�������ýҕ�l

The very contagious and possibly more harmful Delta variant of the coronavirus “probably” will become the dominant strain in the United States in the coming months, Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Friday on "Good Morning America." “It's more transmissible than the Alpha variant or U.K. variant that we have here. We saw that quickly become the dominant strain in a period of one or two months,” Walensky said. “I anticipate that is going to be what happens with the Delta strain here.” (Leonard, 6/18)

The transmission of the more contagious delta variant in the United States could spur a fall surge in coronavirus infections if only 75 percent of the country’s eligible population is vaccinated, former Food and Drug Administration chief Scott Gottlieb said Sunday. Although Gottlieb cited one projection forecasting an increase in infections reaching as high as 20 percent of last winter’s peak, he called that an “aggressive estimate,” saying he doesn’t “think it’ll be quite that dire.” But he said states with low vaccination rates already are showing a concerning rise in cases with the spreading of delta, which is up to 60 percent more contagious than earlier variants. (Whalen, 6/20)

With the United States unlikely to reach his self-imposed deadline of having 70 percent of adults partly vaccinated against the coronavirus by July 4, President Biden on Friday stepped up his drive for Americans to get their shots, warning that those who decline risk becoming infected by a highly contagious and potentially deadly variant. In an afternoon appearance at the White House, Mr. Biden avoided mentioning the 70 percent target that he set in early May and instead trumpeted a different milestone: 300 million shots in his first 150 days in office. But even as he hailed the vaccination campaign’s success, he sounded a somber note about the worrisome Delta variant, which is spreading in states with low vaccination rates. (Gay Stolberg and Weiland, 6/18)

President Biden announced Friday that 300 million coronavirus shots have been administered in the United States in the last 150 days. More than 175 million Americans have gotten at least one COVID-19 vaccine shot and infection rates, as well as deaths, have decreased by more than 90%, according to the White House. (Doherty, 6/18)

Some states are making great strides in vaccinating their residents against Covid-19, but the ones that are not may soon be contending with a more transmissible variant, experts say. About 45.1% of the US population is fully vaccinated against Covid-19, CDC data showed, and in 16 states and Washington, DC, that proportion is up to half. But some states like -- Alabama, Arkansas, Louisiana, Mississippi, Tennessee and Wyoming -- have fully vaccinated less than 35% of residents. (Holcombe, 6/21)

A new poll shows only 21% of Americans fear contracting COVID-19 from someone they know well, the lowest number since the pandemic began, according to the Associated Press–NORC Center for Public Affairs Research. Only 25% are concerned that lifted restrictions will lead to more infections in their community. About 40% of those polled said their communities were handling reopening at a correct pace, with 27% thinking it has been done too slowly and 34% feeling restrictions were lifted too hastily. (Soucheray, 6/18)

With more than 600,000 Americans dead of COVID-19 and questions still raging about the origin of the virus and the government’s response, a push is underway on Capitol Hill and beyond for a full-blown investigation of the crisis by a national commission like the one that looked into 9/11. It is unclear whether such a probe will ever happen, though a privately sponsored team of public health experts is already laying the groundwork for one. (Reeves and Kunzelman, 6/17)

National Security Advisor Jake Sullivan said on Sunday that the U.S. would not be issuing "threats or ultimatums" to China as it seeks access for an investigation into the origins of the COVID-19 pandemic. Appearing on CNN's "State of the Union," host Dana Bash pressed Sullivan on what actions the U.S. would take to pressure China to help facilitate an investigation, noting that Sullivan had once said the U.S. wouldn't take China's inaction lying down. Sullivan stated that the U.S.'s approach was on "two tracks." (Choi, 6/20)

Speculation about origin abounds as the lab-leak theory puts a spotlight on virological research. (Achenbach, 6/20)

Talk of ‘gain-of-function’ research, a muddy category at best, brings up deep questions about how scientists should study viruses and other pathogens. (Zimmer and Gorman, 6/20)

A federal judge ruled Friday that the Centers for Disease Control and Prevention's conditional sailing orders on the cruise industry "likely constitutes an unconstitutional delegation of legislative power to CDC." In a motion for a preliminary injunction, the state of Florida alleged that the CDC's order exceeds the agency's authority and that it was was "arbitrary and capricious" in issuing the conditional sailing order. The state claimed the CDC failed to recognize the prevalence of vaccines and the effectiveness of Covid-19 mitigation measures. (Lynch and Beneveniste, 6/19)

U.S. District Judge Stephen Merryday granted a preliminary injunction Friday, meaning the CDC cannot enforce its guidance for ships departing or arriving at a Florida port pending further legal action on a broader Florida lawsuit. ... However, the injunction has been stayed until July 18. At that point, the CDC's orders will become "recommendations," similar to "guidelines" the agency offered other industries like airlines, hotels, sports venues and public transportation.(Schreiner, 6/18)

Royal Caribbean International’s Freedom of the Seas left PortMiami on Sunday night on the cruise company’s first simulated cruise to test its COVID-19 health and safety protocols. The ship left Miami about 7 p.m. with a fully vaccinated crew and about 600 volunteer employee passengers. The federal Centers for Disease Control and Prevention had issued a conditional sailing requirements for cruise lines to resume revenue sailings. Options were for ships to execute a test voyage or mandate that 95 percent of the passengers were vaccinated against COVID-19. (6/21)

The United States has extended Covid-19 restrictions on non-essential travel at land and ferry crossings with Canada and Mexico until July 21, according to a tweet from the Department of Homeland Security (DHS) on Sunday. "To reduce the spread of #COVID19, the United States is extending restrictions on non-essential travel at our land and ferry crossings with Canada and Mexico through July 21, while ensuring access for essential trade & travel," DHS wrote. (Rose, 6/20)

U.S. land borders with Canada and Mexico will remain closed to non-essential travel until at least July 21, the U.S. Homeland Security Department said on Sunday. The 30-day extension came after Canada announced its own extension on Friday of the requirements that were set to expire on Monday and have been in place since March 2020 because of the coronavirus pandemic. (Shepardson, 6/20)

State efforts to juice Covid-19 vaccination rates through million-dollar lotteries haven’t reversed the steep decline in adults seeking out shots when many pockets of the country remain vulnerable to the coronavirus. While Ohio did see a two-week bump in adult vaccination rates last month after becoming the first state to offer sizable cash prizes, the pace of vaccinations there has already fallen off. And states that followed its headline-grabbing example made some small gains without showing evidence of any comparable surge, a POLITICO analysis of federal and state data shows. (Goldberg and Doherty, 6/19)

NBA season tickets. Scholarships. A chance at $5 million. The list of lotteries and raffles states are launching to drive up COVID-19 vaccination rates is growing, and some local officials are already reporting "encouraging" results. The reason why, some psychologists and public health experts say, is that the allure of lotteries for many people is simply that the prospect of winning a great prize seems better than passing up the chance, regardless of the odds. (Saric, 6/21)

In some parts of the world with more coronavirus vaccine doses than willing takers, attention-grabbing incentives have begun to catch on. Among them: the chance to win big. Ten vaccinated Californians won $1.5 million each in vaccination lotteries last week. A 22-year-old in Ohio became a surprise vaccine millionaire last month. New York, Maryland and other states are also offering major winnings, and as U.S. vaccination rates slow, White House officials have praised the approach. Other countries have begun to follow suit. Two provinces in Canada announced lotteries with hefty cash prizes this month. Moscow is raffling off five cars a week to vaccinated residents. Hong Kong residents who get the shots are eligible to win a luxury apartment or airline tickets. (Parker and Westfall, 6/20)

A study yesterday in Vaccine reveals socioeconomic disparities in county-level COVID-19 vaccine uptake, with a 32% lower vaccination rate in the most disadvantaged areas. In the study, researchers from the University of Arkansas for Medical Sciences in Little Rock used the COVID-19 Community Vulnerability Index (CCVI) and seven theme scores to identify links between socioeconomic vulnerability and adult vaccination rates in 2,415 counties up to May 25, 2021. (Van Beusekom, 6/18)

But despite the priority access and array of incentives, vaccination rates for police, fire and corrections agencies across L.A. and California have lagged well behind the state’s average for adult residents, according to a survey of agencies conducted by The Times. While about 72% of adult Californians and 64% of Los Angeles residents 16 and older have received at least one vaccine dose, only about 51% of city firefighters and 52% of LAPD officers are at least partially vaccinated. (Rector, Winton, Smith and Welsh, 6/19)

NFL player Cole Beasley said that he does not plan to receive a COVID-19 vaccine and threatened to defy league protocol for players amid the ongoing coronavirus pandemic. “Hi, I’m Cole Beasley and I’m not vaccinated,” the wide receiver for the Buffalo Bills shared in a statement on Twitter on Friday. “I will be outside doing what I do. I’ll be out in the public. If your scared of me then steer clear, or get vaccinated. Point. Blank. Period.” “I may die of covid, but I’d rather die actually living. I have family members whose days are numbered. If they want to come see me and stay at my house then they are coming regardless of protocol,” he added. (Pitofsky, 6/19)

KHN: What It Means When Celebrities Stay Coy About Their Vaccine Status

When two St. Louis Blues hockey players were sidelined because of covid-19 just days before this year’s NHL playoffs, the team said young defenseman Jake Walman had been vaccinated against the deadly illness. But it was mum about the vaccination status of a more well-known player: star forward David Perron. It wasn’t until 10 days later — and after the Colorado Avalanche buried the team, without Perron touching the ice in any of the series’ four games — that he begrudgingly acknowledged he had been vaccinated. (Berger, 6/21)

The United States shipped 2.5 million COVID-19 vaccine doses to Taiwan on Saturday, more than tripling Washington’s previous allocation of shots for the island, which has faced increasing political and military pressure from China. Washington, competing with Beijing to deepen geopolitical clout through so-called “vaccine diplomacy,” initially had promised to donate 750,000 doses to Taiwan but increased that number as President Joe Biden’s administration advances its pledge to send 80 million U.S.-made shots around the world. (Martina, Brunnstrom and Shalal, 6/20)

The U.S. sent 2.5 million doses of the Moderna COVID-19 vaccine to Taiwan on Sunday, tripling an earlier pledge in a donation with both public health and geopolitical meaning. The shipment arrived on a China Airlines cargo plane that had left Memphis the previous day. Health Minister Chen Shih-chung and Brent Christensen, the top U.S. official in Taiwan, were among those who welcomed the plane on the tarmac at the airport outside of the capital, Taipei. (6/20)

Senate Majority Leader Charles Schumer (D-N.Y.) on Sunday threw his support behind a push, led by Sen. Bernie Sanders (I-Vt.), to add dental, vision and hearing coverage to Medicare. “There is a gaping hole in Medicare that leaves out dental, vision, and hearing coverage. This is a serious problem,” Schumer wrote on Twitter. “I’m working with @SenSanders to push to include dental, vision, and hearing Medicare coverage in the American Jobs and Families Plans,” he added. (Schnell, 6/21)

Congressional Democrats are hoping to pass a slew of healthcare priorities later this year aimed at expanding access to coverage and making it more affordable for patients. There appears to be a broad agreement on the types of healthcare policies that should be in the package, like closing the Medicaid coverage gap and adding dental and vision benefits to Medicare, but details are still being ironed out by committee staff and congressional offices and nothing is certain .The stakes are high for Democrats who view this as their last chance to accomplish major healthcare reform before the midterms, in which their majorities in the House and Senate are on the line. (Hellmann, 6/18)

With the Affordable Care Act now secure in the framework of the nation’s health care programs, Democrats are eager to leap above and beyond. They want to expand insurance coverage for working-age people and their families, add new benefits to Medicare for older people and reduce prescription drug costs for patients and taxpayers. (Alonso-Zaldivar, 6/19)

Congressional Democrats are pushing legislation that would expand Medicaid in states that have so far refused to do so, seeking to fill one of the major remaining holes in the Affordable Care Act. There are currently 12 states where Republicans have refused to accept the expansion of Medicaid eligibility provided under ObamaCare, meaning 2.2 million low-income people are left without coverage they otherwise would have, according to estimates from the Kaiser Family Foundation. (Sullivan, 6/20)

Veterans Affairs Secretary Denis McDonough is moving to make gender confirmation surgery available to transgender veterans through Veterans Affairs health care coverage. McDonough announced the move, plans of which were first reported by CNN, at a Pride event at the Orlando Vet Center in Florida on Saturday. "We are taking the first necessary steps to expand VA's care to include gender confirmation surgery -- thereby allowing transgender vets to go through the full gender confirmation process with VA at their side," McDonough said at the event. (Kaufman, 6/19)

The Department of Veterans Affairs plans to offer gender confirmation surgery to transgender veterans, Denis McDonough, the secretary of veterans affairs, announced over the weekend at a Pride event in Orlando, Fla., in a major shift in available care for former service members. “This process will require changing V.A.’s regulations and establishing policy that will ensure the equitable treatment and safety of transgender veterans,” Mr. McDonough said on Saturday at the event, noting that the change would take time. But he said the surgical needs of transgender veterans had been “deserved for a long time.” (Karni, 6/20)

Five months into the Biden administration, changes are beginning to emerge in how the federal government’s occupational safety agency is enforcing its Covid-19 worker-protection mandates. The Occupational Safety and Health Administration has issued more than three times as many violations of the general duty clause, a provision of federal law, than it did during the Trump administration, according to a Bloomberg Law review of OSHA enforcement data. OSHA also has increased the number of inspections of workplaces where Covid-19 could be a hazard, even if an employer or workers haven’t reported complaints to the agency. (Rolfsen, 6/21)

After becoming a top punching bag for the right, Dr. Anthony Fauci is defending himself with a sharp new edge, arguing that an attack on him is an attack on science. In comments to Kara Swisher on her New York Times "Sway" podcast, shared first with Axios, Fauci says: "It is essential as a scientist that you evolve your opinion and your recommendations based on the data as it evolves. ... And that's the reason why I say people who then criticize me about that are actually criticizing science." (Allen, 6/20)

Now the agency faces its biggest test yet: loosening its public safety guidance as the pandemic recedes, while simultaneously trying to prevent infection rates from spiking in undervaccinated communities. Adding to the difficulty, the highly transmissible Delta virus variant is gaining ground across the country. “It’s very hard to separate the criticism of the agency from what we’re seeing in the continued politicization of the response,” said Ali Khan, dean of the University of Nebraska College of Public Health. "There continues to be this thread of partisanship. Until those political issues are relieved CDC will be in the awkward position of ‘They are going too far’ — or not far enough.” (Banco, 6/21)

Nearly $50 billion or a third of Medicare Part D costs in 2016 were for drugs with absent cost-effectiveness analyses, according to a report from JAMA Network Open. The lack of a quality analysis that weighs the relative cost with outcomes of these drugs may create hurdles toward efforts aimed at addressing drug spending in terms of value. (Fernandez, 6/21)

A California law that banned coupons for brand-name prescription drugs failed to significantly boost greater use of cheaper generics during its first year, according to a new analysis. The law, which went into effect in January 2018, was one of many gambits by state officials to control the rising cost of prescription drugs. Coupons made an attractive target. Drug makers argue that they lower out-of-pocket expenses for consumers, but critics say coupons are slick marketing tools used to promote higher-cost medicines and eventually, cost the overall health system more money. (Silverman, 6/18)

File this under “Not every legal brief is eye-glazing. ”Two months ago, Pacira Biosciences (PCRX) took the highly unusual step of filing a libel lawsuit against a medical journal, its editor, and the authors of several published papers, arguing the articles were based on “faulty scientific research” and as a result, its only medicine was portrayed as ineffective. (Silverman, 6/18)

Researchers know how to curb the risks of overdose and disease among drug users, but policymakers are reluctant to allow public health measures that include needle exchanges and access to safer drugs. (Mann, 6/19)

Last month, President Biden quietly extended a policy that critics call a betrayal of his campaign promise to end mandatory minimum sentences. The new law concerns “class-wide scheduling of fentanyl analogues.” It may sound like a wonky snooze-fest, but the measure could land more low-level drug dealers in prison for longer and with less proof than is usually required — while kingpins and chemists who manufacture and distribute these new drugs don’t tend to get caught. An analogue is like a chemical cousin to fentanyl — similar in molecular structure, but not exactly the same. Because illegal fentanyl is made in labs (usually black market labs in China), there are almost infinite ways to tinker with its molecules, creating new drugs and staying one step ahead of the feds. As one becomes illegal, cartel chemists invent another. Class-wide scheduling makes a broad swath of analogues preemptively illegal, including substances that haven’t been invented yet — even those that could turn out to be medically useful. A handful of researchers are studying fentanyl analogues for possible new treatments for addiction to opioids — including some promising avenues for a fentanyl vaccine — but say the new law stymies research. (Schwartzapfel, 6/16)

This June marks the 50th anniversary of the war on drugs, an ongoing campaign that has to a large extent reshaped American politics, society and the economy.″ [The goals of the war on drugs] were to literally eradicate all of the social, economic and health ills associated with drugs and drug abuse,” said Christopher Coyne, professor of economics at George Mason University. “It doesn’t get much more ambitious than that.” (Lee, 6/17)

The sixth week of an opioid trial pitting Cabell County and Huntington against opioid distribution companies came to a gridlock due to lengthy cross-examinations by the companies. Throughout week six, the plaintiffs’ expert witnesses said the opioid crisis was fueled by prescription pain pills and has caused a $3.3 billion impact on Huntington and Cabell County. In an attempt to counter, the defense attorneys picked apart the resources the experts used, attempting to find a hole in the studies. (Hessler, 6/20)

Plaintiffs in a federal opioid lawsuit can depose Walmart Inc.'s chief executive, Doug McMillon, despite the company's objection, a federal court representative ruled Wednesday. Special Master David Cohen, appointed by the U.S. District Court for the Northern District of Ohio, Eastern District, said in his ruling that the plaintiffs showed that McMillon may have "personal knowledge of and involvement in" matters relevant to the case. (McKay, 6/19)

Several Indiana cities have opted out of the state’s pending lawsuits against opioid manufacturers and distributors, reasoning that they will likely see more cash from their own litigation filed in response to the nation’s opioid epidemic. The suburban Indianapolis cities of Fishers and Noblesville recently joined Indianapolis, South Bend, Lafayette and other municipalities in deciding to forgo potential payments from the lawsuits filed by Indiana’s attorney general’s office. (6/19)

The American Red Cross asked the public this week to help replenish the United States' depleted blood inventory amid a "severe" national shortage. The non-profit said the shortage is likely driven by a recent surge in trauma cases and emergency room visits, as well as advanced disease progression from patients deferring care throughout the coronavirus pandemic. (Knutson, 6/18)

As the COVID-19 pandemic comes to a close, more Americans are seeking medical care -- only to find roadblocks to long-awaited elective surgeries or unexpected traumatic injuries: a critical national shortage of blood. In June, the blood supply dropped to "red" level, indicating dangerously low supply at blood centers nation-wide, according to the AABB Interorganizational Task Force on Domestic Disasters and Acts of Terrorism. (Rosen, 6/20)

On a Tuesday afternoon in April, among tables of vegetables, clothes and telephone chargers at Fresno’s biggest outdoor flea market were prescription drugs being sold as treatments for Covid. Vendors sold $25 injections of the steroid dexamethasone, several kinds of antibiotics and the anti-parasitic drug ivermectin. Chloroquine and hydroxychloroquine — the malaria drugs pushed by President Donald J. Trump last year — make regular appearances at the market as well, as do sham herbal supplements. (Maxmen, 6/20)

KHN: ‘It’s A Mission’: Volunteers Treat Refugees Massing At The Border

El Chaparral Plaza once teemed with tourists, street vendors and idling taxis. But the plaza, just outside the San Ysidro port of entry on the Mexican side of the border, now serves as a sprawling refugee camp where migrants from Mexico, Central America and Haiti wait in limbo while they seek asylum in the U.S. Dr. Hannah Janeway, an emergency medicine physician who works in a Los Angeles hospital but volunteers at the border, estimates at least 2,000 people are jammed into tents and repurposed tarps here, living without running water and electricity. (de Marco, 6/21)

KHN: Nurses And Docs At Long Beach Center ‘Consider It An Honor’ To Care For Migrant Children

The 5-year-old had nodded off while waiting for her 10-year-old brother to be treated for scabies at the clinic in the Long Beach Convention & Entertainment Center, which she currently calls home. Nurse Chai-Chih Huang asked if she wanted to be taken back to her dormitory to sleep. “She looked so sad and didn’t say anything,” Huang recalled. The girl’s brother explained that they had been separated for a week during their journey. His sister cried every day without him, he said. Now, she wanted to stick close at all times. (Stephens, 6/21)

The algorithms carry out an array of crucial tasks: helping emergency rooms nationwide triage patients, predicting who will develop diabetes, and flagging patients who need more help to manage their medical conditions. But instead of making health care delivery more objective and precise, a new report finds, these algorithms — some of which have been in use for many years — are often making it more biased along racial and economic lines. (Ross, 6/21)

The past decade drove quick and necessary expansion of community health centers fueled largely by billions in grant funding provided through the Affordable Care Act.But the program has also been a constant source of concern for these providers. The Community Health Center Fund, created in 2010, accounts for 70% of federal support. So every year, CHC providers hold their collective breath, waiting to see if Congress will re-authorize the Fund. ... Those concerns have prompted more CHCs to diversify their revenue streams. Larger community health centers like HCP are finding ways to increase their reimbursement from public and commercial insurers. (Ross Johnson, 6/18)

Sylvia Perry had mainly worked in primary care before the Covid-19 pandemic hit. But as sick patients started flooding into Massachusetts General Hospital clinics, the nurse practitioner was redeployed to help handle the “onslaught.” It was a “high-stress work environment, lots of unpredictability, long hours, and trauma,” said Perry, who, like so many of her colleagues, wanted to feel cared for and connected as she worked through the crisis. “The only way that we can bring our A-game in caring for patients is to feel grounded and feel like we’re taking care of ourselves.” (Lin, 6/21)

Pandemic restrictions are falling away almost everywhere — except inside many of America’s nursing homes. Rules designed to protect the nation’s most vulnerable from COVID-19 are still being enforced even though 75% of nursing home residents are now vaccinated and infections and deaths have plummeted. Frustration has set in as families around the country visit their moms and, this Father’s Day weekend, their dads. Hugs and kisses are still discouraged or banned in some nursing homes. Residents are dining in relative isolation and playing bingo and doing crafts at a distance. Visits are limited and must be kept short, and are cut off entirely if someone tests positive for the coronavirus. (Rubinkam, 6/20)

The coronavirus pandemic forced hospitals and patients to delay care — everything from heart procedures and knee replacement surgeries to lab tests and X-rays — but people have been flocking back to their doctors as coronavirus cases wane. A return to normal levels of care means health care spending is back on the rise, which will continue to strain governmental budgets and people's paychecks. (Herman, 6/21)

Screams are heard from a Northeast Georgia Health System patient room, as the patient pins a nurse against a door and pushes her head into it with his hands. Elsewhere, a patient grabs a member of the staff by the wrist and twists while kicking her in the side of her ribs. These are some of the examples provided by NGHS officials including Kevin Matson, the health system’s vice president of facilities, support services and oncology, regarding the violence against health care workers that has increased in the past year. (Watson, 6/18)

In a decade-long legal fight that could involve hundreds of millions of dollars, a state appeals court this past week refused to halt a case that argues Sarasota County is required to reimburse private hospitals for providing care to indigent patients. A three-judge panel of the 2nd District Court of Appeal backed a circuit judge’s decision that denied the county’s request for a summary judgment that could have ended the case. The county argued that it should be shielded by sovereign immunity, which generally is designed to protect government agencies from lawsuits. (Saunders, 6/19)

After facing nearly a dozen challenges from hospitals across the state, Gov. Ron DeSantis’ administration has withdrawn a series of proposed rules related to regulating highly specialized health care services. The state Agency for Health Care Administration announced last week it planned to employ a rarely used option called “negotiated rulemaking” to try to reach a compromise on one of the withdrawn proposals, a regulation that would set licensure standards for neonatal intensive care units. (Sexton, 6/20)

A much higher percentage of teachers reported frequent job-related stress and symptoms of depression compared to the general adult population, in part because they were navigating unfamiliar technology and struggling to engage students, while also having concerns about returning to in-person instruction amid a pandemic. In January 2021, 78% of teachers said they experienced frequent job-related stress, compared to 40% of employed adults, according to a survey of public school teachers from the Rand Corp. funded by the National Education Association and the American Federation of Teachers. (Cerullo, 6/18)

The Centers for Disease Control and Prevention (CDC) said this week that it's investigating a cluster of tuberculosis (TB) infections in patients who've recently undergone spinal surgery that used a single lot of a bone repair product. The CDC said patients who underwent spinal fusions or fracture repairs using FiberCel products from a single lot (#NMDS210011) are likely to have been exposed to Mycobacterium tuberculosis. The agency is recommending that all patients who received this product lot obtain TB treatment, even if they are asymptomatic. (6/18)

Older adults who have significant difficulty falling asleep and who experience frequent night awakenings are at high risk for developing dementia or dying early from any cause, a new study finds. "These results contribute to existing knowledge that sleep plays a very important role, each and every night, for reducing our longer term risk for neural cognitive decline and all cause mortality," said study author Rebecca Robbins, an instructor in medicine at Harvard Medical School who specializes in sleep research. (LaMotte, 6/18)

Fish kills that are believed to be caused by red tide have been reported this week in Pinellas, Hillsborough and Manatee counties, according to the Florida Fish and Wildlife Conservation Commission. Also, people have reported respiratory irritation along Pinellas County's beaches that are believed to have been caused by red tide, according to the commission's Friday report. (Newborn, 6/19)

A rabid dog imported into the United States this month has sparked a public health investigation across several states. Health officials say a dog brought to the U.S. from Azerbaijan that ended up with a family in Chester County, Pennsylvania began acting strangely. It later tested positive for rabies and was euthanized. At least 12 people were exposed to the animal. The dog was one of 34 animals — 33 dogs and one cat — imported by an animal rescue organization from Azerbaijan to O’Hare International Airport in Chicago on June 10. (Stobbe, 6/18)

Dog and cat adoptions climbed in 2020. Pets have been constant companions — easing our grief and fears. Now it's our turn to ease dogs' separation anxiety, as we head back out into the world. (Mirk, 6/19)

Lakiea Bailey has tried to hide the pain and breathlessness she feels from her disease for most of her life. As a child, she missed weeks out of every school year because of sickle cell -- a painful, genetic disease that's believed to impact 100,000 Americans. Patients' red blood cells are "sickle" shaped and can clump together to impede blood flow to the rest of the body, causing serious problems, including strokes and organ failure. (Chillag, 6/18)

Afghanistan and six African nations—reported more polio cases this week, all involving circulating vaccine-derived poliovirus type 2 (cVDPV2), according to the latest update from the Global Polio Eradication Initiative (GPEI). Afghanistan's latest case is from Ghanzi in the southeastern part of the country, putting its total for the year at 41. In Africa, Burkina Faso reported two more cVDPV2 cases, one each from Dori and Banfora, which are counted in its 2020 total, which is now 65. Benin reported one case, which involves a patient from Couffo, marking the country's second case of the year. (6/18)

Guinea has declared an end to an Ebola outbreak that emerged in February and killed 12 people, according to the World Health Organization. The latest outbreak was the first to emerge in Guinea since a deadly outbreak from 2014 to 2016 killed more than 11,300 people in West Africa. That originated in the same region before spreading to neighboring Liberia and Sierra Leone. Guinea’s latest outbreak was declared Feb. 14 after three cases were detected in Gouecke, a rural community in the southern N’zerekore prefecture. There were 16 confirmed and seven probable cases. (Petesch, 6/19)

Virginia’s state mental hospitals are “dangerously” full, and staffing shortages are leaving facilities “overwhelmed” — a long-standing problem that has been exacerbated by the pandemic, according to the state agency in charge of the facilities. But lawmakers and policy experts hope to use money from the latest federal pandemic relief package to create systematic changes that will free inpatient beds and develop community services to keep people out of hospitals in the first place. “We have the opportunity with these funds to really do something transformational. That is what we are asking for,” said Alison Land, commissioner of the state Department of Behavioral Health and Developmental Services, which runs the state mental hospitals. (Portnoy, 6/20)

If someone with a disability or brain injury goes missing, a Purple Alert could go out to help find them. That’s due to a new law signed by Gov. Ron DeSantis this past week. Beverly Marshall is from Sebring. She says if a Purple Alert had been in place sooner, her son might still be alive. Her son had a cognitive disability and wandered away from home. He came to a 7-Eleven store but couldn’t ask for help due to his disability. (Gaffney, 6/19)

Gov. Gavin Newsom says California will pay off all the past-due rent that accumulated in the nation’s most populated state because of the fallout from the coronavirus pandemic, a promise to make landlords whole while giving renters a clean slate. Left unsettled is whether California will continue to ban evictions for unpaid rent beyond June 30, a pandemic-related order that was meant to be temporary but is proving difficult to undo. (Beam, 6/21)

KHN: Montana Tribe Welcomes Back Tourists After Risky Shutdown Pays Off

Millions of people will flock to Montana’s Glacier National Park this summer after last year’s pandemic-caused tourism skid, and they will once more be able sightsee and camp nearby on the recently reopened Blackfeet Indian Reservation. The tourists’ return is a relief to the owners of the restaurants, campgrounds and hotels forced to shut down last summer when Blackfeet tribal leaders closed the roads leading to the eastern side of the popular park. (Bolton, 6/21)

In the four weeks ending March 20, emergency department visits involving suspected suicide attempts jumped 51% for girls age 12-17 compared with the same period in 2019. For boys, the rate increased by 4%. That’s according to a new report from the federal Centers for Disease Control and Prevention. The agency also reported that one-quarter of young adults age 18–24 said they had experienced suicidal thoughts related to the pandemic last summer. (Vestal, 6/19)

Tokyo Governor Yuriko Koike on Saturday said that all public viewing during this summer's Olympics will be canceled due to the COVID-19 pandemic, the Japan Times reports. After meeting with Japanese Prime Minister Yoshihide Suga, Koike told reporters that the locations where viewings were scheduled will instead be used as vaccination sites. (Gonzalez, 6/19)

Olympic organizers will allow spectators at this summer's Tokyo Games but cap attendance at 10,000 people or 50 percent of a venue's capacity, whichever is smaller, they announced on Monday. But they have also warned they could still ban spectators entirely if the situation with covid infections deteriorates dramatically before the Games begin on July 23. Earlier Japanese Prime Minister Yoshihide Suga said he would prefer to see fans in the stands but said if the pandemic situation worsens, banning any from attending is “definitely a possibility.” (Denyer, 6/21)

A Uganda Olympic team member tested positive for COVID-19 upon arrival in Japan late Saturday, officials said. Japan's government has faced criticism for vowing to host the Tokyo Games next month as coronavirus cases rise. The Ugandan team is the second to arrive in Japan after the Australian women's softball players, and this is the first COVID-19 infection detected among the Olympic athletes, Al Jazeera notes. (Falconer, 6/20)

Qatar will only allow people fully vaccinated against COVID-19 to attend next year's World Cup and is in talks to secure one million doses in case global immunisation efforts lag, the prime minister said. The Gulf Arab state hosts the four-week tournament in November 2022 and the president of global soccer body FIFA has said the matches would be held in full stadiums. Prime Minister Sheikh Khalid bin Khalifa bin Abdulaziz Al Thani told newspapers that while most countries were expected to have vaccinated their citizens by then, Qatar was still taking measures to ensure a successful event. (6/21)

Oxygen is in short supply in Afghanistan as the country is battling a third wave of COVID-19 cases and its hospitals are being overrun. Health ministry spokesman Ghulam Dastigir Nazari told The Associated Press that the government is working to install more oxygen supply plants in 10 provinces where up to 65 percent of people tested in some areas are positive for COVID-19. According to the AP, Afghans are banging on the doors of suppliers, begging for their oxygen cylinders to be filled for suffering loved ones; however, the country is running out of cylinders as well, with Iran sending 900 on Saturday and Uzbekistan sending 1,000 last week. (Lonas, 6/19)

The number of so-called black fungus cases in India shot up to more than 30,000 from negligible levels in just three weeks. The deadly disease has sickened former coronavirus patients across the country, and doctors believe that hospitals desperate to keep Covid-19 patients alive made choices that left them vulnerable.bIndian states have recorded more than 2,100 deaths, according to news reports. The federal health ministry in New Delhi, which is tracking nationwide cases to allot scarce and expensive antifungal medicine, has not released the number of fatalities. (Schmall, 6/21)

Thousands of Japanese companies began distributing COVID-19 vaccines to workers and their families Monday in an employer-led drive reaching more than 13 million people that aims to rev up the nation’s slow vaccine rollout. Yuka Daimaru, among the Suntory workers getting the shot on a sprawling office floor, was visibly relieved after spending more than a year worrying about the coronavirus. “I was nervous, but it didn’t hurt as much as I thought it would,” she said. “Now I don’t have to worry as much on commuter trains or at meetings.” The Tokyo-based beverage maker plans to inoculate 51,500 people, including part-time workers and employees’ families, with the Moderna vaccine. (Kageyama, 6/21)

Covid-19 vaccine rollouts have accelerated in many Asia-Pacific countries in recent weeks, overtaking the pace of doses being administered in the U.S. and other Western nations and increasing the chances of a sooner-than-expected easing of some pandemic restrictions. China now accounts for roughly half of the world’s 33 million Covid-19 shots administered every day, with four-fifths of Beijing’s adults having gotten a single dose. In the past month, South Korea increased the number of daily doses administered by 10-fold, to about 700,000. Japan and Australia, adjusted for population, are administering more doses daily right now than the U.S. or Israel, where daily uptake has slowed. (Yoon, 6/20)

China has administered more than a billion doses of its Covid-19 vaccines, a key milestone in the world’s largest inoculation drive. As of Saturday, 1,010,489,000 doses had been given to people in China, according to the country’s National Health Commission (NHC). More than 100 million doses had been administered in the six days up to and including Saturday. (Kharpal, 6/21)

In Jamsoti, a village tucked deep inside India’s most populous state of Uttar Pradesh, the common refrain among the villagers is that the coronavirus spreads only in cities. The deadly infection, they believe, does not exist in villages. So when a team of health workers recently approached Manju Kol to get vaccinated, she locked up her house, gathered her children and ran to the nearby forest. The family hid there for hours and returned only when the workers left in the evening. “I would rather die than take the vaccine,” said Kol. (Kumar Singh, 6/21)

An Israeli health official on Monday urged more 12- to 15-year-olds to be vaccinated against COVID-19, citing new outbreaks that he attributed to the more infectious Delta variant. Israel expanded vaccine eligibility to include adolescents last month. Infections have fallen off sharply in recent weeks. Vaccination turnout has largely flatlined at around 55% of the 9.3 million overall population having received both shots, implying that adults have largely stopped getting vaccinated. (6/21)

The Palestinian Authority called off the COVID vaccine deal with the new Israeli government after determining the does were too close to their expiration date, Reuters reports. Israel had agreed to transfer 1.2 million doses of Pfizer to the Palestinian Authority in exchange for the fresh Pfizer shipment Palestinians were expected to receive in October. But on Friday Palestinian officials said the doses from Israel were set to expire soon and did not meet the necessary standards. (6/18)

The European Union failed in its attempt to force AstraZeneca (AZN) to speed deliveries of its Covid-19 vaccine or face huge fines, the latest round in a high-profile battle between the 27-member bloc and the drug maker. In its 67-page ruling, a court in Brussels refused to require AstraZeneca to supply 120 million doses by the end of June, which the EU had demanded. However, the court set a schedule for 80 million doses to be delivered by Sept. 27 and will require AstraZeneca to pay $11.80 for every dose not delivered by that deadline. The court also criticized the drug maker for a “serious breach” of its contract with the EU after repeatedly failing to meet delivery terms. (Silverman, 6/18)

AstraZeneca and the European Union (EU) are both claiming victory in a court dispute over the EU’s accusation that the vaccine manufacturer was not developing doses at an adequate speed. Both parties claimed victory, citing a Belgian Court of First Instance judge’s Friday ruling that mandated the Anglo-Swedish company provide millions of COVID-19 vaccine doses before Sept. 27. The friction between the 27-nation bloc and AstraZeneca heightened after the vaccine supplier agreed to provide 300 million doses to make up the backbone of the EU’s vaccine supply, but AstraZeneca adjusted the expected timing of the delivery following production issues. (Coleman, 6/18)

The Covid-19 death toll in Brazil has now surpassed 500,000, behind only the United States, which marked 600,000 deaths last week, and India, where deaths may range from 600,000 to as high as 4.2 million. Nearly 18 million people have been infected so far, and the country is averaging almost 73,000 new cases and some 2,000 deaths a day, according to official data. But many experts believe the numbers understate the true scope of the country’s epidemic, as they do in India. (Abelson, 6/21)

Demonstrators took to the streets in at least 22 of Brazil’s 26 states to protest President Jair Bolsonaro's handling of the pandemic — as deaths from COVID-19 in the country surged past 500,000 Saturday, per AP. Brazil has the world's second-highest coronavirus death toll and third-highest number of reported cases. Only 12% of the country's population has been vaccinated against the virus, AP notes. (Falconer, 6/20)

Developing countries now account for more of the COVID-19s daily global death toll, at 85 percent and climbing, than high-income countries. Thanks to high vaccination rates, deaths in these rich countries have fallen from 59 to 15 percent of the global share, an all-time low, according to the Brookings Institution. The signs of this switch are jarring. Vaccinated Americans are reading up on how to make the most of a summer vacation in Europe, while unvaccinated Indians are searching for tips on how to stay alive. (Chelsea Clinton and Achal Prabhala, 6/20)

Before thousands descended on St. Petersburg for Russia’s annual economic forum this month, the local governor boasted to radio listeners that no one had held an event of a similar scale since the pandemic struck. A few days later, President Vladimir Putin told the audience that his country was in a better virus position than most and would quickly open to vaccine tourists. The triumphalism proved premature. Russia has seen a spike in COVID-19 cases over the past two weeks, with numbers at the highest in months and the added threat of troublesome new variants. Moscow Mayor Sergei Sobyanin declared an extended holiday to curb what he called an “explosive” growth in infections, and on June 16 went further, ordering the city’s service sector and municipal employees to get vaccinated. The Kremlin has said for months that there are no plans for compulsory jabs. (Clara Ferreira Marques, 6/19)

Other places in the country may be shooting off fireworks to hail the end of covid-19 restrictions, thanks to vaccination successes such as the 70 percent rate for adults in New York state. Nobody is lighting end-of-covid celebratory fireworks in Detroit. There, just 36.8 percent of residents age 12 and up have received at least one shot. Like many other U.S. cities, Detroit was battered by covid soon after the coronavirus began spreading last year and in subsequent waves. The city’s 2,419 dead include the beloved sheriff of Wayne County, high-profile community leaders, cops, firefighters and health-care workers. Everyone in southeast Michigan seemed to know or know of someone who had been sick with covid or died from it. (Micheline Maynard, 6/18)

Considering how bad stress is supposed to be for our bodies, it’s still a confusing concept. Is it worse for our health to have too much work or too little? To have too much responsibility or to be bored? The Covid-19 pandemic triggered lots of stress — even in people who never got the virus. It’s not clear how much the forced isolation, fear or job loss harmed our health. But scientists are starting to identify the kinds of stress that damage us physically by studying other species — not just lab rats, but animals from whales to iguanas to fish. That research has already generated some understanding of the harms we have imposed on them through captivity, pollution and underwater noise. It might also help us understand the harms we impose on each other. (Faye Flam, 6/19)

My personal journey with Alzheimer’s began in 2005 when my wife, Valerie, received her diagnosis with this terrible disease, one that robs the afflicted of their minds and forces family and friends to watch with dread as their loved one slowly disappears. Stunned by the news, I was overwhelmed with grief for my life partner and the loss of our future together. Valerie was a vivacious, energetic person with a passion for education, which we shared. After her diagnosis, I began a quest to better understand the cause of the disease and to find new approaches and therapies that might prevent, delay or reverse its spread in others. (Leroy Hood, 6/20)

Facebook unveiled a remarkable piece of internal infrastructure in the spring of 2020. Called Web-Enabled Simulation (WES), the platform is a detailed replica of Facebook, with artificial user accounts ranging from simple bots that browse the site to machine-learning-based agents that mimic social interactions. The sophistication of the platform is astonishing. (Gopal Sarma, 6/21)

The New York Times recently conducted an important investigation revealing the use of sickle cell trait (SCT) as a cover-up for the deaths of Black people at the hands of police while in custody. The newspaper reported finding 47 cases in the past 25 years in which medical examiners, law enforcement officials or defenders of accused officers cited the trait as a cause or major factor in a Black person’s death in custody, with 15 of these deaths occurring since 2015. As hematologists who specialize in both SCT and sickle cell disease, we appreciate the importance of highlighting the disturbing information uncovered by this investigation, including ascriptions of SCT as a causative factor in the death of individuals who have been “roughed up” by the police. (A. Kyle Mack, Rachel S. Bercovitz and Hannah Lust, 6/20)

While many of us were celebrating the ray of hope that was the COVID-19 vaccine in December, low-income Texans with HIV and their advocates were wrestling with bad news. A state program that pays for these patients’ life-saving medications was facing a significant budget shortfall that led officials to scale back who was eligible to have their costs covered. The program’s financial outlook was shaky for months, so we’re relieved to report that state and federal funds have come through to shore up this critical safeguard for uninsured and underinsured HIV patients. (6/21)

Why am I still alive? How have I survived this long? Those are the questions on my mind four years after being handed a death sentence in the form of Stage IV colon cancer. A death sentence rendered a month before my son’s first birthday. After years of fighting to survive, the moment I’ve dreading came to be – chemotherapy stopped working. My fight is not over, though. I’m still fighting, because I’ve realized the legacy I can leave behind. I’m a Vermont Army National Guard veteran, who completed combat deployments to Iraq and Afghanistan from 2009 to 2010. One thing they had in common was inescapable smoke emitted from burn pits outside the base where we lived. I still remember the oxygen being sucked from the air as burn pit smoke engulfed everything in its path. (Wesley Black, 6/20)

If Black patients hospitalized with covid-19 were cared for in the same hospitals where White patients went, their mortality rate would have been 10 percent lower. That’s the conclusion of a newly published study we authored in JAMA Network Open. In it, we look at data from 44,000 patients hospitalized with the disease from January through Sept. 21, 2020. Unlike prior studies based on single health system data, our study examined a diverse set of nearly 1,200 hospitals across 41 states and D.C. (David A. Asch and Rachel M. Werner, 6/18)