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The majority of Supreme Court justices on Friday seemed willing to let the federal government’s healthcare worker COVID-19 vaccine mandate go into effect while appeals continue in lower courts. But justices seemed more skeptical of the Labor Department’s ability to require a broad requirement for staff at primarily non-healthcare businesses to be vaccinated or get tested weekly, with Chief Justice John Roberts questioning if the federal government is trying to work around state and congressional powers through the requirement. The Labor Department’s Occupational Safety and Health Administration is set to begin enforcement of its own non-healthcare-specific rule on Monday, though employees won’t be required to get vaccines or weekly tests until Feb. 9. The tight deadline means the Supreme Court could issue rulings as soon as Friday evening. (Goldman, 1/7)

The Biden administration contends that under the 1970 Occupational Safety and Health statute, it was obligated to act. After all, COVID-19 has already claimed more than 800,000 lives in the United States and sickened 50 million more, many with lasting effects. But at Friday's argument, the OSHA regulation ran into a conservative buzz saw. Right off the bat, Chief Justice John Roberts cast doubt on the regulation, declaring: "This is something the federal government has never done before." (Totenburg, 1/7)

KHN: Supreme Court Weighs Biden’s Workplace Vaccine Requirements 

Notably, Friday’s arguments were held in a Supreme Court chamber with even stricter anti-covid rules than those at issue. The court is closed to most members of the public, masks are required for everyone other than the justices, and lawyers and journalists must maintain physical distance and have negative tests. As the omicron variant surges in Washington, D.C., Justice Sonia Sotomayor, who has diabetes, opted to participate remotely from her chambers at the court. Also participating remotely were two of the six lawyers, including Ohio Solicitor General Benjamin Flowers, who tested positive for covid after having a mild case over the holidays. (Rovner, 1/7)

Two attorneys from states challenging the Biden administration's vaccine and testing mandates participated in oral arguments at the Supreme Court remotely Friday due to the court's Covid-19 protocols. In addition, Justice Sonia Sotomayor took part from her chambers, but she is not ill, the court said. (de Vogue and Sneed, 1/7)

USPS is watching the case with a careful eye, as it recently warned the Occupational Safety and Health Administration that implementing the rule at the wrong time could have “catastrophic” results. Should the mandate survive the Supreme Court, USPS is seeking a 120-day exemption from its enforcement. (Katz, 1/7)

Federal government agencies are preparing to take increasingly harsh steps against unvaccinated employees in order to implement President Biden’s COVID-19 vaccine mandate for federal workers.  Some agencies plan to send letters warning of possible suspensions to employees who have not complied with the mandate. Many are also prepared to fire employees who don’t follow the rule, though such moves would be further down the road. (Gangitano and Chalfant, 1/9)

The Louisiana Supreme Court on Friday unanimously upheld a COVID-19 vaccine mandate for the state’s largest healthcare system. The ruling was handed down the same day that the U.S. Supreme Court heard arguments about the Biden administration’s order for companies with at least 100 employees to require vaccination or testing. (McConnaughey, 1/7)

Citigroup Inc. was the first major Wall Street bank to impose a strict Covid-19 vaccine mandate: Get a shot or face termination. With its deadline fast approaching, the company is preparing for action. Office workers who don’t comply by Jan. 14 will be placed on unpaid leave, and their last day of employment will come at the end of the month, according to a message to staff seen by Bloomberg. While some of the employees will be eligible for certain year-end bonus payments, they’ll have to sign an agreement that states they won’t pursue legal action against the company to receive the funds, according to the message. (Surane, 1/7)

Arkansas Gov. Asa Hutchinson (R) said large businesses should not comply with the Biden administration's "oppressive" mandate for COVID-19 vaccinations or testing that's due to take effect Monday. Hutchinson told CNN's "State of the Union" Sunday the requirement "needs to be struck down" and urged Arkansas businesses with 100 or more employees affected by it to wait for the Supreme Court ruling on the matter. (Falconer, 1/9)

The seven-day average for newly reported cases in the U.S. topped 700,000 for the first time, data from Johns Hopkins University show, as the highly infectious Omicron variant spreads throughout the country. The average of known cases could soon triple the pre-Omicron record set a year ago, when the U.S. briefly saw about a quarter million daily cases. The numbers reported by state health departments and collected by Johns Hopkins also likely reflect a fraction of the true number, due in part to Omicron’s rapid spread and the difficulty many Americans have had getting tested. Some laboratories are limiting test-processing to certain people such as those with symptoms because of the surge in demand. (Kamp, 1/9)

The extremely transmissible Omicron variant is spreading quickly across the United States, making up a vast majority of U.S. cases after becoming dominant in the week before Christmas. The Centers for Disease Control and Prevention have said that it is still too soon to predict the full impact Omicron could have on deaths and illness across the country. But data in some of the earliest-hit cities is beginning to show what the future could hold. (Leatherby and Lutz, 1/9)

Hospitalization rates among the youngest children are reaching their highest levels yet as the omicron variant spreads and babies and toddlers remain ineligible to be vaccinated, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Friday. Although hospitalization rates among the youngest children remain lower compared to many older Americans, data from the CDC indicate 4.3 per 100,000 children 4 years old and younger were hospitalized in the week ending Jan. 1. Children ages 5 to 17 had a hospitalization rate of 1.1, while adults ages 18 to 49 had a rate of 4.2. The rate among people 65 and older was 14.7 per 100,000, according to the CDC data. (Tebor, Thornton, Weintraub and Miller, 1/7)

When a health-care system crumbles, this is what it looks like. Much of what’s wrong happens invisibly. At first, there’s just a lot of waiting. Emergency rooms get so full that “you’ll wait hours and hours, and you may not be able to get surgery when you need it,” Megan Ranney, an emergency physician in Rhode Island, told me. When patients are seen, they might not get the tests they need, because technicians or necessary chemicals are in short supply. Then delay becomes absence. The little acts of compassion that make hospital stays tolerable disappear. Next go the acts of necessity that make stays survivable. Nurses might be so swamped that they can’t check whether a patient has their pain medications or if a ventilator is working correctly. People who would’ve been fine will get sicker. Eventually, people who would have lived will die. This is not conjecture; it is happening now, across the United States. “It’s not a dramatic Armageddon; it happens inch by inch,” Anand Swaminathan, an emergency physician in New Jersey, told me. (Wong, 1/7)

About 24% of US hospitals are reporting a "critical staffing shortage," according to data from the US Department of Health and Human Services, as public health experts warn the Covid-19 surge fueled by the Omicron variant threatens the nation's health care system. "Given how much infection there is, our hospitals really are at the brink right now," Dr. Ashish Jha, dean of Brown University's School of Public Health, told CNN on Sunday. (Andone and Cullinane, 1/9)

A hospital in eastern Kansas ran out of ventilators Friday as the state continued to report a surge in COVID-19 cases. The Lyons County Board declared a local emergency Friday after the Newman Regional Health hospital in Emporia ran short of ventilators. The Kansas City Star reports that the emergency declaration will help the hospital receive two additional ventilators from the state’s Emergency Operations Center. (1/9)

A weeklong stretch of record-setting coronavirus numbers continued uninterrupted Sunday, with area hospitals reporting across-the-board spikes in admissions, intensive care patients and ventilator use. The region's four main health care systems were treating 1,283 COVID-positive patients Sunday, the St. Louis Metropolitan Pandemic Task Force reported. That figure surpassed Saturday's all-time peak of 1,219. An average of 1,139 patients were in the hospital for COVID each day of the past week — another record — up from 1,085 on Saturday. (Schrappen, 1/9)

Los Angeles County reached another daily record of coronavirus cases as health officials on Sunday reported more than 45,000 new infections. The county recorded 45,584 new cases amid the surge in infections driven by the highly contagious Omicron variant of the coronavirus, according to figures released by the county’s Department of Public Health. The department also reported 13 new deaths, bringing the county’s total number of deaths to 27,785 since the start of the COVID-19 pandemic. (Vega, 1/9)

Pandemic forecasters in Texas say the state’s current surge of omicron infections and hospitalizations is likely to get much worse before it gets better, with hospitalizations expected to continue climbing for at least three weeks if social behaviors don’t change and slow the trend. Across the nation, hospitalizations are already on the verge of breaking new pandemic records. In Texas on Thursday, according to state data, about 9,200 people were hospitalized with COVID-19 — far short of the record 14,218 hospitalizations from Jan. 11, 2021. (Brooks Harper and Astudillo, 1/9)

Pennsylvania hospitals say the vast majority of hospitalized coronavirus patients are still unvaccinated — as high as 90% at some hospitals — even as more vaccinated people are also getting infected amid the omicron-delta surge. Over the last year, the rate of hospitalization and death among unvaccinated people in the United States has been much higher than for those fully vaccinated. But now as more immunized people get breakthrough cases of the omicron variant of the virus, the protection provided by the vaccine has been proven again and again, doctors say. While the shots do not always prevent mild or asymptomatic infections, the risk of not being vaccinated is on grim display, they say, pointing to their overflowing wards and strained intensive care units. (McDaniel and McCarthy, 1/7)

With Massachusetts hospitalization rates now climbing higher than last winter, four leaders of hospitals and health systems say their workers have done their part — and now it’s time for the public to do its part by getting vaccinated, boosted, and wearing masks. “We are here for you and your families, whether you have been vaccinated or not. We will do our part; we ask that you do yours,” they said in a Globe op-ed. The state reported Thursday that 2,524 patients with COVID-19 were in the hospital. That exceeds the peak during last winter’s deadly surge of 2,428 on Jan. 4, 2021. (Fatima, 1/7)

The omicron wave that has whiplashed the world with surging cases has peaked after approximately four weeks in a large South African hospital in the City of Tshwane where the global outbreak first started, according to a recent paper. The research, which is not yet peer-reviewed, compared 466 hospital COVID-19 admissions at the Steve Biko Academic Hospital since Nov. 14, 2021 (when the omicron outbreak began) to 3976 prior admissions at the same hospital before the outbreak began. (Sudhakar, 1/9)

Gov. Ron DeSantis on Friday defended his administration’s decision to allow up to one million Covid-19 rapid test kits to expire, a move that comes as he is facing increasing criticism from Democrats over his handling of the Omicron surge. Florida Division of Emergency Management Director Kevin Guthrie admitted during a Thursday press conference that the tests expired, and DeSantis on Friday sought to explain why the state didn’t distribute them. DeSantis has argued that the stockpile resulted from a lack of demand in the later part of 2021 and blamed President Joe Biden’s administration for not granting extensions to keep the tests eligible — something it did in September for three months. (Dixon, 1/7)

With coronavirus tests nearly impossible to find in the Bay Area — and San Francisco health officials saying they will limit testing early this week because of “challenges beyond our control” — California officials are now warning against price gouging for at-home test kits. California Attorney General Rob Bonta issued a consumer alert Saturday about sellers charging exorbitant prices for over-the-counter rapid tests, after Gov. Gavin Newsom signed an executive order over the weekend limiting sellers’ markups. Unauthorized test sites also are becoming a concern, San Francisco health officials warned. (Flores, 1/9)

California would spend $2.7 billion on new efforts to respond to the surge in COVID-19 cases, including additional testing capacity and assistance to hospitals, under a budget proposal Gov. Gavin Newsom will send to state lawmakers next week. Newsom will also ask legislators to help craft new COVID sick pay rules for Californians, modeled after the policy that expired last fall, requiring businesses with 26 or more workers to offer up to two weeks of supplemental paid sick leave for employees to care for themselves or a family member. (Myers, 1/8)

The Biden administration's plan to send 500 million at-home tests to Americans for free is an historic undertaking, but one that will take weeks or months to fully execute, recently released contracts and interviews with seven test manufacturers suggest. Contracts for the first two batches of tests were announced on Friday, one for 13.3 million kits from a health technology company and another for an undisclosed amount from a distribution company in Virginia that had extras on hand -- all to be distributed in an effort to reduce the massive testing shortage in the U.S. (Haslett and Abdelmalek, 1/10)

Escalating demand for Covid-19 tests is prompting some laboratories to ration access, giving priority to people with symptoms or other health concerns as the Omicron variant quickly spreads. Triaging who is eligible for Covid-19 tests can help ensure that patients who need a test the most get results fast enough to isolate or get treatment, pathologists and public-health experts say. The strategy, however, risks perpetuating the virus’s spread if some people get turned away from testing altogether. (Abbott, 1/9)

At-home rapid coronavirus tests remain the “bedrock of our long-term strategy for managing this virus,” said Ashish Jha, dean of the Brown University School of Public Health — even in the face of new research that suggests they may be less effective at identifying illness caused by the omicron variant. The antigen tests, commonly referred to as rapid or at-home tests, “remain a very, very effective tool,” Jha said on ABC’s “This Week.” He noted that “in the first day of symptoms” with omicron, “it does look like the test is a little less sensitive,” but beyond that, “these antigen tests continue to work really effectively.” (Pietsch and Hassan, 1/10)

Early data suggests virus particles from COVID variants – including omicron – may appear in the throat before reaching nasal passages where test swabs are done. And federal regulators warn the rapid tests in general may not be as effective detecting the new variant. To make sure they don't miss an infection, some have opted to add a swab to the back of their throat as well as their nose. But federal agencies and health experts urge that at-home tests be used as directed and to not add a throat swab – for now. Throat swabbing may be called for in the future, experts say, but the tests currently authorized in the U.S. weren’t manufactured to detect virus in a person’s throat and could deliver false results. (Rodriguez, 1/8)

The good news: Rapid antigen tests can definitely detect Omicron. The bad news: Some research indicates that rapid tests may be less sensitive to Omicron than they are to other variants. That means the tests might be yielding more false negatives, especially in the early days of infection. And preliminary data from one small study suggests that people could be contagious before they get a positive result on a rapid test. (Reddy, 1/9)

As America's record Omicron surge continues, cities and states across the country have no cohesive strategy to monitor the results of at-home rapid COVID tests. This patchwork system means the official COVID case counts are almost certainly a vast undercount. Many cities don't have an accurate sense of just how prevalent COVID is as they make decisions about mask mandates, school closures and other restrictions. (1/8)

A major health care provider in Arizona will allow employees who are experiencing mild COVID-19 symptoms or are asymptomatic to keep working at its hospitals and facilities. Because of the omicron variant’s rapid spread in Maricopa County and in anticipation of a continued increase, Dignity Health officials said they have enacted the “third tier” of the federal guidelines for health care workers with the coronavirus. (1/9)

As the raging omicron variant of COVID-19 infects workers across the nation, millions of those whose jobs don’t provide paid sick days are having to choose between their health and their paycheck. While many companies instituted more robust sick leave policies at the beginning of the pandemic, some of those have since been scaled back with the rollout of the vaccines, even though omicron has managed to evade the shots. Meanwhile, the current labor shortage is adding to the pressure of workers having to decide whether to show up to their job sick if they can’t afford to stay home. (D'Innocenzio and Durbin, 1/9)

As COVID-19 hospitalizations climb into uncharted territory, fueled by the highly contagious omicron variant, Maryland’s medical workforce is increasingly diminished by illness and exposure, burnout and turnover. Gov. Larry Hogan has responded with pleas for people to get vaccinated and boosted and wear masks to spare the hospitals. The state opened several testing sites near hospitals so people would stop flooding emergency rooms with nonemergencies. (Cohn and Miller, 1/8)

Erine Cressell worked as a hospital nurse for 15 years, with dreams of finishing an advanced degree and treating patients with addiction issues in her corner of Appalachia. That was before the pandemic. Beginning in 2020, she spent most of her days diverted to her hospital’s emergency room, tending to people who would have been admitted to the floors above, if only there was enough staff there to care for them. After her 12-hour shifts, she sometimes would sit on a curb in the hospital parking lot and cry. Then she would drive 45 minutes to her home in Glen Lyn, Va., and do her second job—which was supposed to be her only job—compiling data for the hospital’s quality department. Sneak in a little sleep, and repeat. (Feintzeig, 1/10)

“Most pharmacists who’ve been in the field for a while, have been telling students ‘just stop, don’t go to pharmacy school, do something else, anything else,’” one clinical pharmacist in Boston said. “I’m hoping that the people who are going into pharmacy school are doing it because they truly have a passion for it and will fight for it and want to do nothing else with their lives.” This pharmacist, who asked to remain anonymous for job security, said she’s faced challenges unique to the COVID era, including staffing shortages due to COVID outages and people leaving the industry. She’s even been asked to come into work while caring for her COVID-positive child, she said. (Sokolow, 1/9)

With infection rates mounting, the Omicron variant has ushered in a new and disorienting phase of the pandemic, leaving Americans frustrated and dismayed that the basic elements they thought they understood about the coronavirus are shifting faster than ever. (Bosman, 1/9)

Like so many COVID-weary Americans, Kyle Hopwood thought the pandemic was winding down over the summer, as virus case counts in the Chicago area waned and life seemed to inch closer to normal. She was relieved after getting vaccinated against COVID-19, and tentatively began dining at restaurants and resuming small get-togethers with loved ones. Hopwood and her fiance set a wedding date for September 2022, assuming that by then the pandemic would be a distant memory. (Lourgos, Presa and Lee, 1/9)

A series of messaging missteps is threatening the credibility of federal health agencies, and critics say the White House isn’t doing enough to manage the fallout. While much of the unvaccinated population is unlikely to be persuaded by any messenger, large swaths of the public are still receptive to expert guidance, but federal health agencies, particularly the CDC, may be squandering their credibility with this population. (Owens, 1/10)

On Friday, the Centers for Disease Control and Prevention held a telebriefing.Director Rochelle Walensky presided, along with two career scientists. The substance was notable — updated COVID-19 guidance for K-12 schools. But even more notable was the fact that the briefing was happening at all. It was the first such briefing in months, despite the ongoing pandemic crisis. That lack of regular communication has spurred criticism of the agency. In recent days, public health experts have called out CDC for confusing isolation and quarantine guidance, and asked the agency to communicate more often and more clearly. (Simmons-Duffin, 1/7)

New York Rep. Alexandria Ocasio-Cortez has tested positive for COVID-19 and “is experiencing symptoms and recovering at home,” her office said in a statement Sunday evening. The Democratic congresswoman’s office said Ocasio-Cortez received a booster shot last fall, adding that she “encourages everyone to get their booster” and follow the guidance of the Centers for Disease Control and Prevention. (1/10)

Tennessee Rep. Jim Cooper (D) announced that he has tested positive for COVID-19, making him at least the third lawmaker of the weekend to announce a breakthrough case of the virus. "This morning I tested positive for COVID-19," Cooper, 67, said in a tweet on Saturday. "Thankfully I only have mild symptoms because I have been vaccinated and received my booster. Everyone should be vaccinated and boosted as soon as they’re able. It’s the best way to protect yourself and your loved ones." (Choi, 1/9)

U.S. Rep. Sean Casten of Illinois has tested positive for a breakthrough case of COVID-19, according to his office. The suburban Chicago Democrat’s office released a statement Saturday saying Casten was fully vaccinated and had received a booster vaccine dose. He described his symptoms as “mild” and said was in isolation. (1/9)

A new strain of the coronavirus appears to be a genetic fusion of currently known omicron and delta variants, a researcher claims. The so-called "deltacron" strain pairs omicron genetic signatures with delta variant genomes, says Leondios Kostrikis, a professor of biological sciences at the University of Cyprus, according to CNBC. While 25 cases of the uniquely recognizable strain have been found, Kostrikis predicted it will not last against the globally dominant omicron variant. (Richard, 1/8)

A researcher in Cyprus has discovered a strain of the coronavirus that combines the delta and omicron variant, Bloomberg News reported on Saturday. Leondios Kostrikis, professor of biological sciences at the University of Cyprus, called the strain “deltacron,” because of its omicron-like genetic signatures within the delta genomes, Bloomberg said. So far, Kostrikis and his team have found 25 cases of the virus, according to the report. It’s still too early to tell whether there are more cases of the strain or what impacts it could have. (Bursztynsky, 1/8)

Doctors studying Omicron's spread around the world have found new clues to the pattern of symptoms caused by the highly-mutated COVID-19 variant, which a growing number of reports suggest might show up differently and faster compared to the Delta variant it is now displacing. ... A sore throat ranked among the most common early Omicron symptoms, as well as congestion, a dry cough and lower back pain. The incubation period — the time from infection to symptoms appearing — was as short as three days. That's several days faster than previous strains of the virus. (Tin, 1/7)

As the super contagious omicron variant of the coronavirus spreads, hospitals are seeing a growing trend: Patients admitted for other ailments are also testing positive for Covid-19. Doctors say it may mean more people have asymptomatic or undiagnosed disease than the current data show. Across NewYork-Presbyterian Hospital’s 10 campuses, just less than half of patients are admitted with Covid, meaning they were hospitalized for a non-Covid related issue but were also tested and found to be carrying the virus. Statewide the figure is 43 percent, according to state data. (Lovelace Jr., 1/8)

Theresa Camarena used to be able to workout and walk her dog in the same day. She used to be able to unload the dishwasher without experiencing shortness of breath. She used to be able to work four days a week. Camarena, 63, works as a respiratory therapist and started the pulmonary rehabilitation program at Franciscan Health Crown Point more than 30 years ago. She has worked there for 43 years. On July 20, 2020, Camarena, a mother of three who lives in Hobart, tested positive for COVID-19, she said. (Kukulka, 1/9)

At least 3,626 children across North Carolina — mostly students of color — are currently coping with the death of a caregiver due to COVID-19. Schools will bear responsibility for supporting children who’ve experienced this loss as they learn and grow over the next two decades. Research published in October in the journal Pediatrics revealed the high toll caregiver deaths are taking on children nationwide, particularly Native American, Hispanic, and Black children. The researchers used fertility, household composition data, and COVID-19 and excess death rates to estimate what they termed “COVID-19-associated orphanhood.” They estimated at least 1,855 children in North Carolina lost a caregiver between April 1, 2020 and June 30, 2021. Updated estimates now put this number even higher. (Dukes, 1/8)

The federal government has resumed shipping all three monoclonal antibody treatments authorized for early-stage covid-19 to states despite evidence that two might be ineffective against the omicron variant of the coronavirus that is sweeping the country. The move has drawn mixed reactions from physicians and experts. Some are concerned many of the costly infusions will be useless, causing confusion among patients who have heard glowing reports about the treatments. (Bernstein, McGinley and Shepherd, 1/9)

Gov. Ron DeSantis has criticized the Biden administration for not sending Florida more monoclonal antibody treatments to reduce the risk of severe COVID-19. But experts say most of these experimental treatments aren't effective against the omicron variant, and the one that does work is in short supply nationwide. After proving helpful during Florida's delta surge, early data now suggests the monoclonal antibody treatment made by Regeneron doesn't work well against omicron. Neither does one made by Eli Lilly, which is why the federal government temporarily paused its distribution in December. The only antibody therapy that does appear to be effective against omicron is one made by British drugmaker GlaxoSmithKline, with U.S. partner Vir Biotechnology, called sotrovimab. (Colombini, 1/7)

The Covid-19 treatments came as a surprise, care of the Florida Department of Health: six big, mysterious boxes that showed up at Nicholas Suite’s iCare Mobile Medicine clinic near Miami on the morning of Dec. 24. “We were wondering, what’s this? Who sent us presents? Did Santa land on the roof?” he said. “Then we opened it up and thought, ‘This is Evusheld! My goodness!'” To some infectious disease doctors, that shipment has worrisome implications. When they looked at a government database, they saw that Suite’s tiny private company had gotten more of the federal supply of this scarce therapy than some of Florida’s major hospitals. In fact, iCare Mobile received enough for 264 courses — the most the health department sent to any of the state’s providers in its first shipment of Evusheld. (Boodman, 1/7)

Increasing access to COVID-19 booster shots would make a big dent in hospitalizations and unnecessary deaths, new research shows. Tripling the pace of booster vaccination from 770,000 doses per day to 2.3 million could reduce the expected number of COVID-19 hospitalizations by more than 35% and deaths by nearly 30% through April, according to new data from the Commonwealth Fund. While hospital admissions are expected to peak at approximately 30,000 per day near the end of January, tripling booster vaccination would reduce the peak to 21,000 and significantly reduce the duration of the surge, the study found. (Kacik, 1/7)

Two COVID-19 vaccine studies published today respectively identify risk factors for severe outcomes among adults given two doses and describe cancer patients' antibody response to two or three doses. Severe COVID-19 was defined as hospitalization for acute respiratory failure, the need for noninvasive ventilation, intensive care unit (ICU) admission (including those needing invasive mechanical ventilation), or death (including release to hospice). (Van Beusekom, 1/7)

Singapore saw the fewest deaths among those administered with a Moderna Inc. shot and the most among those who received Sinovac Biontech Ltd.’s vaccine, as the city-state’s highly inoculated population provides a glimpse into how different immunizations are holding up in the real world. Of the 802 people who died from Covid-19 last year in the city-state, 555 or about 70% weren’t fully vaccinated, health minister Ong Ye Kung told the parliament Monday, showing the life-saving impact of inoculation. Singapore found 11 deaths per 100,000 among people who received Sinovac shots and 7.8 deaths among those with Sinopharm. This number fell to 6.2 deaths for those with mRNA shots from Pfizer Inc.-BioNTech SE and 1 fatality in those who were administered the vaccines from Moderna. (De Wei, 1/10)

Every state requires children to receive an array of vaccinations before they enroll in school. Typically, those inoculations are for protection against polio, diphtheria, pertussis, measles, rubella, mumps, tetanus, meningitis and chickenpox. Even though COVID-19 has claimed around 830,000 lives in the United States, including fewer than 700 children, only two states—California and Louisiana—have added COVID-19 vaccines to the list of immunizations mandated for schoolchildren. Both requirements would be enforced next school year, and then only if the vaccines receive full authorization by the U.S. Food and Drug Administration. The FDA has granted emergency authorization and asserted that the vaccines are safe and effective for children. (Ollove, 1/7)

Chicago Mayor Lori Lightfoot continued her bruising attacks against the city's teachers union, but said she remains "hopeful" a deal can be reached on Sunday to get children back into their classrooms. The teachers union for the nation's third-largest school district voted last week to shutter classes in a Covid-related labor dispute. (Wolan, 1/9)

New York City school officials fought to keep schools open through a record-breaking surge of Omicron cases. Now, students, parents and teachers are grappling with the consequences. Some 300,000 students missed class on average this week in the nation’s largest school district, which serves 1 million. For others, going to class in-person consisted of little actual learning as students were herded into auditoriums with teachers in short supply. Students stuck at home had no virtual option, and parents had to decide whether to send their children in or risk them falling further behind after years of disrupted, pandemic education. (Querolo, 1/8)

For Los Angeles Unified – the second largest public school system in the US – classes are scheduled to resume on Tuesday, and educators, students, and parents alike are bracing for another winter of anxious uncertainty. Schools here are grappling with coronavirus conundrums that institutions across the country are facing – but on a huge scale. Vaccination rates continue to lag among children, and tests are in short supply. And all this comes as rates of Covid surge in the surrounding community, with about one in every five coronavirus tests in Los Angeles coming back positive. (Singh, 1/10)

The state Department of Public Health has relaxed some guidelines for Georgia school districts in their efforts to fight COVID-19 in the classroom. A letter sent Thursday by Gov. Brian Kemp and DPH Commissioner Dr. Kathleen Toomey says educators and school staff who are exposed to COVID-19 can return to work, regardless of their vaccination status or when they were exposed “if their employer deems it necessary to ensure adequate staffing.” (Dixon, 1/10)

Montgomery County Public Schools announced Sunday that 11 schools with a spike in coronavirus cases will remain virtual this week and return to in-person classes Jan. 18. They also say they will give all students in the county KN95 masks in an effort to limit coronavirus transmission in schools. (Klein and St. George, 1/9)

In a sign of the growing difficulty of keeping schools open, more than a third of Baltimore City schools will switch to online learning Monday after test results that came in over the weekend showing thousands of students and staff may have COVID-19. The school system listed 57 schools transitioning temporarily to online learning on its website Sunday evening. Two other schools were closed for what was described as facilities challenges. The city has 155 schools. (Bowie, 1/9)

Bangor-area schools have begun to see a rise in COVID-19 cases in the week since students returned from their winter break. And school leaders and state officials expect numbers over the next week to keep increasing as the return of regular virus testing picks up new cases. The Maine Department of Education on Thursday reported that schools had detected 4,946 COVID-19 cases among staff and students over the past 30 days. That represented a 20 percent decline from the department’s last report, on Dec. 23, of cases reported over the past 30 days. But the decline was a reflection of the fact that schools were closed over Christmas and New Year’s and didn’t report new cases in that time, said Kelli Deveaux, a Department of Education spokesperson. (Russell, 1/9)

The union representing Southwest Airlines flight attendants says the company is refusing to enforce mask mandates with pilots, on and off airplanes. Transport Workers Union Local 556, which represents 15,400 flight attendants, said Friday that many of the carrier’s pilots are not only going maskless in the cockpit as allowed by Federal Aviation Administration rules but they’ve also dropped face coverings during on-ground training. The union said its members are still required to wear masks and are reprimanded if they don’t. (Arnold, 1/7)

Shortly after the controversial Biogen drug for Alzheimer’s was approved in the U.S. last year, a pair of state Medicaid directors tried to ring alarm bells. In a terse letter, they implored the Biden administration to ensure Medicare covers the medicine, despite limited effectiveness and a $56,000 price tag. Their reasoning was simple: If Medicare reacted to the highly questionable approval by withholding or restricting coverage, Medicaid would be left holding the proverbial bag, because by law it must cover drugs endorsed by the Food and Drug Administration. And if that happened, they warned, Medicaid would have a big money problem. (Silverman, 1/10)

Amid its sputtering launch, Biogen expects to receive a draft decision on Aduhelm’s coverage on Medicare next week. Industry watchers have been calculating a range of potential scenarios, but whichever direction the ruling goes, doctor feedback suggests it may simply not matter that much. A reimbursement decision on Aduhelm in Alzheimer’s disease from the Centers for Medicare and Medicaid Services (CMS) could go five different ways, with one that appears to be the most probable, a Jefferies team led by analyst Michael Yee wrote in a note this week. The government agency is due to deliver a preliminary decision on whether to cover the drug for elderly people by Jan. 12, with a final verdict scheduled for April. (Liu, 1/6)

The Biden administration wants to rein in fees charged in Medicare by controversial middlemen that play a crucial behind-the-scenes role in the pharmaceutical pricing system. It would be a huge win for pharmacies, which have been lobbying in Washington for the change for years. The proposal would also lower out-of-pocket costs for some Medicare patients, but not all, as plans would likely raise premiums to compensate. The Centers for Medicare and Medicaid Services said the agency expects “more than half” of traditional Medicare patients would see lower total costs. (Cohrs and Silverman, 1/7)

Bayer, the German pharmaceutical and agriculture firm, will pay California-based Mammoth Biosciences, a CRISPR-focused startup cofounded by Nobel laureate Jennifer Doudna, $40 million to work on gene-editing technologies in four different diseases, the firms said Monday. The companies said Bayer could eventually pay Mammoth milestones in excess of $1 billion if the projects pan out. Mammoth could receive royalties of up to a low double-digit percentage of sales on marketed products. (Herper and Molteni, 1/10)

Pharma marketers don’t understand what healthcare professionals need—and, worse, they're overwhelming doctors with drug promos at the expense of more tailored content.  This is according to a new report, the Digitally Savvy HCP, out from healthcare solutions company Indegene, which has been tracking these relationships for the past few years. This report focuses on just under 1,000 physicians from the U.S., Europe, India and China. It makes for some grim reading for pharma sales folks: 70% of healthcare professionals (HCPs) surveyed by the company feel that reps “do not completely understand their needs and expectations,” while 62% of HCPs are “overwhelmed” by product-related promotional content they receive from drugmakers. (Adams, 1/10)

State health workers still often can’t use computers, access shared drives and get to important data a month after a cyberattack crippled Maryland’s health department, the head of a union representing agency employees said Friday. They’ve received little information about what’s going on and are preparing for the possibility that their systems could remain impaired for some time. (Thompson, Wiggins and Cox, 1/8)

A Health and Human Services agency is encouraging healthcare providers, public health agencies and other organizations to consider adopting a new data standard for documenting patient addresses in healthcare. The Office of the National Coordinator for Health Information Technology on Friday released the final version of Project US@, a technical specification designed as an industrywide data standard for patient addresses. ONC has been working on Project US@ with standards development and health IT organizations since launching the effort in early 2021. (Kim Cohen, 1/7)

Psychologists, social workers and therapists employed at Kaiser Permanente's Oakland and Richmond, California, clinics will go on strike for a day to protest Martin Luther King Jr. Day not being a paid holiday. The strike is set to take place Monday, Jan. 17, outside Kaiser Permanente's Oakland Medical Center and corporate headquarters in downtown Oakland. Around 200 workers plan to march alongside allies and elected officials. The strike is the latest move by Kaiser Permanente employees to address issues of structural racism within the organization, said Ixayanne Baez, a marriage and family therapist at Kaiser Permanente's Oakland clinic. (Devereaux, 1/7)

KHN: Black-Owned Hospice Seeks To Bring Greater Ease In Dying To Black Families

This time, it didn’t take much persuading for Mary Murphy to embrace home hospice. When her mother was dying from Alzheimer’s disease in 2020, she had been reluctant until she saw what a help it was. So when her husband, Willie, neared the end of his life, she embraced hospice again. The Murphys’ house in a leafy Nashville neighborhood is their happy place — full of their treasures. “He’s good to me — buys me anything I want,” she said, as she pulled a milky glass vase out of a floor-to-ceiling cabinet with mirrored shelves. (Farmer, 1/10)

The Americans With Disabilities Act has been in force for more than three decades. But do doctors understand their legal obligations under the law — and are they doing all they can to accommodate patients with disabilities? In a word: No. That’s the message of a study in Health Affairs that points to significant knowledge gaps among the providers — and suggests that nearly three-quarters of outpatient physicians don’t understand how to accommodate their patients’ disabilities. (Blakemore, 1/9)

Beginning this month, a new law that was years in the making bans certain unexpected medical bills. However, advocates say it’s important for consumers to still be on the lookout for these charges and to know what steps to take if they get hit with one anyway. “Unfortunately, providers aren’t going to write ‘Surprise!’ on top of a now-illegal bill,” said Caitlin Donovan, a spokeswoman for the National Patient Advocate Foundation. “It’ll be up to patients to recognize when the new protections should apply.” (Nova, 1/7)

There will be no crowded lobbies or $100 chair rentals at this year’s J.P. Morgan Healthcare Conference. But the trillion-dollar life sciences industry’s biggest annual meeting, forced onto Zoom by Omicron, will still attract attention from around the world as investors, executives, and others look to answer critical questions about the future of sectors like biotech and health tech. Is there a second act for mRNA companies? Was teletherapy just a pandemic fad? Can Biogen salvage its foundering treatment for Alzheimer’s disease? And will 2022 be the year of the buyout? (1/9)

Older people who have cataracts removed may be gaining more than better vision. Research published in JAMA Internal Medicine suggests that they are nearly 30 percent less likely to develop dementia, including Alzheimer’s disease, than are people with cataracts who do not have the surgery. (Searing, 1/9)

Exercise is good for you. Breaking a sweat has been shown to improve nearly every organ in the body, fight nearly every disease doctors diagnose and improve nearly every health condition that you might live with on a daily basis. It gets even better. A new study finds exercise boosts levels of a protein known to strengthen communication between brain cells via synapses, which may be a key factor in keeping dementia at bay. (LaMotte, 1/10)

Researchers have identified a possible link between psychological stress and Crohn's disease. In a study led by Canada's McMaster University and the Farncombe Family Digestive Health Research Institute, and published in the journal Nature, the authors said that mouse models found that stress hormones suppressed the innate immune system that normally protects the gut from Enterobacteriaceae. Enterobacteriaceae is a group of bacteria, including E. coli, which has been linked to the inflammatory disease of the gastrointestinal tract. (Musto, 1/8)

About 14,976 pounds of beef sticks sold at Walmart and other retailers nationwide were recalled Saturday because of misbranding and failure to declare milk, a known allergen, on its product label. The beef sticks come from the Wisconsin-based company Abbyland Foods Inc. and came in packages labeled "Iowa Smokehouse Original Smoked Beef Sticks," according to an announcement from the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS). The smoked beef sticks were produced from Nov. 15 to Nov. 17, 2021 and were packaged in two-pound, clear plastic bags. (Shen, 1/9)

Digital behavioral health programs are making a bold pitch to payers, employers, and patients themselves: Shell out upfront for our virtual coaching and remote monitoring, and we’ll save you money by avoiding costly complications from diabetes and other diseases in the long run. For diabetes, which nearly tops the list of chronic health conditions by cost, many virtual programs are promoting continuous glucose monitoring as part of that promise. “We just started to see that with CGMs, it’s a foregone conclusion that they’re going to be the dominant solution,” said Sean Duffy, co-founder and CEO of digital care company Omada Health. The devices, which stream users’ blood glucose data throughout the day, are most commonly used by people who need multiple daily doses of insulin to manage their diabetes, but “this isn’t just for people who inject insulin,” said Duffy. “We decided that it was going to be table stakes and Omada needed to power CGM and coaching in a really deep way.” (Palmer, 1/10)

Women in South Dakota who are seeking a medication abortion will face additional restrictions later this month after state lawmakers approved a new rule from the state's health department. Current state law allows for the medical abortion process to begin 72 hours "after the physician physically and personally meets with the pregnant mother," except in medical emergencies, and usually only required one more visit to a licensed facility to receive the necessary drugs for the process. But on Thursday, state lawmakers on a rules review committee approved the South Dakota Department of Health's rule requiring that women receive both drugs used in a medication abortion -- mifepristone and misoprostol -- in person at a licensed abortion facility. (Stracqualursi, 1/8)

Five health centers in West Virginia will receive a total of $8.3 million from the U.S. Department of Health and Human Services. West Virginia’s two U.S. senators, Democrat Joe Manchin and Republican Shelley Moore Capito, announced the funding. (1/10)

Dr. Danny Avula, who has overseen Virginia’s vaccination efforts during the COVID-19 pandemic, has stepped down from his position. The Richmond Times-Dispatch reports that Avula, who was named state vaccination coordinator a year ago, said he has taken on other responsibilities in the Virginia Department of Health and returned to his position as director of the Richmond City and Henrico County health districts. Avula said the job switch was his decision. (1/9)

U.S. Customs and Border Protection reported a 1,066% increase in fentanyl seized in south Texas during fiscal year 2021, the agency said this week. Border patrol officers at eight ports of entry from Brownsville to Del Rio seized 87,652 pounds of narcotics, including marijuana, cocaine and fentanyl with an estimated estimated street value of $786 million. (Doherty, 1/8)

The Anchorage Downtown Partnership has changed how its safety ambassadors patrol downtown’s streets, ending a program model its executive director says resulted in some unintended negative consequences, like gaps in crime data, and increasingly led to ambassadors dealing with situations better handled by police or social service providers. Safety ambassadors are the partnership’s paid security guards who patrol downtown, working closely with the Anchorage Police Department and other emergency services. The Downtown Partnership, a nonprofit, discontinued its Safety First program on Jan. 1. The program was a collaboration with the Anchorage Community Development Authority that began in 2016. ACDA’s Easy Park ran a hotline that dispatched the safety ambassadors in response to calls about problems downtown. (Goodykoontz, 1/9)

A Florida school has a policy against teaching critical race theory, arguing that such curriculum is the result of a "controlled" message from the media. "As a school, we do not subscribe to or promote Critical Race Theory, Gender Fluidity, or the mainstream narrative surrounding Covid, all hot topics that many schools are now choosing to teach as factual rather than as the theories they are," reads a section of the website for the Centner Academy, a private school in Miami, Florida. (Lee, 1/9)

The U.S. agreed to limit military personnel’s movements off base in Japan, after regional governors blamed American troops for helping to introduce the omicron variant of Covid. For two weeks starting Monday, U.S. Forces Japan personnel will only be allowed outside military facilities for activities deemed essential, the two sides announced in a statement late Sunday. The U.S. said it had also required mask-wearing for all personnel when outside of their homes and would maintain pre-departure and post-arrival testing requirements. (Reynolds, 1/9)

Novak Djokovic, the Serbian tennis star, moved one step closer to competing for his record 21st Grand Slam title after an Australian judge ordered his release from immigration detention on Monday, ending a five-day saga over his refusal to be vaccinated for Covid-19. (Cave and Futterman, 1/9)

A year ago, Chinese health experts had hoped the country could safely reopen to the world by now, as it attained herd immunity against the coronavirus. China achieved last month the herculean goal of vaccinating more than 80 percent of its 1.4 billion people with two doses. But far from reopening, the country has returned to its harshest controls in two years, as it seeks to contain the highly contagious omicron variant. (Dou and Li, 1/10)

U.K. government advisers have recommended against giving a fourth dose of COVID-19 vaccine to nursing home residents and people over 80 because data shows that a third shot offers lasting protection against admission to the hospital. For people over 65, protection against hospitalization remains at about 90% three months after the third dose, according to data compiled by the U.K. Health Security Agency. (Kirka, 1/8)

A 51-year-old Colombian woman died by euthanasia on Saturday after a historic legal battle to exercise the right in this majority-Catholic country. The case of Martha Sepúlveda drew international attention last year when she planned to become the first person in Colombia without a terminal prognosis to die by legally authorized euthanasia. But less than two days before she planned to die in October, a medical committee determined she no longer met the conditions and canceled the procedure. A judge eventually cleared the way for Sepúlveda to move forward. (Schmidt and Duran, 1/8)

Donation data reported on websites by drug makers and patient advocacy groups in Canada that receive industry funding is “haphazard, inconsistent and incomplete,” underscoring the difficulties in deciphering the influence these companies may have on patient interests, a new analysis finds. Specifically, information about the value of donations made by drug companies, the years in which contributions were given, and the percent of income the money represented for patient groups was limited. Consequently, donations made and received often could not be matched, according to the analysis in the International Journal of Health Policy and Management. (Silverman, 1/7)

A physician friend shared a photo of a sign the staff posted in the hospital where she works. It warned readers: Do not assault us, we’re here to help you. A year ago, health care workers were being called heroes, but now they’re being attacked by the very people whose lives they’re trying to save. As a nurse and a doctor, we need you to understand the epidemic of violence that’s raging in our hospitals right now, and what’s at stake if we don’t stop it. (Dr. Shoshana Ungerleider and Sarah Warren, 1/10)

Here’s how I describe being in medical school during the coronavirus pandemic: It feels like I’m starting a job at a new building, except the building is on fire and everyone is rushing outside as they try to save their own lives. It is an appropriate comparison, as nearly 1 in 5 health care workers has left medicine since the pandemic began. The physician exodus sends a clear message to trainees like me: “It isn’t safe here.” It’s a message that has been on display again and again throughout the pandemic. (Tricia Pendergrast, 1/10)

The World Health Organization reports that more than 5 million people worldwide have died of COVID-19, with numbers rapidly rising again. When we look at how people with COVID-19 die, the most common cause is catastrophic lung failure. Once the lungs fail, other organs soon follow, like a game of Jenga when the linchpin block is removed. At this stage, even for patients thought to be previously healthy, we cannot stop the virus from wreaking havoc. It’s a painfully familiar script for many admitted to the hospital with minor breathing issues: Blood oxygen levels drop. Supplemental oxygen isn’t enough. They end up on a mechanical ventilator. Days later they are dead. (Dr. MeiLan K. Han, 1/10)

As the Omicron tsunami crashes ashore in New York City, the comforting news that this variant generally causes milder disease overlooks the unfolding tragedy happening on the front lines. As an emergency room doctor fighting this new surge, I am grateful that vaccines and a potentially less lethal variant have meant that fewer of my patients today need life support than they did at the start of the pandemic. In March 2020, nurses and doctors rushed between patients, endlessly trying to stabilize one before another crashed. Many of my patients needed supplemental oxygen and the sickest needed to be put on ventilators. Many never came off them. Our intensive care units filled beyond capacity, and yet patients kept coming. (Dr. Craig Spencer, 1/10)

On average, approximately 130 Americans die by suicide each day. Since the outbreak of COVID-19, there has been concern that stressors induced by the pandemic, such as social isolation, economic challenges, depression and limited access to healthcare services, would increase suicidal behaviors. While the Centers for Disease Control and Prevention found that overall suicide rates decreased during COVID-19, rates increased among young people and people of color, the latter of which were disproportionately affected by the pandemic. (Indira Paharia, 1/7)

Minnesota is now in line to receive $296 million over 18 years to deal with the state's opioid crisis, thanks to hard work and collaboration among counties, local governments and the state attorney general's office. The recent agreement will send tens of millions of dollars to communities that have suffered the brunt of opioid overdoses among their residents. That is a welcome infusion of funds that can be used to expand addiction recovery efforts, treatment, intervention, additional law enforcement, child protection, education and cover a host of other expenses from the epidemics. (1/9)

The doctor-patient relationship starts at birth and extends across one's life. When patients are honest with their doctors, better decisions can be made about their health. They expect the same honesty in return and, indeed, the Hippocratic Oath demands as much of physicians. Underscoring this important responsibility, throughout the Covid-19 pandemic, national polls have found that most Americans trust medical professionals to give them accurate information about the virus. (Brian Castrucci and Nick Sawyer, 1/8)

Israeli scientists monitoring samplings of sewage water in 2013 made a startling discovery: an outbreak of paralyzing polio was imminent. A national vaccination campaign was quickly mobilized and no cases appeared. That same year, Swedish scientists provided public officials with an early warning for outbreaks of hepatitis A and norovirus using the same methods. If we are to regain, and retain, normal living, we’ll need the same kind of early warning system for future variants and pandemics. Fortunately, we’re getting closer to having that. (Therese Raphael, 1/8)

For Ken Jones, 63, a tech consulting manager from Delano, getting COVID was like having "a truck hit me," with fever and fatigue packing a punch. Writer Pam Bosch, 49, of Roseville, started off with an upset stomach and muscle aches but then had a "harrowing" episode with a racing heartbeat. Meg McEachran, a 27-year-old mom and grad student from St. Paul, grappled with muscle aches, fatigue and congestion for about a week. (1/8)

To understand how ideologically scrambling the Omicron wave of has been, consider this: It's got some 2022 Democrats sounding like 2020 Republicans. In spring 2020, many Republicans, including President Donald Trump, insisted that COVID was hardly worse than the flu; that its fatality risk was comparable to an everyday activity, like driving in a car; and that an obsessive focus on cases wouldn’t give an accurate picture of what was going on in the pandemic. (Derek Thompson, 1/10)

Many of us thought the end of the pandemic was within sight when the first COVID-19 vaccinations started rolling out last year. However, it is clear that COVID will be with us for the long term. We need many tools to manage this virus — vaccination, proper masking, ventilation in indoor spaces, and testing are the primary ones, with widespread vaccination the most crucial. But waning immunity and evolving variants remind us that our work to limit the pandemic has not been a one-way march but, instead, a series of steps forward and back. (Joseph Hogan, Alyssa Bilinski, Elizabeth Stuart and Joshua Salomon, 1/10)

The omicron surge is pushing our nation’s health care system to the brink. As omicron infections surge, the number of people seeking care in emergency rooms and hospitals is skyrocketing. Though omicron may prove to be less virulent than delta and other variants, the volume of infections is placing unprecedented demand on hospitals and their resources. Some hospital systems are delaying elective surgeries to make room for COVID-19 patients. They are focusing on what is immediately urgent versus what is important and critical to avoid the need for emergency care. (Sheldon H. Jacobson, 1/10)

The new year begins with good news for anxious parents wanting COVID-19 vaccinations and boosters for their children. The U.S. Food and Drug Administration granted emergency use authorization of the Pfizer-BioNTech vaccine booster for children 12 to 15 years of age. This means everyone over the age of 12, including adults, can get booster shots. The FDA also allows a third primary series dose for certain immunocompromised children 5 through 11 years of age. (Suma Manjunath, 1/9)