political influence. (Catherine Rampell, 7/29)

Despite hopes of a summer free from Covid-19 worry, the Centers for Disease Control and Prevention is now recommending that vaccinated people wear masks in certain areas. While masks are important for protecting against infections, the United States must proceed carefully. Health officials spent months assuring vaccinated Americans that they didn’t need to mask up against Covid-19 because they were protected from illness and were unlikely to spread infections to others. A return to masking for everyone could be interpreted as moving the goal posts or as a signal that experts are no longer as confident as they were in the vaccines — especially if new masking rules are not tied to specific metrics like vaccinations or if masking rules are in effect in places where hospitals are not dealing with crisis-level admissions. (Dr. Jennifer B. Nuzzo and Beth Blauer, 7/29)

Artificial intelligence (AI) is at an inflection point in health care. A 50-year span of algorithm and software development has produced some powerful approaches to extracting patterns from big data. For example, deep-learning neural networks have been shown to be effective for image analysis, resulting in the first FDA-approved AI-aided diagnosis of an eye disease called diabetic retinopathy, using only photos of a patient’s eye. (Jason H. Moore, 7/29)

In Australia, physicians and psychologists are publicly lamenting that the mental health system cannot handle the demand for new patients. During the pandemic, Australians have been seeking counseling amid growing reports of self-harm and eating disorders. The system was already deeply flawed, with limited highly-skilled psychologists and not enough hospital capacity for patients seeking support. In failing to prepare for mental health well-being during a potential crisis, nor responding adequately now, the Australian health system and government need to take responsibility for not providing people the tools they need to better themselves. (Cat Woods, 7/29)

The new Supreme Court conservative supermajority has already radically changed notions of law in some pockets of America. For proof, look no further than the brief that the state of Mississippi filed last week in the most closely watched abortion case in a generation, Dobbs vs. Jackson Women’s Health Organization, which the Supreme Court will decide next term.The case concerns the constitutionality of a 2018 Mississippi law that generally prohibits abortion after 15 weeks of pregnancy. That Mississippi passed this law is itself breathtaking. The core holding of the Supreme Court’s abortion jurisprudence — reaffirmed as a “super duper precedent” by Chief Justice John G. Roberts Jr. at his confirmation hearing — is that the state is constitutionally forbidden from interfering with a woman’s decision to terminate a pregnancy before the fetus reaches viability, roughly at 24 to 28 weeks. (Harry Litman, 7/29)

As health care companies raised a record-breaking $31.6 billion during the first quarter of 2021, investors drove home two big points: Health care providers adopted digital technologies like virtual care solutions in astonishing numbers as they pushed through the worst of the Covid-19 pandemic. Health care innovation is just getting started. I’ve never been more optimistic about the opportunities to dramatically change health care. (Kieran Murphy, 7/30)

The elderly population in America is growing. For the first time in U.S. history, adults over the age of 65 are on pace to outnumber children under 18 by 2034. With this demographic shift comes a greater demand for health services and a need to innovate care delivery systems in order to meet those demands. (Dr. Richard Stone, 7/29)

New data from the National Institute on Aging (NIA), part of the National Institutes of Health, show that our nation needs a fundamental shift in how Alzheimer’s research and clinical trials are designed and funded to overcome urgent health equity challenges. Alzheimer’s — a progressive brain disease that slowly erodes memory and executive function over time — disproportionately affects people of color, yet health disparities in Alzheimer’s treatment and research remain under-addressed. (Jason Resendez and Stephanie Monroe, 7/29)

While the delta variant and recent surge in the number of COVID-19 cases has reminded us that the pandemic is not over, Texas has taken an important step toward keeping its people safe and the economy strong by establishing the Texas Epidemic Public Health Institute, or “TEPHI” for short. Created by the passage of Senate Bill 1780 and recently signed into law by Gov. Abbott, TEPHI will initially steer us safely through the final phases of COVID-19 and then transition to better prepare Texas for future pandemics. (Eric Boerwinkle and John Zerwas, 7/30)

Many Americans take good nutrition for granted. They shouldn’t. Hunger is a growing problem in the U.S. In 2019, more than 1 in every 10 American households suffered from food insecurity, meaning that they lacked access to enough food for an active, healthy life for all household members. The Covid-19 pandemic made things worse. The need for food assistance increased as millions of families — according to one estimate, nearly 1 in 4 U.S. households across the country — experienced food insecurity, the result of pandemic-related factors such as job loss. (Christina Severin and Erin McAleer, 7/30)