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It’s a milestone that by all accounts didn’t have to happen this soon. The U.S. death toll from COVID-19 eclipsed 700,000 late Friday — a number greater than the population of Boston. The last 100,000 deaths occurred during a time when vaccines — which overwhelmingly prevent deaths, hospitalizations and serious illness — were available to any American over the age of 12.The milestone is deeply frustrating to doctors, public health officials and the American public, who watched a pandemic that had been easing earlier in the summer take a dark turn. Tens of millions of Americans have refused to get vaccinated, allowing the highly contagious delta variant to tear through the country and send the death toll from 600,000 to 700,000 in 3 1/2 months. (Webber and Hollingsworth, 10/2)

To put it in perspective, the staggering number of deaths is greater than the number of Americans who were estimated to have died of cancer last year, one of the nation's leading causes of death. It's higher than the total number of American troops who have died in battle throughout the recent history of the country, and it is about the same as the population of Boston, Massachusetts. (Mitropoulos, 10/1)

The 7-day average of new COVID-19 cases dropped in the United States by 15% this week, to 106,400 cases per day, according to Rochelle Walensky, MD, MPH, director of the Centers for Disease Control and Prevention (CDC). Walensky, during a White House press briefing, said hospitalizations also dropped to 8,300 per day (also a 15% decrease), and deaths remained at 1,476 per day, on average. Yesterday, according to the Johns Hopkins University tracker, the country confirmed 110,060 cases, including 2,718 deaths. (Soucheray, 10/1)

North Dakota Gov. Doug Burgum (R) and medical officials are urging the public to help reduce the need for hospitalizations as hospitals are at "redline capacity." North Dakota's six largest hospitals reported 43 patients were sent to other facilities and 29 patients were waiting in emergency departments to be admitted, the state announced Friday. (Frazier, 10/1)

Hospitals across most New England states are seeing full intensive care units and staff shortages as growing coronavirus cases continue to shake the region, AP reports. The New England region has the highest vaccination rate in the country, per AP. However, the states are still reporting record case counts, hospitalizations and deaths, comparable to pre-vaccine peaks. (Reyes, 10/3)

There was one bed coming available in the intensive care unit in Alaska’s largest hospital. It was the middle of the night, and the hospital, Providence Alaska Medical Center in Anchorage, had been hit with a deluge of coronavirus patients. Doctors now had a choice to make: Several more patients at the hospital, most of them with Covid-19, were in line to take that last I.C.U. spot. But there was also someone from one of the state’s isolated rural communities who needed to be flown in for emergency surgery. Who should get the final bed?Dr. ​​Steven Floerchinger gathered with his colleagues for an agonizing discussion. They had a better chance of saving one of the patients in the emergency room, they determined. The other person would have to wait. That patient died. (Baker, 10/3)

Already dealing with workforce shortages and the brunt of a pandemic, nursing homes are now facing a grim choice: limit new admissions or shut down entirely. A new survey, conducted by the American Health Care Association and the National Center for Assisted Living, found the workforce situation has worsened over the last three months for 86% of nursing homes and 77% of assisted living providers nationwide.��According to the same survey,��58% of them are now limiting new admissions due to shortages. (Christopher Smith, 10/4)

Although nursing home deaths from Covid-19 remain dramatically down from their peak at the end of last year, a Kaiser Family Foundation analysis shows a significant uptick in August as the Delta variant swept through the country. After declining for months, largely because of the federal effort to vaccinate residents, the number of deaths rose sharply from July to August. Nursing homes reported nearly 1,800 deaths among their residents and staff in August, which represented the highest monthly toll since February. (Abelson, 10/4)

After months of sharing their stories of ongoing symptoms, long-haulers are appealing to elected officials for assistance and begging them to provide help. “We need to have more legislation for survivors like ourselves and not just keep telling our stories because there's a bazillion stories out there now,” said Maya McNulty, a long hauler from New York. “We're not like some Netflix series that you can just binge watch and then the problem goes away. We are living with this … disease, and there is no hope.” The grassroots, nonpartisan group COVID Survivors for Change launched a week of action on Friday, with delegations from all 50 states dedicated to illustrating how the virus has changed the lives of long-haulers and families who’ve lost loved ones. (Coleman, 10/3)

American sleep-away camps with high vaccination coverage among eligible children and staff members and routine testing programs largely stamped out the spread of the coronavirus this summer, the Centers for Disease Control and Prevention reported on Friday. But summer camps in less-vaccinated Southern states that failed to mandate shots for staff members or require indoor masking remained vulnerable to outbreaks, the C.D.C. said. Those findings were contained in two studies released on Friday — one focusing on nine heavily vaccinated sleep-away camps across the United States, and the other on outbreaks at 28 camps in Louisiana. (Mueller, 10/4)

Newer variants of the coronavirus like Alpha and Delta are highly contagious, infecting far more people than the original virus. Two new studies offer a possible explanation: The virus is evolving to spread more efficiently through air. The realization that the coronavirus is airborne indoors transformed efforts to contain the pandemic last year, igniting fiery debates about masks, social distancing and ventilation in public spaces. (Mandavilli, 10/1)

It's too soon to say whether the pandemic has eased enough for families to gather for Christmas this year, Dr. Anthony Fauci said Sunday.��Fauci, making the Sunday talk show rounds, said on CBS News'��"Face the Nation" that�� Americans first need to focus on lowering the number of new infections and hospitalizations. The best way to do that: Vaccination and booster shots, he said. "We've just got to concentrate on continuing to get those numbers down and not try to jump ahead by weeks or months and say what we're going to do at a particular time," Fauci said. "Let's focus like a laser on continuing to get those cases down." (Bacon and Santucci, 10/3)

Dr. Anthony Fauci was under fire on Sunday for suggesting Americans might have to spend Christmas alone in 2021. On CBS’s "Face The Nation," Fauci spoke with anchor Margaret Brennan about the status of the coronavirus pandemic and what is expected in the months to come. Specifically, Brennan wondered if families can gather for Christmas.��"We can gather for Christmas, or it’s just too soon to tell?" Brennan asked. Fauci responded it was "too soon to tell" if people could gather in groups by Christmas this year. "It is just too soon to tell," Fauci said. "We have to concentrate on continuing to get those numbers down and not try to jump ahead by weeks or months and say what we’re going to do at a particular time." (Kornick, 10/3)

Trick-or-treating is back this year. Sort of.��The Center for Disease Control has given a green light for children nationwide to trick or treat this Halloween – one year after the CDC advised against the tradition last year due to COVID-19 concerns, instead suggesting��one-way trick-or-treating as an alternative.��Coronavirus cases are decreasing in the U.S. – 13% the last week of September – but community transmission remains high amid the delta variant, according to the CDC.��Rochelle Walensky, director of the CDC, told CBS News. "I wouldn't necessarily go to a crowded Halloween party, but I think we should be able to let our kids go trick-or-treating in small groups." (Gleeson, 10/2)

Dr. Anthony Fauci says he’s worried that people resisting COVID-19 vaccine shots based on religious grounds may be confusing that with a philosophical objection. Fauci, who is President Joe Biden’s chief medical adviser, says getting the COVID-19 vaccine is no different in concept than receiving other vaccines such as for measles, which have been done for many years. He says a public health review found “very, very few, literally less than a handful” of established religions which actually oppose vaccinations. (10/3)

Dr. Anthony Fauci praised Sunday the results of a late-stage clinical trial of an experimental antiviral drug from Merck that public health experts hope could open a new front in the United States’ pandemic response. “It’s extremely important,” Fauci, the nation’s top infectious disease expert and President Joe Biden’s chief medical adviser, told CNN’s “State of the Union” — emphasizing that the drug, molnupiravir, can be taken by mouth as a pill. (Forgey, 10/3)

As the nation’s death toll climbed above 700,000 in October, Dr. Anthony S. Fauci, an adviser on the pandemic to President Biden, emphasized the need for the 70 million Americans who are eligible for a vaccine to get immunized during interviews on Sunday morning talk shows. “Many of those deaths were unavoidable but many, many are avoidable, were avoidable and will in the future be avoidable,” Dr. Fauci, who is also director of the National Institute of Allergy and Infectious Diseases, said on CNN’s “State of the Union.” (Abelson, 10/4)

Trump administration officials fought over whether — and ultimately declined — to fund the same antiviral drug that Merck announced yesterday significantly reduces hospitalizations and deaths among coronavirus patients. The Trump administration's decision almost certainly delayed the development of the drug. Having an effective antiviral pill during the Delta wave could have substantially reduced its death toll. (Owens, 10/1)

Johnson & Johnson is planning to ask federal regulators early this week to authorize a booster shot of its coronavirus vaccine, according to officials familiar with the company’s plans. The firm is the last of the three federally authorized vaccine providers to call for extra injections, amid mounting evidence that at least the elderly and other high-risk groups need more protection. Federal officials have become increasingly worried that the more than 15 million Americans who received the Johnson & Johnson vaccine face too much risk of severe Covid-19. The Food and Drug Administration on Friday scheduled a meeting on Oct. 15 of its expert advisory committee to discuss whether to grant emergency use authorization of a booster shot of Johnson & Johnson’s vaccine. (LaFraniere, 10/4)

The European Union's drug regulator on Friday identified a possible link between rare cases of blood clotting in deep veins with Johnson & Johnson's COVID-19 vaccine and recommended the condition be listed as a side-effect of the shot. The European Medicines Agency also recommended that immune thrombocytopenia (ITP), a bleeding disorder caused by the body mistakenly attacking platelets, be added as an adverse reaction with an unknown frequency to the J&J vaccine product information and to AstraZeneca's vaccine. J&J said while the chances of experiencing these conditions were very low, the product information would be updated accordingly as it continues to work closely with authorities including EMA. (10/1)

The government will not extend the shelf life of hundreds of thousands of unused Johnson & Johnson Covid vaccine doses, but may soon extend the life of millions of Moderna vaccine doses, according to an internal email obtained by NBC News. In an email sent to state health officials and health-care providers Friday morning, the Centers for Disease Control said the Food and Drug Administration will not further extend the life of Johnson & Johnson vaccines sitting on states' shelves across the country, leading to the potential waste of hundreds of thousands of doses. (Strickler and Tirrell, 10/1)

After years in development, the floodgates for RSV vaccines may open up soon, with more and more Big Pharmas piling on data. Now, Johnson & Johnson’s Janssen is adding to the fray, announcing efficacy as high as 80% in preventing severe infections in a mid-stage clinical trial. Janssen revealed the proof-of-concept data at IDWeek Saturday, showcasing a trial called CYPRESS that featured more than 5,700 people aged 65 years and up randomized to receive the RSV vaccine candidate or placebo. The main goal was the preventing the occurrence of lower respiratory tract disease as a result of RSV infection. A dozen secondary endpoints looked for adverse events, neutralizing antibodies and other outcomes. Protection from Janssen’s vaccine ranged from 80% in preventing severe lower respiratory tract infection caused to 70% for more mild cases. The study concluded that the vaccine was effective in protecting against RSV-caused infections through the first viral season.��(Armstrong, 10/2)

Dr. Eric Topol, the founder and director of the Scripps Research Translational Institute, said in an interview published Sunday that up to 90% of Americans may have to be vaccinated to end the COVID-19 pandemic. "Now we need 85 to 95% vaccinated against Delta," he told USA Today. Tom McCarthy, the head of the Rhode Island Department of Health COVID Response Unit, also put the number at about 90%, citing the Delta variant, the paper reported. (DeMarche, 10/4)

About 2 million people received��Pfizer COVID-19 booster shots this week and another 1 million people are scheduled for one in the next couple of weeks, the White House announced Friday. “That’s a very strong start,” White House COVID-19 Response Coordinator Jeff Zients said in a virtual briefing with reporters. The robust demand comes despite confusing messages before the rollout and data suggesting two doses of the mRNA vaccines offer durable protection against severe disease for most Americans. (Kopp, 10/1)

The number of Floridians receiving��coronavirus shots��climbed more slowly in the past week than at any time since late December, an analysis of state data shows. The state added just 85,026 more residents to Florida’s COVID-19 inoculation count in the past seven days, a Health Department report published Friday says. That’s the smallest increase since Dec. 28, the second week of statewide coronavirus immunization reporting. In total, 13,621,499 Florida residents have gotten at least one vaccine dose, covering 71% of the eligible population ages 12 and older, state health officials reported.��That tally includes 436,543 fully vaccinated people who have gotten additional jabs.��(Persaud, 10/4)

Kentucky is planning an outreach campaign in coming months to continue encouraging more people to get vaccinated against COVID-19, Gov. Andy Beshear said. The campaign also will focus on the virus’s symptoms and long-term effects, he said. “The media campaign will emphasize the safety and effectiveness of the vaccine, and it will encourage Kentuckians to talk with a health-care provider about the vaccine,” Beshear said last week. (10/4)

Andrew Wiggins, the Golden State Warriors forward who balked being vaccinated against the coronavirus, has been vaccinated, the team's coach said Sunday. "He just told me today that he was fine with us acknowledging it, and that will be the end of it," coach Steve Kerr told reporters. Wiggins, who had sought a religious exemption from San Francisco's vaccination requirement, was one of several NBA players who had declined to get the shots. (Stelloh, 10/3)

The first study, involving 13 focus groups, reaffirmed a lack of communication and trust among racially and ethnically diverse communities in the United States. The second study examined the effect of emphasizing different data around the Johnson & Johnson and AstraZeneca/Oxford COVID-19 vaccines: People were more interested in uptake when they were presented with the vaccines' effectiveness against death versus their effectiveness against symptomatic infection. (McLernon, 10/1)

A handful of the 77 chimpanzees living at the Project Chimps sanctuary in Morganton received vaccinations against COVID-19 last week. None of the animals showed signs of infection with coronavirus and the immunizations were administered “as another layer of protection from what we already do to keep them healthy,” said executive director Ali Crumpacker. Crumpacker said the staff had plans to vaccinate 10 chimps Wednesday but successfully vaccinated only nine. She said the sanctuary will eventually inoculate all 77 animals. Since the beginning of the pandemic zoo keepers and others have become aware that the disease can be transmitted to animals.��Recently Zoo Atlanta announced��that more than a dozen of its 20 western lowland gorillas had tested positive for COVID-19, and were being treated. (Emerson, 10/4)

KHN: Journalists Drill Down On Covid Vaccine Boosters, Misinformation Online��

KHN Midwest correspondent Lauren Weber discussed how hospitals are dealing with covid-19 on WOSU’s “All Sides With Ann Fisher” on Tuesday. Weber also discussed the Food and Drug Administration’s approval of a covid vaccine booster on WAMU’s “1A” on Sept. 24. ... KHN reporter Victoria Knight discussed doctors who spread covid misinformation on social media on Newsy’s “Morning Rush” on Tuesday. (10/2)

California will require all public and private school students to be vaccinated against the coronavirus once the shot receives final approval for younger age groups. The rule, announced Friday by Gov. Gavin Newsom, adds COVID-19 to the list of diseases that children must be immunized against in order to attend school in the state, which already includes chickenpox, measles, polio and tetanus. Students who refuse will be offered independent study instead. (Koseff and Tucker, 10/1)

Dr. Anthony Fauci has praised California Gov. Gavin Newsom’s mandate for all students to get a COVID-19 vaccine, arguing that this is not a "novel" approach for schools.��California proudly announced the nation’s first-ever statewide COVID-19 vaccine requirement in schools. Newsom’s announcement compared the mandate to those for measles, mumps and rubella.��The mandate has divided parents in the state, but Fauci applauded California’s decision, echoing California’s argument.��(Aitken, 10/3)

New York City teachers and other school staff members are supposed to be vaccinated against COVID-19 when the bell rings Monday morning, in one of the first school district mandates in the country requiring employees to be inoculated against the coronavirus. Mayor Bill de Blasio gave a final warning to the city’s roughly 148,000 public school staffers on Friday, saying unvaccinated employees would be placed on unpaid leave and not be allowed to work this week. The city planned to bring in substitutes where needed. (Matthews, 10/4)

U.S. Supreme Court Justice Sonia Sotomayor on Friday blocked a challenge to New York City's vaccine requirement for public school teachers and employees, allowing the mandate to remain in place. Mayor Bill de Blasio announced in August that all 148,000 staff members of the largest U.S. school district would need to submit proof of at least one dose of a COVID vaccine or risk unpaid leave until September 2022. (Chen, 10/1)

The battle to curb the spread of Covid-19 in schools is quickly moving to football fields and basketball courts. ... Eligible kids in Los Angeles public schools need their second dose of Pfizer’s vaccine by Halloween to join in-person extracurricular activities, including sports and after-school programs. Students 12 years old and up in Washington, D.C., public schools must be fully vaccinated beginning Nov. 1 to participate in school athletics. New York City students in “high risk” public league sports and extracurriculars must also get shots, while Chicago Public Schools has announced an athlete vaccine-or-test requirement. (Perez Jr., 10/3)

At the start of the school year, 9-year-old Harli Hecht pulled out a set of rainbow-colored markers and crafted a letter to her fellow fourth-graders. “My name is Harli, and I’m in your class,” she printed on blue poster paper. “I am learning at home. I have two sisters and three dogs. Please write back to me when you have the time.” The note, now hanging in what should have been her classroom, represents the only meaningful contact Harli has had with other students since lingering covid-19 symptoms forced her into homebound learning this fall. The headaches, fatigue and emotional outbursts that have plagued Harli for more than a year have since kept her from participating in normal classroom learning or virtual instruction. (Iati, 10/3)

When Louisiana lawmakers passed legislation back in June barring schools and universities from enforcing COVID vaccine requirements, they agreed that the protections would only be needed for a limited period of time. By that point, more than 3 million vaccine doses had been administered in Louisiana and data proved the jabs both safe and effective against COVID-19. But vaccine skeptics in the statehouse didn’t trust the nation’s scientists. They claimed that because the vaccines had been approved under emergency-use authorization, they hadn’t been fully vetted, ignoring the rigorous clinical trials that had demonstrated their effectiveness. (Paterson, 10/3)

For some college students, the Covid vaccine is a price they are not willing to pay for a degree. Justin Mishler, a 29-year-old junior at Northern Illinois University, is one of them. After serving in the U.S. Marine Corps, Mishler enrolled in the state school in 2016 through the GI Bill, which helps cover the cost of tuition, books and housing. During the pandemic, he took time off to work rather than attend school remotely. This fall, Mishler would have returned in person, but, in August, Northern Illinois announced all students must submit proof of vaccination or request an exemption and get tested weekly. (Dickler, 10/3)

Maryland universities say mandatory COVID vaccine deadlines have largely been effective for convincing students to get the shot, with just a few dozen at some campuses refusing and facing consequences such as being barred from in-person classes or kicked out of school altogether. At least 14 Maryland colleges and universities required students, and in some cases employees, to get vaccinated before the fall semester. In announcing the mandates in the spring, officials said they feared that a return to in-person classes, coupled with close living quarters on campus, could result in outbreaks. (Reed, 10/1)

More than a year after they graduated, hundreds of Boston University alumni are returning to campus on Sunday for a belated commencement ceremony. The university is hosting an outdoor graduation event for the Class of 2020, which never had an in-person commencement because of the pandemic. Nearly 2,000 graduates are expected to return for the ceremony at Nickerson Field, school officials said. (10/3)

New York this week gave the nation an early glimpse of what the Biden administration's��50-state vaccine mandate for health care workers might look like. The Empire State's hospitals��dismissed or suspended dozens of workers for failing to meet a Monday deadline requiring workers get at least their first dose of the COVID-19 vaccine. Anticipating service disruptions from frontline health workers quitting or getting fired, health systems from New York City to upstate delayed non-emergency operations, cut clinic hours and paid travel nurses up to $200 an hour to fill vacant shifts. (Alltucker, 10/2)

An upstate New York county is being forced to send human bodies to a hospital 50 miles away for autopsies because its prominent medical examiner has not been vaccinated against the coronavirus, according to county officials. Rensselaer County moved autopsies on Friday to Glens Falls Hospital from Albany Medical Center Hospital, which requires everyone who works there to be vaccinated, Richard Crist, the county’s director of operations, told the Times Union. (10/2)

Since former Gov. Andrew Cuomo announced a vaccine mandate for New York healthcare workers more than a month ago, hospital employees in the state have been getting vaccinated at more than twice the rate as all New York adults, according to data provided by the state health department and the Centers for Disease Control and Prevention. As of Tuesday, the day after the mandate took effect, 87% of hospital workers were reported as fully vaccinated, up from 76% on Aug. 17, the day after the mandate was announced. This 11-percentage-point increase compares with a 5-point rise for all adults in the state, whose overall vaccination rate remains at around 75%. (Rust, Dapena and Rivas, 10/2)

Despite being given more than five weeks’ advance notice, 92 health care facilities were not able to meet the state’s COVID-19 vaccine mandate deadline for health care workers on Friday and have requested a 30-day extension. Governor Dan McKee announced in mid-August that all health care workers in the state would have to be vaccinated against COVID-19 by Oct. 1 or risk losing their jobs, and possibly their professional licenses. But on Saturday morning, the state health department published a lengthy list of facilities that were not fully compliant by the deadline. (Gagosz, 10/2)

Several hundred hospital workers in Virginia have been suspended or lost their jobs because they refused to get vaccinated against the coronavirus, as required by most major health-care systems. The earliest vaccine mandates went into effect Sept. 1, with two other waves set for Oct. 18 and Nov. 1, according to a survey of hospital policies. (Portnoy, 10/3)

The largest health care system in Louisiana will charge its employees $200 a month if a spouse or domestic partner covered under its health plan is not vaccinated against the coronavirus, NOLA reports. The new rule, which will take effect in 2022, comes as the vast majority of coronavirus patients who end up hospitalized are unvaccinated. Most will likely have to pay for their own medical bills, according to a KFF analysis, as insurers won't waive out-of-pocket costs for COVID-19 hospitalizations. (Frazier, 10/1)

KHN: Mandatory Vaccines For Health Care Workers Might Upend Nurses’ Training

Kaitlyn Hevner expects to complete a 15-month accelerated nursing program at the University of North Florida in Jacksonville in December. For her clinical training this fall, she’s working 12-hour shifts on weekends with medical-surgical patients at a hospital. But Hevner and nursing students like her who refuse to get vaccinated against covid-19 are in an increasingly precarious position. Their stance may put their required clinical training and, eventually, their nursing careers at risk. (Andrews, 10/4)

More airlines are telling employees they’ll have to get Covid-19 vaccinations as carriers move to comply with new rules for companies that do business with the federal government. American Airlines Group Inc., Alaska Air Group Inc. and JetBlue Airways Corp. announced new vaccine requirements Friday, citing requirements they will have to meet due to their government contracts. (Sider, 10/2)

About 3,000 Connecticut state employees remained noncompliant Sunday with the governor’s order requiring a vaccine or weekly testing, according to the state. That’s down from the roughly 8,000 employees who were not complying as of Friday. Democratic Gov. Ned Lamont’s executive order requires employees to get vaccinated, or begin weekly testing, by the end of the day Monday. (10/3)

With the clock ticking, thousands of public employees — many of them police and firefighters — are claiming and receiving religious exemptions from the COVID-19 vaccine requirements that state and local governments have adopted in an effort to reduce the spread of the virus. The vaccine mandates have been pushed by public officials looking to crack down on shot-shunners they blame for facilitating the virus’s deadly spread. But the number of granted exemptions suggests it can be challenging to enforce the mandate on unwilling workers whose religious beliefs are protected under federal and state law, especially if those workers are backed by a strong labor union. San Jose has approved about four out of five religious exemption requests from the vaccine requirement, a total of more than 300. Although no major religious leaders oppose vaccination of their faithful, workers still can legitimately claim the shots violate their personal religious beliefs. (Woolfolk, 10/3)

A few hundred people gathered on the Strip on Sunday night to protest Gov. Steve Sisolak’s COVID-19 vaccine mandate. The group met outside of the Aria at 7 p.m. and marched north along Las Vegas Boulevard toward Bally’s, where they turned around. They stopped momentarily in front of the Fountains of Bellagio as the water crashed along to Lady Gaga’s “Bad Romance.“ Many protesters held signs, some of which appeared to oppose the vaccine, while others focused their attention more specifically on the��governor’s mandate. Brock Abbe, who moved to Las Vegas from New York in January, said he joined the group to protest the mandate, not the vaccine itself. (Ford, 10/3)

Alaska Sen. Lisa Murkowski (R) voiced alarm and frustration about the surge of COVID cases in her state on Friday, decrying comparisons of mask mandates to Nazism. Alaska's number of weekly cases has steadily increased in recent months, jumping 10% from just last week, according to state health data. Meanwhile, anti-vaxxers continue to protest mask and vaccine mandates in increasingly hostile situations. (Chen, 10/2)

The docket for this term is a humdinger, with major cases involving the biggest social issues of the day: abortion, guns, separation of church and state, and potentially affirmative action in higher education. "It seems like every few years, we say we're going to see radical conservative takeover of the Supreme Court in American law," says Tom Goldstein, publisher of SCOTUSblog. But this time, he adds, "We really mean it. " (Totenberg, 10/4)

The Supreme Court embarks Monday on what could be an extraordinarily controversial term, with its justices on the defensive, its actions and structure under a political microscope and abortion — the most divisive issue of them all — taking center stage. Before the term ends next summer, the justices will have weighed in on three major public policy disputes — guns, religious rights and possibly race, if the court takes up a request to once again review affirmative action in university admissions. (10/2)

The Supreme Court is beginning a momentous new term with a return to familiar surroundings, the mahogany and marble courtroom that the justices abandoned more than 18 months ago because of the coronavirus pandemic. Abortion, guns and religion all are on the agenda for a court with a rightward tilt, including three justices appointed by President Donald Trump. The justices will meet in person for arguments Monday, although Justice Brett Kavanaugh will participate remotely from his home after testing positive for COVID-19 late last week. Kavanaugh, who was vaccinated in January, is showing no symptoms, the court said. All the other justices also have been vaccinated. (Sherman and Gresko, 10/4)

The first Women’s March of the Biden administration headed straight for the steps of the Supreme Court on Saturday, part of nationwide protests that drew thousands to Washington to demand continued access to abortion in a year when conservative lawmakers and judges have put it in jeopardy. Demonstrators filled the streets surrounding the court, shouting “My body, my choice” and cheering loudly to the beat of drums. (Knickmeyer, 10/2)

Thousands of women gathered in Washington, D.C., and several other cities in the United States and around the world to march for abortion rights in response to the Supreme Court's recent decision to allow Texas' new restrictive abortion law to go into effect. Texas' new law, which went into effect in early September, is one of the most restrictive abortion bans to be enforced since the Supreme Court's Roe v. Wade decision legalized abortion nationwide in 1973. (10/2)

Democratic lawmakers on Sunday offered numerous options for��pathways for the potential to pass the stalled infrastructure bill and reconciliation package after failing to bring either key measures of the Biden administration to a vote in the House last week. Some lawmakers said they were confident that they would be able to pass both measures while others, including some progressives who refused to vote for the bipartisan bill unless they could pass the larger reconciliation package first, suggested they'd be open to a smaller price tag or a shorter amount of years of funding social programs. House Democrats failed to bring either bill up for a vote last week as moderate lawmakers like Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.)��refused to budge��from their demands of a lowered reconciliation package. (Choi, 10/3)

Senate Majority Leader Charles Schumer (D-N.Y.) on Sunday said he hopes to pass the bipartisan infrastructure bill and a reconciliation package in the next month, setting another target date for Congress to approve two pieces of legislation central to President Biden’s��domestic agenda after a failed attempt last week. Schumer, during a press conference in New York City on Sunday, said he believes Congress is on track to pass the pair of bills. (Schnell, 10/3)

Sen. Kyrsten Sinema skewered Democratic leadership on Saturday for delaying a vote on the bipartisan infrastructure package, calling the decision “inexcusable” and “deeply disappointing.” In a statement, the Arizona Democrat warned that delaying the vote only reduced trust within the party. “Democratic leaders have made conflicting promises that could not all be kept — and have, at times, pretended that differences of opinion within our party did not exist, even when those disagreements were repeatedly made clear directly and publicly,” Sinema said. (Levine, 10/2)

Congresswoman Alexandria Ocasio-Cortez, a Democrat from New York, said Sunday that moderate Democratic senators are "not really coming to the table" to negotiate the details of a sweeping $3.5 trillion social spending package that is a cornerstone of President Biden's economic agenda but has been at the center of infighting among Democrats. "What we're seeing here is the dynamic where progressives are trying to skin this cat nine different ways but moderates are not really coming to the table," Ocasio-Cortez said in an interview on "Face the Nation." "This is the issue, is that we're saying, 'OK, we're going down from $6 trillion to $3 trillion, now it's $1 trillion, and we have some of these conservatives that say, 'Well, our line is zero, and you're lucky if you get $1.'" (Quinn, 10/3)

Democrats, working to unite around a far-reaching social policy and climate bill, are weighing two different approaches to reduce its overall cost: eliminating proposed programs entirely or cutting their duration. Democrats’ debate over the two options took on fresh urgency this weekend after President Biden said Friday that they would have to shrink the size of the legislation, projected to spend $3.5 trillion over a decade to expand and create education, healthcare, climate and other programs. (Duehren, 10/3)

Means-testing Medicare, a long-running controversy in health policy debates, is re-emerging as a major source of tension for Democrats seeking a path forward on their stalled social spending package. Centrist lawmakers are demanding that an expansion of the program to cover dental, vision and hearing care be limited to the poorest Americans, to pare the projected cost by as much as half. (Ollstein, 10/1)

Rep. Pramila Jayapal, the chair of the Congressional Progressive Caucus, said Sunday she would not support a sweeping economic bill if it includes the Hyde Amendment, adding another complicating factor to the ongoing negotiations among Democrats as they hash out details for the massive spending bill. The Hyde Amendment blocks federal funds from being used for most abortions except in cases of rape, incest or when the woman's life is in danger. (Duster, 10/3)

KHN: KHN’s ‘What The Health?’: The Health Agenda Still On Hold��

Democrats on Capitol Hill missed their deadline to finish two huge bills that constitute the bulk of President Joe Biden’s domestic agenda, but negotiations continue over expansions to major health programs, as well as ways to rein in prescription drug costs. Meanwhile, the Biden administration issued regulations to implement last year’s law to limit “surprise” medical bills to patients who get care outside their insurance networks. Health providers — doctors and hospitals — are already complaining that they will be asked to pick up too much of the bill to protect patients. (10/1)

KHN: What The Stalemate On Capitol Hill Means For Your Drug Prices��

As President Joe Biden’s government overhaul stalls in Congress, tensions are mounting over what changes ― if any ― could come for Americans at the pharmacy counter. The proposals in flux range from tinkering with tax credits to far-reaching changes in federal payments systems. (Tribble, 10/1)

The chaos surrounding President Biden’s agenda and Congress is threatening to spill into the Virginia governor’s race as Democrats look to defend the governor’s mansion in Richmond. The race is seen as a bellwether for next year’s midterm elections, a likely referendum on President Biden’s first two years in office. While the race is a state election, its geographic proximity to Washington and Democratic candidate Terry McAuliffe’s ties to Biden could��influence the results in November. (Manchester, 10/3)

The Nobel Prize in medicine was awarded to two U.S.-based scientists whose fundamental work revealed the basic biology that underlies the sensations of temperature and touch. David Julius at the University of California at San Francisco and Ardem Patapoutian at Scripps Research share the award. “Our ability to sense heat, cold and touch is essential for survival and underpins our interaction with the world around us. In our daily lives we take these sensations for granted, but how are nerve impulses initiated so that temperature and pressure can be perceived?” the Nobel Assembly wrote in announcing the award. “This question has been solved by this year’s Nobel Prize Laureates.” (Johnson, 10/4)

The work by Dr. Julius and Dr. Patapoutian, for the first time, allows us to understand how heat, cold and mechanical force can initiate the nerve impulses that allow us to perceive and adapt to the world around us. Their work, the committee said, has already spurred intensive research into the development of treatments for a wide range of disease conditions, including chronic pain. (Santora and Engelbrecht, 10/4)

Julius is a professor at the University of California, San Francisco. Patapoutian is a professor at the Howard Hughes Medical Institute at Scripps Research in La Jolla, California. "Our ability to sense heat, cold and touch is essential for survival and underpins our interaction with the world around us," the Nobel Assembly said in a statement announcing the prize. ... Thomas Perlmann, the secretary of the Nobel Assembly and the Nobel Committee, said the discovery "unlocks the secrets of nature ... It explains at a molecular level how these stimuli are converted into nerve signals. It's an important and profound discovery." (Kottasova, 10/4)

On Sunday, Frances Haugen revealed herself to be “Sean,” the whistle-blower against Facebook. A product manager who worked for nearly two years on the civic misinformation team at the social network before leaving in May, Ms. Haugen has used the documents she amassed to expose how much Facebook knew about the harms that it was causing and provided the evidence to lawmakers, regulators and the news media. (Mac and Kang, 10/3)

Frances Haugen came out publicly on Sunday as the Facebook whistleblower whose revelations have in recent weeks prompted a congressional investigation into the company, public hearings with its executives and extensive reporting in The Wall Street Journal about the social network’s harmful effects on young children and teens. The social media giant has since faced intense backlash from critics outraged by its plans to expand into that market despite being aware of the dangers it could pose to younger users. (Levine and Cohen, 10/3)

Frances Haugen says in her time with Facebook she saw, "conflicts of interest between what was good for the public and what was good for Facebook." Scott Pelley reports. (10/3)

The former Facebook Inc. employee who gathered documents that formed the foundation of The Wall Street Journal’s Facebook Files series said she acted to help prompt change at the social-media giant, not to stir anger toward it. Frances Haugen, a former product manager hired to help protect against election interference on Facebook, said she had grown frustrated by what she saw as the company’s lack of openness about its platforms’ potential for harm and unwillingness to address its flaws. She is scheduled to testify before Congress on Tuesday. She has also sought federal whistleblower protection with the Securities and Exchange Commission. (Horwitz, 10/3)

The stress of carrying around debt is correlated with not only a mental burden but a physical one, according to a new study from the University of Missouri. Those who carry unsecured debt, such as credit card balances or medical bills, tend to have poorer physical health than those who don’t carry unsecured debt, the study found. The study examined the unsecured debt and income of 8,000 Americans over time from age 28 to age 40, as well as their physical health at age 50. (Shrikant, 10/1)

A pair of new studies highlights the effects of the COVID-19 pandemic on adults, one showing the fallout of unstable housing on Americans' mental and physical health and the other describing how UK residents who were depressed or anxious before the pandemic experienced more disruptions to their jobs and access to healthcare after it began. (Van Beusekom, 10/1)

A sweeping new legislative proposal on Capitol Hill could give Congress a rare opportunity to address an issue that has long been on the backburner – paid family leave. Today, only some workers have access to paid time off to care for their loved ones or their own medical needs. Lawmakers on both sides of the aisle have proposed a national paid leave policy so that all workers can take time out of work. (Konish, 10/2)

KHN: Youthful Advisers Help Shape A Mental Health Program For Their Peers��

Phebe Cox grew up in what might seem an unlikely mental health danger zone for a kid: tony Palo Alto, California, in the heart of Silicon Valley. But behind its façade of family success and wealth, she said, is an environment of crushing pressure on students to perform. By 2016, when Cox was in middle school, Palo Alto had a teen suicide rate four times the national average. Cox’s family lived by the railroad tracks where many of the suicides occurred. She got counseling. But that option, she told KHN, is not always easily available to teens in crisis — and she and her peers regarded school mental health services as their last choice because of concerns about either confidentiality or anonymity. (Kreidler, 10/4)

A University of Illinois-led study found women who added an avocado a day to meals showed a healthier distribution of visceral fat vs. subcutaneous fat around the abdomen after three months. The research was published this summer in the Journal of Nutrition. The study was led by Naiman Khan, an Illinois professor of kinesiology and community health. Subcutaneous fat, found right beneath the skin, is relatively harmless when it comes to disease. But visceral fat (which lies behind the abdominal wall and around organs) is associated with higher risk of Type 2 diabetes — one of the biggest drivers of illness and health care costs in the nation. (Eng, 10/1)

The Centers for Disease Control and Prevention (CDC) in an updated yesterday confirmed an additional 140 cases in an outbreak of Salmonella Oranienburg illnesses with no confirmed food source, bringing the outbreak total to 419 cases and 66 hospitalizations in 35 states. So far there have been no deaths reported in this outbreak. Illnesses started on dates ranging from Jun 19 to Sep 14, the CDC said. The CDC first announced the outbreak on Sep 17, and cases have been increasing at a significant pace. (10/1)

Victoriana Lara was breastfeeding her 3-month-old baby last November when she felt small lumps in her breast. The mother of four knew quickly that was something wrong. At first, she and her husband thoughts it could be a clogged milk duct, a common occurrence for breastfeeding women. But the lumps didn’t go away. After several months, Lara, who is uninsured, began calling Houston-area clinics in search of options. A mammogram showed a large mass, covering more than half her breast and cancerous lymph nodes under her arm, said Dr. Polly Niravath, oncologist and director of cancer survivorship program at Houston Methodist. Lara’s case was referred to the Houston Methodist Community Scholars Program through a partnership with Legacy Community Health, where she receives her primary care. (Garcia, 10/1)

With extreme heat waves on the rise in a changing climate, doctors are finding that pregnant women are particularly vulnerable. Heat waves increase the chances of going into labor early, having a stillbirth, or having a baby with low birthweight. The risk is even greater for women of color, especially Black mothers. While women are often advised to stay hydrated during pregnancy, many are not warned by their doctors about the risks of heat. "Pardon the pun, but it really is a bun in a really hot oven and that's a dangerous scenario," says Dr. Nathaniel DeNicola, an OB-GYN and environmental health expert for the American College of Obstetricians and Gynecologists. (Sommer, 10/3)

In the race to secure computer chips amid a global shortage, medical device makers say they have found their ace card: their products save lives. While only a tiny fraction of the world’s chips end up in medical equipment compared with cars and consumer electronics, the components are key to a range of vital devices like MRI machines, pacemakers and blood-sugar monitors for diabetes. To win priority over larger buyers, medical device makers say their most effective tactic is to raise awareness with executives at chip suppliers. (Roland, 10/3)

Three generic drug makers agreed to pay nearly $450 million to resolve civil allegations that they conspired to fix prices for numerous medications, which caused U.S. federal government health care programs and their beneficiaries to overpay for the treatments. In each instance, the companies — the Sandoz unit at Novartis (NVS), Taro Pharmaceuticals and Apotex — admitted to working with rivals to set prices and supplies, and allocate customers for different medicines between 2013 and 2015, according to the U.S. Department of Justice. The drugs included treatments for high cholesterol, pain, fungal infections, and skin infections, among other maladies. (Silverman, 10/1)

In a setback to the pharmaceutical industry, a federal judge ruled that programs Pfizer (PFE) wanted to launch to provide copay assistance to Medicare patients would likely violate kickback laws, a controversial notion that has caused numerous drug makers to pay large fines. The ruling came in a closely watched lawsuit Pfizer filed in July 2020 that argued rules prohibiting companies from funding programs — either directly or indirectly — were unconstitutional. In one, Pfizer sought to provide direct financial assistance to Medicare beneficiaries using a heart failure drug. The other program would have used a charity to run a program to cover patient copays. (Silverman, 10/3)

In a span of eight years, 10 pharmacies dispensed nearly 49 million prescription pain pills in two counties near Cleveland — enough to provide about a dozen doses to each man, woman and child who lived there every 12 months. Now Lake and Trumbull counties are set to face off against four of the nation’s largest chain pharmacies in a federal trial that could serve as a litmus test for thousands of cities and counties looking to hold them accountable for their role in the nation’s opioid crisis. (Kornfield, 10/3)

The people trading in used needles at Anchorage’s lone syringe exchange are more worried than ever about dying from a drug overdose. The nonprofit’s staff hear about it anecdotally in short conversations with clients returning old needles for clean new ones, and in the frequency of requests for overdose-reversing medication. “Guys got Narcan?” asked one man, who later declined to speak with a reporter, as did several others on a recent weekday afternoon. (Hughes, 10/3)

The trial of Theranos founder Elizabeth Holmes concluded its fourth week on Friday, with the lengthiest witness testimony of the trial so far. That testimony has come from former Theranos lab director Adam Rosendorff, who has been on the stand for four days and will continue his testimony Tuesday. Rosendorff said on the stand that he "felt pressured to vouch for tests that I did not have confidence in" and that he "felt obligated from a moral and ethical perspective" to tell the public what was happening at the company. (Iyengar and O'Brien, 10/2)

Providers are crying foul about a regulation from the Biden administration that lays out the process they can use to settle out-of-network billing disputes with payers. The rule, released Thursday by the Centers for Medicare and Medicaid Services, is the next step in its implementation of the surprise billing ban passed last year by Congress. Payers praised the regulation as the "right approach," while providers swiftly denounced it as a "miscue" arbitrarily favoring insurers. At issue is the part of the regulation that lays out the independent dispute resolution process used when there is a disagreement between providers and payers over the fair price for an out-of-network service. (Bannow and Hellmann, 10/1)

The cost of similar Covid-19 treatments can vary by tens of thousands of dollars a patient, even within the same hospital, according to a Wall Street Journal analysis of pricing data that indicates pandemic care hasn’t escaped the complex economics of the U.S. health system. One kind of patient, with a type of severe respiratory condition that is common among those admitted with Covid-19, is an example of the wide range. The rates for these patients usually spanned from less than $11,000 to more than $43,000, the analysis found, but some prices could be far higher, depending on the severity of the case. (Mathews, McGinty and Evans, 10/3)

Air ambulance utilization and charges have been steadily increasing over the past several years, according to a new study. The average in-network negotiated rate for emergency transport by airplane—excluding mileage charges—rose 76.4%, from $8,855 in 2017 to $15,624 in 2020, according to a FAIR Health analysis of around 35 billion healthcare claims. But most air ambulance rides are out of network, leaving consumers to pay for most of the charges. The average charge associated with airplane ambulances rose 27.6%, from $19,210 in 2017 to $24,507 in 2020. The average Medicare reimbursement rose 4.7% to $3,216 over that span, the same rate increase as emergency helicopter rides. (Kacik, 10/4)

The Center for Medicare and Medicaid Innovation will take a closer look at value-based payment models, with CMMI's chief operating officer Jon Blum noting that full-risk models can lead to overpayments by federal agencies and penalize providers with more vulnerable patient populations. "I don't think that CMS will be promoting models that have more risk just for the sake of having more risk," Blum said at the National Association of Accountable Care Organizations conference Thursday. (Tepper, 10/1)

Johnson Memorial Health says it was a victim of a cyberattack Saturday that disabled its computer network. According to a statement posted on their website, most services at the hospital system are "unaffected." Patients should keep appointments unless they are contacted.��"We are currently working closely with our expert cybersecurity partners and law enforcement to investigate this attack and restore normal computer operations as quickly as possible," the statement said. "While we are working quickly to resolve the impact of the cyberattack, we recognize that these situations can take time to fully resolve." (Carter, 10/2)

The University of Texas MD Anderson Cancer Center has appointed Dr. Caroline Chung, a radiation oncologist, as its vice president and chief data officer, effective Friday. Chung is the Houston-based cancer center's first-ever chief data officer. As chief data officer, Chung will be responsible for developing and implementing the organization's data strategy, according to a news release. That includes supervising a data governance and provenance office, as well as working with legal, information security, risk and compliance offices to create policies for how the center's data is used. (Kim Cohen, 10/1)

Dr. Catherine Gordon on Friday starts her new roles as chief pediatrician at Texas Children’s Hospital and chair of pediatrics at Baylor College of Medicine, becoming the hospital’s first female chief and one of a few women to helm a major U.S. pediatric institution. She will lead the country’s largest pediatric hospital at a critical time, following the peak of a COVID-19 surge that sickened a record number of children and an out-of-season outbreak of a common respiratory disease known as respiratory syncytial virus. (Gill, 10/1)

Guardant Health Inc. has decided not to pursue a potential acquisition of rival medical testing company NeoGenomics, according to people familiar with the matter. Guardant had hoped to use a tie up with NeoGenomics as a way to boost its reach into community cancer facilities, typically smaller, local clinics where most cancer patients are treated, the people added, asking not to be identified because the matter is private. (Hammond, 10/4)

Tennessee officials say they are receiving more than $116,000 in federal funding to address the mental health needs of victims of deadly flooding in August. The Tennessee Department of Mental Health and Substance Abuse Services says the money through the Federal Emergency Management Agency will be directed toward services for survivors of the Aug. 21 flooding that killed 20 people in Humphreys County. (10/4)

California is poised to clamp down on the fast-growing hemp market in a push to make sure CBD-infused products are accurately labeled and safe — a shift that could be felt nationwide, given the state’s formidable purchasing power. The extract used in soap, food and other wellness goods has exploded in popularity since Congress legalized hemp in the 2018 farm bill. But the FDA has refused to regulate CBD, or cannabidiol, as a dietary supplement because it’s an active ingredient in a federally approved medication. In the absence of federal oversight, states largely have been left to monitor the products — and untested and mislabeled items have been flooding stores. (Nieves, 9/30)

A new program, designed largely by the people who use it, provides an alternative. Called Allcove, it offers stand-alone health and wellness sites to those ages 12 to 25, often on a walk-in basis, at minimal or no cost. Although Allcove is built to support a wide range of physical, emotional and social needs, its overarching goal is to deal with mental health challenges before they develop into deeper problems. Allcove is yet in its infancy, with two sites just opened in the Bay Area and five more in the pipeline around California. It’s modeled on a 15-year-old program in Australia, Headspace, which has 130 such clinics. Headspace has inspired programs in other countries as well, including Jigsaw in Ireland and Foundry in Canada. All of them, including Allcove, also offer online and phone services. (Kreidler, 10/3)

KHN: Santa Cruz Health Officials Honored For Persevering In Covid Battle Against Tide Of ‘Denialism’

Two California public health officials who pressed forward with aggressive measures to contain covid-19 even while enduring death threats and harassment will be honored with the 2021 PEN/Benenson Courage Award from PEN America, the group announced Friday. Mimi Hall and Dr. Gail Newel, health director and health officer, respectively, for Santa Cruz County, California, will be honored Tuesday at the PEN America Literary Gala in New York City. Newel was one of the first officials in the nation to institute a shelter-in-place order at the beginning of the pandemic, and under Hall and Newel, Santa Cruz has experienced some of the lowest covid case rates in the country, as well as one of the smallest gaps in vaccination by race or ethnicity. (Barry-Jester, 10/1)

KHN: Listen: California Banks On A Bold Treatment: Pay Drug Users To Stop Using

When Billy Lemon was trying to kick his methamphetamine addiction, he went to a drug treatment program at the San Francisco AIDS Foundation three times a week and peed in a cup. If it tested negative for meth, he got paid about $7.As the pandemic has raged, so has the country’s drug epidemic. Health officials have been struggling with methamphetamine and cocaine abuse, in particular, because of a lack of effective treatment for those stimulants. (Dembosky, 10/4)

Utah is one of 22 states that enforces workplace safety through a��“state-run program.”��In Utah, instead of OSHA the program is called Utah Occupational Safety and Health (UOSH) and is funded by a mix of state and federal money.��In the current fiscal year, $2.5 million of the budget for UOSH comes from federal sources and about $1.15 million is from state money. While federal funds cover a substantial part of the budget, the state’s portion of the money is why lawmakers believe Utah may have some wiggle room. “When the rule comes out, whether or not we choose to implement it or go into a process where we’re talking with OSHA and the federal government about not implementing that component,” House Speaker Brad Wilson, R-Kaysville, said. “We don’t know yet if that’s going to be something that will work.” (Schott, 10/3)

Forty-five. It was a number that would quite literally make your head spin because it represented the percentage of tetrahydrocannabinol — or THC, the main psychoactive chemical in marijuana — that one lab reported was contained in the cannabis flower from a Utah producer. Even the strongest marijuana strains rarely break into the low 30% range, and some believe the physical limit of the plant to be in the mid-30s. Indeed, Sugar House Selects’ Ice Cream Cake Bud, coming in at 45.13% to be precise, might well have set a world record for the most potent weed on Earth. The cultivator promoted the jaw-dropping report on its Instagram page, as did one local dispensary. But the numbers didn’t pass the smell test for Christine Stenquist, a long-time patient advocate. (Gehrke, 10/3)

A West Virginia law banning transgender girls and women from competing on public school sports teams that align with their gender identity will cost the state a tournament that would have brought more than 1,600 visitors to the Kanawha Valley. US Quidditch, the organizers of the Quidditch Cup, say they will no longer consider bids from the state of West Virginia because of House Bill 3293. Quidditch is a sport that comes from the mind of author J.K. Rowling in her fantasy series “Harry Potter.” The real-life game blends elements of rugby, basketball and dodgeball. (Kersey, 10/3)

Kids born today in Central Texas will live longer than most of their fellow Texans, per an Axios analysis of life expectancy data. Travis, Hays and Williamson counties rank in the top 10 of Texas’ 254 counties for average life expectancy, according to 2021 data from the University of Wisconsin's Population Health Center. A child born in Austin today will likely die in the year 2103 — or live 81.9 years. (Price, 10/1)

A nurse was shot and killed inside Jefferson Hospital in Center City early Monday morning, CBS Philly reports. Police say the suspect, a man wearing scrubs, shot the 43-year-old male nurse on the hospital's 9th floor just after midnight. The suspect fled the hospital in a U-Haul truck and was seen heading toward I-95. A short time later, the suspect was involved in a shootout with police near the School of the Future, a public high school in the city. (10/4)

New Zealand’s government acknowledged Monday what most other countries did long ago: It can no longer completely get rid of the coronavirus. Prime Minister Jacinda Ardern announced a cautious plan to ease lockdown restrictions in Auckland, despite an outbreak there that continues to simmer. ... Until recently, that elimination strategy had worked remarkably well for the country of 5 million, which has reported just 27 virus deaths. But that all changed when the more contagious delta variant somehow escaped from a quarantine facility in August after it was brought into the country from a traveler returning from Australia. (Perry, 10/4)

All foreign nationals entering New Zealand will need to be fully vaccinated from November 1, the government announced Sunday. Travelers will have to declare their vaccination status when registering with the country's isolation system and provide proof of vaccination or exemption to their airline and customs officers on landing, Covid-19 Response Minister Chris Hipkins said in a statement. "To further reduce the possibility of the virus getting through our border, we are introducing the requirement for air travellers aged 17 and over, who are not New Zealand citizens, to be fully vaccinated to enter New Zealand," he said. (Humayun, Chang and Ravidran, 10/3)

Worldwide deaths related to COVID-19 surpassed 5 million on Friday, according to a Reuters tally, with unvaccinated people particularly exposed to the virulent Delta strain. The variant has exposed the wide disparities in vaccination rates between rich and poor nations, and the upshot of vaccine hesitancy in some western nations. (B and Abraham, 10/2)

U.K. Health Secretary Sajid Javid told care home workers they needed to get vaccinated against Covid-19 or find another job.��The government has given the workers until Nov. 11 to get the vaccine or risk losing their jobs. In an interview with the BBC’s Radio 4 on Saturday, Javid said he wasn’t prepared to “pause” the requirement, adding that if you work in a care home and “cannot be bothered to go and get vaccinated, then get out and go and get another job.” The U.K. has suffered more than 137,000 deaths from Covid, the most in Western Europe. The virus swept through care homes, with their elderly and often medically vulnerable residents, at the start of the pandemic. (Davis, 10/2)

Israel on Sunday piled pressure on its vaccinated citizens to get a booster shot by making only those who received their third dose of the COVID-19 vaccine eligible for a "green pass" allowing entry to restaurants, gyms and many other venues. Israel was an early adopter of Pfizer/BioNtech booster shots -- administering them to members of risk groups in July and by the end of August to anyone above the age of 12. Its campaign is being watched closely by other countries. (10/3)

Russia on Sunday reported a record daily death toll from COVID-19, the fifth time in a week that deaths have hit a new high. The national coronavirus task force said 890 deaths were recorded over the past day, exceeding the 887 reported on Friday. The task force also said the number of new infections in the past day was the second-highest of the year at 25,769.Overall, Russia, a nation of 146 million people, has Europe’s highest death toll from the pandemic, nearly 210,000 people. (10/3)

Not a single hurricane has hit Puerto Rico this year, but hundreds of thousands of people in the U.S. territory feel like they’re living in the aftermath of a major storm: Students do homework by the light of dying cellphones, people who depend on insulin or respiratory therapies struggle to find power sources and the elderly are fleeing sweltering homes amid record high temperatures. Power outages across the island have surged in recent weeks, with some lasting several days. Officials have blamed everything from seaweed to mechanical failures as the government calls the situation a “crass failure” that urgently needs to be fixed. (Coto, 10/3)

Merck & Co. and Ridgeback’s antiviral pill molnupiravir is a potential pandemic game-changer, judging from the positive test data that arrived Friday. To make the most of this promise, governments and global health organizations��need to prepare to manufacture the pills in great quantities. The clinical trial results are preliminary, but��impressive. People with fresh symptoms of Covid-19 who took the pills for five days were about half as likely as those on placebo to be hospitalized or die. The difference was so stark —��eight who took a placebo died while none who got the pill did —��that independent monitors stopped the trial early. (Nisen, 10/1)

Vaccine mandates work. Just ask New York Governor Kathy Hochul, whose state gave roughly 600,000 health care workers until this past Monday to get a Covid-19 jab or lose their jobs. Much naysaying ensued, accompanied by predictions that doctors, nurses, orderlies and other holdouts would quit en masse rather than allow a needle to compromise their liberty. They’ve chosen instead to do the right thing. Thousands got their shots and, as of this week, 87% of New York’s hospital workers were fully vaccinated — up from 77% in mid-August. About 92% of hospital staff have received at least one dose, as have some 92% of nursing home workers and 89% of adult care workers. (10/1)

Ninety percent of NBA players are vaccinated, the league has reported, but the unvaccinated status of the Brooklyn Nets’ Kyrie Irving, the Washington Wizards’ Bradley Beal, the Golden State Warriors’ Andrew Wiggins, and the Orlando Magic’s Jonathan Isaac took center stage. Each player made troubling, uninformed statements when asked why he hadn’t been vaccinated. (Jemele Hill, 10/1)

When Autumn became pregnant earlier this year, she and Zach considered their options. The couple had experienced three prior miscarriages. After talks with their physician, they both decided to wait on the COVID-19 vaccine. With that decision, Autumn became part of a growing and dangerous trend in the U.S. “The Delta variant in unvaccinated pregnant patients is one of the most horrifying disease processes I’ve ever seen,” says Danielle Jones, an obstetric hospitalist who works at several centers in Austin, Tex. “My heart is broken. My patients are suffering. Families are grieving. Moms are never meeting their babies.” (Carolyn Barber, 10/1)

This pandemic has been especially hard for Black folks in Washington. We have lost our jobs, gotten sicker and died at higher rates than other residents. I know firsthand the hurt the coronavirus can cause. My 41-year-old cousin died just a few weeks ago. He was unvaccinated. I’ve lost multiple aunts and uncles. They also were unvaccinated. I have family members who still aren’t vaccinated. Even with the personal loss, the toll that it has taken on them and those they love, some people are no closer to taking the vaccine today than they were when the shots first became available. (Crystal Gray, 10/1)

Thanks to COVID-19, schools in Tennessee's third-most populated county were closed Monday. But it's not for the reason you'd think. Earlier this month, the Knox County School Board voted against requiring students wear masks, which prompted some families of children with disabilities to file a lawsuit alleging the school was infringing on their children's right to an education under the Americans with Disabilities Act. Last week, U.S. District Judge J. Ronnie Greer agreed, prompting Knox County Schools Superintendent Bob Thomas to issue a statement over the weekend informing parents that the district would close "in an effort to ensure we are in compliance with" the ruling. (Skylar Baker-Jordan, 10/1)

The increasingly popular r/HermanCainAward subreddit on Reddit.com is a distressingly predictable sign of America’s conflict-filled times. The subreddit, which now has upwards of 340,000 followers, “celebrates” those “who have made public declaration of their anti-mask, anti-vax, or Covid-hoax views,” only to die from Covid-19 or Covid-related complications. (It is named for Herman Cain, the former GOP presidential candidate and businessman who died from Covid-19 complications in 2020 after attending a Trump campaign rally in Oklahoma.) (F.Diane Barth, 10/2)

Those on the pandemic's frontlines -- health and care workers, including nurses -- risk their lives every day to treat their patients. They face high risk of infection with Covid-19; the World Health Organization (WHO) estimated in May, almost certainly a substantial underestimate, that a stunning 115,000 or more had already died from Covid-19. By July, the death toll was estimated at 200 each and every day since the pandemic began. The WHO has declared 2021 the International Year of Health and Care Workers, but to celebrate them as heroes is an empty, meaningless gesture if we continue to fail to protect them. (Strive Masiyiwa and Tom Frieden, 10/3)

October is upon us, which means the world is about get a whole lot more pink. It’s as predictable as the return of pumpkin spice lattes and decorative gourds: ‘Tis the season for plastering a pink ribbon on everything from socks to skincare products, all in the name of Breast Cancer Awareness Month. But a lot has changed since the monthlong event was dreamed up in the 1980s. With 1 in 8 women diagnosed with breast cancer, almost everyone knows someone affected by the disease. I was diagnosed with it at the end of September when I was 28, meaning that my first rounds of chemotherapy were punctuated with pink ribbon sightings: at the pharmacy, on the street, in store windows. (Hil Moss, 10/3)

After giving birth in Brooklyn in 2015, before��I��had even eaten, I phoned the hospital lactation consultant to beg for help feeding my daughter. She never called back or came, so I attended her weekly class. It consisted of bedraggled women wheeling their infants into a converted closet to watch a video. In it, a woman stroked her breast a couple of times and milk gushed out like Niagara Falls. Meanwhile, the only fluids exiting my body were the tears drenching my face. I left the hospital knowing zilch about breastfeeding, feeling defeated before I began.��(Allison Yarrow, 10/1)

If you deliver healthcare, you know that children who live in disinvested neighborhoods too often land in emergency departments with conditions like asthma, uncontrolled diabetes and bacterial pneumonia that could be effectively prevented with better access to routine medical care, as well as other factors that influence health, like safe and affordable housing and healthier foods. As the COVID-19 pandemic has revealed, these barriers to health disproportionately impact people of color and those with low incomes. (Dr. Don Schwarz and Tim Robinson, 10/1)

The COVID-19 pandemic has made global aging impossible to ignore. This pandemic is the first to occur since the world’s population of those older than 65 exceeded the population of children under 5 — and COVID-related mortality rises sharply with age. In the United States, for example, more than half of COVID deaths are among those aged 75 and older. Based purely on these demographic factors and mortality rates, the loss of life worldwide (4.7 million as of late September) has been greater than if the pandemic had occurred in previous eras. (John E. Ataguba, David E. Bloom and Andrew J. Scott, 10/3)

Along with the inherent health and safety risks faced during service in the armed forces, veterans may face a higher risk of developing dementia based on their military experiences. Studies by the U.S. Department of Veterans Affairs found that older veterans diagnosed with a traumatic brain injury had a 60 percent greater risk of developing dementia as compared with veterans of the same age who had not suffered a TBI. Prisoners of war had about a 50 percent greater risk of developing dementia later in life, and POWs affected by post-traumatic stress disorderhad more than double the risk. (Charles J. Fuschillo, Jr., 10/2)

I recently tried to order white blood cell growth factor (pegfilgrastim) biosimilar for one of my patients. This is a drug that helps prevent fever and infection associated with low white blood cell counts. For years, prescribing it has been simple, since the only option was the brand-name drug, Neulasta brand pegfilgrastim. But the patent on Neulasta expired in October 2015, and there are now several FDA-approved biosimilars on the market: Fulphila (pegfilgrastim-jmdb), Nyvepria (pegfilgrastim-apgf), Udenyca (pegfilgrastim-cbqv) and Ziextenzo (pegfilgrastim-bmez). (Howard S. Hochster, 10/4)

A few friends recently received letters informing them that their doctors were leaving their practices. The letters were perfunctory .... In no case did the letters discuss the departing doctors’ plans — notably that they will still be practicing in Charlotte — nor tell the patients how they could continue care with their primary physicians. I am both shocked and not surprised. This is one more example of the encroachment of business decisions on the practice of medicine, of the primacy of institutional profit over the doctor-patient relationship. (Dr. Jessica Schorr Saxe, 9/30)