Morning Briefing
Summaries of health policy coverage from major news organizations
From Ńī¹óåś“«Ć½Ņīl Health News - Latest Stories:
Ńī¹óåś“«Ć½Ņīl Health News Original Stories
OSHA Let Employers Decide Whether to Report Health Care Worker Deaths. Many Didn't.
Four workers died at a facility with one of the largest U.S. outbreaks, but the Occupational Safety and Health Administration never conducted an inspection. Itās a pattern thatās played out across the nation, a KHN investigation finds.
How Pharma Money Colors Operation Warp Speedās Quest to Defeat COVID
A Trump administration maneuver allows executives who are leading the federal effort to keep investments in drug companies that would benefit from the pandemic response.
Thousands of Doctors' Offices Buckle Under Financial Stress of COVID
Across the nation, primary care practices that were already struggling are closing, victims of the pandemicās financial fallout. And this is reducing access to health care, especially in rural and other regions already short on doctors.
āAn Arm and a Legā: How to Avoid a Big Bill for Your COVID Test
Tests for the coronavirus are supposed to be free. And, usually, they are. But sometimes ⦠things happen. Hereās how to avoid getting a surprise bill for a test.
Summaries Of The News:
Vaccines
Moderna Applying Today For FDA Approval Of 94%-Effective Vaccine
Moderna said Monday it will request emergency clearance from the Food and Drug Administration for its coronavirus vaccine after new data confirms the vaccine is more than 94% effective in preventing Covid-19 and was safe. Moderna is the second drugmaker to seek emergency use from the FDA after Pfizer, another front-runner in the Covid-19 vaccine race, applied for the same authorization on Nov. 20. The announcement means some Americans could get the first doses of Modernaās two-dose vaccine within a few weeks. (Lovelace Jr., 11/30)
Moderna is just behind Pfizer and its German partner BioNTech in seeking to begin vaccinations in the U.S. in December. Across the Atlantic, British regulators also are assessing the Pfizer shot and another from AstraZeneca. Moderna created its shots with the U.S. National Institutes of Health and already had a hint they were working, but said it got the final needed results over the weekend that suggest the vaccine is more than 94% effective. (Neergaard, 11/30)
Continuing the spate of stunning news about COVID-19 vaccines, the biotech company Moderna announced the final results of the 30,000-person efficacy trial for its candidate in a press release today: Only 11 people who received two doses of the vaccine developed COVID-19 symptoms after being infected with the pandemic coronavirus, versus 185 symptomatic cases in a placebo group. That is an efficacy of 94.1%, the company says, far above what many vaccine scientists were expecting just a few weeks ago. More impressive still, Modernaās candidate had 100% efficacy against severe disease. There were zero such COVID-19 cases among those vaccinated, but 30 in the placebo group. (Cohen, 11/30)
Although the firm has done deals around the world, the US will get access first. Moderna said it expected to have 20m doses of its vaccine ready for use in the US by the end of this year. In August, the US bought 100m doses with an option on 400m more. Moderna says it is on track to manufacture 500m to 1bn doses globally in 2021. (Boseley, 11/30)
Also ā
KHN: How Pharma Money Colors Operation Warp Speedās Quest To Defeat COVIDĀ
April 16 was a big day for Moderna, a Massachusetts biotech company on the verge of becoming a front-runner in the U.S. governmentās race for a coronavirus vaccine. It had received roughly half a billion dollars in federal funding to develop a COVID shot that might be used on millions of Americans. Thirteen days after the massive infusion of federal cash ā which triggered a jump in the companyās stock price ā Moncef Slaoui, a Moderna board member and longtime drug industry executive, was awarded options to buy 18,270 shares in the company, according to Securities and Exchange Commission filings. The award added to 137,168 options heād accumulated since 2018, the filings show. (Pradhan, 11/30)
First Doses Of Pfizer's Vaccine Arrive In US By Chartered Flights
United Airlines Holdings Inc. on Friday began operating charter flights to position doses of Pfizer Inc.ās Covid-19 vaccine for quick distribution if the shots are approved by regulators, according to people familiar with the matter. The initial flights are one link in a global supply chain being assembled to tackle the logistical challenge of distributing Covid-19 vaccines. Pfizer has been laying the groundwork to move quickly if it gets approval from the Food and Drug Administration and other regulators world-wide. (Sider and Loftus, 11/27)
Charter flights bringing Pfizer'sĀ COVID-19 vaccine to the United States from Belgium began on Friday, the startĀ of what the Federal Aviation Administration calls the firstĀ "mass air shipment" of a coronavirus vaccine. There are no authorized coronavirus vaccines in the U.S. yet, but preparations for distribution are ramping up.Ā Under FDA rules,Ā vaccine cannot beĀ shipped to actual administration sites until it was been either licensed or authorized by FDA. (Weise and Aspegren, 11/29)
In related developments on vaccine distribution ā
Members of President Donald Trumpās coronavirus task force fanned out across Sunday talk shows to promise a rapid rollout of coronavirus vaccines to millions of Americans by year-end. U.S. Surgeon General Jerome Adams said the federal government hopes to quickly review and approve requests from two drugmakers for emergency approval of their Covid-19 vaccines. (Condon and Yang, 11/29)
State officials were prepared to distribute doses of drugmaker Pfizerās COVID-19 vaccine āin the coming days,ā Gov. Greg Abbott said Saturday. Abbott tweeted a link to a Wall Street Journal article that reported United Airlines had started operating charter flights to position doses of the vaccine for rapid distribution if approved by federal and global regulators and wrote, āTexas is ready to distribute these vaccines in the coming days.ā (Serrano, 11/28)
Who Gets The Shots First? CDC Panel Set To Vote
A panel of U.S. advisers will meet Tuesday to vote on how scarce, initial supplies of a COVID-19 vaccine will be given out once one has been approved. Experts have proposed giving the vaccine to health workers first. High priority also may be given to workers in essential industries, people with certain medical conditions and people age 65 and older. (11/28)
Divisions are emerging among top U.S. officials over when the countryās first Covid-19 vaccine will be authorized ā and who should be at the front of the line to get vaccinated. (Branswell, 11/30)
In other COVID vaccine news ā
While many adults older than 50 say they plan to get a COVID-19 vaccine once it becomes available, plenty indicated they probably won't rush to get it right away, a new poll found. According to theĀ National Poll on Healthy Aging from the University of Michigan, 58% of adults between the ages of 50 and 80 years old said they were somewhat or very likely to get the vaccine if itĀ became available at no cost to them. (11/25)
For as long as there have been vaccines, there have been people like Winnie Harrison who shun them. Harrison, 67, a former educator and mother of four, became an ardent disbeliever in immunizations after her first child had an adverse reaction to a measles, mumps, and rubella shot some three decades ago. But it wasnāt until recent years that she and other skeptics began to forge online connections, fostering fear about vaccines and what doctors call a growing ecosystem of health misinformation that has only ramped up amid the coronavirus pandemic. (Ulloa, 11/28)
Overcoming distrust of a covid-19 vaccine is about āsurvival instinctsā for Shane Lee, a family physician in Perry County, Ala., a rural, mostly African American community of about 9,000 where more than a third of people live in poverty. When the outbreak erupted in Alabamaās Black Belt in the summer and āswept through hospitals and nursing homes like a grass fire,ā the 59-year-old doctor, a retired Army general, became infected. His heart muscle grew inflamed. Months later, he is still short of breath. (Stanley-Becker, 11/29)
Covid-19
'A Really Dangerous Time': Task Force Warns Of Huge Surges Coming
Those who are traveling during the holiday weekend should quarantine and get tested for coronavirus if possible to āprevent further spread and further surge,ā according to the governmentās top infectious disease expert, Anthony Fauci. āThe travel that has been done has been done,ā Fauci said Sunday on ABCās āThis Week.ā āRight now as people go back, we want to urge them, if they've been in situations outside of the family setting in which they really don't know the level of exposure, to be really careful when you either return from the place that you went or other people come back into your house.ā (Bice, 11/29)
Americaās top infectious-disease expert sounded the alarm Sunday, warning of a āsurge superimposed uponā a surge of coronavirus cases over the coming weeks due to Thanksgiving travel and celebrations. Anthony S. Fauci and other experts urged Americans to take aggressive action as the December holidays loom to mitigate the surge overwhelming hospitals across the country. As the number of coronavirus-related deaths per day rose to its highest point since April, Fauci and others highlighted the importance of complying with mask mandates and physical distancing. (Alemany, 11/29)
U.S. Surgeon General Jerome Adams said Sunday that the coronavirusĀ pandemic will "get worse" in the weeks ahead, but noted that the firstĀ vaccines would likely be available to vulnerable populations by mid-December. āI want to be straight with the American people, itās going to get worse over the next several weeks, but the actions that we take in the next several days will determine how bad it is or whether or not we continue to flatten our curve,ā Adams told guest host Bret Baier on āFox News Sunday.ā (Budryk, 11/29)
A member of President-electĀ Joe Biden's COVID-19 advisory board on Saturday made a grim prediction about U.S. coronavirus cases in the coming weeks after millions of Americans traveled for Thanksgiving, despite warnings from public health officials. āWe fully expect that in about a week or two after Thanksgiving we will see an increase in cases first, then about a week or two later youāll start to see an increase in hospitalizations, and then another week or two after that youāll start to see deaths,ā Dr. Celine Gounder told CBS News. (Betz, 11/29)
And Dr. Fauci looks ahead to Christmas and New Year's ā
Dr. Anthony Fauci suggestedĀ Thanksgiving may be the beginning of a dark holiday season as the surge in coronavirus cases is likely to persist, or even get worse, through December, January and February. āIf the surge takes a turn of continuing to go up and you have the sustained greater than 100,000 infections a day and 1,300 deaths per day and the count keeps going up and up ... I donāt see it being any different during the Christmas and New Yearās holidays than during Thanksgiving,ā he said in an interview with USA TODAY last week. (Rodriguez, 11/27)
"I cannot see, all of a sudden, a relaxation of the kinds of recommendations or restrictions because we're getting into colder weather and an ⦠even larger holiday season, as people travel to come back and forth for Christmas,ā Fauci said on ABC News's "This Week." (Coleman, 11/29)
Worries High Over COVID Spikes As Thanksgiving Travelers Head Home
As millions of Americans head home after Thanksgiving, the coronavirus could be hitching a ride -- threatening to plant seeds of infection across the country as the US on Sunday topped more than 100,000 new cases for the 27th consecutive day. ... A surge of new travel-related infections could overwhelm hospitals already stretched to capacity. Hospitalizations of Covid-19 patients reached a record high of 93,238 on Sunday, trumping Saturday's record-breaking 91,635 figure, according to the Covid Tracking Project. (Yan and Holcombe, 11/29)
The weekend after Thanksgiving met expectations that it would be the busiest travel period in the U.S. since the coronavirus pandemic began, aided by clement weather and lower gas prices that encouraged some to drive rather than fly. Almost 50 million people were expected to have made a journey during the Thanksgiving holidays, said AAA, despite tightening local clampdowns and warnings from federal health officials. The U.S. Centers for Disease Control and Prevention on Nov. 19 recommended people not travel over Thanksgiving. (Cameron and Sider, 11/29)
And now we wait. Thanksgiving is over, and public health officialsā persistent warnings that large celebrations and travel could douse accelerant on out-of-control Covid-19 spread have passed. But whether their warnings were heeded āĀ and what kind of impact Americansā decisions might have had āĀ wonāt be clear for a few weeks. (Joseph, 11/29)
First and foremost, anyone who traveled to visit with family and friends or hosted guests outside their immediate household unit should quarantine, [Leana] Wen advised. Taking action to protect others around you will help mitigate the spread of Covid-19, especially with Hanukkah, Christmas and New Year's just around the corner. (Chiu, 11/27)
As millions of people in the United States travel back home from the Thanksgiving holiday, Covid-19 hospitalizations are inching closer to 100,000 -- the highest they've ever been. With infections expected to increase, experts say the stakes are even higher for the public to get tested to help slow the spread. (Holcombe, 11/30)
In related news from Maine and Massachusetts ā
Coronavirus-related hospitalizations in Maine rose again on Friday, even as a temporary drop in testing and reporting over the Thanksgiving holiday may lead to a artificial drop in the number of new reported cases this weekend. The spread of the virus in Maine has spiked over the past month, with the seven-day average of new cases rising to 221 on Thursday, up from only 40 one month earlier. But the Thanksgiving closure of the state lab that processes tests led to the Maine Center for Disease Control and Prevention not reporting case data on Friday. (Piper, 11/27)
Fallout from Thanksgiving travel and festivities could intensify challenges Massachusetts will face as it continues to battle the pandemic through the December holidays, when officials will be navigating more uncertain terrain amid soaring numbers of cases. While more indications emerge that people are chafing under pandemic restrictions, those measures are vital to curb the spread and ease pressure on the stateās health care system, officials said. (Hilliard and Tziperman Lotan, 11/29)
Administration News
Canada Restricts Export Of Prescription Drugs In Limited Supply
Ahead of an expected surge in U.S. demand for prescription drugs, the Canadian government has blocked the distribution of certain medications outside Canada in order to avoid a shortage within the country. The Canadian health minister signed an order Friday to limit bulk exports, saying it would help safeguard the country's drug supply. The move comes in response to a new U.S. rule that would let pharmacists or wholesalers import certain prescription drugs in bulk. (Schwartz, 11/29)
Canada has imposed measures to limit the distribution of some drugs, a move thatās largely aimed at the U.S. The Canadian government is putting the new guidelines in place to protect its drug supply from bulk sales across the border that could worsen the current deficit, Health Minister Patty Hajdu said in a statement. Companies will now be required to provide information to assess existing or potential shortages, and within 24 hours in serious cases. (Balji, 11/28)
Canadian officials, responding to a move by President Trump allowing Americans to import some prescription drugs, blocked bulkĀ exportation of drugs in casesĀ in which a domestic shortage would be created. The order took effect Friday ahead of the U.S. rule, which drug suppliers have warned could lead to shortages within Canada, Reuters reported. (Budryk, 11/29)
Also ā
An influential pharmaceutical lobbying group is suing to end the Trump administrationās plan to allow prescription drugs to be imported from Canada into the United States. That could have major implications for Florida, where Gov. Ron DeSantis and President Donald Trump have highlighted state and federal efforts to lower the cost of prescriptions. DeSantis announced last week that Floridaās importation plan had been submitted to the federal government. (Wilson, 11/27)
Republican State Senator Learns He Has COVID At Meeting With Trump
A Pennsylvania state senator abruptly left a West Wing meeting with President Donald Trump after being informed he had tested positive for the coronavirus, a person with direct knowledge of the meeting told The Associated Press on Sunday. Republican state Sen. Doug Mastriano had gone to the White House last Wednesday with like-minded Republican state lawmakers shortly after a four-hour-plus public meeting that Mastriano helped host in Gettysburg ā maskless ā to discuss efforts to overturn president-elect Joe Bidenās victory in the state. (Scolforo, 11/29)
A Republican lawmaker from Pennsylvania abruptly left a White House meeting with President Trump after he was informed that he had tested positive for COVID-19, The Associated Press reported Sunday. Pennsylvania state Sen.Ā Doug Mastriano (R) was informed during the Wednesday meeting with Trump about the president's efforts to overturn the 2020 election results that he had tested positive for the virus and was led away by White House medical staff, one source at the meeting told the AP. (Bowden, 11/29)
In other Trump administration news ā
U.S. Surgeon General Jerome Adams made clear on Sunday that mask-wearing is personal to him. In an interview on āFox News Sunday,ā Adams cited his hospitalized mother as a reason Americans should start wearing masks to curb coronavirus case counts that have skyrocketed in recent weeks and placed a severe strain on the nationās hospitals. (Semones, 11/29)
White House testing czar Adm. Brett Giroir promoted mask wearing and social distancing on Sunday, saying that ātesting alone will never solve this issue.ā Giroir told CNNās āState of the Unionā that the U.S. is ādoing everything we canā to improve COVID-19 testing as the number of coronavirus hospitalizations and cases surge across the nation amid the Thanksgiving holiday. āUnless we can control the viral spread, by doing the things like wearing a mask, avoiding indoor crowded spaces, you cannot test your way out of this,ā he said. (Coleman, 11/29)
Supreme Court
High Court Shifts To Right As Barrett Plays Decisive Role in COVID Ruling
The U.S. Supreme Court on Wednesday nightĀ blocked New York Gov. Andrew Cuomo from reimposing strict attendance caps at worship servicesĀ in areas hit hard by the novelĀ coronavirus.Ā The court ruled 5-4 to bar Cuomo from enforcing his Oct. 6 āCluster Initiativeā against houses of worship that sued to challenge the restrictions. (Aaro, 11/26)
The Supreme Court signaled a major shift in its approach to coronavirus-related restrictions late Wednesday, voting 5-4 to bar New York state from reimposing limits on religious gatherings. The emergency rulings, issued just before midnight, were the first significant indication of a rightward shift in the court since President Donald Trumpās newest appointee ā Justice Amy Coney Barrett ā last month filled the seat occupied by liberal Justice Ruth Bader Ginsburg, who died in September. (Gerstein, 11/26)
In a Supreme Court ruling just before midnight on Thanksgiving eve, Supreme Court Justice Sonia Sotomayor penned another of her fiery dissentsāthis time warning, in her view, of the dangers of the Courtās majority position on New York Stateās Covid-19 restrictions. (Reyes, 11/26)
The Supreme Courtās order temporarily blocking New York from setting coronavirus capacity limits at houses of worship is āirrelevantā and āmoot,ā Gov. Andrew Cuomo claimed Thursday. ... Cuomo, in a Thanksgiving Day conference call with reporters, insisted the order was moot because the houses of worship in question in the curt battle are no longer in designated red and orange zones in Brooklyn in Queens so the restrictions no longer apply to them. (Campanile, Hogan and Hicks, 11/26)
Also ā
Pandemic restrictions on places of worship in Massachusetts wonāt run afoul of a US Supreme Court ruling this week that barred certain capacity limits on religious gatherings in areas of New York where coronavirus infections were rising, according to legal scholars and Governor Charlie Bakerās office. āThe administration believes the Supreme Court decision is consistent with the way Massachusetts is working with our houses of worship during the pandemic,ā Baker spokeswoman Sarah Finlaw said in an e-mail. (Pan and Finucane, 11/27)
U.S. Supreme Court Associate Justice Samuel Alito denied a Louisiana pastor's legal petition requesting an exemption from state restrictions effected in response to the coronavirus pandemic. Reverend Tony Spellāwho currently faces a half-dozen misdemeanor charges for violating Louisiana's COVID-19 orders and an assault charge for alleged conduct during a protest last springāfiled his petition in Louisiana over the summer. After multiple rejections, Spell's attorneys brought his case before the Supreme Court. (Czachor, 11/29)
Medicare
Lower Medicare Drug Costs Could Pose Serious Challenge To Providers
The Trump administration's plan to tie Medicare payment for outpatient drugs to prices charged in foreign countries depends on providers negotiating drugmakers' prices down to meet reduced reimbursement levels. While the administration pitches the Center for Medicare and Medicaid Innovation demonstration as an effort to lower drug prices, it's unclear whether or by how much drugmakers would actually lower the prices they charge healthcare providers. If they don't, providers have to choose whether to offer the drugs at a financial loss. (Cohrs, 11/25)
Also ā
The Trump administration proposed lowering the user fee for Affordable Care Act insurers from 3% to 2.25% of the premium for the 2022 coverage year. The Centers for Medicare & Medicaid Services released late Wednesday the proposed Notice of Benefit Payment Parameters for the 2022 coverage year. The rule also proposes enabling states to partner with the private sector to create a website that competes with the state-run exchange website or HealthCare.gov. (King, 11/25)
Just over a decade ago, celebrated surgeon and writer Dr. Atul Gawande penned a New Yorker article that called out certain areas of the country for their high Medicare spending.Ā But despite the public lashing some regions endured, the most recent data from the Dartmouth Atlas show little has changed since then with respect to the communities atop the Medicare spending tower and those at the bottom. Miami was highest among hospital referral regions in the latest price-adjusted data, from 2017, followed by two smaller cities that were also near the top in 2010: Munster, Ind., and Monroe, La. Grand Junction, Colo., Anchorage, Alaska, and Honolulu had among the lowest spending in both years.Ā (Bannow, 11/28)
Elections
Biden Beefs Up His Coronavirus Task Force
President-elect Joe Biden announced Saturday he is adding three new members to his transition team's coronavirus task force as the incoming administration focusesĀ on preparation to tackle the coronavirus pandemic. The transition said in a statement that Jane Hopkins, Jill Jim and David Michaels are joining the team, which is co-chaired by David Kessler, former Surgeon General Vivek Murthy and Marcella Nunez-Smith. The task force is charged with helping Biden, Vice President-elect Kamala Harris and the transition cobble together a ārobust and aggressive response to contain the virus." (Axelrod, 11/28)
A raging pandemic and a gridlocked Congress could upend President-elect Joe Bidenās plan to hire 100,000 public health workers to trace Covid-19ās spread, despite widespread agreement itās needed to finally end the crisis. Contact tracing will be essential even after Covid-19 vaccines become widely available, because not everyone will get shots and scattered outbreaks will continue to ripple across the country. Quickly identifying whoās been exposed to people with infections can guide efforts to stamp out new hot spots and break chains of transmission. (Ollstein and Goldberg, 11/26)
A new Monmouth University poll finds that 27% of Americans say that the coronavirus pandemic is the biggest issue facing President-elect Joe Biden over the next four years. That's the top percentage for any issue, and it follows months of polling from Gallup showing that Americans think the coronavirus is the most important problem facing the country. (Enten, 11/29)
Also ā
President-elect Joe Biden, long viewed as a drug policy hawk during his four decades in the Senate, is signaling a different approach to confronting a still-raging drug addiction epidemic made worse by the pandemic. Biden, who has stocked his team with addiction experts with extensive backgrounds in public health, will emphasize new funding for substance abuse treatment and prevention, while calling to eliminate jail time for drug use. Itās a departure from his tough-on-crime approach as a senator ā and from President Donald Trumpās frequent focus on a law enforcement response to the drug crisis, which experts said undercut necessary public health measures. (Goldberg and Ehley, 11/28)
Hairline Fracture In Foot Lands Biden In Walking Boot For Several Weeks
President-elect Joe Biden will need a walking boot after sustaining small fractures to his right foot while playing with one of his dogs, according to his doctor. Biden was injured Saturday and visited an orthopedist at Delaware Orthopaedic Specialists in Newark, Del., for an examination Sunday afternoon, according to a pool report. (Genota, 11/29)
Fractures are a concern generally as people age, but Bidenās appears to be a relatively mild one based on his doctorās statement and the planned treatment. At 78 he will become the oldest president when heās inaugurated in January; he often dismissed questions about his age during the campaign. (Jaffe, 11/30)
Although initial X-rays showed no obvious fracture, a āfollow-up CT scan confirmed hairline (small) fractures of President-elect Bidenās lateral and intermediate cuneiform bones, which are in the midfoot,ā Dr. Kevin OāConnor, the director of executive medicine at GW Medical Faculty Associates, said in a statement distributed by Mr. Bidenās office. (Karni, 11/29)
President-elect Joe BidenĀ suffered hairline fractures inĀ his right foot while playing with his dog and will wear an orthopedic walking boot, Biden's transition team said Sunday. BidenĀ slipped and twisted his ankle on Saturday while he was playing with Major, one of his two German shepherds, and he was seen by a doctor on Sunday. (Coleman and Bowden, 11/29)
Economic Toll
Can Lame-Duck Congress Push Through Stimulus Package?
After months of shadowboxing amid a tense and toxic campaign, Capitol Hillās main players are returning for one final, perhaps futile, attempt at deal-making on a challenging menu of year-end business. COVID-19 relief, a $1.4 trillion catchall spending package, and defense policy ā and a final burst of judicial nominees ā dominate a truncated two- or three-week session occurring as the coronavirus pandemic rockets out of control in President Donald Trumpās final weeks in office. (Taylor, 11/30)
For many, the outcome is of extreme financial importance: Evidence suggests the unemployed have drawn down savings at a rapid clip and are going hungry more often than those whoāve kept their jobs and hours intact. Time is quickly running out to pass something by year-end to prevent a ābenefits cliff,ā which would erase temporary protections in place for renters, student loan borrowers and the jobless. (Iacurci, 11/28)
Former President Obama's chief economist said on Sunday that Democrats should accept a smaller coronavirus relief package if necessary in order to get at least minimal relief to Americans.Ā Former White House Chief Economist Austan Goolsbee told CNNās āInside Politicsā that heās ānot an expert on the political negotiationsā but he said he hopes that Congress can agree on a relief package soon because Americans are āreally hurting.ā (Coleman, 11/29)
In related news on COVID's economic toll ā
Tens of millions of workers stand to lose access to federally mandated paid sick and family leave at the end of December, compounding the hardship over the surging pandemic for American families. Families First, a relief package enacted in March, required many employers to provide workers with two weeks of coronavirus-related sick leave at full pay and up to 12 weeks of family and medical leave to care for family members at two-thirds pay. Researchers estimate this covered half the U.S. workforce. (Mueller, 11/29)
A nationwide eviction ban was supposed to protect tenants like Tawanda Mormon, who was forced out of her two-bedroom apartment last month in Cleveland. The 46-year-old, who was hospitalized in August for the coronavirus and canāt work due to mental health issues, said she fell behind on her $500-a-month rent because she needed the money to pay for food. When she was evicted in October, Mormon said she was unaware of President Donald Trumpās directive, implemented in September by the Centers for Disease Control and Prevention, that broadly prevents evictions through the end of 2020. (Casey, 11/29)
In other news from Capitol Hill ā
Rep.-elect Carlos Gimenez of Florida announced Friday evening that he and his wife tested positive for Covid-19 Thursday and are self-isolating in their home. "After several negative tests, both Lourdes and I tested positive for COVID-19 yesterday. We are both feeling good and experiencing no symptoms at this time," Gimenez said in a statement. (Flores and LeBlanc, 11/27)
Coverage And Access
Overwhelmed Hospitals Fret As Reinforcements Get Tougher To Find
Hospitals in much of the country are trying to cope with unprecedented numbers of COVID-19 patients. As of Sunday, 93,238 were hospitalized, an alarming record that far exceeds the two previous peaks in April and July, of just under 60,000 inpatients. But beds and space aren't the main concern. It's the work force. Hospitals are worried that staffing levels won't be able to keep up with demand, as doctors, nurses and specialists such as respiratory therapists become exhausted or, worse, become infected or sick themselves. (Farmer and Feibel, 11/30)
In excruciating pain with lesions on her face and scalp, Tracey Fine lay for 13 hours on a gurney in an emergency room hallway. All around her, Covid-19 patients filled the beds of the hospital in Madison, Wis. Her nurse was so harried that she could not remember Ms. Fineās condition, and the staff was slow to bring her pain medicine or food. In a small rural hospital in Missouri, Shain Zundelās severe headache turned out to be a brain abscess. His condition would typically have required an operation within a few hours, but he was forced to wait a day while doctors struggled to find a neurosurgeon and a bed ā finally at a hospital 375 miles away in Iowa. (Abelson, 11/27)
As the coronavirus pandemic swelled around the 160-bed Mayo Clinic hospital, the day was dawning auspiciously. Two precious beds for new patients had opened overnight. At the morning ābed meeting,ā prospects for a third looked promising. Better yet, by midmorning, there were no patients in the Emergency Department. None. Even in normal times, a medium-size hospital like this can go many months without ever reaching zero. Everyone knew better than to trust this good fortune. They were right. (Bernstein, 11/29)
Like many primary-care physicians across the country, Dr. Trevor Huber is using telehealth to triage patients for COVID-19 symptoms. In one of these recent visits, a man in his mid-60s was complaining of chest pain, thinking it may be the virus. Huber wasnāt convinced, urging him to come into his practice in Little Elm, Texas, right away to make sure he wasnāt having a heart attack.Ā After hooking the patient up to an electrocardiogram, it was clear the patient was in cardiac arrest. Huberās team called 911 right away. (Castellucci, 11/28)
In the emergency room of Sparrow Hospital in Lansing, Michigan, Pam Warfle begged for compassion. Her autistic sonĀ had COVID-19 andĀ neededĀ to be hospitalized, though the staff informed her she couldn't stay." 'You don't understand. You're going to have to carry me out of here. He cannot communicate,'" Warfle recalled tellingĀ the doctors and nurses as she pleaded to stay. "Ā 'You can put me in bubble wrap. I'll stay in a corner.' "But the hospital wouldn't bend: "We cannot do it," they said. (Baldas, 11/29)
In other health care industry news ā
KHN: Thousands Of Doctorsā Offices Buckle Under Financial Stress Of COVIDĀ
Cormay Caine misses a full day of work and drives more than 130 miles round trip to take five of her children to their pediatrician. The Sartell, Minnesota, clinic where their doctor used to work closed in August. Caine is one of several parents who followed Dr. Heather Decker to her new location on the outskirts of Minneapolis, an hour and a half away. Many couldnāt get appointments for months with swamped nearby doctors. (Ungar, 11/30)
The news stunned Asheville and Western North Carolina, where Mission Health System Inc. was the areaās largest employer, its main healthcare provider, and a long-time source of civic pride. Seemingly out of the blue, Missionās directors publicly announced on March 21, 2018, that they had voted to sell the 133-year-old nonprofit to HCA Healthcare, the nationās largest for-profit hospital chain, for an estimated $1.5 billion. āTo say that [Missionās] announcement ⦠was a surprise would be an understatement,ā the Asheville Citizen Times observed in an editorial. āThere has not been the slightest hint anything was afoot until Mission announced that its board had approved the deal unanimously.ā (Lewis, 11/26)
Years from now, the decision in 2018 by the directors of Mission Health to sell to HCA Healthcare might be seen as a brilliant strategic maneuver, one that guaranteed affordable, high-quality healthcare for future generations of western North Carolinians. This was, and still is, the position of the directors and executives who pushed the deal. (Lewis, 11/27)
Healthcare Personnel
Refusing To Wear Masks: Sanford CEO Quits; Nurse Shows Off On TikTok
Longtime Sanford Health President and CEO Kelby Krabbenhoft is stepping down after sparking controversy for refusing to wear a mask. Tuesday evening, Sanford announced Krabbenhoft "mutually agreed" with the board of trusteesĀ to part ways with the health system.Ā (Reed, 11/25)
An oncology nurse in OregonĀ has been placed on administrative leave after posting a video on social media showing disregard for COVID-19 restrictions.Ā In the video, uploaded Friday to TikTok, the nurse, identified by Salem Health hospital officials as Ashley Grames,Ā says she doesn't wear a mask in public outside of work, continues to travel andĀ allowsĀ her children to have playdates.Ā (Barreda, 11/29)
In other news on health care personnel ā
KHN: OSHA Let Employers Decide Whether To Report Health Care Worker Deaths. Many Didnāt.Ā
As Walter Veal cared for residents at the Ludeman Developmental Center in suburban Chicago, he saw the potential future of his grandson, who has autism. So he took it on himself not just to bathe and feed the residents, which was part of the job, but also to cut their hair, run to the store to buy their favorite body wash and barbecue for them on holidays. āThey were his second family,ā said his wife, Carlene Veal. (Pattani, Lewis and Jewett, 11/30)
Over 1,400 U.S. health care workers have died fighting COVID-19. KHN and The Guardian count them and investigate why.
When the coronavirus first flared up across Maine last spring, many of the stateās frontline health care workers were scared by how little they knew about it. Would they have enough face masks and gowns? Would they bring the virus home to their loved ones? Would they die from it? And how quickly would the strange new infection storm across a rural state whose large elderly population was particularly threatened by it? (Eichacker, 11/28)
Carol Siewert wasn't planning to leave hospital-based nursing for another two to five years. But then the novel coronavirus swept across the globe and into her 39-bed unit in a teaching hospital in Madison, Wis., and she knew it was time to go. "I left because of staffing. I left because of health reasons, because I had blood clots in both lungs last summer, and I'm concerned that I'm higher risk for COVID complications like blood clots or acute respiratory distress. I also left because I was, quite literally, heartsick at doing my job," she said. "I realized I was experiencing what healthcare people have come to call 'moral injury,' or a kind of PTSD, and that it was best for my health if I left." (Christ, 11/25)
Alaskans are stressed, and their dentists can tell.āThereās no question there has been increased incidence of people grinding their teeth,ā said Dr. Dave Logan, executive director of the Alaska Dental Society. āI think thatās to be expected with the stress of the pandemic," he said. āCertainly I have seen more (incidence of grinding) than usual," said Dr. Guy Burk, a dentist at Midtown Dental in Anchorage. (Burman, 11/29)
Science And Innovations
More COVID Surprises: Baby Born With Antibodies; Long-Haulers' Teeth May Suddenly Fall Out
Doctors are studying the impact of COVID-19 on pregnant women and their unborn babies in Singapore, where an infant delivered by an infected mother earlier this month had antibodies against the virus but did not carry the disease. The ongoing study among the city-stateās public hospitals adds to international efforts to better understand whether the infection or antibodies can be transferred during pregnancy, and if the latter offers an effective shield against the virus. (Aravindan and Geddie, 11/30)
Celine Ng-Chan, 31, is part of an ongoing study taking place at several public hospitals in Singapore that seeks to better understand the impacts of covid-19 on pregnant women and their babies. She told the paper that she and several family members all got sick in March after returning from a vacation in Europe, and that she experienced relatively mild symptoms while her mother spent nearly a month on life support. At the time, Ng-Chan was 10 weeks pregnant. When her son, Aldrin, was born in early November, he had antibodies but not the virus ā but her antibodies seemed to have disappeared. āMy doctor suspects I have transferred my Covid-19 antibodies to him during my pregnancy,ā Ng-Chan told the Straits Times. (Farzan, 11/30)
In other science and research news ā
Earlier this month, Farah Khemili popped a wintergreen breath mint in her mouth and noticed a strange sensation: a bottom tooth wiggling against her tongue. Ms. Khemili, 43, of Voorheesville, N.Y., had never lost an adult tooth. She touched the tooth to confirm it was loose, initially thinking the problem might be the mint. The next day, the tooth flew out of her mouth and into her hand. There was neither blood nor pain. (Yan, 11/26)
Large-scale seroprevalence studies conducted over the summer show that, through September, less than 1 in 10 of Americans had evidence of previous coronavirus infection, researchers from the Centers for Disease Control and Prevention (CDC) reported yesterday in JAMA Internal Medicine. In the nationwide seroprevalence survey, researchers from the CDC's COVID-19 Response Team tested blood serum samples from people in 50 states, the District of Columbia, and Puerto Rico during four periods from July through September, looking for the presence of detectable antibodies for SARS-CoV-2, (the virus that causes COVID-19. (Dall, 11/25)
New Study Sheds Light On Treatments For Pediatric Brain Cancers
Brain tumors are among the most common ā and the most deadly ā cancers among children. A new paper, published Wednesday in the journal Cell, explores the intricacies of how cancers of the brain operate in children and proffers tantalizing clues about how they may be treated. (Keshavan, 11/25)
In other developments ā
The UK's National Health Service (NHS) is to pilot a simple blood test that may detect more than 50 types of cancer and, it is hoped, could help thousands of people by allowing the disease to be treated more successfully at an earlier stage. The Galleri blood test, developed by Californian healthcare company Grail, will be piloted with 165,000 patients in what the NHS described as a "world-first deal" in a news release Friday. (Smith-Spark, 11/27)
Adventist Health for several years has been rolling out a genetic testing and cancer risk-assessment program to sites across the Roseville, Calif.-based system. Now, the program is playing a part in Adventistās efforts to get patients in need of cancer screenings back into its facilities despite fears over COVID-19. In the wake of the pandemic, patients have deferred or canceled preventive care appointments out of concern theyāll be exposed to the virus. That could have long-term consequences for cancer care, since fewer patients screened could make it harder to catch cancer cases at an early stage. (Kim Cohen, 11/28)
On the evening that would jolt the global traffic of cancer treatments, David Kim was driving his baby daughter around, trying to get her to sleep. Bedtime was rough: Only the smooth motion of a car could get her to doze off. So Kim was playing dad-chauffeur, with the radio on low, when he heard that President Trump was banning travel between the United States and Europe. (Boodman, 11/30)
Public Health
More Airlines Will Offer Digital Health Passes To Bring Back Passengers
Following a successful test with United Airlines in October, four more major airlines plan to start offering passengers a digital health pass to certify they are COVID-19-free. JetBlue, Lufthansa, Swiss International Airlines, United Airlines, and Virgin Atlantic will begin the roll-out of CommonPass mobile app in December to help bring back global travel. The health pass app will be usedĀ on select flights departing from New York, Boston, London, and Hong Kong. (Landi, 11/25)
Driven in part by holiday plans and fears of exposure amid a second wave, a record number of Massachusetts residents are seeking tests. At many sites, particularly the appointment-free locations meant to offer convenience, test-seekers are greeted by long lines that wind around buildings and blocks, through parking lots and playgrounds. Waits can extend for hours as staff struggle to test hundreds of people who suddenly ā and urgently ā want to know whether they have COVID-19. But donāt expect the lines to dissipate anytime soon. Experts warn that serious shortcomings in the stateās testing infrastructure, including inadequate space and staffing, have left providers ill-equipped to meet the demand for testing as the pandemicās second wave crashes over the state. (Moore, 11/27)
A study that tests for parts of the coronavirus in sewage is giving public health workers advance notice of virus surges. The Lawrence Journal-World reports that the City of Lawrence has been taking weekly sewage samples at both of its wastewater treatment plants to test for components of the virus shed in feces as part of a study contracted through the University of Kansas School of Engineering. The city has also been sharing that data with local and state health departments. (11/28)
KHN: āAn Arm And A Legā: How To Avoid A Big Bill For Your COVID TestĀ
Tests for the coronavirus are supposed to be free. And, usually, they are. But sometimes ⦠things happen. Hereās how to keep those things from happening to you. New York TimesĀ reporter Sarah Kliff has been asking readers to send in theirĀ COVID-testing bills. Sheās now seen hundreds of them, and she ran down for us the most common ways things can go sideways, and how to avoid them. (Weissmann, 11/30)
Restaurants, Grocery Stores Scramble To Deal With Winter Outbreaks
Turkey farmers raised smaller birds for reduced Thanksgiving gatherings. Restaurants are begging Congress for a lifeline as state and local officials clamp down on indoor dining. And major grocers including Kroger, H-E-B and Publix are bringing back per-customer limits on high-demand items like toilet paper and household cleaners. Across the food and grocery industry, the holidays are starting to resemble the panic of the pandemic spring, when the supply chain was stressed and businesses were teetering. This time around, grocers say the limits are proactive measures, rather than a sign of looming shortages. Still, photos of empty store shelves have again started cropping up online ā a sign that the countryās food industry is still on edge as worried customers snap up more toilet paper and milk than they may need. (McCrimmon, 11/26)
Some restaurants are rejecting a new round of shutdown orders, saying that serving customers indoors is their only way to stay in business and that they can do so safely. Mike Coughlin is breaking an Illinois state order by doing what he has done for 26 yearsāserving pot-roast and fish-fry platters inside his Village Tavern and Grill. He says it is worth the risk if it keeps his restaurant in business through the coronavirus pandemic. (Haddon and Wernau, 11/29)
Sheriffās deputies arrived at a building in Midtown Manhattan just before 3 a.m. on Saturday and found almost 400 people drinking and partying inside. Few were wearing face masks. Deputies shut the party down and arrested four people. The episode reflected the way that, despite the onset of a second wave of the coronavirus, people are continuing to gather at large events in New York City in violation of public health safeguards. (Zaveri, 11/29)
Until the coronavirus pandemic, their meetings took place quietly, every day, discreet gatherings in the basements of churches, a spare room at the YMCA, the back of a cafe. But members of Alcoholics Anonymous and other groups of recovering substance abusers found the doors quickly shut this spring, to prevent the spread of Covid-19. What happened next is one of those creative cascades the virus has indirectly set off. Rehabilitation moved online, almost overnight, with zeal. Not only are thousands of A.A. meetings taking place on Zoom and other digital hangouts, but other major players in the rehabilitation industry have leapt in, transforming a daily ritual that many credit with saving their lives. (Richtel, 11/28)
Itās been a long time since employers around the world abruptly sent their staff home, and workers are feeling it. What was once a creative workaround or show of resilienceāplop a monitor on your ironing board, take a conference call in your carāhas become an ergonomic nightmare. ... Left unchecked, ergonomic issues can lead to permanent pain, disability and an inability to work at all. Still, at the beginning of the pandemic, employers were understandably more concerned with pressing crisesākeeping their businesses afloat, keeping workers safe from the virusāthan the threat of aches and pains. (Feintzeig, 11/29)
In sports news ā
The NFL fined the New Orleans Saints $500,000 and stripped them of a seventh-round draft choice for violations of the sportās coronavirus protocols during a postgame locker room victory celebration without masks. The Saints become the second NFL team to lose a draft pick because of protocol violations. The Las Vegas Raiders previously were fined $500,000 and stripped of a sixth-round selection because of violations. (Maske, 11/29)
The National Football Leagueās Thanksgiving weekend is supposed to be a feast of tradition and marquee matchups. The pandemic-year edition has exploded into a series of crises that threaten to break the NFLās season. Over the past several days, new coronavirus problems erupted across the league as Covid-19 cases continued to surge throughout the country. The situation is so severe that, after Sundayās games, the NFL will shut down most in-person activities for two days to regroup from the weekend amid worries that behavior over the holiday may make matters worse. (Beaton, 11/29)
NBA players who test positive for the coronavirus this season may have to miss nearly two weeks in some instances before being allowed to return to the court, the league told its teams Saturday. That revelation was one of many in a 63,000-word document, a copy of which was obtained by The Associated Press, that explained some of the heath and safety protocols for the looming season. Preseason games begin Dec. 11 and regular-season contests start Dec. 22. (Reynolds, 11/28)
From The States
NYC To Reopen Public Schools For In-Person Learning; HBCUs Fare Well
New York Mayor Bill de Blasio announced Sunday that he would begin to allow the cityās youngest students and those with special needs to return to classrooms beginning next week, abandoning a previous plan that forced the entire school system to close 10 days ago and marking another disruption in an already challenging school year. The move, which will be accompanied by ramped-up coronavirus testing, only impacts a fraction of the more than one million public school students in New York City, home to by far the largest school system in the nation. (Balingit, 11/29)
In August, the semester at UNC Chapel Hill came to an abrupt end as hundreds of students fell ill as a result of COVID-19. When students were told to move off campus and classes moved online exclusively, UNC became something of a national punchline for how quickly the wheels fell off. (Bowden, 11/30)
The public schools in Baltimore County, Md., will remain closed Monday and Tuesday as officials respond to a cyberattack that forced the district to cancel remote classes for its 115,000 students just before the Thanksgiving holiday, officials said. The attack, first detected late Tuesday night, affected the districtās websites and remote learning programs, as well as its grading and email systems, officials told WBAL-TV. (Paybarah, 11/29)
In other news from Colorado, Oregon, California and New York ā
Colorado Gov. Jared Polis and his partner both tested positive for COVID-19, the governorās office said Saturday evening. Polis, who went into quarantine on Wednesday after saying he was exposed to someone who tested positive for the coronavirus, said in a statement he and partner, First Gentleman Marlon Reis, were asymptomatic and āfeeling well.ā (Miller, 11/28)
An Oregon mink farm has reported an outbreak of coronavirus among mink and farmworkers. Ten mink samples submitted all came back positive for coronavirus, the Oregon Department of Agriculture (ODA) said in a news release on Friday. The farm has been placed under quarantine, meaning "no animal or animal product can leave the farm until further notice," according to ODA. (Elassar, 11/28)
California has more people hospitalized with COVID-19 than at any time since the pandemic began, an ominous development that comes as officials warn of further virus spread after the long holiday weekend. The rising numbers raise new concerns about hospitals filling up in the coming weeks, which has been predicted as coronavirus cases surge to unprecedented levels across the state and, in particular, Los Angeles County. (Wigglesworth and Lin II, 11/29)
Also ā
South Carolina health officials are offering free HIV and other testing as part of World Aids Day. The testing for the virus that causes AIDS along with sexually transmitted diseases and Hepatitis C will be conducted Tuesday at local health clinics across the state, according to the South Carolina Department of Health and Environmental Control. (11/29)
Since Oregon became the first state in the country to decriminalize drugs earlier this month, advocates there are hoping the new law could shift national perceptions around addiction and how to treat it. Officials in Philadelphia are paying close attention. The ballot measure, written by the national advocacy organization Drug Policy Alliance and backed by a slew of local groups in Oregon, will make the possession of small amounts of drugs for personal use ā including heroin, methamphetamine, and cocaine ā a violation punishable by a $100 fine or a substance-abuse screening, instead of a criminal misdemeanor. (Whelan, 11/30)
Global Watch
The Race To Vaccinate: UK Prepares To Start Soon
Britain said Sunday it has secured 2 million more doses of a promising coronavirus vaccine as it gears up to launch within days the countryās most ambitious inoculation program in decades. ... The Department of Health said Sunday it had increased its order for a vaccine developed by U.S. firm Moderna from 5 million to 7 million doses, enough for 3.5 million people. The Moderna vaccine is expected to be referred soon to the U.K.ās Medicines and Healthcare Products Regulatory Agency, to see if it is safe and effective. Two other vaccines ā one developed by Pfizer and German firm BioNTech, the other by Oxford University and AstraZeneca ā are already being assessed by the regulator, the final stage before being rolled out. (Lawless, 11/29)
The U.K. is poised to become the first country to approve Pfizer Inc. and BioNTech SEās Covid-19 vaccine, ahead of a long line of countries waiting for protection from the coronavirus. Clearance is possible as early as this week, according to a person familiar with the situation, who asked not to be identified because the process is confidential. (Hipwell, Kresge and Ross, 11/28)
Health Secretary Matt Hancock asked the U.K. medical regulator to potentially bypass its European Union counterpart and approve the supply of AstraZeneca Plcās coronavirus vaccine to speed its deployment. Until the end of the year, when the U.K. exits a post-Brexit transition period, vaccines there must be authorized by the European Medicines Agency. But on Friday, Hancock said he invoked a special rule allowing Britainās Medicines and Healthcare products Regulatory Agency to authorize a temporary supply of the vaccine Astra is developing with Oxford University if the data is robust enough, after it showed positive results in trials this week. (Morales, 11/26)
In other global developments ā
Brazilian President Jair Bolsonaro says he wonāt take any working COVID-19 vaccine himself and calls the use of masks to limit the spread of the disease āthe last taboo to fall.ā Bolsonaroās comments, broadcast on his social media channels Thursday night, alarmed health experts who said they could undermine efforts to achieve vaccination levels essential to halting the pandemic and might scare off vaccine makers negotiating with local authorities. (Savarese, 11/27)
Suicide rates among young women have increased notably in Japan and South Korea, raising possible links to the prolonged coronavirus pandemic as it amplifies stress levels, worsens economic woes and aggravates feelings of loneliness and isolation. No comprehensive global studies are yet available on whether the pandemic has caused higher suicide numbers or how it may have affected different age groups and genders. (Denyer and Kashiwagi, 11/29)
Also ā
The authorities searched the home and offices of Diego Maradonaās personal doctor on Sunday as part of an investigation into the circumstances surrounding the soccer starās death last week. Prosecutors requested a search warrant for the doctor, Leopoldo Luque, after collecting evidence and interviewing Mr. Maradonaās relatives, according to a statement by the prosecutorās office in San Isidro, Buenos Aires Province. The statement did not provide more details. (Politi and Kwai, 11/29)
Editorials And Opinions
Viewpoints: Lessons On Keeping Public Health A Priority After COVID And Knowing How Well Vaccines Work
āWeāre almost there.ā Thatās what Iāve been thinking recently, and especially during our eerily sparse Thanksgiving celebrations. Things may be unpleasant now, but if everything goes well, then sometime next summer, we should reach the end of this miserable journey through plagueland. But on closer inspection, the more I realize I donāt really know what āthereā will look like. For all the talk of a āreturn to normal,ā large chunks of the old normal are due for a post-covid-19 rethink. And Iām not just talking about movies heading to video or takeout cocktails ā though, please, letās keep the takeout cocktails. The more I think about it, the more I think Iām talking about practically everything. (Megan McArdle, 11/29)
The Food and Drug Administration may approve a Covid-19 vaccine for emergency use within the next few weeks. Within days of that green light, millions of doses will start making their way to patients. The distribution and administration will be logistically complex and difficult. And the study of a vaccineās safety and efficacy doesnāt end with FDA approval. Researchers will be gathering evidence on how well these products work in the real world. The vaccine is likely to reduce the odds of serious or symptomatic infection. But will vaccinated patients be less likely to be infected at all? Do the vaccines confer, as preliminary evidence suggested, āmucosal immunity,ā in which immune cells in the respiratory tract can help reduce the chance of spreading the virus? If so, parts of the country with low spread and high rates of vaccination may be able to ease up on mitigation measures like wearing masks and distancing. (Scott Gottlieb and Mark McClellan, 11/29)
With the Covid-19 pandemic now resurgent across the globe, itās a comfort to know that there are several promising vaccine candidates in speedy development. Their success is crucial in fighting the virus and charting a path back to normal. It's important, though, that we are able to see rigorous, clean and transparent trial data, to help gain trust in any vaccine and know that proper protocols are in place. Unfortunately, one of the leading vaccine candidates ā from AstraZeneca Plc, working with the University of Oxford āĀ is having a problem in this area. (Sam Fazeli, 11/30)
My painful excursion into the world of dueling infections started on a Tuesday afternoon with a scratchy throat and a mild-yet-annoying cough. I chalked it up to fall in Kentucky, where sunny afternoons in the mid 70s can be followed by freezing temperatures at night. Iām no stranger to respiratory infections, having lived for years with the triple threat of allergies, asthma, and low immunity. (Lauren Hines, 11/27)
Does freedom mean the right to refuse to wear a mask during the COVID-19 pandemic?Ā Many Americans think so. It is President Trumpās most important legacy. Hereās one implication that is too little noticed: If that is what freedom means, then we owe drunk drivers an apology. (Andrew Koppelman, 11/29)
America is sliding into a winter limbo of alarming spikes in Covid-19 cases and deepening economic pain while an apathetic lame duck White House and a deadlocked Congress provide no political leadership. The darkest holiday season in modern history beckons, yet President Donald Trump and his closest aides, sulking after his election defeat, are doing little to save lives, apart from claiming credit for a vaccine that represents a way out of the nightmare of 2020 but remains months away for most Americans. (Stephen Collinson, 11/30)
With federal health officials meeting this week to make crucial decisions about who they will recommend to get the coronavirus vaccine first, pressure is mounting on Congress to step back into the governing role that they have abdicated and strike an agreement not only on the expiring aid for struggling Americans, but also the dollars needed by cash-strapped states to ensure the vaccine is equitably and effectively distributed. (Maeve Reston, 11/29)
Communities facing rising cases of the novel coronavirus are reconsidering their policies on public gatherings. That makes this the perfect time to devise new, evidence-based policy on reopening our schools. Montgomery County leadership has made unreasonable health metrics, not grounded in science or the interests of our children, a prerequisite for hybrid learning: a daily average of fewer than five cases per 100,000 residents over a 14-day period. This is far more stringent than the state recommendation and approximately four times stricter than what the Centers for Disease Control and Prevention recommends. (Margery Smelkinson, 11/27)
Last month, I wrote that Amy Coney Barrett would help to usher in a new post-truth jurisprudence on the Supreme Court. While I had cited her anti-science statements on climate change, her arrival on the court has created a new 5-4 majority against public-health science at the height of the Covid-19 pandemic. When it ruled this week against New York state's decision to limit religious gatherings in a few high-incidence parts of New York City, the court proved the dangers of scientifically illiterate judges overturning government decisions that were based on scientific evidence. (Jeffrey D. Sachs, 11/27)
Different Takes: States Need To Protect Essential Workers This Winter; GOP Has To Stop Single Payer In Its Tracks
The darkest days of the pandemic are still ahead of us, as we head into the winter with a surge of cases and without a national strategy to address Covid-19. It will be especially grim for essential food workers like farmworkers and meat packers who still lack basic protections in the workplace. (Amy K. Liebman, 11/30)
ObamaCare returned to the Supreme Court this month and the law seems sure to survive a legal challenge from GOP state attorneys general. That lawsuit has long looked like a futile exercise, and the real question for Republicans is: How many elections will the party lose before coming up with a potent political argument on health care? For all the Republican success in Senate and House races, health care continues to haunt the GOP. John Hickenlooper, the Colorado Democrat who defeated GOP Senator Cory Gardner, set up the subtly named CoryGardnerWontProtectPreexistingConditions.com. Many others pounded the GOP as wanting to snatch away health insurance from Americans during a pandemic. Arizona Democrat Mark Kelly cut an ad touting himself as a defender of the vulnerable featuring a mother of a child with a heart defect. (11/29)
There is determination in the face of adversity and then there is sheer stupidity. Right now, the NFL is going all in on the latter.The Baltimore Ravens put six more players on the reserve-COVID-19 list Saturday and another two Sunday, leaving them with 36Ā active players. The San Francisco 49ers are homeless after Santa Clara County banned all contact sports for the next three weeks. And the Denver Broncos called up a wide receiver from the practice squad to play quarterback against the New Orleans Saints because they had no others available ā yes, you read that right, none ā after Drew Lock, Brett Rypien and Blake Bortles were found to have had āhigh-riskā contact with Jeff Driskel, who tested positive for COVID on Thursday.Yet the NFL is continuing to pretend that itās business as usual, insisting that the games be played. (Nancy Armour, 11/28)
Our fourth annual Football Injury Highlight Reel is taking a different tack this year. In previous years ā 2017, 2018, and 2019 ā we surveyed injuries to youth, high school, college, and pro football players, some quite serious and some even career- or life-ending. This year we focus on the effect Covid-19 has had on the game because in 2020 a chief health harm of football at all levels of play hasnāt been the physicality of the game itself but the coronavirus. (Lisa Kearns, Kathleen Bachynski and Arthur L. Caplan, 11/26)
With more than 250,000 Americans killed by Covid-19, itās time to think about reimagining Black Friday... If Black Friday celebrates American consumers spending in order to live well, we could also adopt it as a day to consider what it means to die well. As the ancient Greek philosopher Epicurus ostensibly put it, āThe art of living well and the art of dying well are one.ā (L.S. Dugdale, 11/27)